• 대한치과보철학회지
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• 제46권6호
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• pp.610-619
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• 2008

STATEMENT OF PROBLEM: Factors affecting patients' decision-making for dental prosthetic treatment should be examined in terms of understanding improving patients' oral health. PURPOSE: The main purpose of this dissertation was to investigate patients' dental prosthetic treatment and factors affecting patients' decision-making for dental prosthesis treatment in Deagu and Gyungbook areas. MATERIAL AND METHODS: This study was based on the preliminary survey of dental patients conducted from July 1 to August 31 in 2006. A total of 700 questionnaires had been distributed and 640 were collected. 629 questionnaires were used for the statistical analysis. Descriptive and inferential statistics, such as frequencies, cross tabulation analysis, correlation analysis, logistic regression analysis, and multiple regression analysis were introduced. In the multiple regression analysis and logistic regression analysis, twenty-two independent variables were employed to explore the factors which have impacts on decision-making and satisfaction. RESULTS: The results of this dissertation are as follows: Logistic regression analysis turned out that monthly income, age, degree of expectation, marital status, and employer-insured policy of national insurance statistically increased the odds of decision-making of dental prosthesis treatment. But educational attainment decreased the odds ratio of the decision-making of dental prosthesis treatment. However, the rest independent variables do not have statistically significant impacts on the decision-making of dental prosthesis treatment CONCLUSION: Among independent variables, marital status had the most significant influence on the decision making of dental prosthesis treatment. Finally, suggestions for the future study and policy implications to improve satisfaction of the patients' dental prosthetic treatment were discussed.

• 보건행정학회지
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• 제19권4호
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• pp.66-77
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• 2009

This study aims to examine the effect of socioeconomic status (hereafter, SES) on healthcare utilization of the patients with rare and incurable diseases. Information of 2,973 patients who were self-employed insured and utilized healthcare service in 2007 was drawn from the National Health Insurance (hereafter, NHI) claim data. SES was set as four groups based on the monthly contribution. Outcome variable was the expense for outpatient and in-hospital services, which was log-transformed and square-rooted in oder to obtain normal distribution. Covariates included age, gender, residence and diagnosis. To examine the effects after controlling for covariates, we employed generalized estimating equation model, since patients with the same diagnosis are likely to have similar characteristics of demographics and healthcare utilization. Univariate statistics showed that lower SES was associated with less utilization of healthcare services. After controlling for covariates, a significantly smaller amount of money was expended for the lowest SES group compared to the highest one. Rural residence was associated with less utilization, except that residents in Seoul significantly more utilized outpatient services in tertiary hospitals. Considering that there is a subsidy program for the low income patients, such differences in healthcare utilization according to SES seems to result from the burden of out-of-pocket payments for uncovered services of the NHI.

• 응용통계연구
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• 제21권4호
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• pp.589-602
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• 2008

순위형 다범주 자료에 있어서 범주값의 증감에 대한 설명변수의 특성분석을 위하여 다항로짓모형을 적합하여 분석하고 로지스틱 회귀모형을 적합하여 분석한 결과와 비교하였다. 이를 통하여 장애연금 수급자자료의 재정추계를 위해 필요한 일곱 가지 요인인 성별, 수급나이, 가입기간, 가입종별, 소득활동여부, 소득수준, 장애원인이 장애등급에 미치는 영향을 파악하였다. 일곱 요인 모두 장애응급에 대한 연관성이 있음을 확인하였고 이 가운데 다섯 요인은 장애등급의 증감에 있어서도 일정한 추세를 보였으나, 장애원인과 소득수준은 장애등급의 증감에는 일정한 추세를 보이지 않음을 확인하였다. 본 연구의 결과는 장애연금 관리방안을 모색하는데 있어서 장애등급에 따른 설명 요인의 특성을 반영하는데 필요한 가이드라인을 제공할 수 있을 것으로 기대한다. 장애등급 분류에 있어서 다중분류의 정분류율은 각각 42.56%와 42.43%로 로지스틱 회귀모형의 경우 다중로짓 모형의 경우보다 다소 높았지만 거의 비슷한 정확도를 보였다.

