• Journal of Preventive Medicine and Public Health
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• 제52권1호
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• pp.21-29
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• 2019

Objectives: The Regional Cardiocerebrovascular Center (RCCVC) Project designated local teaching hospitals as RCCVCs, in order to improve patient outcomes of acute cardiocerebrovascular emergencies by founding a regional system that can adequately transfer and manage patients within 3 hours. We investigated the effects of RCCVC establishment on treatment volume and 30-day mortality. Methods: We constructed a panel dataset by extracting all acute myocardial infarction cases that occurred from 2007 to 2016 from the Health Insurance Review and Assessment Service claims data, a national and representative source. We then used a panel fixed-effect model to estimate the impacts of RCCVC establishment on patient outcomes. Results: We found that the number of cases of acute myocardial infarction that were treated increased chronologically, but when the time effect and other related covariates were controlled for, RCCVCs only significantly increased the number of treatment cases of female in large catchment areas. There was no statistically significant impact on 30-day mortality. Conclusions: The establishment of RCCVCs increased the number of treatment cases of female, without increasing the mortality rate. Therefore, the RCCVCs might have prevented potential untreated deaths by increasing the preparedness and capacity of hospitals to treat acute myocardial infarction patients.

• 적정기술학회지
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• 제6권1호
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• pp.45-50
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• 2020

우리는 전세계 최초로 무선 초음파 진단기를 개발하였다. 임산부의 원활한 출산을 위해 WHO에서는 4번의 사전 진찰을 받도록 하고 있으며, 이를 위해 초음파 진단기의 사용이 필수적이다. 하지만, 개발도상국의 소득수준과 의료시설은 이에 미치지 못하고 있다. 우리는 자체개발한 무선 초음파 진단기를 이용해 KOICA의 CTS 프로그램을 베트남에서 진행하였다. 우리는 베트남 흥화현 내 보건소 및 병원에 휴대용 무선 초음파 진단기인 Sonon300C를 보급하였고, 사업성과를 더욱 높이기 위한 노력으로 진단 교육과 실습을 병행하고 아웃리치(Outreach) 프로그램을 실시하였다. 그 결과, 해당 지역의 초음파 진단기 보급률은 100%를 달성하였고, 교육 수료인원 비율은 59%까지 끌어올리는 성과를 얻었다.

• 한국보건간호학회지
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• 제3권2호
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• pp.47-76
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• 1989

