• 보건행정학회지
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• 제16권1호
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• pp.54-72
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• 2006

This study was conducted as the primary work to develop a customer relationship management (CRM) system to improve the performance of health screening programs. The specific aims of the study was to identify and classify the characteristics of the people who did not receive their health screening using decision trees and to propose management strategies according to their characteristics identified. The data on a total of 5,102,761 subjects of health screening provided by the National Health Insurance Program in the year of 2002 were used. The target variable was whether they underwent their health screening. The input variables included a total of 27. The SAS 9.1 version was used for data preprocessing and statistical analyses. SAS Enterprise Miner was used to develop the decision trees model. The decision trees identified the factors greatly affecting the health screening. In the non-disease group, the highest rate of non-examinees was characterized by: no experience of receiving a health screen, household's age, non-insured episode for the last one year, and patients' age. In the disease group, the one showing the highest rate of non-examinees was characterized by: no experience of receiving a health screening, no experience of going to public health center or midwife clinic for the last one year, and examinees' age. Developing CRM systems for health screening management taking into account the individual characteristics would be considerably helpful to increase the rate of receiving health screening.

• 정신신체의학
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• 제10권1호
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• pp.48-54
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• 2002

연구목적: 종합 병원 건강 증진 센터를 내원한 일반 성인들을 대상으로 생활 스트레스, 신체적 및 정신적 증상, 그리고 신체 이학적 지표들을 측정하여 스트레스와의 관련성을 알아보고자 하였다. 방법: 2000년 7 월부터 12월까지 종합병원 건강증진센터에 내원한 성인 남녀 중 186명을 대상으로 하여 생활 스트레스 측정도구, 간이정선진단검사, 건강 검진 문진표를 사용하여 대상들이 지각하는 생활스트레스와 신체적 및 정신적 증상을 조사하였으며, 건강 진단에 통상적으로 시행되는 검사 중 스트레스와 관련이 있다고 생각되어지는 신체 이학적 지표를 선정하여 분석하였다. 전체 연구 대상을 생활스트레스지각의 정도에 따라 스트레스 낮은 군과 높은 군으로 나누어 두 군간에 연구변인들의 유의미한 차이가 있는지 분석하였다. 결과: 스트레스가 낮은 군과 높은 군 사이에 간이정신진단검사의 모든 소항목 점수들은 모두 유의미한 분포의 차이를 보였으며, 주관적인 신체증상에서도 불안, 우울 증상과 그와 관련된 자율신경계 증상들이 유의미하게 분포함을 알 수 있었다 그러나 성인병의 지표라 볼 수 있는 신체이학적 검사자료에서는 두 군간에 유의미한 차이가 없었다. 결론: 생활 스트레스는 일반 성인남녀에서 정신적 증상 및 신체생리 증상들을 야기할 수 있지만, 고혈압, 당뇨병, 고지혈증, 심장병 등의 스트레스성 성인질환으로 진행되기까지는 스트레스가 상당기간 지속되어야 함을 시사하였다.

• 한국산학기술학회논문지
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• 제13권12호
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• pp.5976-5985
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• 2012

본 연구는 장기요양서비스의 질 제고를 위해 장기요양서비스 이용 노인들의 신체적 및 정신적 기능 상태를 평가해 보고, 그에 영향을 미치는 관련 요인을 규명하고자 시도하였다. 조사대상은 대전지역에 거주하는 65세 이상 노인 중 장기요양서비스 이용자 350명(재가급여 178명, 시설급여 172명)으로 하였으며, 자료 수집은 2011년 2월 16일부터 3월 31일까지의 기간 동안에 표준화된 무기명식 면접조사용 설문지를 사용하여 면접조사를 통해 이루어졌다. 연구결과, 재가급여 노인의 IADL과 MMSE-K는 시설급여 노인보다 유의하게 높았으나 ADL과 CES-D는 유의한 차이를 보이지 않았다. ADL, IADL, CES-D 및 MMSE-K 상호 간의 상관관계를 보면, 재가 및 시설급여 이용노인 모두 ADL은 IADL 및 MMSE-K와 양의 상관관계를 보인 반면, CES-D와는 음의 상관관계를 나타내었다. IADL은 MMSE-K와 양의 상관관계를 보인 반면, CES-D와는 음의 상관관계를 나타내었다. 다중회귀분석 결과 재가 및 시설 급여 이용 노인 모두 ADL과 IADL에 유의하게 영향을 미치는 변수로는 건망증 증상 유무, 규칙적 운동 및 MMSE-K가 선정되었다. 또한 CES-D와 MMSE-K는 주관적 건강상태, 건망증 증상 유무 및 IADL이 유의하게 영향을 주는 것으로 나타났다. 이상과 같은 결과는 장기요양서비스 이용 노인들의 신체적 및 정신적 기능은 개인의 건강상태나 건강관련행위 특성과 밀접한 관련성이 있음을 시사하고 있다.

• 한국사회복지학
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• 제63권2호
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• pp.5-29
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• 2011

본 연구는 선진복지국가 중 독일, 스웨덴, 영국의 사회보험제도의 통합사례를 분석하였다. 제도통합과 조직통합이라는 두 가지 차원으로 나누어 세 나라의 사회보험 통합을 역사적 맥락에서 분석하였다. 독일은 여전히 제도와 조직이 분리되어 있고, 사회보험의 적용 징수업무를 질병보험조합이 담당하고 있다. 영국은 제도와 조직 모두 통합되어 있고, 적용 징수업무를 국세청이 담당하고 있다. 스웨덴은 사회보험체계가 각각의 제도별로 구분되어 있지만 운영기관은 통일되어 있고, 적용 징수업무를 국세청이 담당하고 있다. 본 연구는 이러한 선진국 사회보험 통합의 역사적 발전경로에 대한 고려를 바탕으로 한국 사회보험제도가 이제까지 걸어온 과정에 비추어 2011년부터 시행되고 있는 사회보험료 징수업무 건강보험공단 이관이 적절한 선택이었는지를 평가하였다.

