• 한국산학기술학회논문지
• /
• 제14권2호
• /
• pp.713-720
• /
• 2013

본 연구는 의과 일부 상병에 국한된 지역간 의료이용변이 연구의 범위를 한방으로 확대하여 다양한 실증적 연구기반을 마련하고 의과 상병의 지역간 의료이용변이가 한방에서도 존재하는지, 존재한다면 그 요인은 무엇인지를 파악하여 한방 의료서비스의 합리적 이용을 위한 정책수립에 필요한 기초 자료를 제공하는데 그 목적이 있다. 2010~2011년 건강보험 자료에서 의과, 한방외래 다빈도 10대 상병을 선정하고 86개 군 지역을 대상으로 지역 간 의료이용 변이여부를 분석하였다. 분석결과 한방에서도 지역별의료이용변이가 존재하는 것으로 나타났는데 내원일당진료비는 공급자측면 보다는 수요자특성이 주요한 요인으로 작용하였고 수진자당진료비는 공급자와 수요자특성이 동시에 주요한 요인으로 작용하였다. 따라서 한방 의료서비스의 합리적 이용을 위한 의료의 과다이용과 미 충족 방지를 위해 한방 의료서비스 표준화, 한방의료 역할강화, 올바른 의료이용과 불필요한 의료행위를 줄이기 위한 정보제공 및 정보공유 확대정책이 필요하다.

• Journal of Preventive Medicine and Public Health
• /
• 제9권1호
• /
• pp.139-146
• /
• 1976

This survey attempted to determine the overall health situation in Kyunggido in terms of sickness prevalence, sickness distribution, demand for medical care by type, and utilization of medical care. The survey was conducted on 766 households, or 4,065 people, from July 1-31, 1975. The findings from the survey are as follows: 1) In terms of age distribution, 28.7% of the sample was from 10-19, the 40-49 age group was the next largest group, and those over 60 made up 7% of the sample. 2. The education distribution is as follows, 30.4% completed primary school, 22.4% had no formal education, 20.6% attended but did not onplete primary school, and 1.8% attended unversities or higher. 3) In terms of occupation, 55.9% were unemployed or family employees, which represents a large dependent population, 30.4% of the workers were employed in farming or fisheries. 4. The marital status is as follows, 58.8% of the women were married, 32.3% unmarried, and 7.5% divorced. 5) The prevalence rate of mouthy illness was 19.7% of 100 infant, 42.8% became fatally ill within the first year of life. This is a very high percentage compared with more developed nations. 6) Of those reportion on illness, 54.6% sought treatment. The rate of treatment was highest in infants at 77.7%. Us age increased, demand for treatment decreased to 43.1% for those in the aldest age group. The oldest age group also had the highest rate of non treatment at 56.8%. 7) The demand for medical care showed that 65.6% utilized drug stores, 20.2% utilized hospitals and clinics, 5.4% used herbdrug-stores and herb clinices, and 3.9% relied upon folk medicine and withch craft. 8) The utilization of medical facilties by sex is as follows, 65.1% of the men and 66.0% of the women used drug stores, and 19.2% of the men and 20.2% of the women used hospitals and clinics. However, more men (3.5%) were hospitalized than women (1.8%) 9) In terms of out-patient care, the largest age group of males was 10-19 (28.2%), and the largest age group of females was 0-9 (30.8%). There was no sex difference in the use of western pharmacies. Menaged 30-39 and women aged 50-59 were the most frequent users of herb clinics. 10) The rate of receiving treatment at drugstore hospitals went towards declining level in the second case of what While increaing much more at herb clinics and folk medicines in the second case than the first one. 11) After primary utilization of hospitals, 32.7%. of the adults aged 20-59 used drug-stores as a secondary source of care, and 12.8% of children and youth under age 20 continued receiving care at hospitals. 12) After primary utilization of drug-stores, 32.5 % of the adults continued to seek care at drug stores and 1.8% used hospitals. 4.2% of those over age 60 utilized folk medcine and witch craft.

