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.

부모양육 태도와 부모소진 및 자녀 학업소진의 관계

한은아,김보영,이상민,신효정 안암교육학회 2011 한국교육학연구 Vol.17 No.1

본 연구에서는 부모와 청소년 자녀를 대상으로 부모양육 태도와 부모소진 및 자녀 학업소진의 관계를 각각 알아보고, 부모양육 태도가 부모소진과 자녀 학업소진에 미치는 영향력, 지각된 부모양육 태도가 자녀 학업소진에 미치는 영향력, 그리고 부모소진이 자녀소진에 미치는 직·간접적인 영향력을 검증하였다. 경로분석(path analysis)의 결과, 어머니의 경우, 어머니 돌봄, 과보호가 자녀가 지각한 어머니 돌봄 과보호에 각각 직접효과가 있었다. 어머니 돌봄과 어머니 소진의 감소, 그리고 어머니 소진과 자녀소진은 직접효과로 유의한 영향력이 있었으며, 어머니 돌봄은 자녀 학업소진에 간접적인 영향이 있었다. 아버지의 경우, 아버지 돌봄은 아버지 소진에 부적인 영향력이 있었고, 아버지 과보호는 아버지 소진에 정적으로 유의한 영향력을 나타냈다. 아버지 소진은 자녀 소진과 관계가 없고, 자녀가 지각한 아버지 돌봄과 과보호는 아버지 자신이 지각한 돌봄과 과보호와 간접효과를 가졌다. 아버지 소진은 자녀가 지각한 아버지 돌봄과 부적으로 직접적인 영향이 있는 것으로 나타났음을 확인할 수 있었다. 마지막으로 연구자는 연구결과의 함의와 한계점에 대해서 논의하였다. The purpose of this study was to investigate relationship between parental bonding and parents burnout, relationship between perceived parental bonding and children academic burnout, and relationship between parents burnout and children academic burnout. The data were composed of 115 pairs of elementary school students and their parents through a self-reported questionnaire. The results showed that mothers' care and overprotection had a direct effect on perceived parental bonding of children respectively. Mothers' care had indrectly influenced children's academic burnout. Also, mothers' burnout directly affected on academic burnout of children. While father's burnout had nothing to do with children's academic burnout. Father's care and overprotection had a indirect effect on perceived parental bonding of children. Perceived paternal care was directly influenced by father's burnout. Implications for the findings and directions for future study are discussed.

Hyperbaric oxygen therapy association with occurrence of delayed neurologic sequalae in patients with carbon monoxide poisoning

한은아,유지나 대한응급의학회 2023 대한응급의학회 학술대회초록집 Vol.2023 No.2

응급실에 내원한 Klebsiella pneumoniae 균혈증 노인 환자의 임상적 특성 및 생존

한은아,김현종,정성필,김경민,김창오 대한노인병학회 2012 Annals of geriatric medicine and research Vol.16 No.4