The objectives of this study was to analyze the major causes of decreasing utilization rate of health care institutios in pilot-project area of regional medical insurance, Kwang-hwa and Kun-wi country. After the implementation of medical insurance, utilization rate of health institutions turned out' to be lower than it was estimated, when the pilot-project of regional medical insurance was planned. It might be due to changes in inhabitant's behavioral attitude toward medical insurance. So this study was made to find measures for financial stability by increasing utilization rate of health care institutions and to be available for basic demand-supply program of medical care. The hypothesis of this study was as follows; First. there is difference in understanding health care institutions between Kun-wi and Kwang-hwa. Second. respondesnts of inquiry survey have exact knowledge of their past experience of treatment taken prior to enforcement of medical insurance, Questionaire survey was made as to each 700 household among total 11, 884 households in Kun-wi and 20,919 households in Kwang-hwa. In case of Kun-wi, 70% of inquired households (491) gave their answers. In Kwang-hwa, the number was 560 households (80% of inquireds). Dollected data was processed and analyzed by way of using SPSS batch system. To evaluate facto rs distribution aspects of data and to make comparison between two area, percentage and $X^2$ distribution were applied. The results were as follows; L The utilization rate of health care institutions in Kun-wi and Kwang-hwa was lower than it was estimated. when pilot-project of medical insurance was planned. 2. Prior to the implementation of medical insurance. inhabitants in two area chose the medical institutions considering such factors. First was medical care fee cheap. second in habitant's residence, Third was the institutions conveniently easy of access. 3. After the implementation of medical insurance. 26.1% of inqurieds in Kun-wi and 41.6% in Kwang-hwa, changed medical institutions. In case of Kwn-wi, from health care institution (p 0.05), and in case of Kwang-hwa, vice versa, from general medical institutions to health care institutions. 4. Evaluation by factors were made such as follows. Inquired gave high marks to following facts: In case of Kun-wi, general medical institutions were difficult of access and relation between patients: was not friendly, but burden of medical expenditure was light. Effects of treatment and facilities was good. In case of Kwang-hwa, inquired gave high evaluation marks to the follow ing facts; facilities of medical institutions was not good, but the burden of medical expenditure was light. 5. After the implementation of medical insurance, the services was evaluated as good, but inquired hopec for lessening the burden of medical expenditure. 6. In case of exact understanding of cost-sharing, the evaluation rate in Kwang-hwa was higher than that of Kun-wi (p < 0.005). And positive attitude toward necessity of medical insurance was also good in Kwang-hwa (p < 0.05). 7. In case of inquired's attitude toward medical institutions, Kwang-hwa showed positive response (p < 0.05) 8. In the case of comparison between general medical institution and health care institution, two area showed similar positive response; medical manpower, facilities of medical institutions and effest: of treatement was good. 9. In comprehensive evaluation of benefit-service; the general medical institution's positiveness was higher than that of health care institutions in Kun-wi. But in Kwang-hwa vice-versa. 10. If the medical expenditure of general medical institution and health care institutions was equal 77% of inquireds in Kun-wi and 59.1% in Kwang-hwa answered that they chose general medical insurance. Considering results above mentioned, the conclusion of this study was made as follows. 1. In Kwang-hwa county, where the understanding of health care institutions's was good, the utilization's of health care institutions was shown high. Therefore, in case of Kwang-hwa, betterment: should be made to induce increasing utilization rate for negative factors of health care institutions. 2. In case of Kun-wi, where the understanding of health care institutions was on the decrease, measures for changing such negative factors should be taken by way of strengthening public relations. And cases of Kwang-hwa should also be studied. 3. On the side of financial stabilization and establishing health care delivery system, primary health care should be available. Therefore, the major cause of inhabitant's avoiding health care institutions should be known. And measures for activating that institutions have to be taken. So, the facilities of health care institution have to be improved up to the level of clinic. And supportive measures for securing equipment and improving health care services should also be taken. It is necessary that strategy for public relations should be employed with policy considerations and supports.

• Journal of Preventive Medicine and Public Health
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• 제21권1호
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• pp.21-30
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• 1988

농촌 여성들의 출산력과 임신소모율을 조사하기 위해 군위군에 거주하는 15-49세의 여성 가운데 조사시작 당시 영구불임 수술을 하지 않은 유배우 가임여성을 대상으로 17명의 면 보건요원들이 1985년 4원 1일부터 1987년 3월 31일까지 2년간 추적 관찰하여 그들의 피임 실천율, 출산율 그리고 임신 소모율을 조사하였다. 총 관찰된 6,826 여성인년 가운데 피임을 실천한 기간은 3,522인년(51.6%), 임신, 유산 그리고 출산을 한 기간은 519인년(7.6%)이었으며 피임을 하지 않은 기간은 2,491인년(36.5%)이었다. 조사시작 당시에 영구불임 수술을 한 사람을 포함시켰을 경우에는 피임을 실천한 기간이 72.1%로 전국의 피임 실천율보다 오히려 높은 수준이었다. 그러나 30대 여성의 경우 2-3명의 자녀를 갖고서도 피임을 하지 않고 있는 사람이 약 28%나 되고, 피임을 하는 경우에도 월경 주기법이나 콘돔과 같은 실패율이 높은 피임법을 20대 여성보다 더 많이 쓰고 있었다. 관찰기간 동안 전체적으로는 100 여성인년당 14.3건의 임신이 일어났으며, 25-29세 여성 이 100 여성인년당 27.4건의 임신으로 가장 높은 임신율을 보였다. 전체임신 중 22.0%가 사산(0.9%), 자연유산(3.8%), 그리고 인공유산(17.3%)으로 소모되었다. 연령이 증가함에 따라 임신 소모율이 증가하여 30세 미만 부인의 임신 소모율은 15.8%인데 비해 30대 여성이 임신을 한 경우 37.5%가 인공유산을 하여 자연유산과 사산을 합한 임신 소모율이 43.5%나 되었다. 추적기간 동안에 인공유산으로 종결한 부인이 출생으로 종결한 부인에 비해 평균 자녀수와 자연유산 및 인공유산 경험회수가2배 이상으로 많아 유산을 경험한 사람이 유산을 반복하고 있었다. 출생으로 종결한 임부는 평균 4.2회의 산전 관리를 받았고 분만은 85%가 의료기관에서 일어났으며, 가정 분만은 15%로 전국의 농촌지역에 비해 높은 시설 분만율을 나타냈는데, 이것은 군위군이 일차 보건의료시범사업 지역이었기 때문으로 생각된다. 이와 같은 연구 결과로 보아 농촌 여성을 대상으로 한 가족계획 사업은 30대 여성을 대상으로 하여 경구 피임약이나 자궁내장치와 같이 피임 효과가 높은 피임법을 보급하는데 중점을 두어야 임신 소모율을 줄이고 여성건강을 증진시킬 수 있을 것으로 생각된다.

