• 보건행정학회지
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• 제26권4호
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• pp.305-314
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• 2016

Background: The purpose of this study is to examine the characteristics of and factors associated with long-term care (LTC) utilization under public long-term care insurance (LTCI) among end-of-life older adults in Korea. Methods: Using a 5% sample of older people aged 65 or older and their health and LTC insurance data, two-part model analyses were conducted. We compared LTC uses and their determinants during the last year of life among decedents in the year 2010 with those of survivors. We also compared the medical uses of the same sample with their LTC uses. Results: The end-of-life elderly were more likely to use LTC, and their expenditure on LTC was higher than their counterparts. Whether or not older people used LTC during their last year of life was significantly affected by age, sex, health insurance, household income, and living alone; however, LTC costs of the decedents were only affected by functional status, which may have been due to the reimbursement scheme of the current LTCI, which is mainly based on functional dependency level. For the survivors, having chronic diseases significantly increased the likelihood of LTC use, which was not the case for the decedents. End-of-life elderly with relatively low social economic status were more likely to use the LTC other than medical services, while the health conditions affected their medical uses most significantly. Conclusion: The study findings provide key information for predicting demand related to the increasing LTC needs of Korean older people at the end of life.

• 보건행정학회지
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• 제22권1호
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• pp.29-48
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• 2012

The purpose of this study is to analyze medical expenses by decedents in their last year of life and compare them with those by survivors during the year 2008. This study is conducted firstly in Korea, except some studies focusing on medical cost of decedents from specific diseases. To study this, national health insurance(NHI) claims data was used with medicaid claims data. The study group(decedents) was selected from the insurance entitlement file who were dropped out from January to December of 2008. The control group(survivors) was selected from the entitlement file by stratified sampling with keeping age-sex composition of the study group. The medical expenses of decedents during one year before death were measured and compared with those of survivors by sex and age. And the medical expenses were analyzed by causes of death, and also the expenses were examined by each item of medical services. On average, the medical expense amounted to 11 million Korean Won per decedent during their last year of life in 2008. The medical expense per decedent was 9.3 higher than that of survivor. The death-related expense of under the age 35 was about 16 million Won, compared with 4 million Won in the case of over the age 95, in average. The death-related expense is higher in younger ages. This means that more medical resources are put in to save life in younger ages. Total death-related expenditure took 8.3 percent in total NHI expenditures. Of the death-related medical expenses, the largest one was injection-related cost which shares twenty five percent, and the second largest one was hospitalization charges, and then the third one was surgery cost. The results of this study suggested that we should pay attention to the medical expenses in the last of year of life when we study health care expenditure in Korea. In addition, we have to deliberate health care policy to cope with medical expenditures before death in more efficient way.

• 문화기술의 융합
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• 제10권4호
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• pp.295-303
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• 2024

글로벌 환경에서 문화적 다양성을 이해하는 것은 학계와 기업에 매우 중요한 의미를 가진다. 중앙아시아는 한국에 전략적으로 중요한 지역이며, 한국에 거주하는 약 200만 명의 외국인 중 중앙 아시아인이 5위를 차지하고 있으며, 이 지역은 '고려인'이라 불리는 30만 명의 한국인이 거주하는 곳이다. 잠재력과 관련성이 점점 더 인식됨에 따라 구소련 지역은 한국의 기업과 학계에서 중요성이 커지고 있다. 본 연구는 호프스테드 지수를 활용하여 중앙아시아 지역민들이 한국 제품과 서비스를 경험하는 정도와 한국 제품과 서비스 충성도의 관계를 탐색적으로 분석하고자 한다.

• 보건행정학회지
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• 제14권4호
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• pp.1-20
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• 2004

This study is to examine relationships of several socioeconomic position indicators with mortality risk in a nationwide longitudinal study of South Korea. The Korea Labor & Income Panel Study, conducted on a probability sample of urban South Korean households by Korea Labor Institute, contains date of death information for the decedents which were used to estimate relative risks of mortality and their $95\%$ confidence intervals (CI) with Cox regression analysis. A total of 125 men and women among 8,415 subjects died between 1998 and 2002. Socioeconomic differentials in mortality were observed after adjustment for sex and age. Those with less than 12-year education had 1.90 times $(95\%\;CI=1.25-2.91)$ greater mortality risk than those with 12-year education or more. Greater mortality risks were also found among those with low occupational class and manual occupation. The magnitude of differentials in mortality risks between occupational class were similar in two different approaches to measuring women's occupational class: (1) approach 1 where women, married or not, retain their own occupational class, and (2) approach 2 where married women are assigned their husbands' occupational class. Relative risks of dying among those with low household Income were 1.62 $(95\%\; CI=1.08-2.42)$ compared with the counterparts. Those who reported economic hardship at the time of survey in 1998 had greater risk of mortality $(RR=1.83,\;95\%\;CI=1.21-2.78)$ than those who did not. In conclusion, increased social discourse and policy discussions about these health inequalities are needed in Korean society. Future studies should explore the causes and mechanisms of socioeconomic mortality inequalities.

