• Journal of Radiation Protection and Research
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• 제30권1호
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• pp.9-15
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• 2005

전산화 단층촬영검사 시 환자가 받는 피폭선량과 장치 이용 실태를 파악하기 위한 목적으로 대한병원협회에 등록된 전국의 278개 의료기관에 설문지를 발송하여 설문에 응답한 161개 의료기관의 자료를 분석하여 다음과 같은 결과를 얻었다. 1. 검사의 부위별 촬영분포는 Brain(40.7%), Abdomen(27.8%), Chest(15.7%), Spine(4.8%), Pelvis(4.1%), PNS(3.2%) Facial bone(2.5%), Extremity(1.1%)등으로 Brain검사가 가장 많았다. 2. 검사 부위별 선량지수에 대한 통계는 성인의 경우 Brain 38.0mGy, Chest 10.1mGy, Abdomen 12.0mGy, Pelvis 13.2mGy, PNS 27.5mGy, Facial bone 28.6mGy, Spine 26.0mGy, Extremity 13.5mGy이었고, 유아의 경우 Brain 13.6mGy, Abdomen 6.2mGy 이었다. 3. 검사부위별 촬영조건에 대한 통계는 관전압 $100kVp{\sim}120kVp$, 관전류 $100mA{\sim}250mA$, 조사시간은 1초${\sim}$2초를 가장 많이 사용하고 있었다.

• 대한방사선기술학회지:방사선기술과학
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• 제14권1호
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• pp.29-44
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• 1991

A Study on the distribution and types of the total 40 CT units, as of 1st October 1990, in Pusan area(29 for whole body CT units, 11 for brain CT units) were carried out during the period from January 1989 to December 1989 to find out the status of operation and utilization of whole body CT units. The results were as following ; 1. As of 1st October 1990 in Pusan area, a total of 40 CT units(29 for whole body CT units, 11 for brain CT units) were set up and operated. The number of cases of CT examination performed per day per unit were appeared to be less than 5 cases among 59.5% of CT units, and 2.7% of the total units has peformed more than 16 examinations. 2. The CT units under operation occupied 93.5% of the total and 2.6% of the total units was not properly been operated due to mechanical breakdown. This results is appeared to be better than other reports. 3. The average number of scanning per week for each CT were 35 cases and the average days under operation of the unit per week were 6.7 days. Consequently, the average days under operation of units was higher than that of the other reports, but the average number of scanning was lower. 4. The cases referred from other institutes to hospitals were 6.4% of total cases. 5. As a site of scanning, the brain appeared most frequently with 71.2% of the total cases and followed by spine 12.4%, abdomen 8.5%, and thorax 3.6%, respectively. 6. Positive rate by scanning was 70.8% of total cases, and it was 98.9% with thorax, abdomen 96.3%, spine 93.1%, and brain 38.4%, respectively. According to the results of this study, it is highly recommended that the regulations and the guidelines for setting-up of such high cost medical equipments as CT units be provided in order to ensure the cost-effectiveness of the system.

• 대한전자공학회:학술대회논문집
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• 대한전자공학회 2002년도 ITC-CSCC -1
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• pp.184-187
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• 2002

Two-dimensional (2-D) X-ray computerized tomography (CT) equipments are widely used in industrial and medical fields, and nowadays studies on reconstruction algorithm for 3-D cone-beam acquisition systems are active for better utilization. The authors recent-By have proposed a fast reconstruction aigorithm using tree-structured filter bank for 2-D C1, and shown the algorithm is applicable to an approximate reconstruction of 3-D CT. For exact 3-D CT reconstruction, however, we have to backproject 1-D signal into 3-D space. This paper proposes a fast implementation method for this back-projection by use of tree-structured filter bank. and shows the proposed method works approximately 700 times faster than the direct one with almost same reconstruction image quality.

• 대한방사선기술학회지:방사선기술과학
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• 제8권2호
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• pp.29-45
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• 1985

Computed Tomography Scanner (CT) is highly expensive in operation as well as purchasing. That reason may cause not only to increase the burden of patients but also to waste the capital resources leading to financial difficulties. However the numbers of CT installed throughout the country is increasing, because of efficiency in medical care, patient's concern, competitions among the hospitals within the same area. In the non-Metropolitan area the scanners were expected to be less utilized and less profitable. Nine hospitals equipped with the CT were studied on the utilization of that equipment during the period from November 1984 to February 1985 in non-Metropolitan area and break-even point in one hospital was analyzed for estimating profitabilities. The results were as follows ; 1. Among those nine hospitals, four hospitals had less than 400 beds, which is one of the restrictive minimum standards on the installation of Whole-body Computed Tomography Scanner. 2. The operating time during the normal operation period was longer than those of any other studies, but the accumulated down time was also longer than those of any other studies. The average number of scanning per week for each CT was 45, while the estimated number of for the break-even point was 56.7 cases. 3. When the downtime was excluded in calculating the average operation would be much closer to the cases for the break-even point. Therefore the break-down of the equipment was to be a main cause of the low profitability. 4. The average scanning rate for head area was 33.6%, however three of the nine hospitals showed about 20%. 5. If scanning ratio for the body parts excepting head was increased, the number of scanning for the break-even point would be diminished. 6. The small size hospital especially located near the Metropolitan area showed largest loss in the CT operation. In purchasing the highly expensive equipments in hospitals, demand should be taken into account and planning is recommended.

