• 응용통계연구
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• 제30권3호
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• pp.391-401
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• 2017

본 연구는 노인장기요양보험 수급자격을 결정하는 장기요양 등급인정의 지역별 차이를 관리하기 위해 지역별 인정의 차이 관리지표를 개발하고자 수행되었다. 이를 위해 지역별 인정률은 시군구 지역단위별로 설치된 227개 장기요양운영센터의 등급판정자 대비 인정자 비율인 운영센터별 인정률로 정의하고, 등급판정을 받은 자(등급판정자)의 특성에 따라 장기요양 등급인정 여부가 결정되므로, 운영센터별 인정률은 등급판정자의 특성에 의해 영향을 받는다고 가정하였다. 또한 운영센터 인정률에 영향을 미치는 등급판정자 특성 요인을 고려하여 추정된 운영센터별 인정률은 표준인정률이라 정의하였고, 관찰된 인정률 간의 차이(오차)가 클수록 등급판정자의 특성 외의 요인이 인정률에 영향을 끼쳤다고 가정하여 이 지역의 등급인정에 오류가 있다고 판단하였다. 관리지표 개발을 위해 2015년 1월 1일부터 12월 31일까지 장기요양 등급판정이 완료된 433,115명의 인정조사 자료와 등급판정을 실시한 인정조사자 특성을 활용하였다. 운영센터별 관리지표 생산을 위해 분석대상자가 장기요양 등급을 부여 받은 운영센터를 기준으로 자료를 변환하여 회귀분석을 실시하였다. 연구결과, 등급판정자의 인구사회학적 특성과 장기요양 등급 재신청 비율에 영향을 받는 것으로 나타났다. 이를 통해 운영센터 인정의 차이 관리지표를 산출하였고, 인정의 차이 값이 전체 분포의 중앙95% 구간을 벗어난 운영센터를 등급인정에 오류가 있는 지역으로 확인하였다. 본 연구에서 제안한 지역별 인정의 차이 관리지표를 통해 장기요양 등급판정에 대한 국민적 신뢰도 제고와 형평성 향상에 기여할 것으로 기대한다.

• Child Health Nursing Research
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• 제16권4호
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• pp.277-286
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• 2010

Purpose: The purpose of this study was to provide descriptive data about the characteristics of pediatric patients and nursing interventions in Regional Emergency Medical Centers (REMC). Methods: A retrospective design was used to examine the medical records of 4,310 children. The clinical data and nursing terminologies of REMC were analyzed using the Nursing Intervention Classification (NIC). Results: Male toddlers dominated the sample. The mean age of the children was 3.51 yr. In more than half of the visits, patients arrived between from 7 a.m. to 3 p.m., on a weekday. There were only 189 ambulance transports to REMC, (4.4% of visits). The most frequent injuries were due to falls (28.0%) and contusions (27.3%), but the most common reasons for visits were non-injury (73.4%): fever, cough/shortness of breath, seizures, and abdominal pain. Of the 4,310 visits, 27.8% spent 6-24 hours in the REMC, while 33% resulted in hospital admission and 2.1% in transfer to another hospital. Of the 17,929 nursing interventions, 17,909 elements (99.9%) were classified under NIC. All the listed NIC interventions, however, were not reflected in the level of practice demonstrated by REMC nurses. Conclusion: These results can enhance the understanding of pediatric emergency nursing interventions and can make NIC more applicable.

• 대한핵의학회지
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• 제39권1호
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• pp.1-8
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• 2005

상용 PET사이클로트론의 기술적인 변화는 PET의 수요와 밀접한 관계가 있다. PET활용이 일반화 되어 미국을 중심으로 PET의 수요가 급증하게 됨에 따라 사이클로트론의 수요도 증가 하였다. 기존의 사이클로트론은 크기와 무게로 병원에 설치에 공간과 전원 공급 등 여러 문제가 있어 각 사이클로트론 제작사들은 새로운 모델을 출시하게 되었다. 새로운 모델의 특징은 다음과 같다. 첫째 기존의 모델이 양성자와 중양자 등의 2가지 이온을 인출 하였으나 시스템의 복잡성 등의 문제와 양성자로 O-15 생산이 가능하여 양성자 빔만을 인출 하거나 중양자는 선택 사양으로 전환 하였다. 둘째 기존 모델의 경우 양성자의 빔 에너지는 약 16 MeV 이상 가속 시킬 수 있으나 신 모델은 13 MeV 이내로 대폭 낮추어 PET 용 Rl생산에 최적화하였다. 셋째 전자석, RF 장치등의 최적화를 이룩하여 전력소모를 대폭 개선하였으며 외양도 대폭 작아져 무게를 20톤 이내로 대폭 낮추었다. 넷째 새로운 모델 사이클로트론들은 자체 차폐기능이 일반화 되었으나 IBA제품이나 삼영유니텍 제품은 사용자의 견지에 따라 선택 사양이 가능하다.

