• 한국임상약학회지
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• 제25권4호
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• pp.280-285
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• 2015

Objectives: To suggest direction for improving policies by understanding current management of narcotics or psychotropic drugs and analyzing their distributions and usage. Method: We conducted a comparison analysis between health insurance claims and the amount supplied to health care institutions for narcotics or psychotropic drugs through health insurance claims data and drug distribution supply data from 2010 to 2012 collected from Korea Pharmaceutical Information Service Center (KPIS). Furthermore, we carried out literature investigation and online search to comprehend the current management of narcotics drugs in Korea. Results: The amount supplied to medical institutions for all drugs in 2012 was 19.4 trillion won, which increased from 19.5 trillion in 2011 by 0.54%. For narcotic drugs, the amount supplied was 318.4 billion won in 2011 and increased to 335.1 billion won by 5.3% in 2012, which exceeded the rate of increase for the amount supplied for all drugs. The proportion of amount claimed in the total amount supplied to medical institutions for all drugs was 60.5% in 2012, whereas the proportion of amount claimed for narcotic drugs was 55.6%, which showed that narcotic drugs were used relatively less within health insurance. Furthermore, management of the current domestic distribution supply data focuses on manufacturing and medical institution supply stages. Conclusion: Hereafter, the management of narcotics or psychotropic drugs needs to be improved by reinforcing active monitoring in optimal prescription and usage in patients by collecting and analyzing information on drug usage of patients.

• 한국산학기술학회논문지
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• 제17권2호
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• pp.75-86
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• 2016

본 연구의 목적은 남자 중 고등학생의 인터넷 게임 중독에 영향을 미치는 요인을 분석 및 비교하고자 하였다. 본 연구는 한국청소년정책연구원에서 수행한 "2009년 한국 아동 청소년 온라인 게임 및 가족여가활동 실태 조사"를 분석자료로 사용하였다. 분석결과, 남자 중학생과 고등학생의 경우 공통적으로 평일 평균 게임시간과 일요일 및 공휴일 및 게임시간이 3시간 이상인 경우, 여가 장애 수준이 높을수록 게임중독 수준이 높은 것으로 나타났다. 부모와의 의사소통 변수 또한 게임중독 수준에 영향을 미치는 것으로 나타났으나, 중학생의 경우 어머니와 문제형 의사소통이, 고등학생의 경우 아버지와 문제형 의사소통과 어머니와 개방형 의사소통이 영향을 미치는 것으로 차이를 보였다. 본 연구결과를 토대로 올바른 인터넷 사용법 및 인터넷 게임 예방 교육 프로그램과 부모와의 원활한 의사소통을 위한 학부모 교육 프로그램을 개발 및 실시할 것을 제언하고자 한다.

• 한국의료질향상학회지
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• 제22권2호
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• pp.43-73
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• 2016

Purpose: The aims of this study were to assess the presence of core patient safety practices in Korean hospitals and assess the differences in reporting and learning systems of patient safety, infrastructure, and safe practices by hospital characteristics. Methods: The authors developed a questionnaire including 39 items of patient safety staffing, health information system, reporting system, and event-specific prevention practices. The survey was conducted online or e-mail with 407 tertiary, general and specialty hospitals. Results: About 90% of hospitals answered the self-reporting system of patient safety related events is established. More than 90% of hospitals applied incidence monitoring or root cause analysis on healthcare-associated infection, in-facility pressure ulcers and falls, but only 60% did on surgery/procedure related events. More than 50% of the hospitals did not adopted present on admission (POA) indicators. One hundred (80.0%) hospitals had a department of patient safety and/or quality and only 52.8% of hospitals had a patient safety officer (PSO). While 82.4% of hospitals used electronic medical records (EMRs), only 53% of these hospitals adopted clinical decision support function. Infrastructure for patient safety except EMRs was well established in training, high-level and large hospitals. Most hospitals implemented prevention practices of adverse drug events, in-facility pressure ulcers and falls (94.4-100.0%). But prevention practices of surgery/procedure related events had relatively low adoption rate (59.2-92.8%). Majority of prevention practices for patient safety events were also implemented with a relatively modest increase in resources allocated. Conclusion: The hospital-based reporting and learning system, EMRs, and core evidence-based prevention practices were implemented well in high-level and large hospitals. But POA indicator and PSO were not adopted in more than half of surveyed hospitals and implementation of prevention practices for specific event had low. To support and monitor progress in hospital's patient safety effort, national-level safety practices set is needed.

