한의 외래에서 첩약을 포함한 비급여 조제 한약 이용결정요인 분석

김동수,김현민,임병묵,Kim, Dongsu,Kim, Hyunmin,Lim, Byungmook 대한예방한의학회 2018 대한예방한의학회지 Vol.22 No.1

Objectives : This study aimed to analyze the characteristics of uninsured herbal medicine(UHM) users and the economic and social barriers of UHM utilization. Methods : We used the Korea Health Panel Data, representative national survey on medical utilization and cost, provided by National Health Insurance Service and Korea Institiute of Health and Social Affairs. The frequency analysis was used to identify the characteristics of the respondents, and the cross-analysis (${\chi}^2-test$) was used to verify the relationship between their characteristics and the usage of UHM. In order to analyze the determinants of using the UHM considering the individual's characteristics, logistic regression analysis and multiple regression analysis were conducted for those who used the Korean medicine (KM) outpatient service in 2015. Results : The usage of UHM was significantly lower for those (1) who's age of 20 to 65; (2) who have the university or higher education degree; (3) who live in Jeju province, and (4) who bought the herbal medicine for other health related purposes. On the other hand, the usage of UHM for those (1) who have the first quintile of household income; (2) who have the chronic respiratory disease; (3) who have been taking the medicine for health promotion purpose for more than 3 months and (4) who have purchased the food which has health promotion function was significantly higher than others. The patients who have chronic musculoskeletal diseases accounted the most among the UHM users. Conclusions : There was the considerable inequality in the usage of UHM among household income groups, which provides policy rationale for UHM to be covered by national health insurance. To facilitate the coverage expansion, restrictive covering model can be considered for children and adolescents, or for patients with muskuloskeletal diseases who have the high demand for UHM.

비급여를 포함한 한의 외래의료이용의 최근(2008-2013) 변화추이

김동수,임병묵,Kim, Dongsu,Lim, Byungmook 대한예방한의학회 2017 대한예방한의학회지 Vol.21 No.1

Objectives : This study aimed to analyze the structure and the trend of utilization and expenditure for Korean Medicine (KM) in Korea. Methods : Data were drawn from the 2008-2013 annual Korea Health Panel (Version 1.2.2), a national representative sample. We combined the data of household members with the data of outpatient KM service use. The volume of KM use was estimated based on the frequency of use and co-payment. Results : The KM utilization rate slightly increased in recent years, and it is presumed to be resulted from the increase of elderly population. Most KM outpatient visits were being concentrated in treating musculoskeletal diseases, and the procedures used frequently were acupuncture, moxibustion, cupping, and physical therapy. The imbalance of KM use between lower income group and higher income group was deepening. Conclusions : To expand restricted disease areas KM covered, the more herbal prescriptions should be insured and the insured form of herbal medicines need to be diversified.

남북 전통의학 용어 표준화의 필요성과 향후 과제

김동수,이은희,최문석,Kim, Dongsu,Yi, Eunhee,Choi, Moonseok 대한예방한의학회 2020 대한예방한의학회지 Vol.24 No.3

Background : Mutual understanding between North and South Korea is essential for the engagement of Inter-Korean exchange and cooperation. However, the two Koreas have been divided for 70 years where Korean evolved differently within the two countries. This created a gap in the most basic foundation for mutual understanding, language. Fostering exchange and cooperation in the traditional medicine field requires a higher understanding of the specialized traditional medicine terminologies. Objectives : The purpose of this study is to formulate a future management plan for the "Comparative Terminology of Korean Medicine in South and North Korea," providing a foundation for standardizing Korean medicine terminology of the two Koreas. Methods : The study collected case studies of Korean medicine terminology management and standardization from government and international organization websites and documents. It provided future terminology management strategies based on this data. Results : The project for the standardization of Korean medicine terminology between North and South Korea can be divided into 4 stages according to the level of exchange and cooperation. The first step is to "establish a foundation for terminology standardization." The second step is "term comparison." If the exchanges and cooperation between North and South Korea, the third step will be to promote the "terminology standardization" project through Inter-Korean dialogue. Finally, after incorporating discussion on terminology standardization, the Inter-Korean Medicine Terminology can be published. Conclusions : This requires a system to support and facilitate Inter-Korean medicine exchange and cooperation. It is important to provide a support system that can provide results in a timely fashion by training relevant experts, collecting data and information, communicating with experts in the industry, academia and research institutes. This system will be able to ensure the continuity of the terminology standardization project.

