• 디지털융복합연구
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• 제11권1호
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• pp.339-347
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• 2013

최근 우리나라 중소병의원의 열악한 경영환경은 새로운 전략이 필요하다. 이러한 전략의 하나로서 한국에서 네트워크 병원의 개념이 빠르게 확산되고 있다. 즉 경제학적으로 유효한 규모의 경제를 적절히 활용한 양적 및 질적 측면 모두에서 양질의 의료 서비스를 제공 할 수 있다. 그러므로 본 연구에서는 병 의원이 마케팅 강화전략 차원에서 도입한 네트워크 병원의 이론적 배경과 네트워크병원 시스템 구조를 살펴보고자 한다. 연구모델은 의료환경 변화에 따라 중소 병의원들이 마케팅측면의 단점을 극복하고, 경쟁력 강화차원에서 급증하고 있는 네트워크병원의 SD모델을 개발하고 경영성과를 평가하고 분석하는데 있다. 연구모델은 선행연구에서 도출된 광고, 브랜드로 인한 효과와 교육효과를 네트워크 효과라 정의하였다. 네트워크 병원에 가입된 6개 병원의 가입 전후 각 3개년간의 재무적 자료(2006년~2011년)와 네트워크효과를 반영하여 모델을 개발하였고, 시뮬레이션 결과 경영성과에 미치는 영향이 있는 것으로 나타났고 그 기간은 4년이 지속되는 것으로 분석되었다. 병의원은 지역간 경쟁이 심화되어 마케팅 전략차원에서 네트워크병원에 가입하게 된다. 네트워크병원에 가입으로 인하여 광고 등 브랜드 효과와 정기적으로 시행하는 교육은 경쟁력 향상으로 이어지고 경영성과로 결과가 나타나게 되는데 이러한 결과는 선행연구와 일치하였다. 네트워크 병원은 일부 프랜차이즈 업종에서 나타난 것처럼 초기 신규개원이나 시설개선을 통한 리뉴얼 오픈에 적합하며, 그 효과가 클 것으로 예견된다.

• 한국식품영양과학회지
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• 제11권4호
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• pp.25-30
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• 1982

임신중독증 환자의 식이와 혈청중의 전해질과의 관계를 살펴 보고저 환자의 식단과 혈청중의sodium, potassium, chlorine의 함량을 조사하였다. (1) 환자의 혈청에서 측정된 나트륨 함량은 평균 $147.2{\pm}11.0mEq/l(338.5mg/dl)$로 한국 정상인의 평균치 140mEq/l(322mg/dl)보다 7.2mEq/l(16.5mg/dl)가 높았다. (2) 염소의 함량도 평균 $113.4{\pm}5.6mEq/l(402.5mg/dl)$로서 정상인의 평균치인 103.5mEq/l(365.6mg/dl)와 비교할 때 9.9mEq/l(36.9mg/dl)의 차이를 보여 임신중독증 환자는 정상인보다 혈청중 나트륨과 염소의 함량이 높다는 것을 알 수 있었다. (3) 칼륨 함량은 평균 $4.59{\pm}0.7mEq/l(17.9mg/dl)$로서 정상인의 칼륨 평균치인 4.2mEq/l(16.3mg/dl)보다 0.39mEq/l(1.5mg/dl)의 차이를 보여 정상인과 큰 차이가 없는 것으로 나타났다. (4) 임신 중독증 환자의 식단에서 검출된 식염의 함량은 하루에 평균 $20.84{\pm}2.1g$으로서 정상인의하루 섭취량인 19g보다 1.84g을 더 섭취하고 있는 것으로 나타나 저염식이를 하고있지 않음을 알 수 있었다.

• 한국산학기술학회논문지
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• 제16권2호
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• pp.987-994
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• 2015

본 연구에서는 토빗모형을 이용하여 1인가구의 소비패턴이 연령별, 소득별로 얼마나 다른지 추정하였다. 분석을 위해 2006년부터 2012년까지 통계청 가계동향조사의 지출 데이터를 이용하였다. 추정결과, 음식료품, 주거 및 수도광열, 통신 지출을 제외한 모든 품목에서 1인가구의 소득탄력성은 1보다 크게 나타났으며 품목별로 다른 소비 특성을 보인다는 것을 확인했다. 또한 1인가구의 품목별 소득탄력성은 연령별, 소득별로 크게 차이를 보였다. 향후 1인가구의 관련 정책 또는 기업의 전략을 수립할 때 연령별, 소득별로 차별화된 접근이 필요할 것이다. 특히 기업은 1인가구 중 고소득 미혼자 그룹 등 구매력이 큰 소비자의 소비를 이끌어내는 전략이 필요할 것이다. 1인가구가 증가함에 따라서 음식료품이나 에너지 등과 같은 필수재구매 비중이 줄어들고 서비스에 대한 수요가 늘어날 것이다. 따라서 1인가구 증가에 따른 보건, 의료, 기사지원 등 서비스 시장 확대에 대비한 정책 대응이 필요하다.

