• 한국생물정보학회:학술대회논문집
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• 한국생물정보시스템생물학회 2006년도 Principles and Practice of Microarray for Biomedical Researchers
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• pp.11-18
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• 2006

바이오칩의 대표 주자인 DNA 칩은 점차 분자생물학의 주요 도구로 인식되고 있다. 쓰임새 또한 다양해져 기초 생물학, 기능 유전체학 연구뿐만 아니라 임상 현장에서의 적용을 위한 연구가 활발히 진행되고 있다. 임상분야에서 최근 주목 받고 있는 분야가 DNA 칩을. 이용한 질병진단 및 예후 측정이다. 개별 환자 세포의 분자유전학적 상태는 DNA 칩의 유전체 프로파일링(genome-wide profiling)으로 상세히 파악될 수 있으므로, DNA 칩은 질병의 세부아형 진단, 약물에 대한 개인 민감도 측정, 정확한 예후 측정을 통한 환자의 세심한 관리 등 미래 의료의 핵심이라 할 수 있는 개인별 맞춤 치료(personalized medicare)를 가능하게 하는데 지대한 역할을 할 것으로 기대되고 있다. 특히 수많은 질병 중에서 현대인의 난치병으로 손꼽히는 암은 DNA 칩 분석의 주요 적용 대상이다. 암에 연관된 복잡한 메커니즘을 기존의 단일 표지자로 진단하는 데는 한계가 있기 때문에, DNA 칩을 이용해 질병의 특정 phenotype과 관련 있는 암의 특이 패턴을 전사체 수준에서 분석하여 새로운 형태의 분자유전학적 표지자(transcriptional molecular signature)를 발굴하는 것이다 본 발표에서는 이러한 연구에 쓰이는 DNA 칩 분석 방법들과 실제 위암 데이터에 적용한 사례에 대해 논의하고자 한다. 연세의대 암전이 연구센터의 17K cDNA 칩을 이용하였으며, 진단 및 예후 측정을 위한 여러 분석 방법을 수행하였다.

• 지역사회간호학회지
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• 제12권3호
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• pp.589-599
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• 2001

The purpose of this study was to analyze the relation amongst health status, health care costs. health service utilization among the low income elderly who were 60 years of age or older, earning a half of the average Korean family income. The cross-sectional descriptive survey research we conducted used families randomly sampled nationwide. The data were collected from July 12 to August 7, 1999 and the total sample was 1.259 household members (421 households). These were the major findings. 1. As for the health status. 72.4% of respondents fell ill in the last 1 month; 54% of respondents had chronic disease. 2. As for the health care cost. the cost of hospitalization and the medical treatment were 1.069,000 won and 226.000won. respectively. 59.3% of respondents experienced a burden from the monthly health care expenses. 3. As for the health service utilization for the last 3months. 28.5% of respondents didn't utilize the health service. In addition, 22.2% of respondents gave up a medical treatment because of economic situation (88.8%). 4. The statistically significant determinants of health service utilization are old age, female, living with a spouse, unemployed state, medicare, and more days sick. 5. It is shown conclusively that equity and efficacy of the health care policy are to be considered for lower income older adult.

• 대한예방한의학회지
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• 제14권1호
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• pp.137-149
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• 2010

In recent decades, as the utilization of complementary and alternative medicine in the United State have been growing rapidly, regulatory controls surrounding complementary and alternative medicine(CAM) aims to ensure patient protection against unproven practices and to provide safe and effective treatments. Regulation and policy method on licensing CAM practitioners varies across the states. Over 85% of the states have the licensing system for acupuncturists, chiropractors, and naturopaths. For acupuncture, although the requirements for formal education are various across the states, a unified written examination has been adopted by almost entire states which have acupuncturist licensing law. Medicare, the public medical insurance, does not cover CAM practices except chiropractic and biofeedback. In some states, however, Medicaid programs cover some CAM therapies including acupuncture, naturopathy, and massage therapy. 67% of Health Maintenance Organizations, the private health plans, provide at least one modality of CAM services. In conclusion, government policies have been strengthened to ensure patient protection, and will continue to integrate CAM practices that are proven to be safe and effective into mainstream health care system.