• 보건행정학회지
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• 제2권2호
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• pp.194-220
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• 1992

In recent years there has been a rapid influx of high cost MRI equipment into Korea. This diffusion has raised concerns about the changes it will bring for the health care utilization. Therefore, the purpose of this study is to identify socio-economic characteristics of MRI uses in Korea. A structured questionnaire was designed for this purpose, and 1, 091 users were surveyed at the 35 MRI units of 33 hospitals during a week, sometimes March 1992. The study reveals that high cost technology such as MRI, CT scanner is so prevalent in Korea. This is particularly the case in metropolitan areas. Among others, Seoul has the highest percentage of MRI equipment, 51.05%, Pusan 12.10% and Kwangju 11.9%. Unfortunately, most high cost technology equipments are foreign products. Thus, hospitals with such a high cost technology have difficulties in maintenance of the equipment. The average performance of MRI equipment has declined from 10.2 cases per day in 1988 to 7.16 cases in March 1992. Due to the rapid increase, the performance of MRI equipment seems to be deterioration. Male usere are dominant in the case of MRI use. The utilization rate has positively increased with the rise of educational level of users. The same is true for the level of income; the MRI utilization rate by income level shows that it is negatively proportional to income, which indicates that the poor have difficulties in the use of high cost technology. Particularly, the cost of MRI is so high that ordinary patients are unable to pay for it. For example, 86.3% of respondents have answered that the cost is too high even though they are insured by health insurance. This is the first empirical study on the use status of MRI. The information obtained in this study is sufficient to maintain that the Korean health insurance programme is urgently in need of improving the insurance benefit schemes. The easiest way to do this is to include provision of high cost technology service into the benefit package.

• 한국의학물리학회지:의학물리
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• 제16권1호
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• pp.10-15
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• 2005

IAEA는 영상의 질에 영향을 주지 않는 범위에서 피부흡수선량의 기준선량을 제시하였다. 이러한 개념은 점차적으로 국제적인 기준으로 사용하게 되었다. 이 기준선량은 강제사항이 아니며 권고사항이지만 방사선촬영에서 아주 훌륭한 기준이 된다. 그러나 IAEA에서 제공한 선량기준은 서양 사람을 기준으로 개발된 것이어서 우리나라 사람에게는 맞지 않고, 상대적으로 우리나라의 환자선량은 적으리라 예상된다. 따라서 방사선촬영 시 촬영부위에 따른 환자 피폭선량에 대한 기준을 따로 개발해야 할 필요가 있다. 본 연구팀은 병원협회에 등록되어 있는 종합병원 278개를 대상으로 환자 피폭에 대한 설문조사를 실시하였다. 설문회수율은 57.9%였으며 각 병원에서 답한 촬영조건을 기초로 NDD법을 이용하여 환자 피폭선량을 계산하였고 방사선장치의 이용현황을 분석한 결과는 다음과 같다 1) 방사선장치의 현황은 일반촬영장치가 42.0%, 투시촬영장치가 29.4%, 치과장치가 13.2%, CT 장치가 8.1% 그리고 유방촬영장치가 7.2%로 나타났다. 2) 방사선장치의 정류방식에 따른 분류는 삼상장치가 29.9%, 인버터장치가 29.5%, 단상장치가 25.5%, 콘덴서방식이 9.0% 그리고 무응답이 6.0%였다. 3) 방사선장치의 수광방식에 따른 분류는 F/S 방식이 46.8%, CR 방식이 26.6%, DR 방식이 17.7% 그리고 무응답이 8.9%로 나타났다. 4) 방사선 촬영건수는 흉부가 49.2%, 척추가 16.8% 그리고 복부가 12.7%순으로 나타났다. 5) 환자 피폭선량은 두부 전후방향촬영 2.23 mGy, 복부 전후방향촬영 3.20 mGy 그리고 흉부 후전방향촬영 0.28 mGy로 나타났다.