• 대한치과기공학회지
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• 제25권1호
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• pp.119-142
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• 2003

In the present work the knowledge of dental health as well as dental prosthesis has been studied on the basis of analysis of current dental prosthetic treatments for dental diseases prophylaxis and the final decision for dental prosthetic appliance. The results have been analyzed by the current dental health care and the subjective acknowledgement from 700 people of urban as well as rural inhabitance in our country. The results from the present work have been summarized as following: Depending dental status has been shown worse to be in the cases of divorce and bereavement, age and less educated or jobless. It is also interesting to note that the dental status has shown to be even worse than health status. It has been shown that the dental prosthetic treatments have been mainly caused by the oral disease (62.2%) and depend on the age and the educational level. According to the actual status of dental prosthetic treatments, the fixed partial denture was the most case (78.9%) that increased as divorced, bereavement and as less educated, less income, retired and jobless as well as from urban to rural. As a clinic for the dental prosthetic treatments, dental clinics have been most frequent visited as indicated by 59.6%, then the un-licensed dentist (6.5%), then the hospitals (3.7%), then the public health centers (2.2%). Most of those who are older in age, less educated and jobless have been treated by the un-licensed dentists. In point of view on the cost for dental prosthetic treatments, 93.1% have claimed to be too expensive, in as the divorced and the bereaved, the older age, the less educated and the jobless. About satisfaction of dental prosthetic treatments, 51.4% was satisfied, 39.4% was normal and 9.2% was dissatisfied. Most of people experienced increasing levels of satisfaction as their income increase. Most in the age range of 40-60 have wanted to be insured for the dental prosthetic treatments. It is also interesting to note that the older age and the less educated wanted to apply this kind of insurance.

• 한국전자파학회논문지
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• 제17권12호
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• pp.1231-1239
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• 2006

본 연구는 수동 루프 축소 시험 장치를 이용하여 수동 루프 유형별 자기장 저감 효과를 분석하였다. 본 연구에서는 수직 2회선 선로 및 수평 선로를 대상으로 실험을 통하여 향후 실증 시험 선로에 적용할 수동 루프의 자기장 저감 효과를 검토하였다. 그 결과 수동 루프 채용으로 선로 리액턴스 보상이 없어도 50 % 이상의 송전 선로의 자기장 저감 효과를 얻을 수 있음을 확인함으로써 실증 선로 수동 루프 적용 방안을 확보하였다. 대부분 우리나라 송전 선로에 채용되는 수직 2회선 선로에서는 수평 루프보다는 수직 루프가 자기장 저감율에 보다 효과적이었으며 차폐 영역에서도 근거리뿐만 아니라 원거리까지도 효과가 좋음을 알 수 있었다. 또한, 수동 루프를 3 턴으로 설치하는 경우가 1 턴에 비해 2배정도 자기장 저감 효과가 있음을 확인하였다.

• 한국항해항만학회지
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• 제32권3호
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• pp.229-235
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• 2008

이 연구는 침몰사고를 일으킨 선박의 사고에 대한 해양안전심판원의 사고판례와 검정인의 검사보고서를 중심으로 사고를 분석하고, 선박침몰사고에 따른 선체보험약관인 ITC협회약관 및 ISM코드의 적용에 관하여 검토하고자 하였다. 이를 위하여 실제 해양사고의 사례연구를 통하여 사고의 원인에 대한 보험사측의 주장과 선주측의 주장을 다루었다. 선주측이 보험금을 노린 고의침몰이라 주장한 보험사측의 주장과 선원의 과실에 따른 일반적인 해양사고임을 주장한 선주측의 주장에 대하여 ITC협회약관과 ISM코드 내용을 적용해 본 결과, 이 사고의 원인은 선박 운용상 승무원들의 과실에 기인한 인위적인 원인(선원의 악행)에 의해 발생한 것으로 판단되었다. 그러나 선주가 ISM 코드에 따른 상당한 주의의무를 태만히 한 사실이 인정되어 보험회사 측의 주장이 더 설득력이 있는 것으로 받아들여졌다. 따라서 이 사고에 대한 전반적인 고찰을 통해 알 수 있는 것은 선주는 그 선박에 적절한 자격있는 선원을 승선시켜야 할 뿐만 아니라 선박의 안전확보를 위한 ISM Code에 의거한 안전관리시스템 구축과 시행을 형식적이 아닌 실제적으로 철저하게 수행하여 비상사태 시에 적절히 대응할 수 있는 능력을 확보해야 함을 알 수 있었다.

• 실천공학교육논문지
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• 제12권1호
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• pp.187-202
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• 2020

"직업훈련 수강을 하나의 사회적 권리로 인정할 수 있는가? 그리고 개인이 수강하는 직업훈련에 소용되는 재원은 누가 부담하는 것이 타당한가?" 본고는 우리나라의 계좌제훈련을 중심으로 두 가지 이슈를 검토한 후 바람직한 계좌제훈련의 발전 방향을 제시하였다. 국내법에서 직업훈련을 권리로 인정한 명시적인 조문은 없지만 취약계층 등에 대한 국가의 훈련 제공 의무가 부정되는 것은 아니다. 그리고 우리나라의 직업훈련은 고용보험의 직업능력개발사업에 크고 의존하고 있으나, 동 사업은 과거의 훈련의무제를 계수한 사업으로서 고용보험에 가입하지 않은 많은 비정규직 등으로 인해 보험원리가 작동되기 어렵다. 향후 정책 방향은 현재 일반회계와 훈련생 자비부담 비율이 30% 미만이므로 이를 높여 나가는 것이 바람직하며 중장기적으로 계좌제 훈련의 발급 대상은 전국민으로 확대해 나가야 한다. 그리고 이미 제도적으로 마련되어 있는 유급교육훈련휴가, 근로시간단축청구 제도의 활용이 촉진될 수 있도록 노사의 공동노력이 필요하다.