• 보건행정학회지
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• 제23권2호
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• pp.132-144
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• 2013

Background: The purpose of this study was to analyze the medical expense change and influencing factors after introducing longterm care insurance system. The study period was 2 years before and after introduction of the system. Methods: We analyzed data collected from two divided group lived in Incheon. Four hundred and eighty-five elderly who received long-term care wage for one year were selected for experimental group. For control group, 1,940 elderly were selected by gender and age stratified random sampling. Difference-In-difference analyses was used for evaluating policy effectiveness. Also multiple regression analyses were conducted to identify the factors associated with total medical expenditures. The control variables were demographic variables, economic status, diseases, and medical examination variables. Results: Difference-in-difference analyses showed that total average medical expenses among long-term patients has decreased by 61.85%. Of these, the hospitalization expenses have decreased by 91.63% and the drug expenses have increased by 31.85%. Multiple regression analyses results showed that total average medical expenses among long-term patients have significantly decreased by 46.5% after introducing the long-term care insurance. The hospitalization expenses have significantly decreased by 148.5%, whereas the drug expenses have increased by 53.6%. And outpatient expenses have increased by 10.4%, but the differences were not statistically significant. Conclusion: The results showed that total medical expenses and hospitalization expenses have decreased after introducing the long-term care insurance. These results could support the opinion that the health insurance spending among long-term patients will be reduced gradually by long-term care insurance through changing medical demand.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 2001년도 제53차 추계 학술대회 연제집
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• pp.184-185
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• 2001

• 보건행정학회지
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• 제23권4호
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• pp.387-396
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• 2013

Background: The purpose of this study was to analyze the association between areas of Korea Train Express (KTX) region and external medical service use in Korean society using spatial statistical model. Methods: The data which was used in this study was extracted from 2011 regional health care utilization statistics and health insurance key statistics from National Health Insurance Corporation. A total spatial units of 229 districts (si-gun-gu) were included in this study and spatial area was all parts of the country excepted Jeju, Ulleungdo island. We conducted Kruskal-Wallis test, correlation, Moran's I and hot-spot analysis. And after, ordinary linear regression, spatial lag, spatial error analysis was performed in order to find factors which were associated with external medical service use. The data was processed by SAS ver. 9.1 and Geoda095i (windows). Results: Moran's I of health insurance patients' external medical service use was 0.644. Also, population density, Seoul region, doctor factors positively associated with health insurance patients' external medical service. In contrast, average age, health care organization per 100 thousand were negatively associated with health insurance patients' external medical service use. Conclusion: The finding of this study suggested that health insurance patient's external medical service use correlated for seoul region in korea. The study results imply the need for more attention medical needs in the region (si-gun-gu unit) for health insurance patients of seoul region. It is important to adapt strategy to activation of primary health care as well as enhancing public health institution for prevent leakage of patients to other areas.

• Clinical and Experimental Pediatrics
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• 제51권3호
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• pp.225-232
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• 2008

The mission of National Health Screening Program for Infant and Children is to promote and improve the health, education, and well-being of infants, children, families, and communities. Although the term 'diagnosis' usually relates to pathology, a similar diagnostic approach applies to the child seen primarily for health supervision. In the case of health, diagnosis determines the selection of appropriate health promoting and preventive interventions, whether medical, dental, nutritional, educational, or psychosocial. Components of the diagnostic process in health supervision include the health 'interview'; assessment of physiological, emotional, cognitive, and social development (including critical developmental milestones); physical examination; screening procedures; and evaluation of strengths and issues. Open and informed communication between the health professional and the family remains the most significant component of both health diagnosis and health promotion. Families complete medical history forms at their health supervision visit. Family-friendly questionnaires, checklists, and surveys that are appropriate for the child's age are additional tools to improve and update data gathering. This type of information helps initiate and inform discussions between the family and the health professional. This article provides a comprehensive review of current National Health Screening Program for Infant and Children in Korea.

• 대한족부족관절학회지
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• 제15권1호
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• pp.44-46
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• 2011

Sural nerve is a sensory nerve that innervates the lateral side of ankle and foot, and the injury of this nerve can be usually caused by surgical approch of calaneal fracture or achilles tendon injury. Entrapment neuropahty of sural nerve caused by bony fragment after calcaneal fracture is not reported, yet. Authors experienced one case that sural nerve injury due to bony fragment after calcaneal fracture and we regard that it is a rare case, so we report this case after reviewing literatures.

• 대한두경부종양학회지
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• 제29권1호
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• pp.22-25
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• 2013

Angiolymphoid hyperplasia with eosinophilia(Kimura's disease) is a relatively uncommon chronic benign disorder of unknown etiology, predominantly in the head and neck region and associated with lymphadenopathy or salivary gland enlargement. The treatment options are still controversial including medical therapy, surgery, and radiation. Kimura's disease of bilateral postauricular involvement has rarely been reported. We report a male patient with sequentially developed Kimura's disease involving the bilateral postauricular region and was treated by combined surgical excision and steroid therapy.