• 보건행정학회지
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• 제9권1호
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• pp.72-109
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• 1999

This study is conducted to investigate the current status on the utilization of health care and plan for solving this problem. The claims data of the fiscal tear 1995 obtained from the regional health insurance society are used for the study. The main findings of the study are summarized as follows. Indexes(The Extremal Quotient(EQ), coefficients of variance(CV's))which represent the regional difference in the admission rate of the tertiary medical diagnosis group report that there is difference in quantity and quality of utilization of health care. The admission rate is lower in the big city areas, Kyoungkido, Kangwondo and Chunlapukdo. Even after age-sex adjustment, the admission rate is still low in Kangwondo, Chunlapukdo and Kyoungsangpukdo. The big city areas tend to have higher rates in the expenses per claim, hospital days per claim, and daily expenses but the rates are still low in some area in Kangwondo, Chunlanamdo and Kyoungsangpukdo. This result remains as same after age-sex adjustment. There is a large regional difference in average utilization rate for the tertiary hospital of the tertiary medical diagnosis group: 57.2%(SD 11.53). The utilization rates for the tertiary hospital in their large catchment area are 96.34%, 83.19% and 73.22% in each Kyoungin, Kyoungnam and Kyoungpuk areas whereas it is lower in a Chungpuk and Chungnam areas. The regional differences of health care utilization of the tertiary medical diagnosis group gave some relationships with their geographical characteristics such as socio-economic characteristics and supply factors of medical services. It is important that many medical policies should be developed in order to minimize and balance out the regional differences of health care utilization. The service allocation policy should include the reconstruction of manpower policy, developing the resource allocating formula, finding the self-sufficient catchment area and reforcing of public health services. Moreover, in order to achieve the balanced development by region, they should investigate and consider each county's microscopic properties under the consistent macrocopic policy. The further studies to find causes of regional difference are needed.

• 논리연구
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• 제16권2호
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• pp.131-154
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• 2013

마이클 윌리엄스는 그의 논문에서 데이빗슨의 원초적 해석은 진리 조건적 의미 설명에 해당한다는 통설에 반대하면서, 해석에서는 실제로 팽 창적 진리가 설명적 역할을 수행하지 않으므로 해석은 진리 축소주의와 조화될 수 있다는 제안을 내놓는다. 본 논문을 통해 필자는 원초적 해석 내에서 진리와 의미 사이의 설명적 구도에 관한 올바른 이해를 모색하고, 이를 바탕으로 윌리엄스의 주장이 적절한가의 여부를 검토하고자 한다. 필자의 진단은 해석에 포함된 몇 가지 중심적인 요소들을 어떻게 바라볼 것인가에 따라서 윌리엄스의 대안적 해석 이론이 수용될 여지가 결정된다는 것이다. 특히 진리 조건에 대한 축소 또는 팽창적 이해는 원초적 해석을 이해하는 방식에서도 차이를 낳는 전제조건이며 그에 따라서 원초적 해석을 축소주의적으로 이해할 수 있는 가능성 도 결정됨을 본 논문은 논증할 것이다. 아울러 이와 비슷한 평가가 호위치의 사용 의미론과 데이빗슨 사이의 유사성을 주장하는 윌리엄스의 또 다른 주장에 대해서도 동일하게 적용될 수 있음을 서술할 것이다.

• 한국병원경영학회지
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• 제4권2호
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• pp.286-304
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• 1999

The purpose of the study was to analysis physician's prescribing behavior. Data was collected from 320 medical doctors of 10 general hospitals from August to September in 1996. The major findings are as follows; 1) Prescribing dosage: 74% of total selected middle dosage. Resident doctors used maximum dosage. 2) The number of similar antibiotics: 72.4% of total used 1 antibiotic. Surgery depts. and resident doctors selected 2, 3 antibiotics. Physicians to consider of insurance benefit or non insurance benefit used the number of antibiotics less than not to consider. Physicians to think over patient's economic state used less the number of antibiotics than that not to consider. 3) Used term of antibiotics: Total mean was 7.39 days. medical parts had 9.11 days but surgery used 6.41 days. Specialists consumed 6.57 days and residents applied 7.80 days. Physician to reflect result of claim used short term of antibiotics than that don't reflected. 4) Optional order of antibiotics: First antibiotics were selected 68% of total respondents, by medical depts, but secondary, tertiary antibiotics was used surgery depts. Tertiary antibiotics was used residents doctors, universal hospitals, fill beds and over. 5) The number of the items of oral drug : 3-4 the items of oral drug were used 76% of respondent Surgery parts selected 1-2 the items of oral drug, medical depts. selected five and over. Physician to reflect result of claim used less the number of the items of oral drug than that don't reflected. Physician to prescribe different of class of insurance used less the number of the items of oral drug than that don't prescribe different.