한의의료비 자료원의 비교 분석 연구 : 조사 방법 및 2012년 한의원 의료비를 중심으로

김동수,정명수,이은경,고성규,Kim, Dongsu,Chong, Myongsoo,Lee, Eunkyoung,Ko, Seong-Gyu 대한예방한의학회 2015 대한예방한의학회지 Vol.19 No.2

Objective : In order to understand the scale of medicinal expenditure in the Korean medicine, an analysis has been made of Korean National Health Account and statistic archives used to estimate the Korean National Health Account and also of such archives as are contributory to learn the scale of total health expenditures in the Korean medicine. Method : From the Korean National Health Account archives, an analysis has been made of National health insurance statistic annual reports, National health insurance non-payment items, Korean Economic Census (The Service Industy Survey), and Korea Health Panel data. Moreover, in order to know the sales of overall Korean medicine clinics, relevant data have been utilized and cited from investigations into National tax statistics, Korean medicine medical institutions and Korean medicines used, and current states of medicinal herbs and Korean medicine industry. Results : It is found that the average scale of each section of the medical expenditures archives in the Korean medicine in 2012 was KRW 3.5638 billion and that the average medical expenditures in the Korean medicine derived from Total Health Expenditure, The Service Industy Survey, National tax statistic, and Korean medicine industry are approximately KRW 3.3901, 3.4796, 3.7218 and 3.9634 billion. And the average expenditures derived from National health insurance patients and Korea Health Panel data are 2.5162 and 2.2292 billion won and those from the users and consumers of Korean medicines and herbs are 5.6,461 billion won. In order to verify the appropriateness of estimated medical expenditures in the Korean medicine included in the archives, an analysis has been made of uninsured costs which come from the aggregate sales amount surveyed minus health insurance treatment expenditures and it is found that the ratio of insured costs against total health expenditures in 2006 was 50.67% and 41.92% in 2012 and that the ratio based on National tax statistics and The Service Industy Survey was 52.19% and 49.28% in 2006 and 50.54% and 50.64% in 2012 and that the ratio of uninsured costs against Korean medicines and herbs and Korean medicine industry was 37.5% and 58.27% in 2013. Conclusion : It calls for the improvement of the accuracy of an investigation into Total Health Expenditure which comprise the actual conditions of health insurance and Korea Health Panel, the development of statistic schemes for understanding and classifying medical expenditures of all the Korean medicine medicinal institutions like medicinal clinics, and enhanced methods for independent panels to comprehensively collect and analyze the number of sampled Korean medicine medical institutions.

한약재의 연도·산지·업체별 가격변동 분석 연구

김동수,임병묵,현은혜,이은경,Kim, Dongsu,Lim, Byungmook,Hyun, Eunhye,Lee, Eunkyung 대한예방한의학회 2019 대한예방한의학회지 Vol.23 No.2

Objectives : This study aimed to analyze price variance by year, region and company of raw herbal medicines to draw payment system for herbal medicine insurances in the National Health Insurance. Methods : To analyse price variance, we used 2015-2017 data of 'Quality test results of imported herbal medicines' provided by Korea Pharmaceutical Traders Association and 'Price data of 56 raw herbal medicines' that was surveyed by the Association of Korean Medicine. We analysed gap of highest price and lowest price those were compared with average price and coefficient of variation(CV) of prices by year, region and company of raw herbal medicines. Results : In analysing 3 years data, the highest price was 23.2% higher, and the lowest price was 19.1% lower than the average price. As of 2018, the average price of domestic produced herbal medicines was 1,8 times higher than that of imported herbal medicines. By companies, the highest price was 117.5% higher, and the lowest price was 57.3% lower than the average price. Conclusions : The price of herbal medicines varied by production year, region and company. This results suggest that comprehensive payment model needs to be considered in modeling the health insurance coverage for herbal medicine decoctions.

