• 한국병원경영학회지
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• 제28권1호
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• pp.37-51
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• 2023

Purposes: There exist many non-covered services that the National Health Insurance does not cover, and thus, their prices are set by individual health care providers. However, little study has been done to investigate how hospitals set prices for those services. The purpose of this study is to examine the relationship between ownership, profitability, and prices of those services for a sample of general hospitals. Methodology/Approach: Data regarding the prices of major non-covered services (e.g., upper-level hospital room fees, MRI, Da 7inci robot surgery, and LASIK) were obtained from the Health Insurance Review and Assessment Service and the financial information, as well as other characteristics, were derived from the financial reports from the Korea Health Industry Development Institute. Descriptive statistics, t-tests, and multiple linear regression analyses were used to test the relationship between the independent variables and the dependent variables. Findings: Hospitals owned by private universities appeared to have higher prices for non-covered services while regional public hospitals tend to have lower prices. Profitability, measured by operating margin, was not significantly related to the prices. Hospitals that charge higher prices were more likely to be located in the capital area (Seoul, Incheon, and Gyeonggi), and to employ larger number of personnel. Practical Implications: Public hospitals tend to charge lower prices for non-covered services. Relative market power appears to be related to pricing. Further research is needed to investigate whether such a relationship varies over time and its effects on the quality and access.

• 한국정보교육학회:학술대회논문집
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• 한국정보교육학회 2021년도 학술논문집
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• pp.113-121
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• 2021

본 연구는 AI교육 선도학교 착수워크숍 컨설팅 연수와 창의융합형 정보교육실 컨설팅 연수의 운영 후, 온라인 설문 조사 실시 및 설문 결과를 분석하여 제시하고자 하였다. 이를 통해 AI교육 선도학교 컨설팅 연수와 같은 지원이 필요하다는 인식을 가지고 있음을 확인하였고 전국단위의 선도학교 운영 측면에서 우수사례 공유 및 효율적이고 유연한 운영체계를 공유할 수 있도록 네트워크가 활성화되어야 함을 알 수 있었다. 또한 설문 대상자들은 AI교육 관련 역량의 중요성을 인식하고 있는 반면에 본인의 AI교육 관련 역량에 대해 낮게 인식하고 있음을 파악하였고 이에 대해 체계적이고 맞춤형 AI교육 관련 역량 강화를 위한 다양한 지원이 필요함을 인식하였다.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제29권4호
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• pp.69-77
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• 2023

Purpose: During the COVID-19 pandemic, there have been many cases of converting regular hospital wards into temporary negative pressure isolation wards. The purpose of this study is to evaluate the minimum airflow differences that satisfies the pressure difference criteria(-2.5 Pa) according to airtightness of switching type wards, in preparation for utilization of aging regular wards as negative pressure isolation wards. Methods: Visual inspection and field measurements were conducted using blower door to evaluate airtightness of 5 hospital wards. CONTAM simulation was used to assess the airflow differences when pressure difference between the corridor and wards met the criteria at various levels of airtightness. Results: The ACH₅₀ of evaluated wards ranged from 19.3 to 50.1 h^-1 with an average of 37.0 h^-1, indicating more than four times leakier than other building types. The minimum airflow differences increased as the airtightness of the wards decreased and the size of the wards increased. Implications: When operating rapidly converted negative pressure isolation wards, understanding airtightness is crucial for determining the minimum airflow differences to maintain the pressure differences. The analysis of this study suggests that improving the airtightness of aging rooms is essential and the minimum airflow differences should be suggested considering both the airtightness and size of rooms.

• 동서간호학연구지
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• 제29권2호
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• pp.106-116
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• 2023

