「생명에 대한 사회의식조사」논평_문옥륜

문옥륜 서강대학교 생명문화연구소 1993 생명연구 Vol.1 No.-

濟州道 一部地域의 絲狀蟲症患者와 象皮病患者에 對한 學的調査 및 Spatonin에 依한 集團化學療法의 臨床報告

文玉綸 서울大學校 保健大學院 1968 公衆保健雜誌 Vol.5 No.2

Filariasis survey was carried out on 1107 subjects of 3 villages located in southern county of Che Ju Do from June to October of 1968. Mass chemotherapy with spatonin (Diethylcarbamazine) on 208 microfilaria positive cases was followed after the survey. The summarized results are as follows: 1. Epidemiological characteristics of microfilaria positives and elephantiasis patients. Microfilaria rates varied by areas with average of 20.9% ranging from 17.3% to 27.1%. Distribution of microfilaria rate by sex did not show any significant difference, however, the distribution of microfilaria rate by age showed two peaks, one for 21-30 years and the other for 41-50 age group. For the remarkable dropped rate for 31-40 years age group, more studies may be necessary to give explanations. The range of microfilaria counts per 40㎣ of blood (density) varied widely from 1 to 788, although the most of microfilaria positives (40%) had less than 25 Mf (microfilaria) per unit of blood. Also the microfilaria density showed interesting correlation between Mf. rate and the density by villages; where the rate was high, the density was proportionately high. The survey by family unit revealed that 40% (average) of total households surveyed had Mf positives, and 80% of positive households had one or two positive family members. On the survey of clinical filariasis, 41 of 1107 subjects were found to have elephantiasis. Female showed predominantly higher rate (2.2 times) compared with that of male. The distribution by age showed definite tendency of increasing rate by increasing age; in more than 80% of the cases, the elephantiasis appeared after 20 years of age, even though the earlest case was 14 years old girl. Sites for elephantiasis were found in 75% on lower extremities, 5% on upper extremities and 20% on both extremities. Erythematous swellings of extremities accompanied by fever seemed to occur once or twice annually. Some contributing factors for the episodes seemed to be related to over exhaustion and/or injuries. 2. Mass treatment with spatonin, its efficacy and side reactions. Mass chemotherapy with spatonin on 208 microfilaria positives gave all excellent efficacy according to the results of blood smear immediately after the last dose of the drug; four experimental groups (by village) treated with 6mg of spatonin/kg body weight every day, every other day for 6 doses, same amount of the drug 6mg/kg of b.w. every other day for first 2 doses and every day for rest of doses, and 3mg/kg of b.w. every other day for 14 doses, showed similar results (92.6%, 91.2% and 88.4% of rate turning to microfilaria negative) for 6mg/kg of b.w. groups regardless of way of administration except 3mg/kg of B.W. group, which had much inferior efficacy than the another groups(only one of five became negative). Six doses of 6mg/kg b.w. spatonin may be enough to turn the positives to negative, although long term follow up study is strongly desired. The side reactions due to the drug was relatively severe especially after the first and second doses. More frequent symptoms were anorexia, fever, headache, joint pain, and dizziness, which became milder when the drug was administered every other day. From this study, it was tentatively concluded that filariasis is one of important endemic diseases in the area studied. and spatonin could be a potent drug for control of filariasis when administered properly.

의료보험 고액진료비 환자의 특성연구

문옥륜,강선희,이은표,좌용권,이현실 韓國保健行政學會 1993 보건행정학회지 Vol.3 No.1

A small number of high cost patients usually spend a larger proportion of scarce health resources. Korea is no exception. Under the national health insurance, 12% of the insured persons have consumed approximately half of the national health insurance expenditures. Therefore, it is necessary to identify the characteristics of the high cost patient group, if we would like to reduce them. This study has defined high cost patients as those who have spent one and half million won and over Per 6 months. The study reveals that high cost users are those who have a longer length of stays(LOS), 40 days of LOS in the 6 months, have multiple admissions, 2 to 3 admissions per 6 months and are the eiderly patients. They have Spent 814, 126won per day on the average, and commonly suffered from malignant neoplasms, circulatory diseases, fracture, diabetes mellitus, etc. Unlike the case of western developed countries, early readmissions are not the major causes of high cost spending in Korea. Undoubtedly, a lengthy admission is the main cause of large spending. Health policies should vigorously be explored to respond appropriately. There are evidences that hospital beds are often misused. As the Korean health care system is lacking in a mechanism of patient evaluation under the fee-for-service remuneration system, an idea of progressive patient care needs to be tested. The Government should set up health policy to diversify the role of long-term care facilities and encourage people to establish them. Further studies are needed to identify factors influencing large medical bills necessary for formulating the health policy on cost containment.