• Journal of Preventive Medicine and Public Health
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• 제41권1호
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• pp.51-60
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• 2008

Objectives : We examined the effect of sociodemographic factors, cancer, and psychiatric disorders on suicide by gender and age-specific patterns in South Korea. Methods : The study is a case-control study. Claim data was obtained from the national health insurance database and national death registration database. The number of people who committed suicide was 11,523, which was matched with a control group consisting of ten times as many people at 115,230 selected from the national health insurance and medical aids beneficiaries. The medical utilization of the case group was one year before death and that of the control group was from July 1,2003 to June 30, 2004. Four variables-address, economic status, presence of a psychiatric disease, and cancer-were used in multiple logistic regression analyses. Results : Living in cities or in rural areas showed a greater risk for suicide than living in a metropolitan city. Low economic status, the presence of a psychiatric disorder, and cancer were also statistically meaningful risk factors for suicide. The three major psychiatric diseases, schizophrenia, alcohol abuse, and bipolar disorder, were meaningful in all age groups, but the scale of the odds ratio differed by the age group. Only the psychiatric disorder variable was meaningful in the adolescent group, whereas a psychiatric disorder and economic status were meaningful for the young adult group, and all variables were meaningful for the middle-aged group. A psychiatric disorder and cancer were meaningful in the elderly group, economic status was meaningful for male subjects, and address was meaningful for female subjects. Conclusions : Factors such as living in city or rural areas, low economic status, the presence of a psychiatric disorder, and cancer were statistically meaningful risk factors in suicide. These factors also differed by age group. Therefore, policymakers should establish policies for suicide prevention that are relevant for each age group.

• 한국산업정보학회논문지
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• 제28권2호
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• pp.1-9
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• 2023

유방암 관련 기존 AI 연구는 보조적인 진단 예측이나 임상적 요인에 따른 진료 결과를 예측하는 주제가 많았다. 또한 연구기관의 코호트 자료나 일부 환자 자료를 이용하는 경우가 대부분이었다. 본 논문에서는 건강보험심사평가원이 보유하고 있는 전 국민 유방암 환자의 전수 데이터를 활용하여 유방암 환자의 40~50대와 다른 연령대 간의 생존 여부 예측과 생존 여부에 미치는 요인의 차이점을 분석했다. 그 결과, 환자들의 생존 여부 예측 정밀도는 40~50대가 평균 0.93으로 60~80대 0.86 보다 높았으며, 요인에 있어서도 40~50대는 치료횟수(46%)가, 60~80대는 나이(32%)의 변수 중요도가 제일 높았다. 기존 연구와 성능 비교 결과, 평균 정밀도가 0.90으로 기존 논문의 정밀도 0.81보다 높았다. 적용 알고리즘별 성능 비교 결과, 의사결정나무(Decision Tree), 랜덤포레스트(Random Forest) 및 그래디언트부스팅(Gradient Boosting)의 전체 평균 정밀도는 0.90, 재현율은 1.0으로 연령대 그룹 내에서 동일하였으며, 다층퍼셉트론(Multi-Layer Perceptron)의 정밀도는 0.89, 재현율은 1.0 이었다. 심평원의 전 국민 심사청구 빅데이터 가치 활용을 제고하기 위해 비전문가용 머신러닝 자동화(Auto ML) 도구를 사용한 더 많은 연구가 진행되기를 바란다.

• 한국환경보건학회지
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• 제26권2호
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• pp.80-90
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• 2000