• 보건행정학회지
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• 제27권1호
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• pp.56-62
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• 2017

Background: There have been deviations in the regional rate of certification in Korean long-term care insurance (LTCI). This study aimed to explore the determinants of the rate of certification in LTCI. Methods: The panel data of the year 2010-2014 of the 227 National Health Insurance Service (NHIS) regional office were used. Making use of 26 explanatory variables (socio-demographic factors, access to the long-term care services, etc.), we estimated the random effects model using STATA SE ver. 13.0 program (Stata Corp., College Station, TX, USA) and tried to find out the determinants of the regional rate of certification. Results: Estimation results showed that the most important determinants of the regional rate of certification in LTCI are the long-term care infrastructure such as capacity or number of the homecare service institution, sanatorium, or convalescent hospital. The number of the elderly who lives alone and the dimentia patients were positively related to the regional rate of certification in LTCI. Conclusion: The estimation results implied that the regional variation in the rate of certification in LTCI has nothing to do with the NHIS regional offices or their employees. To alleviate the deviation in the regional rate of certification in LTCI, we suggested the analysis of the deviation in the survey checklist. We also proposed to found the regional comprehensive support center to prevent the geriatric illness and to improve the residents' health, etc.

• 한국의료질향상학회지
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• 제7권2호
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• pp.168-179
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• 2000

Background : Economic evaluation of clinical pharmacokinetic consultation services for theophylline, which is being widely used recently, is considered in patients for both proper care and cost efficiency. Mathods : This is a cost-benefit analysis of clinical pharmacokinetic consultation service for theophylline. Trial groups were chosen from 2 general hospitals which was performing clinical pharmacokinetic consultation- services in 1998. Control group was chosen from another one general hospital. The analysis includes 25 patients (sample patients) for trial group and 17 patients for control group. Results : On the basis of incremental analysis, it is estimated that the total (direct and indirect) annual costs of the clinical, pharmacokinetic services of theophylline for the patients in the trial group was about \65 million, whereas total annual benefits from those services was estimated to be about \551 million. The net benefits incurred to the sample patients, thus calculated, was about \485 million per year. In the analysis, we assumed that indirect benefits accruing to those services were non-existent. If that amount was included, the estimated net benefits would be much greater than the calculated one. Conclusion : We found that clinical pharmacokinetic consultation services for theophylline could produce more marginal benefits than marginal costs by those services from the social point of view. More controlled prospective trial in the future would be helpful for affirmation of the results of this study.

• 기본간호학회지
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• 제6권3호
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• pp.583-596
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• 1999

The purpose of this study was to examine the effect of self-care of abdominal surgery patients in surgical intensive care unit after offering preoperative nursing information. This study worked out nonequivalant control group post test only design as suspected experimental study. This subjects of the study were 45 patients, 23 in experimental group and 22 in control group. This study was carried at a university hospital in Taegu between January 12, 1999 and March 13, 1999. The experimental group was supplied with preoperative nursing information and the control group received routine care in ICU. The measuring tools of this study were assessment of the self-care role behavior. The data were analyzed by SPSS computer program, $x^2-test$ and t-test and ANOVA were utilized for testing the difference between the experimental and the control group. The hypothesis was examined by t-test. The result of this study are summarized as follows ; 1) The hypothesis, 'The experimental group will show a higher level of self-care than the control group' was accepted(t=-8.958, p=.000). 2) We could not find any meaningful relation about general characteristics and disease associated characteristics between the experimental and the control group. 3) The self-care behavior scores according to the general characteristics and disease associated characteristics show significant statistical difference by economics status (p=.033). 4) The rate of self-care behavior scores of each questionnaire are below average in the questions that request active activity to prevent postoperative complications From the result of this study, the self-care of the experimental group was higher than those of the control group, and the nursing information can be regarded as an effective nursing intervention for preoperative patients.

• 한국방사선학회논문지
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• 제11권1호
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• pp.19-25
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• 2017

본 연구는 부산광역시 거주민을 대상으로 원전주변 갑상선암 논란에 따른 원자력에 대한 전반적 인식을 분석하기 위해 위험도, 발전방식에 대한 선호도 및 경제성, 사전-사후 원자력에 대한 인식 등을 조사하였다. 그 결과, 원전 주변 갑상선암 논란을 계기로 국민들의 원자력에 대한 인식에 변화가 있는 것으로 나타났으며, 특히 사건 이전과 비교하여 위험성 요인에서 가장 큰 폭의 상승을 보였다(p<0.05). 이러한 원자력 위험성에 대한 부정적 인식은 집단의 차이에 의해 다르게 표출되는 것으로 분석되었다. 이는 과학적이고 객관적인 근거에 입각하기보다는 개인마다 상이한 선행경험이나 다른 사람과의 상호작용을 통해 획득한 정보에 기인하는 것으로 판단된다. 향후 국민들의 수준을 고려한 원자력 정책을 수립하기 위해서는 국민들의 원자력에 대한 태도와 견해를 이해하려는 노력과 무엇보다도 원자력에 대한 과학적 신뢰가 보장되어야 할 것으로 사료된다.