• 한국항만경제학회지
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• 제38권3호
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• pp.69-86
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• 2022

본 연구는 초대형선 도입으로 대형선 수리 수요가 증가하고 있으며, 해상 오염물질 규제강화로 스크러버와 선박평형수처리장치를 부착하는 선박개조 시장이 확대되고 있는 상황에서 우리나라 대형 수리조선소의 건립 필요성을 고찰하고, 수리조선소 경쟁력 결정요인들을 도출하여 경쟁력을 평가하였으며, 수리조선소 건립 운영의 경제적 타당성을 검증하였다. 수리조선소의 경쟁력 결정요인에 대한 AHP 분석결과, 수리조선소 경쟁력 결정요인의 중요도는 입출항 안전성, 수리기술력, 도크 및 안벽시설, 수리비용, 수리기간(납기준수), 수리 부품 조달 등의 순서로 나타나 해운선사 및 선박관리회사들은 수리조선소를 선택함에 있어서 수리조선 인프라와 수리기술 및 품질 등을 가장 중요하게 고려한다는 것을 알 수 있다. 향후 건립될 부산항 수리조선소의 경쟁력에 대한 AHP 분석에서는 이동 거리, 수리서비스 품질, 수리부품 조달과 입출항 안전성, 수리 기술력, 도크 및 안벽 시설, 수리기간(납기준수) 순으로 나타났다. 이는 부산항 입항 선박들이 기항 시에 바로 이용할 수 있으므로 이동거리 요인의 경쟁력이 가장 높으며, 해운기업들이 수리조선소를 결정함에 있어서 중요하게 판단하고 있는 경쟁력 요인 대부분에서 부산항 수리조선소의 경쟁력이 높다는 것을 나타낸다. 부산항 수리조선소의 건립 및 운영 타당성을 비용 편익 분석(cost-benefit analysis)한 결과, 순현재가치는 4,356억원, 내부수익률은 9.8%로 사회적 할인율(4.5%)보다 높으며, 비용 대비 편익 비(B/C)가 1.167로 높게 나타나 경제성 타당성(economic feasibility)이 있는 것으로 나타났다. 연구결과 부산항 수리조선소의 필요성과 경제적 타당성이 충분히 확보되고 있으며, 경쟁력에 대한 평가도 높게 나타나므로, 실무적 관점에서 본 연구는 부산항 수리조선소 건립의 논리적 타당성과 사업 추진의 이론적 기반을 제공할 수 있을 것이다.

