노인의 부적절한 다약제 사용 관리 기준 마련

윤상헌,김동숙,채정미,최연미,조호진 건강보험심사평가원 심사평가정책연구소 2023 연구보고서 Vol.2023 No.0

As the elderly often suffer from multiple diseases simultaneously, they must often take several drugs prescribed by various physicians for a long time. Polypharmacy in the elderly is likely to result in negative health outcomes such as emergency room visits or hospitalization and increased medical costs. This does not mean that all polypharmacy is entirely negative or harmful. Since it may be inevitable in some cases, it is necessary to distinguish between appropriate and inappropriate polypharmacy for each patient by considering existing co-morbidities, the patient's clinical condition, and potential drug interactions. This study was conducted to define the criteria for inappropriate polypharmacy in the elderly, analyze its health consequences, and prepare a customizable management plan that promotes changes in prescription and medical usage patterns of medical institutions and patients. We reviewed clinical cases and suggested the inappropriate polypharmacy criteria as follows. ⅰ) the aged 65 years or older who had taken 10 or more medications for 90 days or more, and ⅱ) any of the drugs taken were included in the 77-ingredient list derived from this study or in the overlapping prescriptions or concomitant contraindications. Using health insurance claims data, we analyzed the status of inappropriate polypharmacy in the elderly and its consequent health outcomes, such as hospitalization, emergency room visits, and death. The inappropriate polypharmacy group comprised 245,477 patients, which accounted for 16.0% of the total polypharmacy group. After adjusting for variables affecting negative health outcomes, the probabilities of hospitalization, emergency room visit, and death were 1.32 to 1.35 times higher. This suggested that among polypharmacy patients, patients under inappropriate polypharmacy have a higher chance of experiencing negative health results. The problems and implications of polypharmacy in the elderly in Korea were identified by case review. Based on this, with expert advice, an effective management plan to reduce inappropriate polypharmacy in the elderly was presented. This study is meaningful in that it presented the inappropriate polypharmacy criteria in the elderly in consideration of the clinical situation, including the importance of policies, realistic validity, and applicability, empirically analyzed the current status and further presented realistic and specific management plans at the national level.