• 보건행정학회지
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• 제5권2호
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• pp.35-69
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• 1995

The managerial environment of hospitals in Korea characterized by low levels of medical insurance fees is worsening by increasing government regulations as to the utilization of medical services, rising costs of labor, material, and medical equipments, growing patient expectations concerning the quality of services, and escalating competitions among large hospitals in the market. Hospitals should seek for their survival strategies in this harsh environment and they should have information about costs of their products in doing so. However, it has not been available due to the complexity of the production process of hospital services. The objectives of this study were to develop a service-based cost accounting model and to apply the developed model to a study hospital to obtain cost information of hospital services. A model commonly used for the job-order product cost accounting in the manufacturing industry was modified for the use in hospitals in Korea. Actual costs, instead of standard costs, incurred to produce a unit of services during a given period of time were estimated in the model. Data required to implement the model included financial information, statistics for the allocation of supportive cost center costs to final cost centers, statistics for the allocation of final cost center costs to services, and the volume of each services charged to patients during a study period. The model was executed using data of a university teaching hospital located in Seoul for the fiscal year 1992. Data for financial information, allocation statistics fo supportive service costs, and the volume of services, most of them in electronic form, were available to the study. Data for allocation statistics of final cost center costs were collected in the study. There were 15 types of evaluation and management service, 2, 923 types of technical service, and 2, 608 types of drug and material service charged to patients in the study hospital during the fiscal year 1992. Labor costs of each of seven types of pesonnel, material costs of 611 types of drugs and materials, and depreciation costs of 212 types of medical equipments, miscellaneous costs, and indirect costs incurred in producing a unit of each services were estimated. Medical insurance fees for basic services such as evaluation and management of inpatients and outpatients, injection, and filling prescriptions, and for operating procedures were found to be set lower than costs. Infrequent services which use expensive medical equipments showed negative revenuse as well. On the other hand, fees for services not covered by the insurance such as CT, MRI and Sonogram, and for laboratory tests were higher than costs. This study has a significance in making it possible for a hospital to obtain cost information for all types of services which produced income based on all types of expenses incurred during a given period of time. This information can assist the management of a hospital in finding an effective cost reduction strategy, an efficient service-mix strategy under a given fee structure, and an optimum strategy for within-hospital resource allocations.

• 대한방사선기술학회지:방사선기술과학
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• 제33권2호
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• pp.109-120
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• 2010

치과 X선 검사 시 환자선량의 권고량 가이드라인을 개발하기 위해서 우선 국내 치과방사 선의 현황 및 이용 실태를 설문조사하여 비교분석하였다. 응답을 받은 77곳의 치과병 의원 중에서 치과대학이 있는 치과대학병원을 A그룹(11곳), 치과대학이 없는 대학병원을 포함한 치과병원을 B그룹(30곳), 치과의원을 C그룹(36곳)으로 분류하였다. 그룹별로 분석한 결과는 다음과 같았다. 치과병 의원 한 곳당 평균 unit chairs수는 A그룹 140.2개, B그룹 15.3개, C그룹 5.8개, 평균치과의사수는 A그룹 112.6명, B그룹 7.3명, C그룹 1.7명, 평균방사선사수는 A그룹 3.1명, B그룹 0.5명, C그룹에는 한 명도 없었고, 평균치과위생사수는 A그룹 19.7명, B그룹 12.5명, C그룹 3.3명이었다. 설치된 치과용 X선장치의 평균보유수는 A그룹 14.64대, B그룹 3.21대, C그룹 2.19대로 나타났다. 이 중에서 구내촬영장치가 가장 많았고, 다음은 파노라마 장치, 세팔로 장치, CBCT 장치 순이었으며, 장치시스템의 비율은 세 그룹 모두 DR 시스템이 50% 이상으로 가장 많았다. 필름 시스템인 경우, 사용된 구내필름은 감광도가 높은 Insight 필름(Kodak, USA)이 대부분이었으며, 자동 현상기는 사용하는 곳이 적었으나, 필름유지기구는 사용하는 곳이 약간 많았다. PACS 이용률은 A그룹 90.9%, B그룹 83.3%, C그룹 16.7%이었고, 프로그램은 국내의 Infinitt에서 개발된 PiView STAR가 가장 많이 이용되고 있었다. 치과병 의원 한 곳당 2008년도의 연간 평균촬영건수는 A그룹이 B그룹보다 6.8배, C그룹보다 21.2배 더 많았으며, 구내 치근단 촬영과 파노라마 촬영이 대부분이었다. 구내 치근단 촬영 시 관전압과 관전류는 세 그룹 모두 비슷하였으나, 노출시간은 C그룹이 A그룹의 12배, B 그룹의 3.5배 정도 길었다. 즉, 대부분 치과위생사가 촬영하고 있는 C그룹에서는 방사선 노출량이 다른 그룹에 비해 훨씬 많았다. 그러나 파노라마촬영 시의 조건은 세 그룹에서 큰 차이가 없었다. 결론적으로, 촬영조건은 경험적 지식을 따르기보다는 권장량을 사용해야 하며, 필름시스템에서는 자동현상기와 필름유지기구를 사용하여 방사선의 노출량을 줄여준다. 또한 환자선량의 감소와 X선 영상의 질 향상을위해서 X선발생장치 및 관련기기의 체계적인 정도관리가 반드시 필요하다.