• 대한수의학회지
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• 제44권3호
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• pp.373-378
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• 2004

To help the interpretation of causes of death, it is critical that the background incidence of factors contributing to death be recorded and archived. Information was gathered from the control groups of 19 rat carcinogenicity studies. All cases of death occurring within the 2-year period were reviewed. Out of 1124 males and 1084 females, 720 male (64.1%) and 689 female (63.6%) decedents were recorded. There was no difference in the probability of survival between two sexes. Analysis of factors contributing to death revealed that 400 males (48.7%) had neoplastic changes, 189 males (23.0%) had non-neoplastic lesions, and 232 males (28.3%) died from unknown causes. In females, these figures were 627 (76.4%), 62 (7.6%) and 132 (16.0%), for neoplastic, non-neoplastic and unknown findings, respectively. It could be suggested that the risk of death by non-neoplastic reasons was higher in the males than in the females, whereas females were more likely to be affected by tumours. In the neoplastic causes of death, pituitary tumours were the most common in both sexes, followed by mammary tumours in females, and haemopoietic tumours in males. In non-neoplastic cause of death, renal diseases were the most common in both sexes, followed by skin diseases and cardiovascular diseases in males, and skin diseases and poditis in males. A relatively large number of animals (28.3% in males and 16.0% in females) were found dead, without any significant clinical or histologically identifiable cause. Most of the animals with pituitary tumours were killed in extremis and the proportion of females (70.1%) being greater than males (46.8%). There were no case which died by accident, and also only minimal incidence which died by bleeding procedures.

• Safety and Health at Work
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• 제14권2호
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• pp.193-200
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• 2023

Background: International evidence shows that mining workers are at greater risk of suicide than other workers; however, it is not known whether this applies to the Australian mining sector. Methods: Using data from the National Coronial Information System, rates of suicide among male mining workers were compared to those of three comparators: construction workers, mining and construction workers combined, and all other workers. Age-standardized suicide rates were calculated for 2001-2019 and across three intervals '2001-2006', '2007-2011', and '2012-2019'. Incidence rate ratios for suicide were calculated to compare incidence rates for mining workers, to those of the three comparative groups. Results: The suicide rate for male mining workers in Australia was estimated to be between 11 and 25 per 100,000 (likely closer to 25 per 100,000) over the period of 2001-2019. There was also evidence that the suicide rate among mining workers is increasing, and the suicide rate among mining workers for the period 2012-2019 was significantly higher than the other worker group. Conclusions: Based on available data, we tentatively deduce that suicide mortality among male mining workers is of concern. More information is needed on both industry and occupation of suicide decedents in order to better assess whether, and the extent to which, mining workers (and other industries and occupations) are at increased risk of suicide.

• 중환자간호학회지
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• 제17권2호
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• pp.1-11
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• 2024

Purpose : This study aimed to determine the mortality rate among elderly patients admitted to the intensive care unit (ICU) for acute drug intoxication resulting from suicide attempts. It also compared the characteristics of survivors and decedents to identify factors associated with mortality. Methods : This retrospective descriptive study included 150 patients aged 65 years or older who were admitted to the ICU of a tertiary university hospital in Gwangju due to acute drug intoxication, with the period spanning January 1, 2018 to December 31, 2020. The collected data were analyzed using descriptive statistics, independent t-tests, Chi-squared tests, Fisher's exact test, and multiple logistic regression analysis. Results : The mortality rate among elderly individuals admitted to the ICU for acute drug intoxication was 19.3%. The likelihood of death was significantly higher in patients with an acute physiology and chronic health examination (APACHE) III score of 70 or above (OR=23.75, 95% CI=3.78-149.46, p<.001) and those with metabolic acidosis on initial acid-base results (OR=3.73, 95% CI=1.12-12.43, p=.032). Conclusion : These findings underscore the need for developing and implementing systematic education and targeted nursing interventions for ICU nurses caring for acutely drug-intoxicated elderly adults, particularly considering the APACHE III score and the presence of metabolic acidosis.