• Journal of Preventive Medicine and Public Health
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• 제46권5호
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• pp.237-248
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• 2013

Objectives: The purpose of this study is to examine and explain the extent of income-related inequity in health care utilization and expenditures to compare the extent in 2005 and 2010 in Korea. Methods: We employed the concentration indices and the horizontal inequity index proposed by Wagstaff and van Doorslaer based on one- and two-part models. This study was conducted using data from the 2005 and 2010 Korean National Health and Nutrition Examination Survey. We examined health care utilization and expenditures for different types of health care providers, including health centers, physician clinics, hospitals, general hospitals, dental care, and licensed traditional medical practitioners. Results: The results show the equitable distribution of overall health care utilization with pro-poor tendencies and modest pro-rich inequity in the amount of medical expenditures in 2010. For the decomposition analysis, non-need variables such as income, education, private insurance, and occupational status have contributed considerably to pro-rich inequality in health care over the period between 2005 and 2010. Conclusions: We found that health care utilization in Korea in 2010 was fairly equitable, but the poor still have some barriers to accessing primary care and continuing to receive medical care.

• 농촌의학ㆍ지역보건
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• 제43권2호
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• pp.74-84
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• 2018

Objectives: The purpose of this study is to compare the perceptions of the rural healthcare service improvement project' performance and reorganization of public health centers between project staffs and local residents. Methods: Data collection from this study was performed in 141 project areas using structured questionnaires. Data analysis was used in SPSS 22.0 version. Results: The public health center staffs were more positive about the items for improving health facilities than the local residents. Residents in the Si area generally perceived performance as more positive than residents in the Gun area, while public health center staffs in the Gun area perceived performance as more positive than public health center staffs in the Si area. Local residents expressed negative opinions about the reduction in the number of branches of public health clinics and health medical clinics. Conclusions: In conclusion, careful improvement projects for rural health care and the establishment of health care systems will be necessary, reflecting the opinions of local residents, along with a variety of regional characteristics.

• 가정간호학회지
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• 제29권1호
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• pp.40-49
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• 2022

Purpose: This study aimed to analyze the effects of fatigue, resilience, and self-leadership on nursing service quality of local medical center nurses who nursed COVID-19 patients. Methods: The participants were 135 nurses who worked at regional public hospitals located in H-gun, G, and C-city in province C. The collected data were analyzed using descriptive statistics, t-test, analysis of variance (ANOVA), Pearson's correlation coefficients, and stepwise multiple regression using IBM SPSS Statistics version 25. Results: The participants' nursing service quality showed significant positive correlation with resilience (r=.53, p<.001), and self-leadership (r=.60, p<.001). The factors affecting participants' nursing service quality were commitment to self-leadership (β=.57, p<.001) and work position (chief nursing officer) (β=.26, p<.001), which explained 42% of the participants' nursing service quality. Conclusion: During a crisis such as the COVID-19 pandemic, it is necessary to help nurses enhance their self-leadership skills and build their career continuously by developing relevant policies, systems, and nursing intervention programs. Future studies could expand the knowledge base by including more participants to explore other ways to improve nursing service quality during the COVID-19 pandemic.

• Journal of Trauma and Injury
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• 제34권3호
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• pp.212-217
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• 2021

Various medical scenarios have arisen with the prolonged coronavirus disease 2019 (COVID-19) pandemic. In particular, the increasing number of asymptomatic COVID-19 patients has prompted reports of emergency surgical experiences with these patients at regional trauma centers. In this report, we describe an example. A 25-year-old male was admitted to the emergency room after a traffic accident. The patient presented with stuporous mentality, and his vital signs were in the normal range. Lacerations were observed in the left eyebrow area and preauricular area, with hemotympanum in the right ear. Brain computed tomography showed a contusional hemorrhage in the right frontal area and an epidural hematoma in the right temporal area with a compound, comminuted fracture and depressed skull bone. Surgical treatment was planned, and the patient was intubated to prepare for surgery. A blood transfusion was prepared, and a central venous catheter was secured. The initial COVID-19 test administered upon presentation to the emergency room had a positive result, and a confirmatory polymerase chain reaction (PCR) test was administered. The PCR test confirmed a positive result. Emergency surgical treatment was performed because the patient's consciousness gradually deteriorated. The risk of infection was high due to the open and unclean wounds in the skull and brain. We prepared and divided the COVID-19 surgical team, including the patient's transportation team, anesthesia team, and surgical preparation team, for successful surgery without any transmission or morbidity. The patient recovered consciousness after the operation, received close monitoring, and did not show any deterioration due to COVID-19.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제30권1호
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• pp.7-17
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• 2024