• Tuberculosis and Respiratory Diseases
• /
• 제70권4호
• /
• pp.307-314
• /
• 2011

Background: Chronic obstructive pulmonary disease (COPD) is a major cause of death and disability worldwide and one of the most prevalent diseases in Korea. We examined trends and risk factors of health care utilization for COPD in Korea. Methods: We retrospectively analyzed the database of Patient Surveys from 1990 through 2008, which were nationwide surveys of health services utilization through outpatient department (OPD) visits and hospitalization. Physician-diagnosed COPD patients whose ages were 45 years and older were included. Results: OPD visits and hospitalization of COPD patients between 1990 and 2008 were estimated to be 68,552 and 17,774 persons, respectively. Trends in OPD visits and hospitalization for COPD significantly increased from 1990 through 2008 (p=0.019, p=0.001, respectively). The increment rate for OPD visits was 2.0 fold over those years; for hospitalization it was 3.3 fold. Risk factors for OPD visits for COPD were male gender (odd ration [OR], 1.41; 95% confidence interval [CI], 1.39~1.43), those aged 65 years and older (OR, 1.50; 95% CI, 1.47~1.53), residential area other than a metropolis (OR, 1.08; 95% CI, 1.07~1.010) and access to a physician's office (OR, 1.17; 95% CI, 1.14~1.21). Risk factors for hospitalization were male gender (OR, 2.15; 95% CI, 2.07~2.23), those aged 65 year and older (OR, 2.86; 95% CI, 2.72~3.00), residential area other than a metropolis (OR, 1.98; 95% CI, 1.90~2.07) and access to a hospital (OR, 2.88; 95% CI, 2.59~3.22) (p<0.001, both). Conclusion: Health care utilization for COPD subjects increased from 1990 to 2008. Risk factors for the utilization were male gender, older age, and residential area other than a metropolis.

• 보건의료산업학회지
• /
• 제3권1호
• /
• pp.14-24
• /
• 2009

This study aims at deriving any useful information necessary to strengthen the competitiveness for growth through empirical analyses on general hospital located in a province in order to countermeasure the opening and competition of medical markets. The characteristics of user were identified on the basis of disease groups under KCD in the research method. In addition, the analysis on the expenses of diagnosis and treatment was divided into the treatment progress and degree of hospital resource utilization And the regression was carried out to identify the impacts of characteristics of inpatient users on the degree of hospital resource utilization. As a result of major research, the inpatient users of the general hospital located in the provincial area in consideration of inpatient users were formed around the inpatient disease groups representative for Korea(diseases of the respiratory system, injury and poisoning & certain other consequences of external causes). And it was understood that most of residents within a distance of 40 minute by the public transportation were using. And mostly were under the age of 9 or over 60, and the provision of medical features such as the degree of consultation and operational functions were inadequate. When we classify inpatient treatment cost for each resource application as the medical cost being the center of patient care function, the equipment and human resource application sector are constituted over half. Accordingly, the following suggestions are made as plans to strengthen the competitiveness for the growth of general hospitals located in the provincial areas on the basis of analytical results. First, it is necessary to have the characterization matching to the age and disease groups with a high frequency. Second, it is necessary to increase the degree of hospital resource utilization according to the characterization. Third, it is necessary to concentrate on public relations. The above suggestion, as a method for securing image improvement and competitive power as a general hospital, and through expansion of social function that a regional general hospital needs to secure not only as an individual institution but also as a general hospital, it can be seen that a general improvement of image as a regional general hospital is possible.

• 한국콘텐츠학회논문지
• /
• 제19권9호
• /
• pp.308-320
• /
• 2019

본 연구는 가족돌봄자가 노인의 정신질환을 주로 어떤 증상을 통해 발견하였는지를 알아보는 한편, 가족돌봄자를 중심으로 노인의 정신건강서비스를 이용하게 이끄는 주된 원인이 무엇인지를 실증적으로 검증하고자 하였다. 이를 위해 정신건강문제를 갖고 지역사회에 거주하는 노인을 돌보는 가족돌봄자를 대상으로 설문조사를 실시하였으며 이를 통해 수집된 324명의 자료로 이항 로지스틱 회귀분석을 실시하였다. 연구결과를 보면 첫째, 가족돌봄자가 노인 환자의 정신건강질환을 의심하게 된 주된 증상은 기억력 저하와 다른 인지기능 저하가 가장 많은 것으로 확인되었다. 둘째, 노인이 노인 정신건강서비스를 이용하는데 영향을 미치는 요인으로는 노인의 장기요양등급, 가족돌봄자의 나이, 노인을 돌본 기간, 가족돌봄자가 느끼는 돌봄 스트레스의 수준, 가족 돌봄자의 노년기 정신질환에 대한 이해, 가족돌봄자의 지역사회 정신건강서비스에 대한 인지도가 영향을 미치는 것으로 확인되었다. 이러한 연구결과를 토대로 노인 가족돌봄자의 관점에서 노인 정신건강문제 조기 발견과 대응 및 관련서비스 이용을 위한 정책적 실천적 함의를 제시하였다.

