• 보건의료기술평가
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• 제6권2호
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• pp.123-132
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• 2018

Objectives: Maternal morbidity and mortality are important healthcare issues. However there have been few studies on cost of illness (COI) from maternal disorders. This study aimed to estimate the COI due to maternal disorders in Korea. Methods: By reviewing previous studies and consulting expert we determined the scope of maternal disorders. We operationally defined maternal disorders as maternal hemorrhage, maternal sepsis, hypertensive disorders of pregnancy, obstructed labor, and abortion for maternal disorders. The reference period of this study is the year 2015. Main source of data were the National Health Insurance Service claims data, cause of death statistics from the Korea National Statistical Office, and the Korea Health Panel study. We classified the total costs into direct and indirect costs. The direct costs cover healthcare costs and non-healthcare costs. The indirect costs consist of productivity losses due to morbidity and premature death. Results: The cost of maternal disorders in 2015 was 229.7 billion won. The direct and indirect costs of maternal disorders were 165.2 billion won and 64.5 billion won respectively. The largest cost item for maternal disorders was healthcare cost (138.3 billion won, 60.2%). By age groups, the COI in 30-39 years old women were the highest (165.1 billion won, 71.9%). Abortion was the disorder with the highest COI among maternal disorders (71.9 billion won, 31.3%). Conclusion: The COI due to maternal disorders in Korea is quite substantial. Economic burden of maternal disorder increased when being compared with the year 2012 data despite the continued low birth rate in Korea. Therefore, it is necessary to continuously monitor the social costs of the maternal disorders in Korea.

• Journal of Hospice and Palliative Care
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• 제21권4호
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• pp.144-151
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• 2018

목적: 말기암환자 가족의 영적요구도를 측정하기 위한 도구의 신뢰도와 타당도를 검증하기 위한 연구이다. 방법: 본 연구는 1) 예비문항의 작성 2) 내용타당도 검증 3) 신뢰도와 타당도 검증 4) 최종문항 선정 과정에 따른 방법론적 연구이다. 결과: 요인분석을 통해 '신과의 관계/죽음 수용', '관계성 회복/희망과 평화', '삶의 의미와 목적'의 3가지 요인이 추출되었다. 이 요인들은 총 변량의 61.088%를 설명하였으며, Cronbach's alpha 값은 0.944, Guttman 반분 신뢰도 계수는 0.826으로 나타났다. 결론: 본 도구는 신뢰도와 타당도를 지닌 도구임이 확인되었다. 이에 호스피스 완화의료 분야에서 말기암환자 가족의 영적요구도를 사정할 때 활용도가 높은 도구라고 본다.

• Journal of Preventive Medicine and Public Health
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• 제52권2호
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• pp.72-81
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• 2019

Objectives: The current study presents a new conceptual framework for physician-induced demand that comprises several influential components and their interactions. Methods: This framework was developed on the basis of the conceptual model proposed by Labelle. To identify the components that influenced induced demand and their interactions, a scoping review was conducted (from January 1980 to January 2017). Additionally, an expert panel was formed to formulate and expand the framework. Results: The developed framework comprises 2 main sets of components. First, the supply side includes 9 components: physicians' incentive for pecuniary profit or meeting their target income, physicians' current income, the physician/population ratio, service price (tariff), payment method, consultation time, type of employment of physicians, observable characteristics of the physician, and type and size of the hospital. Second, the demand side includes 3 components: patients' observable characteristics, patients' non-clinical characteristics, and insurance coverage. Conclusions: A conceptual framework that can clearly describe interactions between the components that influence induced demand is a critical step in providing a scientific basis for understanding physicians' behavior, particularly in the field of health economics.

• 한국병원경영학회지
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• 제26권1호
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• pp.71-82
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• 2021

Purpose: The purpose of this study is to estimate incomes and costs of the medical clinics by using secondary data. Methodology: The medical incomes and costs were estimated from 405 clinics operated by sole practitioner providing out-patient services among all clinics subject to the Medical Cost Survey on National Health Insurance Patients in 2017, excluding dental clinics and oriental medical clinics. The incomes and costs of the medical clinics were reflected with incomes and costs of health insurance benefits and were calculated by types of medical services (i.e., basic care, surgery, general treatment, functional test, specimen test and imaging test). The costs were classified as follows: labor costs, equipment costs, material costs and overhead costs. Secondary data was used to estimate the incomes and costs of the medical clinics. For allocation bases for costs for each type of the medical service, the ratio of revenue from health insurance benefits by types of medical services was applied. However, labor costs were calculated with the activity ratio by types of medical services and occupations, using clinical expert panel data. Finding: The percentage of health insurance income for all medical income was 73.1%. The health insurance cost per clinic was 401,864 thousand won. Labor cost accounted for the largest portion of the health insurance income was 191,229 thousand won (47.6%), followed by management cost was 170,018 thousand won (42.3%), materials cost was 35,434 thousand won (8.8%), and equipment costs was 5,183 thousand won (1.3%). Practical Implications: This study suggests a method of estimating incomes and costs of medical clinic services by using secondary data. It could efficiently provide incomes and costs to assess an appropriate level of the health insurance fee to the clinics.