대만 중의 건강보험의 체계와 서비스 질 향상 정책

김동수,권수현,정설희,안보령,임병묵,Kim, Dongsu,Kwon, Soo Hyun,Chung, Seol Hee,Ahn, Bo Ryung,Lim, Byungmook 대한예방한의학회 2016 대한예방한의학회지 Vol.20 No.2

Backgrounds : Taiwan has similar national health insurance (NHI) system for traditional medicine with South Korea. Recently, new quality improvement policies for traditional medicine is being attempted in Taiwan. Objectives : This study aimed to review the Taiwanese NHI system for Chinese Medicine (CM) and introduce quality improvement policies. Methods : Research articles, reports, government publications and year books which handled traditional medicine system and NHI system in Taiwan were searched and collected. The authors analyzed and summarized the contents in a qualitative manner. Results : In Taiwanese NHI system, CM procedures and medication for outpatients are reimbursed through a mix of fee-for-service and global budget payment system. CM shares 4% of total expenditure of NHI in Taiwan. Mostly, the expenses for procedures are reimbursed regardless of disease type, however, in the specialized program for quality improvement, CM doctors have to comply with standard operating procedures (SOPs). Conclusions : Taiwanese NHI system implemented SOP-based new reimbursement system for CM. Yet, the scientific evidences for SOPs are not sufficient, it can be useful references when we develope disease related reimbursement system for Korean Medicine in South Korea.

사용자 경험 개선과 음식물 쓰레기 자원화를 고려한 음식물 쓰레기 처리기

김동수(Dongsu Kim),김관명(KwanMyung Kim) 한국디자인학회 2023 한국디자인학회 학술발표대회 논문집 Vol.2023 No.10

개선된 모집단 초기화 기법을 이용한 콘크리트 아치댐의 형상 최적화

김동수 ( Dongsu Kim ),이상익 ( Sangik Lee ),이종혁 ( Jonghyuk Lee ),서병훈 ( Byunghun Seo ),서예진 ( Yejin Seo ),김동우 ( Dongwoo Kim ),이드아함드파지 ( Ahmed Fawzy Eid ),최원 ( Won Choi ) 한국농공학회 2023 한국농공학회 학술대회초록집 Vol.2023 No.0

콘크리트 아치댐은 일반적인 콘크리트 중력댐과 달리 얇은 아치형의 단면을 가지며 반드시 3차원 형태를 고려하여 설계해야 한다. 특히, 연직 단면과 수평 단면 모두 아치형을 가지는 이중곡률 (double-curvature) 아치댐은 다른 형태의 댐에 비하여 설계 시 고려해야 할 요소가 많고 응력해석이 복잡하지만 보다 적은 양의 재료가 사용되어 경제적인 강점을 가지므로, 전 세계적으로 다수의 아치댐이 건설된 바 있으며 최적 형상을 설계하기 위한 연구가 지속되고 있다. 이에 본 연구에서는 이중곡률을 가지는 콘크리트 아치댐의 형상 최적화를 위하여, 유전 알고리즘 (genetic algorithms)을 기반으로 개선된 모집단 초기화 기법을 적용하는 효율적인 최적화 알고리즘을 개발하고자 하였다. 개선된 모집단 초기화 기법을 적용하기 위하여 축적된 경험 지식과 문헌에서 제시되는 경험식을 조사하여 도메인 지식의 활용성을 검토하였다. 개발된 알고리즘은 아치댐 설계 분야의 도메인 지식을 이용하여 우수한 초기 모집단을 생성하며, iteration 마다 모든 설계안들에 대해 응력해석을 수행하여 제약조건을 검토하고 적합도 (fitness)를 목적함수로써 계산한다. 개선된 모집단 초기화 기법에 의한 최적화 알고리즘의 성능을 검증하기 위하여 기존댐을 시험 대상지로 선정하여 알고리즘 적용 시험을 수행하였으며, 본 연구에서 개발된 알고리즘이 기존의 방법보다 평균 적합도 및 수렴속도 측면에서 더 우수한 성능을 보이는 것을 확인하였다.