Purpose: This study is to present basic data and standards for calculating the space composition and area required when planning a neonatal intensive care unit. Methods: Review domestic and foreign facility standards and regulations related to the current neonatal intensive care unit, select a regional neonatal intensive care center designated by the Ministry of Health and Welfare as a case hospital, and organize a space program for the construction plan of the neonatal intensive care unit through analysis of characteristics such as facility size and function composition. Results and Implications: The size, facility area, and detailed room composition characteristics of the neonatal intensive care unit in Korea were confirmed, and essential rooms and appropriate areas were derived when planning the construction of the neonatal intensive care unit. Korea's legal facility standards related to neonatal intensive care units are lower than the actual hospital status and overseas standards, and the facility standards of the medical law need to be improved.

• Journal of Trauma and Injury
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• 제36권3호
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• pp.224-230
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• 2023

Purpose: Patients with penetrating injuries are at a high risk of mortality, and many of them require emergency surgery. Proper triage and transfer of the patient to the emergency department (ED), where immediate definitive treatment is available, is key to improving survival. This study aimed to evaluate the epidemiology and outcomes of patients with penetrating torso injuries in Incheon Metropolitan City. Methods: Data from trauma patients between 2014 and 2018 (5 years) were extracted from the National Emergency Department Information System. In this study, patients with penetrating injuries to the torso (chest and abdomen) were selected, while those with superficial injuries were excluded. Results: Of 66,285 patients with penetrating trauma, 752 with injuries to the torso were enrolled in this study. In the study population, 345 patients (45.9%) were admitted to the ward or intensive care unit (ICU), 20 (2.7%) were transferred to other hospitals, and 10 (1.3%) died in the ED. Among the admitted patients, 173 (50.1%) underwent nonoperative management and 172 (49.9%) underwent operative management. There were no deaths in the nonoperative management group, but 10 patients (5.8%) died after operative management. The transferred patients showed a significantly longer time from injury to ED arrival, percentage of ICU admissions, and mortality. There were also significant differences in the percentage of operative management, ICU admissions, ED stay time, and mortality between hospitals. Conclusions: Proper triage guidelines need to be implemented so that patients with torso penetrating trauma in Incheon can be transferred directly to the regional trauma center for definitive treatment.

• Journal of the Korean Data and Information Science Society
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• 제26권1호
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• pp.111-121
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• 2015

지금까지 장애인복지관 운영에 대해서는 사업 특성상 장애인복지 전반에 관한 긍정적이거나 또는 관대한 인식을 가져왔다. 그런데 장애인복지관이 다양한 산출물을 효율적으로 얻기 위해서는, 합리적이고 과학적인 장애인복지관의 운영과 만족할 만한 수준의 서비스가 수혜자들에게 제공되고 있는지에 대한 실증적인 연구가 필요하다. 이에 본 연구에서는 자료포락분석을 이용하여, 전국 176개 장애인복지관에 대한 상대적인 효율성을 탐색해 보고, 시사점을 도출해 보고자 한다. 그 결과 전체 176개 장애인복지관에 대한 기술 효율성 평균은 0.4488, 순수 기술적 효율성은 0.6040 그리고 규모 효율성은 0.7080인 것으로 나타났다. 자료포락분석을 활용한 장애인복지관 효율성 탐색 결과를 바탕으로 제언과 한계를 제시하면 첫째, 기술 효율성분석을 적용해 보았을 때, DMU2, DMU3, DMU8, DMU9, DMU11, DMU13, DMU14가 평균이상으로 나타났는데, 이는 지역적인 사회 경제적 편차와 함께, 사회복지 시설 예산의 지방 이양에 따른 정책적 요소에 대한 고려가 있어야 할 것으로 보이며, 둘째, 규모의 효율성 분석 결과, DMU1, DMU5, DMU12, DMU16 등의 규모효율성이 낮은 장애인복지관들은 직원수, 세입액, 면적규모 등의 투입요소 규모를 확대함으로써 운영의 효율성 개선이 기대되어지며, 마지막으로 본 연구가 향후 다양한 분야에서 제공되는 재활서비스에 대한 효율성 분석과 성과평가의 계기가 될 것으로 기대된다.