Background: Recently, the number of elderly patients with bacteremia has been increasing in the emergency room. Klebsiella pneumoniae is the second common agent of all gram negative bacteremia. We designed this study in order to describe the clinical characteristics and outcomes of elderly patients with K. pneumoniae bacteremia in the emergency room. Methods: We retrospectively reviewed medical records of 109 patients infected with K. pneumoniae, who visited an emergency room of a tertiary hospital from March 2006 to October 2010. All patients were divided into two groups (83 survivors versus 26 nonsurvivors). We compared the outcomes and the clinical characteristics between the two groups. Results: A total of 26 patients (23.9%) died in this study. There were no significant differences in age, sex, previous medical and surgical history between survivor and nonsurvivor groups. In the univariate logistic regression analysis, the significant favorable factors for survival associated with K. pneumoniae bacteremia were malignancy (odds ratio [OR], 0.311; p=0.018),Charlson comorbidity index (OR, 0.787; p=0.010), intensive care unit admission (OR, 0.260; p=0.032), mean arterial pressure (OR, 1.053; p=0.001), body temperature (OR, 2.250; p=0.001), blood urea nitrogen (OR, 0.969; p=0.002), albumin (OR, 6.739; p<0.001) and lactate (OR, 0.876; p=0.046). In a multiple logistic regression, the significant risk factors for predicting mortality were low body temperature (OR, 1.036; p=0.044) and low serum albumin (OR, 5.636; p=0.002) at the time of admission. Conclusion: Initial albumin level and body temperature were significant risk factors of mortality in elderly patients in the emergency room infected by K. pneumoniae bacteremia. Elderly patients with K. pneumoniae bacteremia in the emergency room should be carefully observed due to the high mortality rate. 연구배경: 최근 노인 인구가 급증하면서 응급실을 통해내원하는 환자들 중 노인의 비율이 높아지고 있다. Klebsiella pneumoniae 균혈증은 응급실을 통해 내원하는 균혈증 환자들중 많은 부분을 차지하고 있다. 현재 노인 환자에 대한 많은연구가 진행되고 있음에도 불구하고, 국내 노인 환자에 대한K. pneumoniae 균혈증에 대한 연구는 드물어 본 연구를 시행하였다. 방법: 2006년 3월부터 2010년 10월까지 일개 3차 응급의료센터로 내원한 65세 이상의 노인 환자들 중 혈액 배양 검사에서K. pneumoniae가 동정된 환자 115명 중 2쌍 이상에서 동정된환자 109명을 대상으로 하였다. 이들을 생존군과 사망군으로나누었으며, 각 군별로 생체 징후, 기저 질환, 재원 기간, 혈액검사 결과 등의 임상적 특징을 살펴보았다. 결과: 총 109명의 환자들 중 26명의 환자가 사망하였다(23.9%). 생존에 영향을 미칠 수 있는 인자로는 악성 종양(OR, 0.311;95% CI, 0.118 to 0.819; p=0.018)이 있는 경우가 없는 경우에비해 생존의 가능성이 떨어졌고, Charlson comorbidity index (OR, 0.787; 95% CI, 0.655 to 0.945; p=0.010)가 클수록생존의 가능성이 떨어졌다. Intensive care unit 입실 여부(OR,0.26; 95% CI, 0.076 to 0.893; p=0.032)도 환자의 생존에영향을 미치는 인자였다. 생체 징후에서 내원 당시의 평균 동맥압(OR, 1.053; 95% CI, 1.021 to 1.086; p=0.011)이 높고,체온(OR, 2.250; 95% CI, 1.379 to 3.670; p=0.001)이 높은것이 생존과 연관이 있을 수 있는 인자로 통계적으로 유의미한차이가 있었다. 내원 당시의 혈액 검사에서 혈액요소질소(OR,0.969; 95% CI, 0.950 to 0.989; p=0.002)가 낮고, 혈청 알부민(OR, 6.739; 95% CI, 2.763 to 16.436; p<0.001)이 높으며,젖산염(OR, 0.876; 95% CI, 0.769 to 0.998; p=0.046)이낮은 것이 생존과 연관이 있을 수 있는 인자였다. 다중 회귀분석 결과 낮은 체온과 낮은 알부민이 사망의 위험 인자일수 있음을 알 수 있었다. 결론: K. pneumoniae 균혈증은 노인 환자에서 호발하는균주이며, 노인 환자들은 비전형적인 증상 발현이 많은데,K. pneumoniae 균혈증 노인 환자의 기저 질환, 내원 당시의체온과 혈액 검사 결과도 예후를 예측하는데 도움이 될 수있다. 특히 내원 당시의 낮은 체온과 낮은 알부민은 사망과관련된 인자로 나타났으며, 추후 전향적 연구가 필요하다.

Effect of Prehospital Epinephrine on Out-of-Hospital Cardiac Arrest Outcomes: A Propensity Score-Matched Analysis

한은아,공태영,유제성,박인철,박고은,이수지,정성필,Korean Cardiac Arrest Research Consortium (KoCARC) Investigators 연세대학교의과대학 2022 Yonsei medical journal Vol.63 No.2