• International Journal of Advanced Culture Technology
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• 제7권1호
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• pp.155-161
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• 2019

This study was to identify the effects of home visit intervention program for Holistic Healthcare of multi-culture Couples. It used a non-equivalent control group pretest-posttest design quasi-experimental research. The subjects of this study consist of 20 couples for experimental and control groups. Multi-cultural couples comprised of foreign women married to Korean men in farm and fishery areas. The research tools were used stress index by SA-3000P (Medicare co. Ltd. KOREA), Center for Epidemiologic Studies-Depression Scale (CES-D), and World Health Organization Quality of Life (WHOQOL-Bref). The experimental group of the wives had lower stress index than the control group, the experimental group of the husband showed lower stress index than the control group, (t=-3.14, p=.002). The wife (t=-3.75, p=.001) and husband (t=-4.20, p=.001) of the experimental group showed lower depression scores than the control group. Both the wife (t=3.86, p=.001) and husband (t=5.28, p=.001) showed higher scores for quality of life compared to the control group. It was found that this holistic healthcare home visit program is an effective program to make improvements on stress, depression and quality of life for multi-cultural couples. Therefore, as the intervention program developed in this study is home visits for the holistic health of multi-cultural couples, and it is judged that it can be implemented at the local social health centers or healthcare centers.

• 보건행정학회지
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• 제2권1호
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• pp.1-16
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• 1992

This study compares the physician payment of national fee schedule for Korean Medical Insurance with that of the United States based on Resource Based Relative Value Scales (RBRVS) which Hsiao developed in 1988 for the Medicare reimbursement. Through the comparison of two fees schedules, this study is purposed to evaluate the appropriateness of relative values which assigned to each physician services of Korean fee schedule. A total of 264 physician services are selected for the comparison. The ratio of Korean schedule to RBRVS is selected as an index of appropriateness. It the score of index shows large variation among services, the relative value of Korean fee schedule is inappropriate with U.S. RBRVS which was developed recently. The Ratios of Korean schedule to RBRVS are widly variated ; the range of those is 8.1 to 379.3. In subgroups which are regrouped to controll systematic differences between two national fee schedules, these ratios are also variated. Services which are relatively less compensated are management/evaluation services, while services which are relatively more compensated are invasive and imaging services. By the way, the service classification of Korean fee schedule is unclear, specially in management/evalutaion services. Therefore, Korean Medical Insurance fee schedule should be modified to be more balanced and rational.

• 한국중재학회지:중재연구
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• 제21권3호
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• pp.55-87
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• 2011

This paper is to illustrate a variety of court-annexed ADR programs and vindicate its implications of court-annexed ADR in United States. It has been almost three decades since Frank Sender articulated his vision of the multi-door courthouse. The court-annexed ADR originated from the concept of multi-door court house. Professor Sander argued that the court must transform from the court that provides litigation, only one type of dispute resolution, to the multi-door courthouse which provides a variety of dispute resolution methods including a number of ADR programs. The types of court-annexed ADR on which this paper focus are court-annexed mediation, court-annexed arbitration, mini trial, early neutral evaluation(ENE), summary jury trial, rent-a-judge, and med-arb in United States. The findings of this paper is as follows. First, the ADR movement is the irreversible and dominant phenomenon in the US court. The motivation of incorporating ADR into court is to reduce the cost of court to handle the civil disputes and to eliminate the delay of litigation process in the court. At the same time, a couple of studies of ADR revealed that the ADR program satisfied users of ADR. Second, the landscape of ADR has not been fixed. In 1970's, the court-annexed arbitration has been popular. In 1980's, the diverse kinds of ADR programs were introduced into the federal court as well as state courts, such as mini trial, early neutral evaluation(ENE), summary jury trial, and court-annexed mediation. But in 2000s, the court-annexed mediation has been the dominant type of ADR in United States. Third, the each type of ADR program has its own place for the dispute resolution. Since Korean society enters into the stage in which diverse kind of disputes occur in the areas of environment, construction, medicare, etc, it is desirable to take into consideration of the introduction of ADR to dispute resolution in Korea.

• Journal of Preventive Medicine and Public Health
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• 제46권6호
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• pp.300-308
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• 2013

Objectives: The purpose of this study was to classify determinants of cost increases into two categories, negotiable factors and non-negotiable factors, in order to identify the determinants of health care expenditure increases and to clarify the contribution of associated factors selected based on a literature review. Methods: The data in this analysis was from the statistical yearbooks of National Health Insurance Service, the Economic Index from Statistics Korea and regional statistical yearbooks. The unit of analysis was the annual growth rate of variables of 16 cities and provinces from 2003 to 2010. First, multiple regression was used to identify the determinants of health care expenditures. We then used hierarchical multiple regression to calculate the contribution of associated factors. The changes of coefficients ($R^2$) of predictors, which were entered into this analysis step by step based on the empirical evidence of the investigator could explain the contribution of predictors to increased medical cost. Results: Health spending was mainly associated with the proportion of the elderly population, but the Medicare Economic Index (MEI) showed an inverse association. The contribution of predictors was as follows: the proportion of elderly in the population (22.4%), gross domestic product (GDP) per capita (4.5%), MEI (-12%), and other predictors (less than 1%). Conclusions: As Baby Boomers enter retirement, an increasing proportion of the population aged 65 and over and the GDP will continue to increase, thus accelerating the inflation of health care expenditures and precipitating a crisis in the health insurance system. Policy makers should consider providing comprehensive health services by an accountable care organization to achieve cost savings while ensuring high-quality care.

