• 한국병원경영학회지
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• 제1권1호
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• pp.188-202
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• 1996

Telehealth is widely tested in the U.S.A and other developed countries. This system is expected to solve rural health problems reducing professional isolation. Some demonstration projects showed that the system can provide quality care in reasonable prices to rural residents. However, few study has been done on whether telehealth system can attract physicians by reducing professional isolation. The system is not available to most of the rural hospitals because the price for the equipment and telephone charges are not low enough. It is promising that the system cost and telephone charges are decreasing gradually. As time passes, rural hospitals will be more viable for the system. Satisfaction of the physicians and patients is a key factor for the implementation of the system. The physicians need to understand more about telecommunication and computer systems. After physicians are well-versed about the system, we can expect wide use of telehealth in rural areas. Effort for the confidentiality and standardization should be devoted to assure patient's privacy and compatibility of patient records and exam results. In Korea, two projects are being operated in Uljin and Kurye. A study evaluated the economic efficiency of the projects suggesting that increase of the number of patients up to three times of current number or decrease in hardware costs and telecommunication charges into two thirds of the current costs. The hardware and telecommunication charges are decreasing. Another area telehealth system can be applied is psychiatric accommodation facilities. Establishment of telehealth in the psychiatric facilities will increase the access of psychiatric care for patients and is expected to be economically efficient.

• Journal of Preventive Medicine and Public Health
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• 제44권3호
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• pp.101-110
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• 2011

Objectives: Screening for colorectal cancer is considered cost effective, but is underutilized in the U.S. Information on the efficiency of "tailored interventions" to promote colorectal cancer screening in primary care settings is limited. The paper reports the results of a cost effectiveness analysis that compared a survey-only control group to a Centers for Disease Control (CDC) web-based intervention (screen for life) and to a tailored interactive computer-based intervention. Methods: A randomized controlled trial of people 50 and over, was conducted to test the interventions. The sample was 1224 partcipants 50-70 years of age, recruited from Kelsey-Seybold Clinic, a large multi-specialty clinic in Houston, Texas. Screening status was obtained by medical chart review after a 12-month follow-up period. An "intention to treat" analysis and micro costing from the patient and provider perspectives were used to estimate the costs and effects. Analysis of statistical uncertainty was conducted using nonparametric bootstrapping. Results: The estimated cost of implementing the web-based intervention was $40 per person and the cost of the tailored intervention was $45 per person. The additional cost per person screened for the web-based intervention compared to no intervention was $2602 and the tailored intervention was no more effective than the web-based strategy. Conclusions: The tailored intervention was less cost-effective than the web-based intervention for colorectal cancer screening promotion. The web-based intervention was less cost-effective than previous studies of in-reach colorectal cancer screening promotion. Researchers need to continue developing and evaluating the effectiveness and costeffectiveness of interventions to increase colorectal cancer screening.

• 융합정보논문지
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• 제9권3호
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• pp.140-145
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• 2019

IT 기술의 발달과 함께 의료 서비스 환경이 과거에 비해 많은 변화가 일어나고 있다. 그러나, 의료 기술이 IT 기술과 융합하더라도 의료비 문제와 의료 서비스 관리에 대한 문제는 여전히 해결해야할 사항 중 하나이다. 본 논문에서는 IoT 시스템을 구축한 병원을 대상으로 의료 서비스를 제공받는 사용자의 개인 정보를 의료진이 효율적으로 분석 관리할 수 있는 모델을 제안한다. 제안 모델은 병원내 구축된 IoT 시스템을 통해서 사용자의 의료 정보를 효율적으로 체크하고 관리하는 것이 목적이다. 제안 모델은 다양한 이기종의 클라우드 환경에서 사용될 수 있으며, 사용자의 의료 정보를 추가적인 인적 물적 자원 없이 효율적이면서 빠르게 관리할 수 있다. 특히, 제안모델에서 수집된 사용자의 의료 정보는 IoT 게이트웨이를 통해 서버에 저장되기 때문에 의료진이 시간과 장소에 상관없이 사용자의 의료 정보를 정확하게 분석할 수 있다. 성능평가 결과, 제안 모델은 IoT 시스템을 사용하지 않은 기존 의료 시스템 모델보다 직군별 의료진의 의료 서비스에 대한 효율성이 19.6% 향상되었고, 의료 서비스를 제공받은 사용자의 사후 의료관리 개선율이 22.1% 향상된 결과를 얻었다. 또한, 의료진의 업무 부담률은 기존 의료 시스템 모델보다 평균 17.6% 낮게 나타났다.