• Journal of Preventive Medicine and Public Health
• /
• 제14권1호
• /
• pp.65-74
• /
• 1981

This survey was made to determine the overall health situation on (1) the status of sickness; (2) the medical care utilization; (3) the medical cost in Mi-Kum Myun, Nam Yang Ju Gun, Kyung-Gi Do. The survey with questionnaire was carried out with 2,840 peoples in 560 households from August 9th to 16th, 1979. The findings from the survey were as follows; 1. Annual morbidity rate of the prolonged ill cases was 97.2 per 1,000 population (male 94.7, female 99.6), The highest age specific morbidity rate was 274.5 of the 45-to 64-year group and the lowest was 21.9 of the 5-to 14-year group. 2. Annual morbidity rate of the new patients was 777.5 per 1,000 population(male 644.5, female 909.5). 3. The chief complaints distribution of the prolonged ill cases was: local pain 36.6%, indigestion 22.4%, and coughing 7.3%, respectively, In terms of age and sex distribution, a large number of female of the 45-to 64-year group complained of local pain or general pain and a large number of both sexes of the 25-to 44-year group complaned of indigestion. 4. The major diseases of the new patients which classified with International Classfication of Diseases (I.C.D.) were disease of the respiratory system, disease of the digestive system, and disease of the musculo-skeletal system and connective tissue for male, disease of the respiratory system, disease of the digestive system, and accident, poisoning, violence for female. 5. Total ill days of the 92 new patients were 536 days and average ill days per case were $6{\pm}38.3$ days. 6. The rate of receiving treatment in the prolonged ill cases was 82.2%(medical facilities 46.4%, drug stores 27.5%, herb medicine 8.3%). 7. The rate of receiving treatment by first choice of the new patients was 88.0% (drug stores 57.%, medical facilities 28.2%, and herb medicine 2.2%), and the rate of receiving treatment by second choice was 30.9% of first treatment cases (medical facilities 44.0%, drug store 44.0% and herb meicine 12.0%). 8. Annual hospitalization rate per 1,000 population was 12.0 (male 12.0, female 11.9). 9. The locations of medical facilities utilized by out-patients were: in the prolonged ill cases Seoul or other places 66.4%, Nam Yang Ju Gun 33.6%, in cases of the new patients Seoul or other places 35.1% and Nam Yang Ju Gun 64.9% respectively. 10. The satisfaction rate of the new patients by mode of receiving treatment was: in cases of primary utilization by first choice herb medicine 100.0%, medical facilities 88.5%, and drug stores 69.8%, in cases of secondary utilization medical facilities 100.0%, herb medicine 100.0%, and drug stores 72.7% respectively. 11. The medical cost per utilized facilities was as follows; in average medical fee per case out-patient 8.947 won, in-patient 266,000 won, drug stores 1,532 won, and herb medicine 15,607 won, in average medical fee per day out-patient 4,829 won, in patient 14,178 won, drug stores 891 won, and herb medicine 4,906 won respectively. 12. The sources of the hospital charges paid out were: there own expense 50.0%, debt 35.3%, and security of medical care 14.7% respectively.

• 수산해양교육연구
• /
• 제28권1호
• /
• pp.59-68
• /
• 2016

For comparison of tetracycline-resistant ($Tc^R$) genes, we obtained 21 and 14 $Tc^R$ Staphylococcus spp. from marine environment and human patient, respectively. Although all isolates from human were identified as Staphylococcus aureus, higher proportion of $Tc^R$ isolates (12 out of 14) from human were utilizing tet(M) gene compared to that of $Tc^R$ isolates (6 out of 21) from marine environment. Additionally, collaborated utilization of tet(M) and erm(A) in $Tc^R-Em^R$ S. aureus in human patient, but not in $Tc^R$ Staphylococcus spp. isolates from marine environment was also characterized. Based on the nucleotide sequence of transposon related to $Tc^R$ gene, we confirmed the origin of tet(M) gene in $Tc^R$ Staphylococci isolated from marine environments and human are derived from Tn916/1545-like and Tn5801 transposon, respectively. It is the first report showing the presence of Tn5801 in all $Tc^R$ S. aureus carrying tet(M) in human patient. Alignment of the fully sequenced tet(M) from marine environmental isolates was also agreed with the determined transposons by showing the genomic mosaic structure composed with three genomic parts from Tn916/1545 and unknown transposons. Genetic characteristics of these tet(M) in environmental isolates were similar to each other but different from those in isolates from human showing only tet(M) from Tn916/5801 type. It may imply the presence of less dramatic communication of antibiotic resistant genes between Staphylococci isolated from marine environment and human.