• 한국콘텐츠학회논문지
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• 제11권7호
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• pp.1-8
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• 2011

현대사회는 인터넷과 IT융합기술의 발달로 정보의 양이 급속도로 늘어나고 있으며, 이로 인하여 많은 데이터 속에 원하는 정보를 용이하게 획득하거나 검색하는 기술도 발전되고 있다. 의료 관련 시스템통합 또한 다양하게 구축 되어 정보의 누적량이 비약적으로 증가하고 있으나 구축된 자료를 활용한 간호활동의 정보제공 및 지원 내용은 미흡한 실정으로 특히 통증의 중재에 관한 판단은 간호사 개인의 경험적 판단에 의존하게 되는 것이 현실로서 대체적으로 주관적 판단이 내려지게 된다. 본 논문에서는 기존의 의료관련 데이터를 활용, 추출하고 협력적 필터링을 이용한 통증 간호중재 지원 방법론을 제안한다. 제안하고자 하는 협력적 필터링은 유사한 선호도를 기반으로 관련도가 높은 아이템을 추출하는 방법으로 사용자 기반의 협력적 필터링을 이용한 선호도 예측 방법은 피어슨 상관 계수에 의해 사용자 유사도를 구하고, 사용자의 선호도를 기반으로 이웃 선정방법을 사용한다.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제22권3호
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• pp.7-15
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• 2016

Purpose: As medicare services have gotten spreaded, clinical laboratory has been dominant position. So, it has been acted for quality control and clinical pathology accreditation. But there has been quite deficient information to evaluate working space and technical standards of medical laboratory for accreditation. This study goals to figure out accreditation standard and design guideline for clinical laboratory, and to give safe and efficient design information. Methods: This study has been searched by literature for accreditation standards and design guidelines of clinical pathology in USA, UK, and Germany. Results: Three countries have accredited based on working lab space, staff space, storage space, patient space and health and safety equipment. Design guidelines of three countries commonly have focused on worktable layout, worktable distance and module, and specific laboratory biosafety level. And USA guidelines stress on the architectural design such as design process and passage distance for escape, UK stress on the efficiency as functional work flow and construction cost, lastly Germany design guidelines stress on the operator's safety distance and workstation. Three countries have not only accreditation standards but also design guidelines for more specific quality management, separating from accrediting institute. Implications: In korea, it has been needed to make clinical laboratory design guideline for the safe and efficient environment and reliable and competitive medical service.

• Journal of Korean Neurosurgical Society
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• 제60권2호
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• pp.195-204
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• 2017

Objective : This 2009-2011 nation-wide study of adult Koreans was aimed to provide characteristics, medical utilization states, and survival rates for newly diagnosed patients with primary nonmalignant and malignant spine tumors. Methods : Data for patients with primary spine tumors were selected from the Korean Health Insurance Review and Assessment Service database. The data included their age, sex, health insurance type, co-morbidities, medical cost, and hospital stay duration. Hospital stay duration and medical costs per person occurring in one calendar year were used. In addition, survival rates of patients with primary malignant spine tumors were evaluated. Results : The incidence rate of a primary spine tumor increased with age, and the year of diagnosis ($p{\leq}0.0001$). Average annual medical costs ranged from 1627 USD (pelvis & sacrum & coccyx tumors) to 6601 USD (spinal cord tumor) for primary nonmalignant spine tumor and from 12137 USD (spinal meningomas) to 20825 USD (pelvis & sacrum & coccyx tumors) for a primary malignant spine tumor. Overall survival rates for those with a primary malignant spine tumor were 87.0%, 75.3%, and 70.6% at 3, 12, and 24 months, respectively. The Cox regression model results showed that male sex, medicare insurance were significantly positive factors affecting survival after a diagnosis of primary malignant spine tumor. Conclusion : Our study provides a detailed view of the characteristics, medical utilization states, and survival rates of patients newly diagnosed with primary spine tumors in Korea.