• 한국콘텐츠학회논문지
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• 제18권4호
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• pp.664-676
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• 2018

본 연구는 의약품 지출 비용에 미치는 요인을 파악하기 위하여 한국의료패널조사의 2014년 원자료를 분석자료로 이용하여, 의약품 지출 비용이 있는 자 3,107명을 최종 분석 대상으로 하였다. 분석은 빈도분석, 교차분석, 회귀분석 및 t-test를 실시하였고, 모든 검증은 p=.05를 유의수준으로 하였다. 처방전 비용은 72.4%가 지출 경험이 있었고, 최소 비용은 84원, 최대 비용은 270,653원 이었고, '3천원 이상~1만원 이하'가 31.7%로 가장 많았다. 일반의약품 비용은은 81.8%가 지출 경험이 있었고, 최소 비용은 800원, 최대 비용은 2,718,000원 이었고, '2만원 이하'가 31.4%로 가장 많았다. 한약 및 첩약 비용은 9.4%가 지출 경험이 있었고, 최소 비용은 4,000원, 최대 비용은 2,700,000원 이었고, '10만원 초과'가 37.8%로 가장 많았다. 의약품 지출 총 비용은 최소 비용은 84원, 최대 비용은 2,760,093원 이었고, '10만원 초과'가 27.0%로 가장 많았다. 의약품 지출비용에 미치는 요인은 성별, 혼인상태, 소득분위, 지역권, 주관적 건강상태 이었다.

• The Korean Journal of Pain
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• 제30권4호
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• pp.272-280
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• 2017

Background: The high cost of intrathecal morphine pump (ITMP) implantation may be the main obstacle to its use. Since July 2014, the Korean national health insurance (NHI) program began paying 50% of the ITMP implantation cost in select refractory chronic pain patients. The aims of this study were to investigate the financial break-even point and patients' satisfaction in patients with ITMP treatment after the initiation of the NHI reimbursement. Methods: We collected data retrospectively or via direct phone calls to patients who underwent ITMP implantation at a single university-based tertiary hospital between July 2014 and May 2016. Pain severity, changes in the morphine equivalent daily dosage (MEDD), any adverse events, and patients' satisfaction were determined. We calculated the financial break-even point of ITMP implantation via investigating the patient's actual medical costs and insurance information. Results: During the studied period, 23 patients received ITMP implantation, and 20 patients were included in our study. Scores on an 11-point numeric rating scale (NRS) for pain were significantly reduced compared to the baseline value (P < 0.001). The MEDD before ITMP implantation was 0.59 [IQR: 0.55-0.82]. The total MEDD increased steadily to 0.77 [IQR: 0.53-1.08] at 1 year, which was 126% of the baseline (P < 0.001). More than a half (60%) responded that the ITMP therapy was somewhat satisfying. The financial break-even point was 28 months for ITMP treatment after the NHI reimbursement policy. Conclusions: ITMP provided effective chronic pain management with improved satisfaction and reasonable financial break-even point of 28 months with 50% financial coverage by NHI program.

• 근관절건강학회지
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• 제6권2호
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• pp.211-225
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• 1999

This descriptive correlational study was carried to identify the relationship among social support, compliance, and psychosocial adjustment of patients with rheumatoid arthritis. The study was done with 100 rheumatoid arthritic patients who were visited in Outpatient clinic of university hospital in Taegu, Korea from the 23rd of February to the 20th of March in 1998. The Data were collected through person to person interviews which were performed by five researchers. The instruments used for this study were Yu's social support scale(1996), Cho's compliance scale(1987), and Kim's psychosocial adjustment scale(1997). The data was analyzed by using a t-test, Pearson correlation coefficient, ANOVA, and Tukey test with the SAS Program. The results of this study were as follows ; 1. The mean score of social support was 2.76 for 4 full marks, compliance was 3.20 for 5 full marks, and psychosocial adjustment was 2.26 for 4 full marks. 2. Hypothesis 1 : "The higher the social support degree, the higher the compliance degree of the rheumatoid arthritis patient". It was supported(r=0.54, p<0.001). Hypothesis 2 : "The higher the compliance degree, the higher the psychosocial adjustment degree of the rheumatoid arthritis patient". It was supported(r=0.34, p<0.001). Hypothesis 3 : "The higher the social support degree, the higher the psychosocial adjustment degree of the rheumatoid arthritis patient". It was supported(r=0.24, p<0.05). 3. In general, the spouse group compared to other groups was demonstrated as the most dependable group for patients to trust and expect support. And the sons and daughters group was shown higher than other groups in terms of social support(F=4.19, p=0.01). There was no difference in terms of compliance in degree. In the degree of psychosocial adjustment the highly educated group(more than high school) is a little higher than the lowly educated group(F=3.08, p=0.03). In the costs of medical care, the group that could afford was significant higher than the group which could not afford results in terms of the psychosocial adjustment degree(F=3.99, p=0.01). The outcome of this study is that the social support that related rheumatoid arthritic patients had an effect on the following compliance, and the following compliance helps psychosocial adjustment of patients. It also shows that social support related psychosocial adjustment. Therefore, to increase the level of psychosocial adjustment of rheumatoid arthritic patients, it will be effective in supportive nursing intervention to improve social support and compliance.