• 대한한방부인과학회지
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• 제27권4호
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• pp.69-87
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• 2014

Objectives: We analyzed retrospective clinical data of Korean medical institutes for infertility care and investigated current status and outcome of the Korean medical treatment of infertility as a part of foundational research for verifying validity of constructing national support system and developing appropriate policy on Korean medical treatment of infertility. Methods: We investigated data uploaded on the homepage of The Society of Korean Medicine for Subfertility (http://www.okinfertility.org) by Korean medical institutes for infertility care to get informations such as patients' age, body height, weight, methods of Korean medical treatment, cost and duration of treatment, success or failure of pregnancy and result of treatment. Results: The average age of patients was $33.1{\pm}3.8$ and the average body height was $161.2{\pm}5.3cm$ and the average body weight was $55.2{\pm}8.5kg$. The method of Korean medical treatment was Herbal medicine (97.5%), acupuncture (80.4%), moxibustion (57.7%), cupping (32.7%). The average cost of treatment was $1,160,625{\pm}882,499$ won, and the average medical cost per visit was $357,845{\pm}241,602$ won. The average duration of treatment was $11.26{\pm}10.58$ weeks, and the average number of visits per patient was $4.78{\pm}6.10$ times. The average duration of treatment was the longest in the group of infertile patients with the highest average medical cost per visit. The average pregnancy success rate was 30.9% overall, and that of the group of infertile patients was 25.8%. Conclusions: When we develop the standard project model with expectation for about 25% success rate of pregnancy and delivery in the group of patients who have idiopathic and ovulatory factors, it is desirable to perform acupuncture and moxibustion treatment 1-2 times a week with herbal medicine. The treatment period is set to at least 12 weeks. Average treatment fee maybe calculated by converting the averaged treatment cost of clinic's one month worth of daily treatment fee and medical hospital's ten day treatment fee into weekly treatment cost.

• 한국보건간호학회지
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• 제8권2호
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• pp.101-113
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• 1994

Maternity means all the women who are capable to conceive. In the aspect of health and medical care. however. it means the women who are now in pregnancy or have already given birth to a baby or are in a period of being recoverd from physiological changes occurred by pregnancy. According to the rapidly changing social structure. both the Quality and Quantity of the capacity of childbirth experienced by women are changing. Our society. having established a great economical growth by virtue of the highly developing and growing industrialization and urbanization. stimulates the women's advance into society and thereby increasing the number of employed women. When the women's participation in society is increased. their age of marriage is also affected. Which means there are a decrease of the capacity of childbirth in terms of quantity and a trend for women to have less children and to deliver a baby in their old age in terms of quality. On the contrary. since the number of multipara who want to have a baby in their old age is increasing. as a counter functional effect to the political project of decrease of a birth rate. concern has been focussed on childbirth in old age in the present study. And also such kind of the childbirth may be danger to the health of both mother and baby. Therefore the present study intended to provide some basic data of health education in the part of the health management of both mother and baby in the general hospital. based on understanding the realities of childbirth in. old age and things related to them. To achieve such a purpose of the present study. an analytical study by means of SPSS. was done using the data of 269 clinical records on both the newborn .babies and their mothers who had been supported by public general hospitals located in Seoul for 3 years from Jan. 1. 1991 to Dec. 31. 1993. Some significant results from the analytic study are as follows: 1. It appeared that the average age of normal. natural delivery was 33.8 years old and the average age of delivery through the cesarean operation was 35.4 years old. 2. It appeared that danger factors to childbirth women were types of the delivery and placental extrusion and danger factors to newborn babies are not so outstanding. 3. It appeared that the variables of the childbirth capacity which showed a significant difference according to each age group of women were the number of pregnancy. number of still birth, and number of existing children. That is. the age group of 'more than 35 years' had more frequency of experience In all 3 variables than the age group of 'less than 35 years'. 4. It appeared that the variables of the childbrith capacity which showed a significant difference a according to the sex of a newborn baby were number of pregnancy, number of still birth, and number of existing children. That is, the age group of 'more than 35 years' had more frequency of experience in all 3 variables than the age group of 'less than 35 years'. 5. It appeared that the health index of newborn babies which showed a significant difference was only 5 minute APGAR. That is, the health index 9.46 in the age group of 'more than 35 years' was less than an index of 9.72 in the age group of 'less than 35 years'. 6. Since a counter correlation of -0.10, as Pearson Correlation Coefficient, was showed between the age of childbirth mothers and the weight of newborn babies, it indicated that the higher age of childbirth woman, the lesser the weight of newborn baby. 7. It appeared that the number of women who had confirmed the sex of their baby before their delivery were 45 women, $67.2\%$ of total 67 women who had delivered a baby. and the expected sex by women in childbed was male with $73.1\%$ of total childbirth women expecting male birth and with their expression of feeling of female delivery. very regretful' by $39.3\%$ of total childbirth women. The results as shown above may indicate that instead of the possibility of danger to both the mother delivering a baby in old age and the baby delivered, the expectation of getting a son motivates childbirth in old age. As a conclusion, in a dimension of general hospital as well as national reform. it is required that a program of health education for childbirth in late maternal age have to be developed in the part of the health management of both mother and baby in the near future.