• Clinical and Experimental Pediatrics
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• 제55권4호
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• pp.128-135
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• 2012

Purpose: Unbalanced diets and decreased physical activity have contributed to increased prevalence of obesity and metabolic syndrome in adolescents. We have performed a systematic review and data analysis to examine the association between dietary pattern and metabolic syndrome risk factors in adolescents. Methods: We searched the PubMed and BioMedLib databases for appropriate articles published during the past 10 years and selected 6 articles. The studies reviewed applied factor analysis or cluster analysis to extract dietary patterns. For data analysis, we examined the association between dietary patterns and the prevalence of metabolic syndrome risk factors using data of 3,168 adolescents (13 to 18 years) obtained from 4 consecutive Korean Nutrition Health and Nutrition Examination Surveys (1998, 2001, 2005, and 2007 to 2009). Results: Our systematic review confirmed that western dietary patterns are positively associated with metabolic syndrome risk factors such as obesity and elevated triglycerides, while traditional dietary patterns were negatively associated. Data analysis found that the number of adolescents aged 16 to 18 years who had "Rice & Kimchi" dietary pattern decreased, while the number having western dietary patterns increased during the 1998 to 2009 time frame. There were no changes in the dietary patterns in adolescents aged 13 to 15 years. The risk of elevated serum triglycerides and reduced serum high density lipoprotein cholesterol was high in the "Rice & Kimchi" dietary pattern compared to the other dietary pattern groups. Conclusion: Because adolescents' dietary patterns are changing continuously and have long-term effects, further studies on the dietary patterns of adolescents and their health effects into adulthood are necessary.

• 대한간호학회지
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• 제38권3호
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• pp.363-371
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• 2008

Purpose: This analysis was conducted to evaluate the cost-effectiveness of gemcitabine-cisplatin chemotherapy for non small-cell lung cancer patients in an outpatient setting compared with the traditional inpatient setting. Methods: A cost-effective analysis was conducted from a societal perspective. The effects of treatment, which was measured as an adverse event rate, were abstracted from a published literature search and empirical data from one university hospital. The costs included both direct and indirect costs. Direct costs included hospitalizations, outpatient visits, and lab tests. Pharmaceutical costs were excluded in analysis because they were same for both options. Indirect costs included productivity loss of patients as well as care-givers. In order to determine the robustness of the results, sensitivity analysis on treatment protocol was conducted. Results: Literature search showed no difference in adverse effect rates between inpatient treatment protocol and outpatient treatment protocol. Therefore, this analysis is a cost-minimization analysis. Cost-savings in the outpatient setting was 555,936 won for one treatment cycle. Our sensitivity analysis indicated that the outpatient chemotherapy still showed cost-savings, regardless of changes in treatment protocol. Conclusion: The outpatient gemcitabine-cisplatin chemotherapy for non small-cell lung cancer resulted in cost savings compared to inpatient chemotherapy. More importantly, outpatient chemotherapy could improve the utilization of health service resources in terms of available beds.

• Journal of Preventive Medicine and Public Health
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• 제46권4호
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• pp.201-209
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• 2013

Objectives: The goal of this study was to perform an economic analysis of a primary stenting with drug-eluting stents (DES) compared with bare-metal stents (BMS) in patients with acute myocardial infarction (AMI) admitted through an emergency room (ER) visit in Korea using population-based data. Methods: We employed a cost-minimization method using a decision analytic model with a two-year time period. Model probabilities and costs were obtained from a published systematic review and population-based data from which a retrospective database analysis of the national reimbursement database of Health Insurance Review and Assessment covering 2006 through 2010 was performed. Uncertainty was evaluated using one-way sensitivity analyses and probabilistic sensitivity analyses. Results: Among 513 979 cases with AMI during 2007 and 2008, 24 742 cases underwent stenting procedures and 20 320 patients admitted through an ER visit with primary stenting were identified in the base model. The transition probabilities of DES-to-DES, DES-to-BMS, DES-to-coronary artery bypass graft, and DES-to-balloon were 59.7%, 0.6%, 4.3%, and 35.3%, respectively, among these patients. The average two-year costs of DES and BMS in 2011 Korean won were 11 065 528 won/person and 9 647 647 won/person, respectively. DES resulted in higher costs than BMS by 1 417 882 won/person. The model was highly sensitive to the probability and costs of having no revascularization. Conclusions: Primary stenting with BMS for AMI with an ER visit was shown to be a cost-saving procedure compared with DES in Korea. Caution is needed when applying this finding to patients with a higher level of severity in health status.