• 공업화학
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• 제28권6호
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• pp.607-618
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• 2017

석탄화력발전소를 포함한 다양한 산업설비에서 유해 대기오염물질이 배출되고 있으며, 이러한 오염물질은 인체 건강과 자연 생태계에 영향을 준다. 특히, 질소산화물($NO_x$)와 이산화황($SO_2$)은 인체 건강에 악영향을 주는 미세먼지($PM_{2.5}$) 형성에 원인물질로 알려져 있다. 이러한 $NO_x$와 $SO_2$ 배출을 저감하기 위해서 선택적 촉매 환원(SCR)과 습식 탈황 공정(WFGD)으로 결합된 혼합 시스템이 사용되고 있으나, 높은 설치비용 및 운전비용을 필요로 하며, 유지보수의 문제점, 기술적인 한계점을 가지고 있다. 최근에 이러한 혼합 시스템을 대체하기 위한 $NO_x$, $SO_2$ 동시 저감 기술이 연구되고 있으며, 제안된 기술들은 흡수, 고도 산화(AOPs), 저온 플라즈마(NTP), 전자 빔(EB) 등이 있다. 이러한 기술들은 강한 수용성 산화제 및 산화력을 가진 화학활성종에 의한 $NO_x$, $SO_2$를 $HNO_3$, $H2SO_4$ 형태로의 산화 반응, 기-액 계면에서 $HNO_3$와 $H2SO_4$ 흡수 반응, 화학 첨가제에 의한 중화 반응을 기본으로 하고 있다. 본 논문에서는 각각의 동시 저감공정에 대한 기술적인 특징과 대용량 처리 공정 응용을 위한 향후 전망을 정리하였다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권14호
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• pp.5921-5926
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• 2014

A large proportion of patients with thyroid nodules in China undergo thyroidectomy in order to get confirmatory histology diagnosis. The financial impact of this modality remains to be investigated. To evaluate rationality of performing thyroidectomy without a routine FNA preoperatively from the economic perspective, we conducted a retrospective, observational study of all archival thyroidectomies with records of cost per stay (CPS), cost per day (CPD) and length of stay (LOS) from 2008 to 2013 in the First Affiliated Hospital of Nanjing Medical University. We compared all the parameters between cancer and non-cancer thyroidectomies. We recruited 6, 140 thyroidectomies with valid records of CPS, CPD and LOS in this period. The CPS of cancer thyroidectomy was significantly higher than non-cancer thyroidectomy. The percentage of cancer thyroidectomy increased from 26.5% to 41.6%. The percentage of annual cost of cancer thyroidectomies rose from 30.2% to 45.2%. The LOS for cancer and non-cancer thyroidectomy decreased while the CPD increased in the past six years. The estimated national cost in 2012 for all thyroidectomies would be USD 1.86 billion with USD 1.09 billion for non-cancer thyroidectomies. We have witnessed great improvement in the healthcare for patients with thyroid nodules in China. However, given limited healthcare resources, currently thyroid FNA for more precise preoperative diagnosis may help to curb the rapidly increasing demand in healthcare costs in the future for nodular thyroid disease in China.