• Journal of Trauma and Injury
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• 제34권4호
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• pp.225-232
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• 2021

Purpose: Trauma is the top cause of death in people under 45 years of age. Deaths from severe trauma can have a negative economic impact due to the loss of people belonging to socio-economically active age groups. Therefore, efforts to reduce the mortality rate of trauma patients are essential. The purpose of this study was to investigate preventable mortality in trauma patients and to identify factors and healthcare-related challenges affecting mortality. Ultimately, these findings will help to improve the quality of trauma care. Methods: We analyzed the deaths of 411 severe trauma patients who presented to Gachon University Gil Hospital regional trauma center in South Korea from January 2015 to December 2017, using an expert panel review. Results: The preventable death rate of trauma patients treated at the Gachon University Gil Hospital regional trauma center was 8.0%. Of these, definitely preventable deaths comprised 0.5% and potentially preventable deaths 7.5%. The leading cause of death in trauma patients was traumatic brain injury. Treatment errors most commonly occurred in the intensive care unit (ICU). The most frequent management error was delayed treatment of bleeding. Conclusions: Most errors in the treatment of trauma patients occurred in early stages of the treatment process and in the ICU. By identifying the main causes of preventable death and errors during the course of treatment, our research will help to reduce the preventable death rate. Appropriate trauma care systems and ongoing education are also needed to reduce preventable deaths from trauma.

• 산업융합연구
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• 제20권7호
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• pp.21-30
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• 2022

본 연구는 기업의 디지털트랜스포메이션(digital transformation) 분야에서 가장 우선하는 클라우드 기반 회계정보시스템의 성공적 도입에 영향을 미치는 주요 요인을 탐색하는데 그 주안점을 두고 있다. 따라서 기업의 클라우드 현황과 관련 선행연구를 토대로 이론을 종합하였으며, 기업의 주요 성과 요인을 조직적 요인과, 비즈니스 업무 영역, 그리고 기술적 시스템 요인으로 구분하여 조사 분석하였다. 연구분석 방법은 클라우드 기반 회계정보시스템이 도입 초기인 점을 고려하여 전문가 패널을 대상으로 델파이(delphi method)분석 기법을 통해 주요 성공 요인을 중요도에 따라 순위를 정하고, 계층적분석(AHP)방법을 통해 각 주요 요인별 상호 중요도 분석을 통해 최종적으로 주요 성과변수를 탐색하였다. 분석결과 조직적 요인으로는 기업의 지속성과, 기업 운영적 요인은 비니니스 업무 솔루션, 그리고 시스템 확성성 요인으로 분석 되었다. 본 연구는 향후 많은 기업들이 주목하고 있는 클라우드 기반 회계정보시스템의 도입과 운영에 대한 초기 도입 전략과 운영에 추가적인 유용한 정보를 제공할 수 있을 것이다.

• Safety and Health at Work
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• 제13권3호
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• pp.364-371
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• 2022

Background: Respiratory masks can provide healthcare workers with protection from biological hazards when they have good performance. There is a direct relationship between the visual specifications of a mask and its efficacy; thus, the aim of this study was to develop tools for qualitative assessment of the performance of masks used by healthcare workers. Methods: A mixed-methods design was used to develop a qualitative assessment tool for medical face masks (MFM) and particle filtering half masks (PFHM). The development of domains and items was undertaken using observation and interviews, the opinions of an expert panel, and a review of texts and international standards. The second phase evaluated the psychometric properties of tools. Finally, the validated Mask Qualitative Assessment Tools (MQAT) were used to assess six samples from 10 brands of the two types of masks. Results: MQAT-MFM and MQAT-PHFM shared 42 items across seven domains: "cleanliness," "design," "marking, labeling and packaging," "mask layers," "mask strap," "materials and construction," and "nose clip." MQAT-MFM included one additional item. MQAT-PHFM included another nine items associated with an eighth "Practical Performance" domain, and the valve version had another additional "Exhalation Valve" domain and six items. The evaluation indicated 80% compliance for MFM and 71% compliance for PFHM. "Marking, labeling and packaging" and "Layers" were associated with the least compliance in both types of masks and should be checked carefully for defining mask quality. Conclusion: MQAT can be used for immediate screening and initial assessment of MFM and PHFM through appearance, simple tools, and visual inspection.