Purpose: The purpose of this study was to identify the impact of obesity on the incidence of diabetes mellitus in adults with pre-diabetes. Methods: This study employed a longitudinal study design and utilized secondary data drawn from the Korean Genome and Epidemiology Study. This study used data from a sample of 3,693 adults with prediabetes who were followed every two years from 2001 to 2018. Statistical data analysis for frequency, number of cases per 1,000 person-years, log-rank test, Kaplan-Meier curve, and Cox's proportional hazards regression analysis was performed using IBM SPSS statistics version 26. Results: During the observation period, there were 1,309 (35.4%) patients with diabetes, and the total number of person-years was 35,342. The incidence of diabetes was higher in the obese group compared to the normal weight group (body mass index [BMI]: hazard ratio=1.57, 95% confidence interval [CI]=1.40~1.77, waist: hazard ratio=1.55, 95% CI=1.38~1.76, waist to hip ratio [WHR]: hazard ratio=1.53, 95% CI=1.24~1.89, body fat [BF] (%): hazard ratio=1.42, 95% CI=1.27~1.61). Conclusion: An increase in BMI, waist circumference, and WHR, which are indicators of obesity, can exacerbate the risk factors for diabetes. Thus, a decrease in BMI, waist circumference, and WHR is necessary to prevent pre-diabetes. In particular, health care professionals should provide individualized weight management program interventions, including adult obesity programs and obesity counseling in partnership with local health departments, to reduce BMI and waist circumference in people at high risk for diabetes.

• Journal of Chest Surgery
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• 제56권6호
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• pp.420-430
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• 2023

Background: This study provides an update to a landmark 2004 report describing demographics, training, and trends in adherence to thoracic surgery practice standards in Canada. Methods: An updated questionnaire was administered to all members of the Canadian Association of Thoracic Surgeons via email (n=142, compared to n=68 in 2004). Our report incorporates internal data from Ontario Health and the Canadian Partnership Against Cancer. Results: Forty-eight surgeons completed the survey (male, 70.8%; mean±standard deviation age, 50.3±9.3 years). This represents a 33.8% response rate, compared to 64.7% in 2004. Most surgeons (69%) served a patient population of over 1 million per center; 32%-34% reported an on-call ratio of 1:4-1:5 days, and the average weekly hours worked was 56.4±11.9. Greater access to dedicated geographic units per center (73% in 2021 vs. 53% in 2004) has improved thoracic-associated services and house staff, notably endoscopy units (100% vs. 91%), with 73% of respondents having access to both endobronchial and endoscopic ultrasound. Access to thoracic radiology has also improved, particularly regarding positron emission tomography scanners per center (76.9% vs. 13%). Annual case volumes for lung (255 vs. 128), esophageal (41 vs. 19), and mediastinal resections (30 vs. 13), along with hiatal hernia repair (45 vs. 20), have increased substantially despite reports of operating room availability and radiology as rate-limiting steps. Conclusion: This survey characterizes compliance with current practice standards, addressing the needs of thoracic surgeons across Canada. Over 85% of respondents were aware of the 2004 compliance paper, and 35% had applied for resources and equipment in response.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제30권1호
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• pp.37-44
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• 2024

Purpose: The planning of medical facilities involves formulating a comprehensive medical basic plan, translating it into spatial dimensions through a space program. Feasibility assessment often relies on empirical methods like floor area per bed. However, with the shift towards specialized medical concepts, proportional scaling to bed numbers is challenging. This study proposes scale planning improvements during the feasibility assessment stage for comprehensive hospitals, analyzing cases using area determination factors and standard areas based on medical resources. Methods: The Korean Development Institute's Public Investment Management Center (KDI) identified issues in the scale determination of medical facilities in the Preliminary Feasibility Study Guidelines and investigated alternative approaches for determining the scale of a case that passed the preliminary feasibility study in 2019. The study assessed the feasibility of applying individual factors to determine not only the number of beds but also the scale at the sector and department levels. Additionally, a statistical analysis was conducted to examine the correlation between the total number of beds and various area determination factors. Results: Results suggest a strong correlation between total beds and major equipment needs, but in hospitals with <500 beds, this correlation weakens. Ward section scale is better calculated per ward type, not just total beds. Outpatient department scale depends on specialists, influencing treatment room numbers. Medical personnel play a crucial role in determining the scale of sections like rehabilitation therapy rooms, operating rooms, dialysis rooms, and overall facility scale.

• International Journal of Advanced Culture Technology
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• 제12권2호
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• pp.368-374
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• 2024

During an X-ray examination, the beam of radiation is dispersed in many directions. We believe that managing radiation dose is about providing transparency to users and patients in the accurate investigation and analysis of radiation dose. The purpose of measuring the radiation dose as a function of location is to ensure that medical personnel using the equipment or participating in the operating room are minimally harmed by the different radiation doses depending on their location. Four mobile diagnostic X-ray units were used to analyze the radiation dose depending on the spatial location. The image intensifier and the flat panel detector type that receives the image analyzed the dose by angle to measure the distribution of the exposure dose by location. The radiation equipment used was composed of four units, and measuring devices were installed according to the location. The X-ray (C-arm) was measured by varying the position from 0 to 360 degrees, and the highest dose was measured at the center position based on the abdominal position, and the highest dose was measured at the 90° position for the head position when using the image intensifier equipment. The operator or medical staff can see that the radiation dose varies depending on the position of the diagnostic radiation generator. In the image intensifier and flat panel detector type that accepts images, the dose by angle was analyzed for the distribution of exposed dose by position, and the measurement method should be changed according to the provision of dose information that is different from the dose output from the equipment according to the position.

