• 보건행정학회지
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• 제29권2호
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• pp.228-236
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• 2019

Background: This study investigates the impact of weekend admission with a patient safety indicator (PSI) on 30-day mortality among long-term insurance beneficiaries. Methods: Data were obtained from the National Health Insurance Service-Senior claim database from 2002 to 2013. To obtain unbiased estimates of odds ratio, we used a nested case-control study design. The cases were individuals who had a 30-day mortality event after their last medical utilization, while controls were selected by incidence density sampling based on age and sex. We examined the interaction between the main independent variables of weekend admission and PSI by categorizing cases into four groups: weekend admission/PSI, weekend admission/non-PSI, weekday admission/PSI, and weekday admission/non-PSI. Results: Of the 83,400 individuals in the database, there were 20,854 cases (25.0%) and 62,546 controls (75.0%). After adjusting for socioeconomic, health status, seasonality, and hospital-level factors, the odds ratios (ORs) of 30-day mortality for weekend admission/PSI (OR, 1.484; 95% confidence interval [CI], 1.371-1.606) and weekday admission/PSI (OR, 1.357; 95% CI, 1.298-1.419) were greater than for patients with weekday admission/non-PSI. Conclusion: This study indicated that there is an increased risk of mortality after weekend admission among patients with PSI as compared with patients admitted during the weekday without a PSI. Therefore, our findings suggest that recognizing these different patterns is important to identify at-risk diagnosis to minimize the excess mortality associated with weekend admission in those with PSI.

• 한국임상약학회지
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• 제32권3호
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• pp.155-165
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• 2022

Background: Chronic obstructive pulmonary disease (COPD) is not completely reversible and requires long-term management with appropriate treatment. This study aimed to analyze trends in treatment regimens and medication costs for COPD patients using a national claims database. Methods: We conducted this analysis using National Patient Sample data from the Health Insurance Review and Assessment Service covering the period from 2015 to 2018. We have constructed a dataset comprising COPD disease classification codes J43.x and J44.x (based on KCD-7 code, J43.0 was excluded) and compiled a list of drugs fitting current guidelines. To identify trends, we calculated frequency, ratio, and compound annual growth rate (CAGR) using the numbers of prescriptions and patients. Results: The number of COPD patients was 7,260 in 2018, slightly decreased from 2015. Most of these COPD patients were aged 60 or older and included a high proportion of males (72.2%; 2018). The number of patients prescribed inhaled medications increased gradually from 2015 to 2018 (9,227 (47.1%); 2015, 9,285 (51.5%); 2018), while the number of patients prescribed systemic beta-agonists and Xanthines has decreased since 2015 (CAGR -14.7; systemic beta-agonist, -5.8; Xanthines). The per capita cost of medication has increased by 0.4% (KRW 206,667; 2018, KRW 204,278; 2015) annually during the study period. Conclusion: This study showed that treatment with inhaled medications had continuously increased in accord with changing guidelines, but oral medications were still widely used. It is necessary to emphasize the importance of inhaled medications in treating COPD to reduce additional economic burden through appropriate medication use.

• 한국전문물리치료학회지
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• 제30권2호
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• pp.87-91
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• 2023

Most advanced countries that are members of the World Physiotherapy have established a 4-year education system or specialized graduate school system for physical therapists based on national standards. They have also expanded their laws and systems to provide physical therapists with the autonomy and independence to offer services in their clinics. However, compared with developed countries in North America and Europe, there are issues with the autonomy and independence of physical therapists in Korea related to national regulations. Social status and recognition of the profession are also lagging. Korea is expected to become a super-aged society by 2025. To reduce the financial burden of healthcare and welfare on the government, it is necessary to extend the time spent by older adults on independent activities and minimize their time spent using medical services. To achieve this goal and maximize the active life of older adults, a plan to efficiently use licensed physical therapists in the country should be prepared. Korea should increase the license utilization rate of physical therapists to reduce waste at the national level and increase the professional hope of the younger generations of physical therapists. To create a healthcare policy focusing on the use of physical therapy personnel, similar to that in advanced countries, it is necessary to unify educational systems and produce excellent physical therapists. Providing professional autonomy can help physical therapists develop a sense of job satisfaction. Outstanding talent will choose physical therapy as a profession if they can see hope for their future careers, and if physical therapy services in Korea are similar to those delivered in advanced countries, physical therapy in Korea can develop into a healthcare service that people desire.

• 대한조현병학회지
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• 제22권2호
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• pp.34-41
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• 2019

Objectives: This study was performed to examine the effects of the public attention to 'crime of schizophrenia' on the use of mental health services in patients with schizophrenia using big data analysis. Methods: Data on the frequency of internet searches for 'crime of schizophrenia' and the patterns of mental health service utilization by patients with schizophrenia spectrum disorders by month were collected from Naver big data and the Health Insurance Review and Assessment Services in Korea, respectively. Their correlations in the same and following month for lagged effect were examined. Results: The number of outpatients correlated negatively with public attention to 'crime of schizophrenia' in the same month. The lagged relationship between public attention and the number of admissions in psychiatric wards was also found. In terms of sex differences, the use of outpatient services among female patients correlated negatively with public attention in the same month while the number of male patients' admissions in both same and following month correlated positively with public attention. Conclusion: These findings suggested that public attention to 'crime of schizophrenia' could negatively affect illness behavior in patients with schizophrenia.