落島 정주여건 개선에 관한 연구

윤상헌 목포대학교 도서문화연구원 2017 島嶼文化 Vol.0 No.50

본고는 낙도의 정주여건에 초점을 두어 정주환경을 살펴보고 정주여건 향상을 위한 방안을 모색해 보았다. 우선 낙도의 개념과 범위가 명확하지 않은 바, 사전적 정의, 현행 법령상의 조항 및 선행연구를 바탕으로 낙도의 개념과 범위를 규정하였다. 본고에서는 낙도를 ‘육지로부터 원거리에 위치한 도서로서 접근이 불편한 도서’ 즉, ‘연륙(육지와의 차량통행이 가능한 도서 포함)되지 않은 도서로서 육지에서 8㎞ 이상 떨어진 도서이며, 정기여객선이 3항차 이하로 운행하는 도서’로 정의하였다. 이러한 정의에 부합하는 도서 즉, 낙도는 271개로서 유인도서 463개 중 58%를 차지하는 것으로 나타났다. 낙도의 정주여건을 파악하기 위해서 『도서백서』 데이터 및 6개 도서를 표본으로 추출하여 주민에 대한 설문조사 및 현장조사를 실시하였다. 도서백서의 데이터 분석을 통해서 본 낙도의 생활환경은 일반 도서에 비해 더욱 열악함을 알 수 있었다. 주민 설문조사(가장 불편한 점, 섬 발전 장애요소, 개선이 요구되거나 필요한 시설 및 활동 등) 및 현장조사를 통해 본 생활환경 역시 열악함을 알 수 있었다. 특히, 교통(여객선의 운항 횟수, 직항로), 식수(물 부족), 의료(의료시설, 응급의료시스템) 부분에서 많은 불편을 느끼고 있었다. 낙도의 정주실태를 바탕으로 정주여건 개선을 위한 부문별 개선과제를 도출하고 이를 해결하기 위한 방안을 제시하였다. 정주여건 개선을 위한 단기 정책 및 사업으로는 ‘낙도 항로 개편’, ‘낙도 국가 어항 정비’, ‘도서종합개발사업의 낙도 지원 강화’, ‘민간기업과의 협력’을 들 수 있으며, 중․장기 정책 및 사업으로는 ‘낙도 정주여건 개선을 위한 관련법 개정’, ‘체계화된 낙도 실태 조사 및 DB 구축 지속’, ‘낙도에 적합한 정주환경 기준 마련’, ‘낙도별 특성을 고려한 특화발전계획 수립’, ‘중간지원조직 구축 및 전문 인력 확보’를 들 수 있다. This paper focuses on the settlement conditions on remote islands in Korea and examines the islands’ environment to find ways to improve the conditions. First, the concepts and scope of the term “remote islands” is defined based on dictionary definitions, provisions of existing laws and prior research. As a result, a remote island is referred to as “an island that is inconvenient to access as it is located at a considerable distance from the mainland”, or more precisely, an island that is not linked with other land(including other islands through which the mainland could be reached) and that is more than 8 kilometers away from other land and less than 3 hours sailing from any mainland harbor. By this definition, the number of remote islands in Korea is 271, which is 58% of the total number (463) of inhabited islands. In order to understand the settlement conditions on these remote islands, I conducted data analysis based on available islands’ survey records, a questionnaire survey of the residents and a field survey of six sampled remote islands. Analysis of the islands’ survey records revealed that the living environment on remote islands was worse than on islands in general. The residents' survey collected data on what were considered the most inconvenient points, obstacles to development of the island, and facilities and activities required for improvement. Together with the data from the field survey, this also pointed out the poor living conditions. Especially, the residents felt many inconveniences with regard to transportation(the number of passenger ships and direct sea routes), drinking water(the lack of potable water), and medical care(access to medical facilities and the emergency medical system). Given the ascertained situation, the study identifies the tasks for improving the settlement conditions on the remote islands and suggests ways to address particular issues. Short-term policies and projects to improve settlement conditions include “reorganization of the remote islands’ sea routes”, “maintenance of the remote islands’fishing ports”, “support for strengthening the remote islands’ comprehensive development projects”, and “cooperation with private enterprises”. Long-term policies and projects to improve settlement conditions include “reform of related laws to improve the settlement conditions on the remote islands”, “continuation of systematic field surveys and database development of the remote islands”, “establishment of specialized development plans considering the remote islands’ characteristics”, and “establishment of an intermediate support organization and securement of professional manpower”.

어장·어항·어촌을 연계한 소득창출 모델 개발에 관한 연구

윤상헌,이승우 한국해양수산개발원 2014 해양정책연구 Vol.29 No.1

This research was performed with problem raise that fishingground, fishing port and fishing village has to be connected tightly to promoteincome. Therefore model development for income promotion throughconnection of fishing ground, fishing port and fishing village was performedand how this model might be applied to the actual area was shown. Developed five income promotion models are as in the following ;‘Traditional culture type’, ‘Ecological education type’, ‘Marine leisure type’,‘Healing & health type’ and ‘Scenery appreciation type’. ‘Healing & healthtype’ model was applied in Geoje, Dadae village as a case study. For successful action of income promotion model, several points are needed. First, application of income promotion model that community character is considered is needed. Secondly, medium and long term master plan is needed. Thirdly, law and institution for connecting development is needed. Fourthly, in securing financial resources effort of local government is needed. Lastly, expansion of participation opportunities in private sector and local resident for efficient development is needed.

관광지의 캐릭터상품 구매행동에 관한 연구

윤상헌,박석희 한국농어촌관광학회 1999 농어촌관광연구 Vol.6 No.1

The purpose of this study is to know how the mascot merchandise of Everland as a souvenir recognized to visitors. And also to know for them what the purchasing object is, what the mascot merchandise for purchase is, what the purchasing behavior is and what the affective factors for visitor for purchase of the mascot merchandise.<br/> For the verification of this study, a field survey was implemented and got 342 valid samples. The subjects were those who visited the theme park, Everland. Statistical methods including t-test, logistic regression were used.