• Tuberculosis and Respiratory Diseases
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• 제56권6호
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• pp.600-610
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• 2004

연구배경 : 혈중 BNP 의 측정은 간단한 혈액검사로 바로 시행할 수 있고 우심부하의 정도에 비례하여 증가하므로, 혈액 검사 당시의 혈역학적 상태를 잘 반영할 수 있다. 이에 저자들은 급성 악화로 응급실에 내원한 만성폐쇄성폐질환 환자의 혈역학적 불안정 정도가 환자의 예후와 상관이 있을 것으로 생각하였고, 이를 반영하는 지표로 혈중 BNP 검사를 이용하였다. 대상 및 방법 : 2002년 6월부터 2003년 12월까지 본원 응급실을 통해 만성폐쇄성폐질환의 급성악화로 입원한 환자 중 응급실 내원 당시 혈중 BNP 검사를 시행 받았던 환자를 대상으로 하여 입원 중이나 퇴원 후 24시간 이내에 사망한 환자와 생존한 환자를 두군으로 나누고 후향적으로 비교하였다. 결 과 : 다중회귀분석상 생존군과 사망군간에는 $FEV_1$(% of predicted), APACHE II score, BNP 수치만이 의미 있는 차이를 보였다(p=0.043, 0.025, 0.024). ROC curve 상 BNP 88pg/mL 이상에서 사망을 예측하는 민감도는 90%, 특이도는 75%를 보였고, BNP 88pg/mL를 기준으로 사망에 대한 Fisher's exact test를 시행하였을 때 교차비는 21.2였다. 결 론 : 본 연구 결과 혈중 BNP 값은 만성폐쇄성폐질환의 급성 악화 시에 예후를 예측할 수 있는 인자일 가능성이 있으며, 내원 당시 BNP 값이 높은 환자들에 대한 적극적인 처치가 필요할 것으로 사료되었다.

• Journal of Hospice and Palliative Care
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• 제18권4호
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• pp.322-328
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• 2015

목적: 의학의 발달로 인구가 고령화됨에 따라, 사망의 원인이 되는 질환 및 동반질환의 유병기간은 함께 증가하고 있으며, 고령환자의 임종기 관리에 대한 연구의 필요성도 더욱 증가하고 있다. 그러나 임종기 치료 강도에 대한 국내연구는 암환자에 국한되어 있으며, 비-암환자의 임종기 치료 강도에 대한 국내 연구는 없었다. 그래서 본 연구는 암환자와 비-암환자의 임종기 치료 강도에 대해 연구하였다. 방법: 경희대학교병원에서 2014년 12월 1일부터 2015년 3월 31일까지 4개월간 사망자의 의무기록을 조사하여 암환자와 비-암환자의 기본 인구학적 정보, 임종기 치료 강도, 심폐소생술 금지 요청서 경향 등에 대해 비교 연구하였다. 결과: 비-암환자가 암환자에 비해 나이가 많았음에도 불구하고(73.7 vs. 67.4, P=0.001), 중환자실 치료(87.4% vs. 36.0%, P<0.001), 기도 삽관 및 기계 호흡(63.2% vs. 24%, P<0.001), 응급 투석(28.7% vs. 8.0%, P=0.001)을 더 많이 받은 것으로 나타났으며, 나이(P=0.038), 암의 유병 여부(P<0.001)가 임종기 침습적 치료에 영향을 미치는 인자로 나타났다. 결론: 임종기 치료 강도는 비-암환자에서 더 높은 것으로 나타났으며, 나이와 암의 유병여부가 임종기 치료 강도를 결정하는 중요한 인자였다.

• 한국심리학회지:학교
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• 제18권1호
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• pp.121-151
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• 2021

본 연구는 학생의 자살 이후, 중·고등학교 교사들이 상실에 대처하는 과정에서 어떤 어려움과 도움 요소를 경험하는지 개념도 방법을 활용하여 확인하였다. 이를 위해 학생의 자살을 경험한 중·고등학교 교사 7명을 대상으로 개별 면접을 시행하였고, 진술 내용을 기초로 총 113개의 핵심 문장을 추출하였다. 이 문장들은 참여자들에 의해 비슷한 의미를 가진 것끼리 분류되었으며, 이를 바탕으로 다차원척도분석과 군집분석을 실시하였다. 분석 결과, 교사들의 애도 과정에서의 어려움 요인은 '자살사별자 관련 및 자살 학생 관련' 축과 '외부시스템 및 내적 경험' 축의 2차원으로 구조화되었으며, 총 4개의 군집으로 분류되었다. 각각의 군집은 '자살을 예방하지 못한 후회,' '자살 사건에 대한 학교의 무관심,' '자살사별자 관련 무력감,' '자살사별자 관련 접근-회피 갈등'으로 명명되었다. 교사들의 적응과정에서 도움 요인은 '직업적 활동 및 개인적 활동' 축과 '상실 경험 분리 및 상실 경험 밀착' 축의 2차원으로 구조화되었고, 총 6개의 군집으로 나타났다. 각각의 군집은 '자살사별자 간 협조와 보살핌,' '바쁜 일상과 현재에 집중,' '영성 활동,' '사회적 지지,' '이타적 행동을 통한 애도,' '고인에 대한 연민'으로 명명되었다. 본 연구는 그동안 관심을 받지 못했던 교사 집단의 학생 상실 경험을 조명하고, 이들이 애도 과정에서 경험하는 어려움 요인과 도움 요인의 개념적 구조를 당사자의 관점에서 생생하게 규명하였다는 데 의의가 있다.