• 한국IT서비스학회지
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• 제16권3호
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• pp.17-45
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• 2017

Health Information Exchange (HIE) is expected to improve the quality and efficiency of care by allowing providers online access to healthcare information generated by other providers at the point of care. However, the adoption of the technology in Korea has been slow since its pilot program in 2007~2010 at Seoul National University Bundang Hospital. The objective of this study was to survey stakeholders on the incentive program for the facilitation of HIE adoption. We surveyed 39 experts representing 6 categories of stakeholders-provider, insurer, government, information service firms, customers, and medical informatics experts for the interviews. Interview questions included program objectives, program participation requirements, incentive payment method, and administrative burden for program participation. Experts indicated that the quality of care was the most important value the program should aim to achieve through the HIE adoption. They suggested that the requirements and administrative burden for participation should be kept at minimum to recruit a large number of providers to the program, which is an indicator of program success. Experts were divided on the payment method whether the incentive should be paid as a part of the fee payment scheme operated by the National Health Insurance (NHI) or should be a payment made independent of the NHI. The source of the divide was conflict of interest among stakeholders as to who pays for the program, and the insurer and consumer groups were against the NHI taking the financial burden. It appeared to be the most significant factor for the successful program launching to resolve the gap in perceptions about benefits of the technology among stakeholders and to win the willingness to pay for the program.

• 보건행정학회지
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• 제21권1호
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• pp.77-92
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• 2011

Objectives : This study examined the health policy researchers' needs and their accessibility towards health insurance claim datasets according to their academic capacity. Methods : An online questionnaire to capture relevant proxy variables for academic needs, accessibility, and research capacity was constructed based on previous studies. The survey was delivered to active health policy researchers through three major scholarly associations in South Korea. Seven-hundred and one scholars responded while the survey as open for 12 days (starting on December 20th, 2010). Descriptive statistics and logistic regression analysis were carried out. Results : Regardless of the definition for operational needs, the prevalent needs of survey respondents were not met with the current provision of claim data. Greater research capacity was shown to be correlated with increased demand for claim data along with a positive correlation between attempts to obtain claim datasets and research capacity. A greater research capacity, however, was not necessarily correlated with better accessibility to the claim data. Conclusions : The substantial unmet need for claim data among the healthcare policy research community calls for establishing proactive institutions which could systematically prepare and make available public datasets and provide call-in services to facilitate proper handling of data.

• Clinical and Experimental Reproductive Medicine
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• 제43권4호
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• pp.233-239
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• 2016

Objective: Uterine contraction induced by the embryo transfer (ET) process has an adverse effect on embryo implantation. The aim of this study was to determine the effect of oxytocin antagonist supplementation on the day of ET on in vitro fertilization outcomes via a meta-analysis. Methods: We performed a meta-analysis of randomized controlled trials (RCTs). Four online databases (Embase, Medline, PubMed, and Cochrane Library) were searched through May 2015 for RCTs that investigated oxytocin antagonist supplementation on the day of ET. Studies were selected according to predefined inclusion criteria and meta-analyzed using RevMan 5.3. Only RCTs were included in this study. The main outcome measures were the clinical pregnancy rate, the implantation rate, and the miscarriage rate. Results: A total of 123 studies were reviewed and assessed for eligibility. Three RCTs, which included 1,020 patients, met the selection criteria. The implantation rate was significantly better in patients who underwent oxytocin antagonist infusion (19.8%) than in the control group (11.3%) (n = 681; odds ratio [OR], 1.92; 95% confidence interval [CI], 1.25-2.96). No significant difference was found between the two groups in the clinical pregnancy rate (n = 1,020; OR, 1.57; 95% CI, 0.92-2.67) or the miscarriage rate (n = 456; OR, 0.76; 95% CI, 0.44-1.33). Conclusion: The results of this meta-analysis of the currently available literature suggest that the administration of an oxytocin antagonist on the day of ET improves the implantation rate but not the clinical pregnancy rate or miscarriage rate. Additional, large-scale, prospective, randomized studies are necessary to confirm these findings.

• 디지털융복합연구
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• 제16권7호
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• pp.337-343
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• 2018

본 연구의 목적은 2016년 1월부터 검진연령이 만 20세까지 확대된 자궁경부암 검진에 대한 한국 여성의 연령대별 인식을 체계적으로 조사하는 것이다. 자료는 2017년 7월 26일부터 31일까지 온라인 설문 조사를 수행하여 총 332명의 설문응답을 수집하였다. 332부를 활용하여 빈도분석, 교차분석을 실시하였다. 분석결과, 현행 자궁경부암 검진사업에 대해 116명(34.9%)만이 인지하고 있었다. 또한 대다수의 응답자인 298명(89.8%)은 수검의도가 있었지만, 실제 검진경험이 있는 사람은 209명(63.0%)으로 낮았다. 따라서 검진의 중요성에 대한 교육 및 홍보를 통해 수검률을 높일 필요성이 있다.

