국내 시각장애인의 보건의료서비스 이용 실태에 대한 심층면접조사

최민지(Minji Choi),김혜로(Hyero Kim),한은아(Euna Han) 대한약학회 2021 약학회지 Vol.65 No.5

Individuals with visual impairments face many challenges in their daily lives, and among these challenges is accessibility to health care services. Despite increasing awareness of the importance of accessibility for the disabled, research focused on the actual conditions of health care use among the visually impaired is insufficient. This study investigates the health care service utilization of individuals with visual impairments and identifies coping strategies for guaranteeing their rights to accessible health care services and support. Comprehensive interviews with 15 participants were conducted and data were analyzed using the principles of grounded theory. Through this analysis, 29 subcategories emerged from 63 concepts, and these were categorized into 13 main categories. The study revealed that the visually impaired were significantly more likely to report difficulties accessing health care services. Participants had a higher probability of experiencing a variety of barriers, including lack of information, difficulty with transportation, difficulty using facilities, discrimination by others, and anxiety or lack of confidence as a result of these barriers. Therefore, significant changes to the provision of health care services is needed as the current barriers are likely to exacerbate health inequalities for the visually impaired and may increase the likelihood of developing additional ailments.

국내 청각장애인의 보건의료서비스 이용 실태에 대한 심층면접조사

이수현(Soo-Hyun Lee),김혜로(Hyero Kim),한은아(Euna Han) 대한약학회 2020 약학회지 Vol.64 No.4

Hearing impaired people have many difficulties in using health care services because of the disability of communication. Since the use of appropriate health care services are essential elements for disease prevention and health promotion, it is important to investigate their state of health care service use. The purpose of this study is to find ways to increase the accessibility of the hearing impaired to medical services by identifying the obstacles to proper health care service use through qualitative study. The study participants consisted of 14 people with severe hearing impairments. One in-depth interview was conducted per participant, and each interview was recorded and documented. Based on the documents, categorized the responses and drew out the core finding responses within the same category. The study showed that hearing impaired people have the greatest difficulty in communication when using health care services. The negative experiences during medical care and the discomfort in using sign language interpreters were also found to hinder proper access to medical care. The health of the hearing-impaired people is heavily influenced by social and environmental factors, and they have many limitations in the use of health care services. Establishment of system for active use of health care services for hearing impaired people is necessary.

일개 대학병원 외래환자의 예약부도(No -Show) 관련요인

권성탁 ( Sung Tak Kwon ),이예슬 ( Ye Seol Lee ),한은아 ( Euna Han ),김태현 ( Tae Hyun Kim ) 대한보건협회 2015 대한보건연구 Vol.41 No.2

Objective: This study examines factors associated with no-show in an academic medical center in Korea. Methods: Electronic data regarding medical appointment during one academic year (2013.03~2014.02) were derived from a major academic medical center in Seoul. Medical appointment was divided into two groups (i.e., consultation vs. test, treatment, and surgery). Comparisons between patients who did show up and those who failed to show up (no-show) were made. A multiple logistic regression was run to estimate factors that are significantly associated with no-show. Results: The results show that overall no-show rate was 5.0%, but the rate of the appointment for test, treatment, and surgery (8.0%) is higher than that of consultation (4.7%). In general, patients aged less than 18 and carrying Medical Aid had higher odds of no-show. Afternoon appointments and Saturday appointments also had higher odds of no-show. In addition, those who had appointments with the Department of Ophthalmology and Department of Otolaryngology and those who made appointments with instructors or residents had higher odds of no-show. Also, slightly different results were found for the two different groups of medical appointment. Conclusion: The results of this study can be used for setting priority for no-show management based on identifying significant no-show predictors. It is important for hospitals to develop more tailored no-show management approaches for consultation, test, treatment, and surgery, respectively, given that the results are somewhat different by the medical appointment type. In addition, it is recommended that future research incorporate qualitative information about the reasons of no-show.