디젤엔진의 DPF 재생 시 입자상 물질의 크기 분포 및 개수 특성

김동수(Dongsu Kim),이정우(Jeongwoo Lee),이준용(Junyong Lee),이승하(Seungha Lee),이승현(Seunghyun Lee),이정연(Jungyeon Lee),이윤우(Yoonwoo Lee),최회명(Hoimyung Choi),민경덕(Kyungdoug Min) 한국자동차공학회 2012 한국자동차공학회 학술대회 및 전시회 Vol.2012 No.11

EGR is a promising technique to meet the demand of stringent emission regulations. For example, the new upcoming emissions regulation, EURO 6, requires reduction of NOx emissions by 55% while maintaining the same level of PM emissions. However, reducing NOx emissions by applying a higher EGR rate inevitably yields higher PM emissions due to NOx-PM trade-off relationship. Hence, increased PM emissions caused by the use of higher EGR rate lead to more frequent DPF regeneration. Therefore, it is necessary to have a look at emission characteristics during the regeneration event. However, most of recent studies focus on downstream emissions of after-treatment system. Thus, in this research, not only the distribution of downstream PM particle size is studied but also the distribution of upstream PM particle size is investigated so that future strategies and data for DPF regeneration can be established. In general, DPF regeneration is favored at high speed and load conditions.

4차산업 기술 기반 녹조 모니터링 기술 개발

김동수 ( Kim Dongsu ),김영도 ( Kim Young Do ),류시완 ( Lyu Siwan ),박용성 ( Park Young Seung ) 한국물환경학회 2020 한국물환경학회·대한상하수도학회 공동 춘계학술발표회 Vol.2020 No.-

조류는 계절별 기상 및 수질 조건에 따라 규조, 녹조, 남조의 발생 및 천이가 이루어지는데 최근 기후 변화로 인해 출연종 별 발생 및 천이의 시기 또한 빨라지고 있다. 이 중 남조류의 경우 초여름에 발생하여 급격한 증식으로 대발생되어 녹조현상을 야기하고 이는 해당 수역의 생태계 파괴, 그 이외에도 사회적, 경제적, 환경적인 측면에서 많은 문제를 유발한다. 하천·호소의 조류의 발생과 거동에 대한 이해와 효과적인 대응책 마련을 위하여 현상에 대한 모니터링이 선행되어야 하지만 기존 조사방식은 점, 선 단위의 간헐적 측정을 통해 진행되고 있어 많은 인력과 시간이 필요로 하고 있는 실태이다. 현재 이에 따른 문제 해결을 위한 하천 · 호소의 원격탐사 기법을 이용한 조류의 발생 및 거동에 대한 모니터링 연구가 많이 진행되고 있다. 본 연구에서는 조류의 공간적인 조류 모니터링 가능한 몇 가지 방식을 제안하고자 한다. 첫째, 통상적인 BGA 센서를 ADCP 및 YSI 센서와 병행하여 보트에 부착하여 이동식으로 운영하여 지리 참조된 상태로 녹조의 공간분포 산정하는 방식이다. 둘째는 ADCP 자체의 생성되는 자료를 기반으로 Hot-spot 분석 기법을 적용하여 녹조 우심지역을 산정하는 기법이다. 셋째는 현장형 레이저입도분석기인 LISST를 공간적으로 운용하여 녹조입도분포 분석을 통해 녹조 농도를 간접적으로 추정하는 기법이다. 넷째는 통상적인 드론 탑재 광학영상을 활용하여 녹조의 공간적인 분포를 영상분석을 통해 분할하는 방식이다. 마지막으로 드론에 탑재된 초분광 영상을 활용하여 조류의 종류, 농도 등의 공간적인 분포를 추정하는 방식이다. 이러한 다양한 방식들은 조류가 빈번하게 발생하는 합안보 상류인 남강과 낙동강 합류부 인근 하천에 적용되어 가능성을 평가받았다.