• 한국환경복원기술학회지
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• 제15권3호
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• pp.17-28
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• 2012

This study aims to present the ground for the introduction of energy-saving landscape facilities which can meet the requirements of the age and create a new space by introducing the facilities which saves energy and that users prefer at the space where urbanites enjoy leisure activities in the urban parks. Thus, in addition to a spatial analysis of the parks for 10 urban parks in Gimpo, through an attitude survey on the users' behaviors, the following conclusions were drawn out. First, as a result of putting all facilities in the urban parks in Gimpo, on average, 6.9 out of the standards of 9 (76.6%) have been installed, and as a result of an analysis on the total number of the installed facilities, on average, about 28 kinds of facilities have been installed, so only 22.4% of the total 125 facilities were installed. Second, many urbanites are using the parks for the purpose of taking a walk and exercise to improve their health; however, the legal standards regulate only 2.9 exercise facilities on average in the target area, which are somewhat insufficient. Third, regarding the citizens' intent to participate in responding to climate change, 76% of them showed their intention of participation. Thus, if the energy-saving facilities, the purpose of this study, are introduced, many users will use them, and it is judged that costs for existing street lights and electric power plants will decrease. Fourth, as a result of an analysis of their satisfaction with the facilities, the value of R-square meaning the explanatory power of the independent variables put in a linear model for dependent variables was 0.860, approximately 81% of the total satisfaction, which was a high explanatory power. This study conducted an attitude survey on the users of urban parks in Gimpo at the dimensions of the introduction of energy-saving facilities in the urban parks, the national policies and responses to climate change. It is significant that it identified the appropriateness of developing much more energy-saving landscape facilities needed for low-carbon green growth in various types, and as a subsequent project, a more precision study on this is necessary continuously.

• 한국미생물생명공학회:학술대회논문집
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• 한국미생물생명공학회 2000년도 Proceedings of 2000 KSAM International Symposium and Spring Meeting
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• pp.3-6
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• 2000

Antimicrobial resistance has been a well-recognized problem ever since the introduction of penicillin into clinical use. History of antimicrobial development can be categorized based on the major antibiotics that had been developed against emerging resistant $pathogens^1$. In the first period from 1940 to 1960, penicillin was a dominating antibiotic called as a "magic bullet", although S.aureus armed with penicillinase led antimicrobial era to the second period in 1960s and 1970s. The second stage was characterized by broad-spectrum penicillins and early generation cephalosporins. During this period, nosocomial infections due to gram-negative bacilli became more prevalent, while those caused by S.aureus declined. A variety of new antimicrobial agents with distinct mechanism of action including new generation cephalosporins, monobactams, carbapenems, ${\beta}$-lactamase inhibitors, and quinolones characterized the third period from 1980s to 1990s. However, extensive use of wide variety of antibiotics in the community and hospitals has fueled the crisis in emerging antimicrobial resistance. Newly appeared drug-resistant Streptococcus pneumoniae (DRSP), vancomycin-resistant enterococci (VRE), extended-spectrum ${\beta}$-lactamase-producing Klebsiella, and VRSA have posed a serious threat in many parts of the world. Given the recent epidemiology of antimicrobial resistance and its clinical impact, there is no greater challenge related to emerging infections than the emergence of antibiotic resistance. Problems of antimicrobial resistance can be amplified by the fact that resistant clones or genes can spread within or between the species as well as to geographically distant areas which leads to a global concern$^2$. Antimicrobial resistance is primarily generated and promoted by increased use of antimicrobial agents. Unfortunately, as many as 50 % of prescriptions for antibiotics are reported to be inappropriate$^3$. Injudicious use of antibiotics even for viral upper respiratory infections is a universal phenomenon in every part of the world. The use of large quantities of antibiotics in the animal health industry and farming is another major factor contributing to selection of antibiotic resistance. In addition to these background factors, the tremendous increase in the immunocompromised hosts, popular use of invasive medical interventions, and increase in travel and mixing of human populations are contributing to the resurgence and spread of antimicrobial resistance$^4$. Antimicrobial resistance has critical impact on modem medicine both in clinical and economic aspect. Patients with previously treatable infections may have fatal outcome due to therapeutic failure that is unusual event no more. The potential economic impact of antimicrobial resistance is actually uncountable. With the increase in the problems of resistant organisms in the 21st century, however, additional health care costs for this problem must be enormously increasing.