• 보건행정학회지
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• 제34권3호
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• pp.223-225
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• 2024

의사인력 증가 정책에 반발하여 의과대학생이 수업을 거부하고 전공의들이 병원을 그만 둔 지 7개월이 되고 있다. 의학교육이 중단되고 대학병원 진료가 축소되면서 의료공백이 지속되는 가운데 의료체계에 위기가 발생하는 것을 걱정하는 우려도 높아지고 있다. 의사인력을 늘리겠다는 정책에 의사들의 반발이 큰 이유로서 정부의 결정과정에서 개선되어야 할 몇 가지 이슈들을 살펴보고자 한다. 첫째, 정책을 결정하는 근거자료는 다양한 특성들과 범위를 가지고 있기 때문에 이들 근거들을 이해 주체(stakeholders)들과 충분히 협의하는 과정이 매우 중요하다. 둘째, 근거자료를 검토하고 의사결정하는 논의구조가 다양한 이견들을 충분히 협의할 수 있는 구성원들로 구성되어야 하고 공정한 절차를 거쳐서 협의되는 방식으로 운영되어야 한다. 이런 과정들이 갖춰지지 않는다면 근거를 둘러싼 갈등이 더욱 심화될 수 있고 정부신뢰도를 떨어뜨리는 결과를 초래할 수 있다. 이해 주체들이 정부를 신뢰하지 않게 될 경우에 정책을 추진할 때 소요되는 사회비용이 커지고 정책 효율성이 떨어질 수 있다. 앞으로 정책 추진과정에서 발생할 수 있는 갈등을 줄이고 정부 신뢰를 높이는 방향으로 의사결정체계를 재구성해야 할 시점이다.

• 지역사회간호학회지
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• 제12권1호
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• pp.49-59
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• 2001

Purpose: This study was intended to develop the framework of public health center based 'Child growth and developmental clinic' and analyze the efficiency of services. This was the part of Mother-Child Health Guidance Project by the Public Health Center in Seoul. The purposes of this project were to improve children's health and development with early detection of developmental delay by screening test, and to assist and guide the parent for child care and rearing, so that children can reach their maximum potential. Method: Framework and standards for operation of 'Child growth and development clinic' were developed. We selected screening tool. developed parent education materials, and educated the personnel of public health center. Result: 243 children were enrolled for developmental screening, and we detect the children with developmental delay and referred them for further evaluation. The proportion of developmental delayed children was approximately 2% of the enrolled children. Also, we analyzed the characteristics of enrolled children, and their parental needs and attitude on child rearing. Some problems in operation of developmental clinic were discussed. Conclusion: Though we can found some limitations, we are confident that pubic health center can be charge of important role for improving child development for the majority. This study will be the basis of children's developmental clinic running by public health center.

• 농촌의학ㆍ지역보건
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• 제28권1호
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• pp.67-77
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• 2003

통합보건지소의 운영실태를 조사하고 이를 평가함으로써 지역주민에게 더욱 효율적이고 지역주민의 요구에 부합하는 서비스를 제공하는데 필요한 사업방향을 제시하는 것이 연구의 목적이다. 경상북도의 통합보건지소 3개소와 경상남도의 통합보건지소 2개소, 총 5개소의 통합보건지소를 2000년 12월 부터 2001년 1월까지 방문하여 보건지소 통합 전후의 인력, 시설, 장비, 진료 및 보건사업의 내용과 통합운영의 문제점 및 개선방안에 대한 면담을 실시하였다. 조사 대상 통합보건지소의 통합 전후 인력변화는 전체 인력은 6.8명에서 9.6명으로 2.8명 증가하였으며, 근무자 수는 통합보건지소는 6-14명으로 변이가 컸다. 통합 전후의 인력은 의사와 치과의사, 간호인력은 비슷하였고, 임상병리사와 방사선사는 한 명도 근무하지 않다가 3개 통합보건지소에 배치되었다. 보건지소 통합 후 일반진료와 치과진료는 약간 증가하였고, 방사선검사와 물리치료, 임상병리검사는 크게 증가하였다. 보건사업의 변화는 방문보건사업 건수와 이동진료 건수, 보건교육 연인원은 통합 전에 비하여 통합 후에 크게 증가하였으며, 예방접종과 자궁경부암 검진은 비슷하였다. 고혈압과 당뇨병 등록 환자수는 약간 증가하였다. 보건지소 통합 이후에 검사건수가 증가하였으나 서비스의 질은 높아졌다고 보기 어려우나, 방문보건, 이동진료, 보건교육사업은 크게 증가하여 긍정적인 현상으로 보인다. 보건지소 통합의 문제점은 인력간 업무의 내용의 불명확성, 과다하게 넓은 건물의 관리의 어려움, 보강되지 않은 장비, 운영비의 미책정, 보건교육을 위한 전문교육의 부족 등이었다. 향후 통합보건지소 기능 활성화를 위하여 의사, 간호인력 및 행정직을 배치하기 위한 최소배치 기준을 보건지소의 기준과는 별도로 설정하여야 할 것이며, 진료 및 방문서비스의 질을 향상시킬 수 있는 기본장비를 확충하는 것이 필요하다. 또한 인력간 업무의 분장을 명확히 하고, 업무관련 가이드라인을 개발하여 제공함으로써 업무의 효율성을 증대시켜야 한다.