의학교과서를 통해 본 북한예방의학 내용분석에 관한 연구

문옥륜,이신재,김정철,문용,박송림,이상구,Moon, Ok-Ryun,Lee, Sin-Jae,Kim, Jung-Chul,Wen, Yong,Piao, Song-Lin,Yi, Sang-Gu 대한예방의학회 2000 Journal of Preventive Medicine and Public Health Vol.33 No.3

Objectives : The most frequently cited health related slogan in North Korea is that socialistic medicine is preventive medicine. It implies that North Korea puts preventive medicine at the operational center of its national health care system. This study aimed at examining and comparing preventive medicine practices in North Korea with those of South Korea. Methods : Efforts have been made to obtain a textbook for analysis its contents. Many people have iassisted in the study by joining the interview. Some of these people are as follows : a former professor of PyongYang Medical School, NK physicians living in South Korea, WHO staffs, diplomatic officials, etc. The major items of analysis consisted of industrial medicine and hygiene, nutrition, school health, epidemiology, health statistics and heath policy & management. Results : Public health philosophy is finely noted and well integrated in the operation of the North Korean national health care system, particularly in the area of industrial medicine and hygiene. Preventive medicine with a strong health surveillance system spanning a number of broad social organizations is a major tool to improve the health of the people in North Korea. The emphasis on preventive medicine has a close relationship with the 'Juche Philosophy' and the shortage of pharmaceuticals and medical equipment. To cope with the shortage problem, North Korean health workers are encouraged to grow medicinal herbs. We have found that they put little effort into teaching newly emerging diseases, such as AIDS, VDT syndrome, hazards of EMF, and agricultural chemical poisonings. Of the subjects of the preventive medicine text, 78.9% coincide with those of South Korean industrial health manuals and 34.2% with South Korean epidemiology texts. However, an absolute difference was found to exist between the health policies and management systems. Conclusion : In North Korea, the concept of preventive medicine functions as the basic philosophic strategy of the national health care system. It differs greatly from the South Korean system in both practice and educational content. Its contribution to society is simply incomparable to that of South Korea. More communication and further study is called for in order to improve the preventive medicine practices in the future.

英國의 國家保健서비스 制度

文玉綸 대한가정의학회 1988 Korean Journal of Family Medicine Vol.9 No.11

우리나라 의료보험 사업의 정책과제와 전개방향

文玉綸 서울대학교병원부설 병원연구소 1982 병원연구 Vol.1 No.1

약국서비스 평가제도의 도입 방안

문옥륜 약사공론 1996 대한약사회지 Vol.1996 No.1

오늘의 의료보험 어디까지왔나

문옥륜,Mun, Ok-Ryun 대한병원협회 1984 대한병원협회지 Vol.13 No.10

우리나라에 사회보험방식을 통한 의료보험제도가 실시된지 7주년을 맞아 이 제도의 현주소가 어디쯤 되는지, 그리고 그동안의 공과 과가 무엇인지를 살펴본 후 현상태에서 긴급하게 요청되는 정책과제를 몇가지 제시하고자 한다. 그러나 제한된 지면을 고려하여 정책과제의 선정은 전국민 의료보험제도의 실시에 촛점을 맞추어서 이에 관련되는 부분에 국한해서 언급하기로 한다.

질병이 사회에 미치는 영향과 그 대응에 대하여

문옥륜,Mun, Ok-Ryun 한국건강관리협회 1995 건강소식 Vol.19 No.2

보건대학원의 보건전문 인력양성과 활용에 관한 과제

문옥륜 서울大學校保健大學院 2000 國民保健硏究所硏究論叢 Vol.10 No.1

The objective of this paper is to identify problems and status of acts in the production and utilization of health manpower by the Schools of Public Health. The problems are diverse in Korea: too many small Schools of Public Health are established without any accreditation program within a very short period of time. Thus, most Schools of Public Health in Korea lack in basic requirements of the standard School of Public Health, which was laid down by American Public Health Association (APHA) or Association of School of Public Health (ASPH) or by Professor Milton Roemer. In other words, the current status is far from the fulfillment of society's interest in assuring conditions in which people can be healthy as stated by the Institute of Medicine(IOM) in 1998. More specifically, curriculum contents are insufficient to meet the needs of health professionals under the training. Training the leaders of public health should be oriented toward more desired behavioral modifications coupled with provision of scientific knowledge-based evidences. The existing survey results are far from that. Those graduates of Seoul National University School of Public Health, the best one in Korea, stated that half of them 48.9% and 50.6%, were seriously dissatisfied with their training at the School in building practical working capacity and educational capability, respectively. However, three quarters of them were positive in the sense of building basic knowledge and attitudes. A serious reconsideration on curriculum contents of Schools of Public Health is absolutely necessary.