• 융합정보논문지
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• 제10권11호
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• pp.324-331
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• 2020

본 연구는 의료기관 회계정보 공시시스템에 등록된 29개 지방의료원의 재무정보를 이용하여 지방의료원들이 경영활동 운영자금 조달방법별 조달비율과 이들이 당기순이익에 어떠한 영향을 미치는지를 분석하였다. 연구결과, 지방의료원들의 경영활동 운영자금 조달비율은 의료수익 83.50%, 의료부대수익9.53%, 기부금수익 4.54%, 기타 의료외 수익 4.42%, 감가상각비 1.21%, 고유목적사업준비금 전입액 0.73%이었다. 지방의료원들의 경영활동 운영자금 조달방법들이 당기순이익에 미치는 영향을 살펴본 결과 의료수익, 의료부대수익, 기부금수익, 기타 의료외수익에 의한 운영자금 조달비율이 당기순이익에 긍정적인 영향을 미쳤으며, 고유목적사업준비금 전입액에 의한 조달비율이 당기순이익에 부정적인 영향을 미치는 것으로 확인되었다. 따라서 지방의료원들이 바람직한 경영활동을 위해서는 비용관리에 있어서 자체발생수익, 내부에 유보할 수 있는 자금 등을 고려할 필요성이 제기된다.

• 디지털융복합연구
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• 제14권7호
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• pp.403-409
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• 2016

본 연구는 옴니채널 환경의 식품쇼핑 경험연구이다. 안전한 먹거리에 대한 관심은 IT의 발전에 따라 소비자의 다양한 요구에 합리적 방식으로 진화하며 이를 충족한 다양한 채널 증가로 이어졌다. 옴니채널은 소비자의 필요와 욕구를 채우는 것뿐 아니라 고객 행동 이해와 경험 가치를 부여한 실증적 사용자 유형 고찰이 필요했다. 온라인 설문 결과, (1)오프라인 식품쇼핑은 대 소형 마트, 1개월에 2~3회, 품질상태 고려, 신선식품을 직접 구매하기 위해 방문 (2)온라인 식품쇼핑은 온라인 커머스, 1개월에 2~3회, 가격/혜택을 고려, 과일/견과를 주로 구매로 나타났다. 이후 고관여자 8인의 심층면접에서 식품구매여정 4단계를 통해 식품쇼핑 경험을 파악하였다. '건강'과 '식단'을 식품쇼핑 핵심 가치로 한 퍼소나는 가족과 건강을 중요시하고 '절약'을 우선하는 프라이머리 퍼소나와 일과 개인을 중시하며 '자동수급'을 하는 원하는 세컨더리 퍼소나로 세분된 방안을 제시하였다. 본 연구를 통해 옴니채널 식품쇼핑 경험을 위해서는 건강하고 균형 잡힌 식생활의 맥락에서 기능과 서비스 방안을 모색하는 데 도움이 될 것으로 기대한다.

• Pediatric Infection and Vaccine
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• 제22권3호
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• pp.136-142
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• 2015

대한소아감염학회는 2015년 우리나라에서 처음으로 중동호흡기증후군(Middle East Respiratory Syndrome, MERS, 메르스) 환자가 발생하여 보건의료 응급 상황 발생의 긴박했던 시기에 이에 대한 대처에 참여하였다. 우리 학회는 메르스 발생 시 학회 홈페이지에 관련 공고문을 즉시 게시하였고 소아청소년에서의 메르스 환자의 발생시 의심 환자의 검사와 진단 및 국민안심병원 운영을 위해 소아청소년 MERS (중동호흡기) 검사 지침, 국민안심병원 소아청소년과 운영지침을 발빠르게 배포하였다. 이는 메르스 의심환자에 대한 접근에서 소아청소년에서 흔한 호흡기 질환 환자들이 메르스로 오인되어 불필요한 공포, 검사 및 격리를 당하지 않도록 하기 위함이었다. 이를 통해 소아청소년 환자를 진료하는 의사들과 이들의 보호자들을 안심시켰고 결국 많은 심리적 공포와 의료 비용을 감소시켰으며 메르스 종식 시 돌이켜보니 이는 결국 적절한 조치와 가이드라인이었음이 증명되었다. 앞으로 대한소아감염학회와 회원이 유관기관과 긴밀한 협조와 소통을 할 수 있는 체계 시스템을 구축해야 하며 상급의료기관의 소아청소년 감염전문의 필수 상주 및 이에 의한 감염관리료 제도 장착과 수가 신설 및 개선을 유도하는 등의 추진이 필요하다.