원형 제트 충돌 열전달과 유동 특성에 관한 실험적 연구 : 노즐 벽 두께와 노즐 출구 압력의 영향

윤상헌,양근영,손동기,최만수,Yoon, Sangheon,Yang, Geunyoung,Sohn, Dong Kee,Choi, Mansoo 대한기계학회 1999 大韓機械學會論文集B Vol.23 No.10

An experimental study on heat transfer and flow characteristics of a circular impinging jet on a flat plate has been carried out. Of particular interests are the effects of nozzle wall thickness and nozzle exit pressure. Experimental apparatus has been designed to view heating plate coated by TLC from the opposite side of the nozzle in order to measure heat transfer rates for cases of very small nozzle to plate spacings. A visualization study of jet flows has also been performed. As the nozzle wall thickness increases at small nozzle to plate spacings, the effect of mixing is inhibited due to the confinement caused by the finite nozzle wall, consequently, heat transfer rates have been decreased. At small nozzle to plate spacings, heat transfer rates and nozzle exit pressures are increased together, therefore, enhancement of heat transfer at small nozzle to plate spacings should be considered in conjunction with the need of more fan power to generate the same Reynolds numbers.

화성(華城)의 안내해설판 이용에 관한 탐색적 연구

윤상헌 경기대학교 화성학연구소 2004 화성학연구 Vol.- No.1

This article deals with visitor's perception and use of interpretive signs in Suwon Hwaseong Fortress which is registered as world heritage by UNESCO World Heritage Center. To obtain data onsite inspection and survey was performed. As a result, visitor's perception and use of interpretive signs was low. But on the relationship between use and satisfaction of interpretive signs, if visitor is active user for interpretive signs and can understand contents of interpretive signs very well, visitor's satisfaction is much higher. This result explains that if interpretive signs are located properly and contents of interpretive signs are written easier to understand, visitor's perception of Suwon Hwaseong Fortress and satisfaction will be high.

아몰퍼스 판재 성형의 스프링 백에 관한 연구

윤상헌,이용신 한국정밀공학회 2005 한국정밀공학회 학술발표대회 논문집 Vol.2005 No.5월

우울증 외래 진료의 적정성 평가 방안 마련

윤상헌,김태완,김기영,염윤진,이지혜 건강보험심사평가원 심사평가연구소 2019 연구보고서 Vol.2018 No.0

논문 - 중소 어항 및 배후지역 실태와 유형별 정비방안

윤상헌,김진환,전택기,Yun, Sang-Hun,Kim, Jin-Hwan,Jun, Teak-Ki 한국관개배수위원회 2011 한국관개배수논문집 Vol.18 No.2

The purpose of this study was to analyze the conditions of small fishing village & fishing port and to suggest the development direction of them. For this, we tried to field survey and research of development demands for 100 sample places. The results of this study were as follows; First, Small fishing villages & fishing ports have different characteristics and their primary industry was a fisheries. And they have a poor condition for basic facilities and industrial facilities, more smaller fishing port. Second, The living satisfaction of residents was decreased gradually because of a decrease in amount of catching fish, a population aging and etc. Residents and public officers was to demand an expansion of basic facilities, an investment of national expenditure and a simplification of administrative procedure. Third, We could establish the development directions by geographical location and funcion of them. And They must development consider their characteristics.

관광개발과 갈등 : 강원남부 폐광지역을 사례로

윤상헌,박석희 한국관광학회 2006 관광학연구 Vol.30 No.3

The purpose of this study was to examine the conflict structure observed in the tourism development process in the abandoned mine areas of the southern Gangwon province for the past 10 years. To investigate the conflict structure, a content analysis of Gangwon daily newspaper, along with various documents and papers issued by the region was conducted, and in-depth interviews were also involved. The main reason for the conflicts may be explained by the pursuit of economic profit based on the security of the right to live. The core bodies of conflict arisen in the process of regional tourism development were the local residents and the central government. A systemic device for conflict management was absent and yet worse, no sustainable strategies against the occurrence of the conflict were applied. Theses caused more conflicts and aggravated the situation.