• 대한치과기공학회지
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• 제46권2호
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• pp.42-48
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• 2024

Purpose: The purpose of this study is to investigate the applications and prospects of big data in digital dental healthcare. Methods: The study included 30 participants in the dental field (dentists, technicians, professors, and graduate students). From June 25 to 30, 2023, the contents of the study were thoroughly explained, consent was obtained from the research subjects, and a questionnaire was administered via an internet service. The questionnaires of 28 participants who responded completely were used for analysis. The collected data were statistically processed using IBM SPSS Statistics ver. 22.0 (IBM). Results: The use of big data in digital dental healthcare, digital dental health system, mobile dental health, dental health analysis, and telehealthcare were all heavily surveyed, with an average score of 3.97 or higher on a 5-point Likert scale. The areas where big data can be utilized in digital dental healthcare are as follows. The utilization rate for three-dimensional digital product development via linkage with big data systems and industrial field manufacturing technology was found to be 4.11±0.67, and the analysis of trends by age in the occurrence of various oral diseases was found to be 4.00±0.98. Conclusion: In the future, research into the viability of big data's success in the medical data field, which is directly related to human life, is needed. Additionally, social policies and regulations regarding big data-related information and standards in dental healthcare are necessary.

• 농촌계획
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• 제13권2호
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• pp.63-74
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• 2007

This study aims to develop rural house maintenance technique by researching and analyzing the demand for rural house by urban retirees or urbanites who are planning to retire. The target for the survey consisted of urban retirees or urbanites who are planning to retire at the ages between 40 and 65, and were divided into group A, the attendants in rural-related education, and group B, the non-attendants in rural-related education. The contents of the survey included the plan and purpose for rural settlement, the utilization form or residential form of rural house and its expected size, necessary in-house facilities, necessary community facilities, improvement and maintenance factors of rural house, political and legal support for the application of rural house maintenance, etc. The results findings of this study are as follows; 1)For both group, the major purpose of rural settlement appeared to be 'for rural life', utilization form of rural house to be 'acquired ownership or use of empty house', residential form to be 'cohabitation', expected size to be 'under $20{\sim}30$ pung', and expenditure to be 'under $50{\sim}100\;million$'. 2)Most wanted necessary in-house facilities included backyard, multipurpose storage room for group A, and backyard, garden for group B. Necessary community facilities included boardwalk, sewage disposal unit for group A, and boardwalk, shop for group B. 3)Improvement factor for rural house showed 'poor insulation' as first factor for both groups, and for maintenance factor, 'backyard', 'under-floor heating' for group A, and 'environmental-friendly materials', 'backyard' for group B. 4)Most wanted overall political and legal support included 'support on land and real estate supply' for group A, and 'medical and transportation service' for group B. For both group, most wanted support when purchasing a house included 'provision of information on house and realestate purchase', and for legal support, 'legal support for guaranteed house and maintenance' as first factor. The results of this study could be utilized to restructure the rural residence, which would meet the diverse demand of both rural residents and urbanites by providing an opportunity for urbanites to enjoy rural life.

• 문화기술의 융합
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• 제8권3호
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• pp.405-413
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• 2022

COVID-19 이후 원격진료, 스마트 병원, AI 진단 등 ICT 기술과 데이터사이언스를 활용한 새로운 의료서비스모형의 활용이 크게 증가하고 있다. 본 연구에서는 최근 미국에서 원격진료와 대면진료의 혼합 모형 운영, 소비자 중심의 온라인의약품 배송, 가정용 진단기기 개발, 그리고 진료 및 처방, 의약품 배송, 진단기기의 활용이 통합적으로 제공되는 새로운 모형 제시 등 미국 헬스케어산업에서 파괴적 혁신을 선도하는 아마존의 헬스케어 사업 모형을 살펴보았다. 특히 아마존 기존 사업분야와의 시너지 효과 등으로 인해 적극적 시장 확대 및 소비자 가치 증대가 발생함을 다품목시장에서의 시장확대 모형을 통해 보였고, 또한 소비자 선택 유도 확대 시 의료서비스 시장에서의 경쟁이 활성화됨을 호텔링의 공간경쟁모형을 통해 보였다. 분석 결과 소비자 가치 증대의 장점과 함께 공급기반 감소에 따른 경쟁 약화의 부작용이 있을 수 있으므로 장기적으로 공정경쟁 관리 차원의 정책적 관심이 필요할 것으로 보인다.