당뇨병 전단계에서 제2형 당뇨병으로의 전이에 고혈압 및 인슐린 저항성의 영향 분석

정주원(Joo Won Jung), 조윤(Yoon Cho), 이한길(Hankil Lee), 한은아(Euna Han) 한국보건사회약료경영학회 2023 한국보건사회약료경영학회지 Vol.11 No.1

BACKGROUNDS There are many people with prediabetes. As prediabetes is a strong risk factor for Type 2 Diabetes and an opportunity to prevent Type 2 Diabetes, it is important to identify prediabetes with high risk of developing Type 2 Diabetes. The aim of this study is to examine whether hypertension or insulin resistance are valid transition factors to Type 2 Diabetes from prediabetes. METHODS 2265 middle-aged South Korean examinees with prediabetes in the Korean Genome and Epidemiology Studies (KoGES) during the follow-up period of 10 years. RESULTS During 8.24 person- years, we identified 469 incident Type 2 Diabetes cases (21%). The incidence of Type 2 Diabetes increased with hypertension or insulin resistance with the adjusted hazard ratios (HRs) of 1.595 (CI: 1.209-2.105) and 2.286 (1.761-2.968) respectively. Compared to those with hypertension (Adjusted HR, 1.342 [CI: 1.045-1.723]), those with hypertension and insulin resistance showed a larger HR (Adjusted HR, 2.593 [CI: 1.802-3.733]). CONCLUSION Middle-aged South Koreans with prediabetes who had hypertension or insulin resistance were especially high at risk of developing Type 2 Diabetes. Hypertension had an association with Type 2 Diabetes, whereas insulin resistance had a causal impact on East Asian populations to have Type 2 Diabetes.

의약품 허가 과정에서 real-world data와 real-world evidence 사용 시 필요한 항목 도출을 위한 이해관계자 대상 초점그룹인터뷰

안현수(Hyeon-Soo Ahn),권솔(Sol Kwon),이한길(Hankil Lee),강혜영(Hye-Young Kang),한은아(Euna Han) 대한약학회 2022 약학회지 Vol.66 No.2

The limitations of randomized clinical trials (RCTs) have been highlighted in regulatory decision-making. Thus, the requirement for real-world data (RWD) and real-world evidence (RWE) is growing. However, the definition of RWD is ambiguous in domestic laws and regulations, and drug safety management systems that use RWD are insufficient. We conducted focus group interviews (FGIs) regarding the definition of RWD and the approaches national institutions or industries must adopt to introduce RWD/RWE in regulatory decisions for the entire drug life cycle. Experts from academia, industry, government, and medical fields who have experience with RWD/RWE research were requested to participate in FGIs by email. The participants were classified into three groups (academia, industry, and government and medical professionals). Online discussions were conducted for each group. A total of 16 stakeholders were recruited for the FGIs: five from academia, seven from industry, three from government agencies, and one from the medical field. Most participants agreed with the opinion that RWD has not been collected through traditional clinical trials and should be defined comprehensively. The experts also suggested that national institutions and industries should prepare guidelines and infrastructure regarding RWD collection, RWE generation, and RWD/RWE management. In conclusion, national institutions and industries should set short- and long-term goals to introduce RWD/RWE in regulatory decision-making.

테오필린에 대한 약물동력학 자문서비스의 비용-편익분석

한은아,양봉민,이의경 한국의료QA학회 2000 한국의료질향상학회지 Vol.7 No.2

Background : Economic evaluation of clinical pharmacokinetic consultation services for theophylline, which is being widely used recently, is considered in patients for both proper care and cost efficiency. Mathods : This is a cost-benefit analysis of clinical pharmacokinetic consultation service for theophylline. Trial groups were chosen from 2 general hospitals which was performing clinical pharmacokinetic consultation- services in 1998. Control group was chosen from another one general hospital. The analysis includes 25 patients (sample patients) for trial group and 17 patients tor-control group. Results : On the basis of incremental analysis, it is estimated that the total (direct and indirect) annual costs of the clinical, pharmacokinetic services of theophylline for the patients in the trial group was about ￦65 million, whereas total annual benefits from those services was estimated to be about ￦551 million. The net benefits incurred to the sample patients, thus calculated, was about ￦485 million per year. In the analysis, we assumed that indirect benefits accruing to those services were non-existent. If that amount was included, the estimated net benefits would be much greater than the calculated one. Conclusion : We found that clinical pharmacokinetic consultation services for theophylline could produce more marginal benefits than marginal costs by those services from the social point of view. More controlled prospective trial in the future would be helpful for affirmation of the results of this study.