• Journal of Chest Surgery
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• 제30권10호
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• pp.966-972
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• 1997

1994년 6월부터 1996년 8월까지 한림대학교 강동성심병원에서는 총 88례의 관상동맥우회 술을 시행하였 튼데 그중 13례를 응급으로 시행하였다. 응급수술 시행환자의 남녀비는 3:10으로 선택수술의 41:34에 비 하여 여자가 많았으며 나이는 평균 65.5+/-6.3(56-80)세로 선택수술의 58.9+/-10.3(35-82)세와 유의한 차이가 없었다. 응급수술의 적응증은 수회의 심율동전환(cardioversion)에도 반응하지 않는 심실성 빈맥환자 1례를 제외한 12례가 심인성 쇼크였는데 심인성 쇼크의 원인으로는 진행성 심근경색이 6례, 경피적 관상동맥성형술 실패가 4례, 급성 심근경색이 1례, 그리고 급성심근경색후 심실중격파열이 1례를 차지하고 있었다. 13Bl 의 환자중 5례의 환측는 심인성 쇼크가 발생한 후 2시간 이내에 수술을 시작할수 있었으나 나머지 8례의 환자는 3시간 내지 10시간이 지나서야 수술을 시작할수 있었다. 13례의 환자중 12례의 환자에서는 통상의 관상동맥우회 술을 시행하였는데 그중1례에서는 파열된 심실 중격 봉합을 동반시행하였으며 좌주관상동맥에만 국한된 병변이 있었던 1례의 환자에서는 좌주관상동맥 성형술을 실시하였다. 통상의 관상동맥 우 \ulcorner술을 시행한 12례의 환자에서는 37개의 문합을 실시하여 환자 당 평균 3.1개를 실시하였는데 선택적인 수술과는 달리 내흉동맥은 3례의 환자에서만 사용할수 있었으며 나머지는 모두 복제정맥을 이용한 문함을 시행하였다. 수술하는데 필요한 대동맥차단시간은 평군 96+/-25(65-140)분이었으며 인공심폐기 가동시간은 평균 281+/-117(136-592)분으로 손상된 심근의 회복을 위한 심보조시간이 상당부분을 차지하고 있었다. 수술후 5례의 환자가 사망하여(38.5%) 선택수술의 4.0%(3/75)에 비하여 높은 사망률을 보이고 있었으며 사망원인으로는 좌심실기능부전이 3례,심실성 인맥이 1례,그리고 다장기 기능부전이 1례를 차지하고 있 었다. 또한 3례의 환자에서 수술주위 심근경색, 종격동염,그리고 상부위장관출혈, 등의 합병증이 발생하 였으나 별다른 후유증없이 치유되었다. 생존한 환자 8례는 모두 현재 외래에서 특별한 문제없이 추적관 찰중이다. 결론적으로 아직 사망률이 높기는 하지만 심인성 쇼크 등과 같은 중환자들에게서 의 적극적인 치료는 이러한 환자들을 살릴수 있는 유일한 방법이라 생각되며 이러한 치료에 있어서 가장 중요한 점은 심장에 비가역적인 손상이 발생하기 전에 시행하는 조기수술요법이라 생각된다.