• Archives of Plastic Surgery
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• 제34권3호
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• pp.352-357
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• 2007

Purpose: The coverage of distal soft tissue defects and bony exposure of the lower extremity has long been recognized to be difficult clinical problem. Covering with a local skin flap is usually impractical because of the extensive and deep crush, hence free flap has been used commonly for the coverage of the wound. Although it can provide good results, it has many disadvantages. Designing an adipofascial flap raised on perforating vessels of the posterior tibia artery is a reliable and simple method to perform, and it can solve these problems. Methods: From May 2005 to May 2006, 8 patients underwent reconstruction of lower leg defects utilizing various type of the posterior tibial artery perforator adipofascial flaps. The flap provided a durable and thin coverage for the defect, as well as a well vascularized bed for skin grafting. Results: The flap size ranged $15-80cm^2$, and skin graft was done for the recipient site. The flap were successfully used for the lower extremity reconstruction in most cases. Minor complications occurred in 4 cases. There was no functional disability of the donor site with esthetically pleasing results. Furthermore, these flaps were both easy to raise and insured sufficient arterial blood supply. Conclusion: We believe there are many advantages to this posterior tibial artery perforator adipofascial flap and that it can be highly competitive to the free flaps in the lower extremity reconstruction.

• 의료법학
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• 제8권2호
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• pp.69-118
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• 2007

In providing general medical treatments, the medical service contract between the patient and the doctor is the mutually responsible onerous contract. However, the nature of the mutually assumed contract standings of the patient and the doctor has been changing since the implementation of the national health insurance program. For instance, besides the cases of beyond excessive medical charges and medical negligence, if the doctor charged for his/her medical treatments violating the post-treatment/nursing cover criteria, the overpaid medical charge, regardless of being collected with the patient's consent, has to be refunded back to the patient. Medically needed aspects, treatment results, and unfair benefits favoring the patient are not at all taken into consideration in the health insurance scheme. This makes it easier for patients to get refunds for their share of the medical payments by involving the Health Insurance Review & Assessment Service or the National Health Insurance Corporation, without engaging in civil law suits (for reimbursement claim) against doctors. In other words, the doctor's responsibility to provide medical treatments and the patient's responsibility to pay for the medical treatment provided within the contractual realm are being demolished by the administrational arbitration of the National Health Insurance system. The basic rights of medical service providers, and the patient's right to choose are as important constitutional rights, as the National Health Insurance program, which is essential in the social welfare system. Furthermore, the development of the medical fields should not be prevented by the National Health Insurance system. If the medical treatment services can be divided into necessary treatments, general treatments, and high quality treatments, the National Health Insurance is supposed to guarantee the necessary and general treatments to provide medical treatments equally to all the insured with limited financial resources. However, for the high quality treatments, it is recommended that they should not be interfered by the National Health Insurance system, and that they should be left to the private contract between the patient and the doctor.

• 의료법학
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• 제8권2호
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• pp.9-35
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• 2007

The Health care program in Korea has now been systemized after 30 years of declaring the inauguration of the national health insurance system by the current government. The national health care covering all Korean citizens was achieved after 12 years of implementing the national health insurance and the health care program since 1977. Hundreds of multiple operational agencies managing the insured individually had undergone the amalgamation process from 1998 to 2000, and had been restructured as one agency, the National Health Insurance Corporation. In 2003, the community/area based financial management was also merged together with the employment based financial management. The National health care system of Korea offer various merits, compared with that of other countries, such as health care provision covering all Koreans, low insurance premium, accessibility of medical services/facilities etc. However, there are still some weak features which need to be addressed for improvement; below expectation insurance cover system, mistrust on the medical services, low medical charges resulted from excessive restrictions, and unstable financial status of the national health insurance etc. Therefore, the National health care system should continue to evolve to re-establish itself as more effective national health care system by further strengthening its merits, and by improving its weaknesses; with adopting the positive system to optimize the costs of prescribed medicines/drugs, applying simpler insurance coverage system to calculate the optimum medical charges, promoting private medical insurances, and increasing insurance premium etc.