• 문화기술의 융합
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• 제7권4호
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• pp.577-582
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• 2021

본 연구는 코로나19 팬대믹 이후 외국인 환자의 급감으로 심각하게 타격을 입은 국내 의료관광 산업 회복을 위한 방안을 모색하고자 연구하게 되었다. 전문가 패널 에게 순위별 키워드 자문을 구하여 Kendall의 W검증을 사용하였다. 연구의 결론은 외국인 환자를 유치하는 기관은 중증 외국인 환자 치료 확대로 위기상황을 기회로 바꾸는 계기가 필요하겠다. 또한 가상, 증강현실을 통해 해외 방문이 어려운 상황에서 병원에 대한 친숙함과 신뢰를 얻을 수 있고 언택트 시대에 감염의 위험을 막고 환자를 보호 할 수 있는 원격지료 서비스를 시행함으로써 국내 입국을 하지 않고도 현지에서 의료의 혜택을 누릴 수 있다고 하겠다. 그리고 블록체인은 환자의 정보 보완을 유지하며 안전하게 공유가 가능하고 가상화폐 등을 활용한 지불 수단을 이용해 고객의 불편함을 최소화 할 수 있고 마지막으로 스마트 헬스 케어는 장소와 관계없이 환자를 관리하고 정보를 제공 할 수 있다.

• 대한후두음성언어의학회지
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• 제33권2호
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• pp.103-109
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• 2022

Background and Objectives The Voice Perceived Present Control scale (VPPC) has been developed to provide better insight into patients' perceived control over their thoughts or behaviors related to voice disorders. The objective of the present study was to validate the Korean VPPC (K-VPPC) by evaluating its internal consistency and reliability. Materials and Method All items of the English VPPC were translated into Korean. Content validity was analyzed through three Delphi survey rounds by an expert panel (n=44) with active clinical and research experience in treating dysphonic patients. Twenty-three patients with a heterogeneous diagnosis of dysphonia and twenty-three gender-matched vocally normal controls (total n=46) were asked to complete the K-VPPC and the Korean Voice Handicap Index-10 (KVHI-10). Psychometric properties including internal consistency and reliability were evaluated to examine the appropriateness of cross-cultural use of K-VPPC. Results Cronbach's alpha coefficient of K-VPPC was 0.89 for dysphonic patients, indicating good internal consistency in clinical samples. Furthermore, patients with dysphonia scored significantly lower on the total score of K-VPPC and higher on voice handicap than the vocally normal controls. Spearman's correlation coefficients indicated an inverse and moderate association between the K-VPPC and all domains of KVHI-10 (Spearman's r=-0.44- -0.68). Conclusion The findings of the current study indicated that the K-VPPC is a valid and reliable tool for the assessment of perceived control in Korean patients with dysphonia. Therefore, the K-VPPC could be a useful and complementary tool for the comprehensive evaluation of dysphonia, thereby improving care in Korean patients with voice disorders.

• 대한지구과학교육학회지
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• 제16권1호
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• pp.87-102
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• 2023

이 연구의 목적은 지역사회의 시민 강사 등이 지역사회 문제에 기반한 초등학생용 기후변화교육 프로그램을 개발할 때 반드시 포함해야 할 내용을 분석틀로 제안하는 것으로, 이 분석틀의 개발을 위해 현장 및 기후환경교육 전문가 24명에게 총 7번의 자문을 받았다. 최종 분석틀은 문항별 내용타당도는 I-CVI와 S-CVI 계수로, 전문가 패널 간 신뢰도는 Fleiss' Kappa 계수를 통계적으로 검증하였다. 최종 분석틀은 3개의 분석 영역(프로그램 목적 - 프로그램 내용 - 프로그램 평가)과 7개의 분석 항목, 7개의 분석 지표와 세부 설명으로 구분하여 개발했다. 특히 분석 지표에 대한 세부 설명란을 추가하여 내용타당도와 신뢰도를 높임으로써 객관적인 분석틀로서의 성격을 확고히 했다. 이 연구에서 제안한 지역사회 기반 초등학생용 기후변화교육 프로그램 분석틀이 체계적인 프로그램 개발에 도움이 되길 기대한다.