• 한국전자통신학회논문지
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• 제13권5호
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• pp.1125-1134
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• 2018

본 연구의 목적은 작업치료사와 일반인 사이의 장애에 대한 인식을 비교하고 응답자의 인구학적 특성에 따른 장애에 대한 인식을 알아보기 위함이다. 설문지는 소셜 네트워크 서비스 기반의 설문을 통하여 편의표본추출 방법으로 온라인 배포되었으며, 일반인의 응답 62건, 작업치료사의 응답 60건을 분석하였다. 연구 결과, 장애인식은 작업치료사와 일반인 사이에 유의한 차이를 보이지 않았다(p>.05). 그러나 장애인의 하위항목 4번과 7번에서 작업치료사가 일반인보다 유의하게 높았다(p<.05). 모든 응답자에서 남성은 여성보다 장애인식이 긍정적이었다(p<.05). 가족 또는 친척 중 장애인의 유무에 따른 장애인식은 차이가 없었다(p>.05). 그러나 가족 또는 친척 중 장애인이 '있다'라고 응답한 자가 '없다'라고 응답한 자보다 항목 4번 항목에서 유의하게 높았다(p<.05). 나이와 장애인식에서는 상관이 없었다(p>.05). 본 연구의 결과에 대하여 시사점 등을 논의하였다.

• 스마트미디어저널
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• 제5권1호
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• pp.114-121
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• 2016

현재 각 의료기관들은 의료정보화 사업을 꾸준히 진행 하고 있다. 의료기관에서 운영하고 있는 대표적인 시스템으로는 전자의무기록, 처방전달시스템 등이 있으며, 의료법에서 전자서명을 허용함으로써 의료정보를 관리함에 있어 비용절감 및 진료정보의 공유가 가능하게 되었고, 공인인증서를 활용한 의료솔루션 사용이 확산되어 가고 있다. 이러한 현실에서 인증서의 역할은 어느 무엇보다 중요하다고 할 수 있지만, 대부분 개인 인증서 관리에는 매우 적극적인 반면, 의료솔루션 등 업무와 관련된 인증서 관리에 대해서는 소홀한 것이 사실일 것이다. 업무용 인증서의 경우 업무PC에 보관하는 경우가 다수이며 이는 보안에 취약할 수밖에 없다. 이에 대한 해결책으로 인증서 서버가 존재하나 별도서버의 구축이 필요하여 중소병원의 경우 비용에 대한 부담이 적지 않을 것으로 판단된다. 본 논문에서는 추가비용을 최소화하여 별도의 인증서 서버를 구축하지 않고 인증서 파일을 BLOB로 저장하여 현재의 자원을 활용한 인증서 관리 및 보안에 효과적인 시스템을 설계 및 구현 하고자 한다.

• Journal of Information Processing Systems
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• 제11권4호
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• pp.601-615
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• 2015

Region of interest (ROI) is the most informative part of a medical image and mostly has been used as a major part of watermark. Various shapes ROIs selection have been reported in region-based watermarking techniques. In region-based watermarking schemes an image region of non-interest (RONI) is the second important part of the image and is used mostly for watermark encapsulation. In online healthcare systems the ROI wrong selection by missing some important portions of the image to be part of ROI can create problem at the destination. This paper discusses the complete medical image availability in original at destination using the whole image as a watermark for authentication, tamper localization and lossless recovery (WITALLOR). The WITALLOR watermarking scheme ensures the complete image security without of ROI selection at the source point as compared to the other region-based watermarking techniques. The complete image is compressed using the Lempel-Ziv-Welch (LZW) lossless compression technique to get the watermark in reduced number of bits. Bits reduction occurs to a number that can be completely encapsulated into image. The watermark is randomly encapsulated at the least significant bits (LSBs) of the image without caring of the ROI and RONI to keep the image perceptual degradation negligible. After communication, the watermark is retrieved, decompressed and used for authentication of the whole image, tamper detection, localization and lossless recovery. WITALLOR scheme is capable of any number of tampers detection and recovery at any part of the image. The complete authentic image gives the opportunity to conduct an image based analysis of medical problem without restriction to a fixed ROI.