• 융합보안논문지
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• 제18권2호
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• pp.149-158
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• 2018

우리나라의 군 간부들은 현역복무 후 계급정년으로 인해 본인의 의사와 관계없이 조기에 이직할 수밖에 없는 실정으로 최근 중 장기 복무자의 5년간 평균 취업률이 55%수준에 머무르고 있는 현실에 비추어 그 대책이 절실한 상태이다. 지난 박근혜 정부에서 제대군인 일자리 5만개 창출을 국정과제로 선정하여 추진하였으나 그 성과는 크지 않았다. 따라서 이제는 제대군인들의 대규모 일자리 창출을 위해 정부차원의 노력과 학문적 차원의 취업기회 확대 등 기존의 방식을 과감하게 탈피하여야 하며 제대군인들 스스로가 자립하여 조직을 만드는 방안 등을 적극적으로 검토할 필요성이 대두된 것이다. 그러한 이유로 본 연구에서는 제대군인들의 일자리 창출을 위해 제대군인들 스스로 사회적 협동조합을 설립하여 현역부대에서 이루어지고 있는 부대개방행사, 병영체험 등 비전투업무 부담을 경감시켜 주고 먹거리 사업, 경호 경비인력 양성 및 인력제공 사업, 특기병 양성학원 운영 사업, 한강 수중청소 사업, 돌봄 사업, 택배 사업 등을 통해 일자리를 창출하는 방안을 제시한다.

• 한국도서관정보학회지
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• 제54권2호
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• pp.131-154
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• 2023

본 연구는 경기도 A시 도서관 사례를 중심으로 취약계층 어린이를 대상으로 시행한 찾아가는 독서프로그램의 효과를 분석하였다. A시 도서관은 방문교사를 활용하여 어린이의 수준과 흥미에 맞는 책을 비대면으로 책만 배달하거나, 대면으로 책을 읽어주고 책 배달을 함께 하였다. 2022년 프로그램 참여자는 103가정 158명으로 이 중 책 배달은 67가정 103명, 책 읽어주기는 36가정 55명이다. 취약계층 어린이와 양육자를 대상으로 사업 시작과 종료 시기에 독서 효과 측정지표를 설문으로 조사하여 비교 분석하였고, 방문교사와 인터뷰를 하였다. 분석결과 책 배달과 책 읽어주기 중 어린이의 수준과 흥미를 파악하고 상호작용이 큰 책 읽어주기의 효과가 높았다. 연령상으로 독서경험을 쉽게 습득할 수 있는 유아가 초등학생보다 독서 효과가 더 좋았다. 계속 참여집단보다 신규 참여집단을 대상으로 한 프로그램이 약간 더 효과적이었다. 이외에 프로그램 시행 후 독서 흥미, 독서 태도, 독서환경, 독서 상호작용, 자아존중감, 사회성, 언어능력, 독서능력, 자기주도적 학습능력, 도서관 이용률 등에서 향상되었다.