To determine the effect of air pollutants in Taejon City, we used medical insurance claim data for asthma and the data monitored from telemetry system of Ministry of Environment for air pollutants and meteorological factors. From November 1st, 1997 to October 31th, 1998, 95,629 asthma patients were covered by medical insurance at Taejon City. Subjects were composed of 49,563 males (51.8%) and 46.336 females(48.2%), and among the subjects, the proportion under 15 years old was 62.8% of the total. During the study period, daily mean concentrations of each air pollutants-So2, No2, CO, O3 and TSP-were 9.8 ppb, 17.6 ppm, 1.414 pp, 17.3 ppb and 60.6 $\mu\textrm{g}$/㎥, respectively, which were lower than each of the environmental recommended exposure levels, Through the simple correlation analysis between each air pollutants and meteorological factors, O3 was positively correlated with temperature, but negatively with relative humidity. TSP, SO2, NO2, CO were negatively correlated with meteorological factors, and these air pollutants except O3 were positively correlated with each other, O3 was correlated with TSP positively but the others negatively. Estimating relative risks of each air pollutant with the baseline general additive model, daily mean concentrations of TSP(Lag 0, 1, 4, 5day) were significantly associated with the increase of the asthma admission. Two age subgroups, under 15 and 15~54 have shown various association of all air pollutants concentration with the asthma admission. However, in case of over 54 age subgroup, only TSP(Lag 0 day) among all air pollutants was associated with the asthma admission. Each of ambient outdoor pollutant concentrations in Taejon City are significantly associated with the admission of asthma patients even though all concentrations in Taejon City are significantly associated with the admission of asthma patients even though all concentrations were much lower than the environmental recommended exposure levels. Therefore, continuous effort lowering air pollutant concentration and introducing an active environmental conservation policy should be implanted for preventing hazardous health effects. Considering major proportion of asthma admissions, high susceptibility and less confounding factors among the age subgroup under 15 will be a useful target population for assessing such health effect monitoring.

• 보건행정학회지
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• 제7권1호
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• pp.125-154
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• 1997

The hospital, clinical department and the physician factor in explaining variations of hospital resource use in surgically admitted patients was compared. This analysis was based on 6, 361 discharges in 28 hospitals for three surgical conditions - lens procedures anal and stomal procedures, uterine and ovarian procedures using medical insurnce claim data. The results were as follows: 1. Regression analysis indicated that the hospital and clinical department characteristics, such as hospital ownership and size, were more significant predictors of the resource use indicators than the physician and patients' social characteristics. 2. Regarding to the physician factors, the hospital where the physician received the residency training and the medical shool where he/she graduated had less effect compared to the hospitals where he/she currently works. Between the residency trained hospital and medical school, the is more important than the latter. 3. When the hospital charges were divided into type of service provided i. e. room, drug, laboratory & radiologic, procedure & operation, and anesthesic charges, variance due to the hospital factor was larger than that due to the physician factor in each item. In summary, the hospital and clinical departmental factor played an important role than physician factor ; indicating to reduce the variation in hospital resource use, the policy that affects hospital behavior would be more effective than that targets individual physician behavior.

• 한국보건간호학회지
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• 제30권3호
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• pp.512-525
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• 2016

Purpose: Ageing in place may improve the quality of life of frail elderly and decrease their costs of services. The purpose of this study was to examine the factors that influence the institutionalization of elderly using home care services in a Korean long-term care insurance system. Methods: This study used the data of '2009 Satisfaction survey of Korean long-term care system'. The survey proceeded to use a sampling data based on region, level of long-term care need, and insurance type among the beneficiaries between August and September 2009. The onset dates of institutionalization of 1,095 participants were ascertained from long-term care insurance claim data. This study calculated the hazard ratio through the Cox Proportional Hazard Model. Results: A total of 176 subjects who were institutionalized in nursing homes were included. There were higher risks in the group that included those who were 85 years and over, had dementia or fracture, used home-visit nursing service, and were not supported by direct family. Conclusion: The results of this study have policy implications to supplement the home care service system and postpone nursing home institutionalization of elderly.

• 한국자동차공학회논문집
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• 제17권2호
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• pp.90-97
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• 2009

One of the most important factors that affect a person's risk of injury in a motor vehicle crash is the age of the person. This study investigates the characteristics of crash injuries among young, middle-aged and older drivers and occupants. Based on the comprehensive claim data from automobile insurance from 2000 to 2007, this study examines in great detail the drivers and occupants injury body regions and severity by age in car-to-car frontal crashes. It has been shown that elderly drivers and occupants suffer more injuries at a chest region compared to the middle-aged group. This research calls attention to the need for design to make vehicles more protective for older drivers in car-to car frontal crashes.

• 한국세라믹학회지
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• 제45권9호
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• pp.497-506
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• 2008

The long time of twenty years has passed since Diesel Particulate Filter (DPF) was proposed before the practical use. The main factors that DPF has been put to practical use in this time, are the same time proposal of the evaluation method of SiC porous materials linked to he performance on the vehicle, and that the nature of thermal shock required for the soot regeneration (combustion of soot) in the DPF is different from the conventional requirement for the rather rapid thermal shock. For the requirements, these includ demonstrating utmost the characteristic of SiC's high thermal conductivity, and overcoming the difficulty of thermal expansion of SiC-DPF by dividing the filter into segments binding with the cement of lower Young's modulus, and the innovation of technology around the diesel exhaust system such as Common-Rail system. As the results of these, the cumulative shipments of SiC-DPF have reached about 5 million, and it goes at no claim in the market.