• 한국조경학회지
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• 제48권5호
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• pp.80-88
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• 2020

2019년 3월 미세먼지 비상저감조치가 일주일 동안 발령되면서, 미세먼지로 인한 국민의 불안감은 점차 가중되고 있다. 본 연구는 공기정화식물이 적용된 바이오필터의 다중이용시설 내 적용성 평가를 위해 입자상 오염원의 실내 연속방출환경을 조성하여 오염원 저감효과에 대한 측정방법을 제안하고, 시스템의 실내공기질 개선 여부를 확인할 수 있는 기초연구를 진행하였다. 강의실을 대상으로 춘절기에 모니터링 1시간 전 모기향을 오염원으로 배경농도를 조성한 후, 스케줄에 따라 2시간 관수, 1시간 송풍하여 미세먼지의 저감능을 확인하였으며, 바이오필터 2m 전방에 PM₁₀, PM_2.5 및 온습도 센서를 설치하고, 3개 송풍구 중 중앙에 풍속 프로브를 설치하여 시계열 모니터링을 수행하였다. 바이오필터에 구비된 총 3개소의 송풍구 평균 면풍속은 0.38±0.16 m/s로 댐퍼 면적이 제외된 송풍구별 면적 0.29m×0.65m을 적용한 총 공조풍량이 776.89±320.16㎥/h로 산출되었다. 시스템 가동으로 평균온도 21.5~22.3℃, 평균상대습도 63.79~73.6%를 유지하여, 선행연구의 다양한 조건별 온습도 범위에 부합하는 것으로 판단된다. 시스템 공조부 구동을 통해 급격하게 상대습도를 상승시키는 효과를 효율적으로 운용할 경우, 계절에 따른 실내 미세먼지 저감과 적정한 상대습도 확보도 가능할 것으로 판단된다. 미세먼지 농도는 바이오필터 시스템 가동 전의 모든 주기에서 상승 현상이 동일하게 집계되었으며, 시스템 가동 후 1주기 송풍구간(B-1, β=-3.83, β=-2.45)에서 미세먼지(PM₁₀)는 최대 28.8% 수준인 560.3㎍/㎥, 초미세 먼지(PM_2.5)는 최대 28.0% 수준인 350.0㎍/㎥까지 저감되었다. 이후 미세먼지(PM₁₀, PM_2.5)의 농도는 2주기 송풍구간 감소(B-2, β=-5.50, β=-3.30)로 각각 최대 32.6% 수준인 647.0㎍/㎥, 32.4% 수준인 401.3㎍/㎥까지 저감되었고, 3주기 송풍구간감소(B-3, β=5.48, β=-3.51)로 최대 30.8% 수준인 732.7㎍/㎥, 31.0% 수준인 459.3㎍/㎥까지 저감된 것으로 확인되었다. 본 연구는 식생 바이오필터의 다중이용시설 내 설치와 유관한 관련 표준 및 규정을 참조하여, 객관적인 성능평가환경의 구축 방안을 제시할 수 있었다. 이를 통해 일반 강의실 환경 내에 보다 객관화된 모니터링 인프라를 조성하여, 상대적으로 신뢰성 있는 데이터 확보가 가능했던 것으로 판단된다.

• Journal of Trauma and Injury
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• 제18권2호
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• pp.101-106
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• 2005

Purpose: The number of the deceased from free-fall is increasing nowadays. Free-fall comes to a great social problem in that even the survivor will be suffering for cord injury or brain injury, and so on. We analyzed the cases of free-fall patients to find out whether the injury severity is mainly correlated with the height of fall. Methods: We retrospectively investigated the characteristics of patients, who fall from the height above 2m from January 2000 to August 2004. We excluded the patients who transferred to other hospital, transferred from other hospital, and not known the height of fall. 145 patients were evaluated. Variables included in data analysis were age, height of fall, injury severity score (ISS), the being of barrier, and the survival or not. To find out the correlation between height of fall and death, we used receive operating characteristics (ROC) curve analysis. Results: The mean age of patients was $36.5{\pm}19.4$ years old. 110 were male and 35 were female. Mean height of fall was $11.1{\pm}8.5m$. 51 patients (35.2%) were died and 30 patients of them (58.9%) got emergency room on dead body. The mean height of fall is $8.9{\pm}5.8m$ for 94 survivors and $15.2{\pm}11.0m$ for the 51 deceased (p<0.001). The area under the ROC curve was 0.646, which means the height of fall was not adequate factor for predicting for death. At 13.5m, as cut?off value, sensitivity is 52.9%, specificity is 86.2%, positive predictive value is 67.5% and negative predictive value is 77.1%. There were statistical differences in mortality rate and ISS between 'below 13.5m group' and 'above 13.5m group', but there was not statistical difference in head and neck AIS. Conclusion: The height of fall is not adequate factor for prediction of death. So other factors like intoxication or not, the being of barrier or protection device need to be evaluated for predicting of free-fall patient's death.