• 대한방사선기술학회지:방사선기술과학
• /
• 제5권1호
• /
• pp.55-62
• /
• 1982

Measurement of triiodothyronine($T_3$) concentration is useful for the diagnosic and treatment of thyroid gland diseases. Fundermental studies of measurement of $T_3$ concentration by radioimmunoassay were performed and values determined by commercially available kit, Coat-A-Count, Diagnostic Products Corporation. The optimal utilization of the radioimmunoassay in measuring $T_3$ concentrations is dependant not only on high quality performance of the assay, but also on their appropriate application to the clinical situation. These are several aspects that must be considered in every individual case. These include factors such as accurate pippeting in reagent preparation in the assay and through decanting to remove all visible moisture after incubation steps and so forth. In attempt to assess quality control of the radioimmunoassay of serum $T_3$, serum pools with high, medium, low $T_3$ concentrations were assayed for each of 5 samples. The results obtained with this study were as follow: 1. The coefficient of variation(C. V.) for the standard curve ranged between $0.2{\sim}3.5%$. 2. It was necessary that both incubation time and temperature should correctly be maintained all the in the assay performance. 3. The precison with the $T_3$ RIA procedure was good. 4. The measured values of serially diluted serum $T_3$ concentration with Ong/dl standard solution was proportional to the predicted values. However dilution curve of distilled water was not strait. 5. Calculated $T_3$ values of patient serum in normal group was $107.8{\pm}25.90ng/dl$ in male patient and $127.29{\pm}24.08ng/dl$ in female patient.

• 한국콘텐츠학회논문지
• /
• 제12권1호
• /
• pp.379-385
• /
• 2012

본 연구는 최근 들어 급속히 보급이 확산된 스마트폰을 이용하여 이를 치료실과 기공소간의 정보공유체계와 연계 활용하는 방안을 제시하는 것이 목적이다. 이를 위해 최근 모바일 플랫폼 기반의 개발환경을 소개하고 안드로이드 기반의 환자정보 공유체계의 주요 기능을 정의하여 이를 사용자 인터페이스의 설계를 통해 구현 하였다. 이를 실무에 적용한 결과 다음과 같은 결과를 얻을 수 있었다. 1. 스마트폰 등 현재 이슈가 되고 있는 정보화 기반기술을 치기공계에 적용할 수 있는 가능성을 제시하였다. 2. 환자의 구강에 대한 영상촬영 시 카메라와 PC를 연결하여 전송하는 프로세스를 개선함으로서 치료 실내의 정보 활용성이 개선되었다. 3. 환자의 구강정보는 촬영 즉시 서버로 전송되므로 영상화일의 오류를 저감할 수 있었다. 4. 임상에서의 보철물 제작 시 스마트폰에 보철물 이미지를 표출한 상태로 작업함으로서 작업의 효율성이 개선되었다.

• 한국방사선학회논문지
• /
• 제6권6호
• /
• pp.465-471
• /
• 2012

본 연구에서는 ALOKA PDM-117(X-ray 측정용 선량계)선량계를 이용하여 구내방사선 촬영기에서 발생하는 방사선에 대하여 거리의 변화에 따른 선량분포를 3차원으로 측정하였다. 구내 방사선촬영에 있어서 XCP 필름 유지기구(XCP-DS FIT)를 사용하여 영상을 얻는 경우 방사선의 선량 분포는 변할 수 있고 이것은 방사선영상과 환자피폭에 영향을 미치게 된다. 따라서 위치에 따른 선량을 표준화하여 XCP 필름 유지기구 사용 유무에 따른 선량과의 관계를 알아볼 필요성이 있다. 본 연구에서는 측정된 3차원 선량분포를 통하여 등각촬영시 얻을 수 있는 최적의 영상과 동일한 선량을 얻기 위한 조사시간과 거리와의 관계 및 선량분포의 모서리 퍼짐 현상에 대한 결과를 정량적으로 측정하였다. 거리가 증가함에 따라 중심 선량은 감소하였지만 조사통 가장자리 부분의 방사선 퍼짐은 증가하는 경향을 보였다. 이것은 XCP 필름 유지기구를 사용하는 경우에 선속 가장자리 부분에서 방사선의 선량이 퍼지는 경향을 보이기 때문이므로 환자의 병소이외의 부분에 대한 피폭에 주의를 기울여야 함을 정량적으로 확인 하였다. 본 연구의 결과는 품질 좋은 치아영상을 얻고, 환자의 피폭선량을 줄이는데 매우 유용하게 사용되어 질 수 있을 것으로 사료된다.