• KDI Journal of Economic Policy
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• 제30권2호
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• pp.99-128
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• 2008

민간보험은 공적보험과 보완적인 관계를 형성함에도 불구하고 우리나라의 민간보험은 소득계층에 따른 접근성 차이로 인한 사회적 불평등, 도덕적 해이로 인한 공적보험 재정악화 등의 우려를 낳고 있다. 그러나 이에 관한 실증적 분석은 그간 이루어지지 못하여 정책적인 방향을 정립하는 데 장애가 되어 왔다. 본 연구는 건강보험공단, 심사평가원, 민간보험사, 행정자치부 주민등록세대정보 등의 관련 정보를 종합하여 이에 대한 실증분석을 시도했다. 그 결과, 우리나라의 민간보험 가입률은 전 국민의 64%에 달하고 있으며, 고소득층과 저소득층 간에 민간보험 가입률의 차이가 나타나지 않았다. 이는 공적보험의 보장성이 미흡한 상황에서 저소득층 역시 갑작스런 의료지출에 대비하고 있으며, 민간보험이 의료접근성의 계층화를 초래하지 않고 있다는 것을 시사한다. 또한 민간보험 가입자는 평균적으로 미가입자에 비해 의료이용량이 높지 않았으며, Two-Part Model을 통해 다양한 변수를 통제했을 경우에도 동일한 결과가 나타났다. 연령대에 따른 차이로 미루어 이러한 결과는 노동시장과 연관된 한시적인 성격일 것으로 추측되나, 현재로서는 민간보험 가입에 따른 도덕적 해이가 강하게 나타나고 있다는 근거는 발견되지 않았다.

• 한국산학기술학회논문지
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• 제11권12호
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• pp.4863-4872
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• 2010

본 연구는 농 어촌지역 환자들을 대상으로 질병양상을 살펴보고 의료이용 실태를 분석하여 농 어촌지역 의료 관련 기관의 보건의료서비스 계획수립에 필요한 자료를 제공 하고자 시행되었다. 노령화가 진행된 농 어촌지역 G도 G군에 소재한 종합병원을 대상으로 2009년 7월부터 12월까지 6개월 동안 퇴원환자 2,365건 전수의 의무기록 자료를 토대로 분석하였다. 분석결과, 조사대상 환자의 성별은 남자 55.3%, 여자 44.7%, 연령별은 70세 이상 후기 고령자가 42%로 나타냈다. 입원유형별로는 외래경유 입원환자가 65.5%이며, 진료과목으로는 내과 49.7%, 정형외과 16.7%, 신경외과 13.8% 순이었다. 주 진단명(3단 분류)별 10대 다 빈도에서 S00-T98 18.4%, J00-J99 15.5%, I00-I99 11.5% 순이었다. 평균재원일수는 14.8일이었으며, 주 진단명을 포함한 상병개수는 평균 5.6개이었다. 주 진단명(3단 분류) 다빈도 10대에서 성별, 보험유형별, 입원경로, 연령별 분포 등이 통계적으로 유의한 차이가 있었다. 월별 주 진단명(3단 분류) 다 빈도 10대 분류 분포는 통계적 유의한 차이가 있었다. 주 진단명(3단 분류) 다 빈도 10대분류에 따른 평균재원일수와 상병개수는 통계적으로 유의한 차이가 있었다. 결론적으로, 농 어촌지역의 질병분포는 작업환경과 연중 신체적 무리가 가는 노동행위에 따른 외상성 질환 및 호흡기 질환과 노령화에 따른 각종 만성질환 등 이었다.

• Journal of Animal Science and Technology
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• 제53권2호
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• pp.177-182
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• 2011

본 연구는 국내 대규모 양돈농장에 HACCP 시스템을 적용 후 나타나는 생산성 및 안전성의 지표인 분만율, 총 산자수, 초기 포유개시 두수, 이유 두수, 이유후 육성율, 이유일령, 모돈두당 연간 비육돈 출하두수와 월평균 약제비, 농장에서의 사용항생제수 사육구간별 사료내 항생제 첨가 농가수-사료공장에서 첨가, 사육구간별 사료내 항생제 첨가 농가수-농장에서 첨가 등을 조사하여 그 효과를 검토하고 이를 향후 수행할 농장 HACCP 연구 관련 기초 자료로 사용하기 위한 목적으로 실시하였다. 분만율은 HACCP 적용 전에 비하여 적용 후 유의적으로 증가하는 것으로 조사되었다(p<0.05). 모돈 두당 연간 규격돈 출하두수도 HACCP 적용 전 17.99두였으나 적용 후 18.83두로 유의적으로 증가하였다(p<0.05). 농장에서의 사용항생제수는 적용 전 8.88개에서 적용 후 6.13개로 약 25.97%가 유의적으로 감소하였다(p<0.05). 특히 사육구간별 항생제 첨가농장수-농장에서 첨가는 비육구간에서 HACCP 적용 전에는 전체 10개 농장 중 4개 농장이 해당되었으나 적용 후에는 모든 농장에서 항생제를 사료에 첨가하지 않는 것으로 나타났다. 따라서 본 연구결과에 의하면 대규모 양돈농장에 HACCP 시스템을 적용할 경우 동물용 의약품 사용 감소와 함께 농장의 생산성에도 좋은 효과가 있을 것으로 판단되며 동시에 소비자에게 더욱 안전한 축산물을 제공할 수 있을 것으로 판단된다.