• 대한지역사회영양학회지
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• 제2권3호
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• pp.376-387
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• 1997

The elderly are the most rapidly growing segment of the population in Korea and the largest consumers of expensive medical care. It is reasonable to believe that improving the nutritional status would be beneficial to reducing morbidity and to impro- ving the quality of their lives. This study was conducted to assess the health status and the Nutritional Risk Index of the elderly, and to provide the basic data for the Elderly Nutrition Improvement Program at the Public Health Center. One hundred and forty seven(76 males. 71 females) aged 60 years and over living in Suwon, were assessed with anthropometric measurements, body fat analysis, blood pressure measurements, and a set of questionnaires about health and other related variables. Over half of them had less than a junior middle school education and were considered low income. The percentage of overweight and obese subjects was 33% by the BMI(Body Mass Index), and the prevalence of hypertension was 28$\%$(males) and 31$\%$(females). They had a lot of self-recognized health problems, the male elderly complained about more than the female elderly. In the case of psychological health status, however, the female elderly showed a higher proportions of depression than the male elderly(p$\ll$0.05). In social health status, the elderly had good relationships with friends and collegues, whereas they had poor relationships with their families. They had many nutritional risk factors, and smoking was the most prevalent risk factor for the male elderly and anemia was for the female elderly. The results of this study suggest that Elderly Nutrition Improvement Programs should be planned that can be easily followed. It would be helpful to design a program focusing on individual phychological and social health status, this would increase the efficiency of the program.

• 사물인터넷융복합논문지
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• 제6권1호
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• pp.55-63
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• 2020

본 논문은 심리운동프로그램이 보육교사의 자아탄력성과 보육효능감에 미치는 영향을 확인하기 위해 시도되었다. 본 연구의 대상자는 서울시 J구의 8개 어린이집의 보육교사로서 최종 대상자는 실험군 18명, 대조군 19명 이었다. 중재프로그램으로 1회 4시간, 주 2회, 총 10회, 총 40시간의 심리운동프로그램을 보육교사에게 제공하였다. 자료수집은 2017년 9월 2일부터 11월 12일 사이에 이루어졌으며 수집된 자료는 독립표본 Wilcoxon-Mann-Whitney test로 분석하였다. 연구결과는 심리운동프로그램이 보육교사의 자아탄력성과 하위요인인 대인관계 효율성 향상에 유의한 효과가 있음을 보여주었으며 이를 통해 보육교사의 자아탄력성 관리와 지원을 위한 기초근거를 마련의 가치가 있었음을 확인하였다. 본 연구는 보육교사의 직무에서의 적응과 대처능력 향상에 도움이 될 수 있는 방안을 제시하였으므로 그의미와 가치가 있다고 판단된다.

• 한국농촌간호학회지
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• 제2권2호
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• pp.111-119
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• 2007

Purpose: In this study consumers' preference for housing for elderly people was analyzed as well as the recognition by elders of silver town facilities, and their preference for service provided by silver town. The study was done to provide basic data for the development of silver town facilities that are low in cost and high in efficiency. Methods: A sample research was used in this study to analyze the understanding of old age, silver town, and service preference. Results: First, interest and intention to live in silver town was very positive, however low cost was also preferred and that is quite different to current silver towns of Korea. Second, women have more understanding of, requests for, and intention to move into silver town facilities than men. Women's demands for silver town facilities must be reflected in the development strategy of silver towns. Third, the most important part of activating silver town facilities is price strategy. Government political support is required in order to keep silver town move-in costs affordable. Fourth, silver towns must function as total service complex towns. Conclusion: This study is meaningful as efficient operation of silver town is suggested rather than facility degradation to achieve price reduction. This result is important to the development of silver towns based on consumer preference, as it suggests a development direction that is focused on securing differentiated services and programs.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제11권9호
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• pp.4461-4475
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• 2017

Recently, introduction of the hospital information system has remarkably improved the efficiency of health care services within hospitals. Due to improvement of the hospital information system, the issue of integration of medical information has emerged, and attempts to achieve it have been made. However, as a preceding step for integration of medical information, the problem of searching the same patient should be solved first, and studies on patient identification algorithm are required. As a typical case, similarity can be calculated through MPI (Master Patient Index) module, by comparing various fields such as patient's basic information and treatment information, etc. but it has many problems including the language system not suitable to Korean, estimation of an optimal weight by field, etc. This paper proposes a method searching the same patient using MRI information besides patient's field information as a supplementary method to increase the accuracy of matching algorithm such as MPI, etc. Unlike existing methods only using image information, upon identifying a patient, a highest weight was given to physical information of medical image and set as an unchangeable unique value, and as a result a high accuracy was detected. We aim to use the similarity measurement result as secondary measures in identifying a patient in the future.