Purpose: A pilot project using epinephrine at the scene under medical control is currently underway in Korea. This study aimedto determine whether prehospital epinephrine administration is associated with improved survival and neurological outcomesin out-of-hospital cardiac arrest (OHCA) patients who received epinephrine during cardiopulmonary resuscitation (CPR) in theemergency department. Materials and Methods: This retrospective observational study used a nationwide multicenter OHCA registry. Patients were classifiedinto two groups according to whether they received epinephrine at the scene or not. The associations between prehospitalepinephrine use and outcomes were assessed using propensity score (PS)-matched analysis. Multivariable logistic regression analysiswas performed using PS matching. The same analysis was repeated for the subgroup of patients with non-shockable rhythm. Results: PS matching was performed for 1084 patients in each group. Survival to discharge was significantly decreased in the patientswho received prehospital epinephrine [odds ratio (OR) 0.415, 95% confidence interval (CI) 0.250–0.670, p<0.001]. However,no statistical significance was observed for good neurological outcome (OR 0.548, 95% CI 0.258–1.123, p=0.105). For the patientsubgroup with non-shockable rhythm, prehospital epinephrine was also associated with lower survival to discharge (OR 0.514, 95%CI 0.306–0.844, p=0.010), but not with neurological outcome (OR 0.709, 95% CI 0.323–1.529, p=0.382). Conclusion: Prehospital epinephrine administration was associated with decreased survival rates in OHCA patients but not statisticallyassociated with neurological outcome in this PS-matched analysis. Further research is required to investigate the reasonfor the detrimental effect of epinephrine administered at the scene.

치매예방을 위한 ‘인지강화프로그램’의 효과 연구: 60세 이상 인지저하수용자

한은아,금명자 한국교정학회 2014 矯正硏究 Vol.- No.62

The purpose of this study is to identify the prevalence of dementia, improve thequality of life and prevent the progression of severe dementia through earlydetection of dementia of the elderly inmates over 60 years old in K prison locatedin Gyeongbuk. Dementia screening test (Mini-mental State Examination) wasperformed and depression and self-esteem were measured with targets of allelderly inmates over 60 years. Upon examination, it was checked whether theywanted to participate in the program. After the test results came out, it waschecked again whether they wanted to participate in the program. “Cognitiveenhancement program” was performed with targets of 18 volunteers among thosewho had cognitive impairment. After program, satisfaction test was additionallyperformed in addition to all tests performed prior to the program. Upon comparisonof pre- and post-tests, cognitive score in dementia screening test was improvedand depression score was lowered. It seemed effective, but there was no change inself-esteem. However, as participation of the elderly inmates was high, itcontributed to improve the quality of life of the elderly inmates. 본 연구는 경북 K교도소 60세 이상 수용자의 치매유병률 파악과 노인 수용자들의 삶의 질 향상도모와 치매의 조기 발견으로 중증화로의 진행을 방지하기 위하여,60세 이상 수용자 전체를 대상으로 치매선별검사(간이정신상태검사), 우울증, 자존감을 측정하였으며, 검사시 프로그램참여 여부를 확인하고, 검사결과가 나온 후, 프로그램참여 여부를 재확인하여, 인지저하자 중 자발적인 참여자 18명을 대상으로“인지강화프로그램”을 실시하였다. 사후에는 사전과 같은 검사와 더불어 만족도 검사를 실시하였다. 사전. 사후 비교시 치매선별검사의 인지점수는 향상되고, 우울점수는 낮아져 효과적인 것으로 나타났지만, 자존감엔 변화가 없었다. 그러나 참여자들의 만족도는 높아 수용자들의 삶의 질 향상엔 기여하고 있었다.

중독관리센터의 경제적 효과에 대한 체계적 고찰

한은아 ( Eunah Han ),황현아 ( Hyuna Hwang ),유지나 ( Gina Yu ),고동률 ( Dong Ryul Ko ),공태영 ( Taeyoung Kong ),유제성 ( Je Sung You ),좌민홍 ( Minhong Choa ),정성필 ( Sung Phil Chung ) 대한임상독성학회 2021 대한임상독성학회지 Vol.19 No.1

Purpose: The purpose of this study was to conduct a systematic review to investigate the socio-economic benefits of the poison control center (PCC) and to assess whether telephone counseling at the poison control center affects the frequency of emergency room visits, hospitalization, and length of stay of patients with acute poisoning. Methods: The authors conducted a medical literature search of the PubMed, EMBASE, and Cochrane Library databases. Two reviewers evaluated the abstracts for eligibility, extracted the data, and assessed the study quality using a standardized tool. Key results such as the cost-benefit ratio, hospital stay days, unnecessary emergency room visits or hospitalizations, and reduced hospital charges were extracted from the studies. When meta-analysis was possible, it was performed using RevMan software (RevMan version 5.4). Results: Among 299 non-duplicated studies, 19 were relevant to the study questions. The cost-benefit ratios of PCC showed a wide range from 0.76 to 36 (average 6.8) according to the level of the medical expense of each country and whether the study included intentional poisoning. PCC reduced unnecessary visits to healthcare facilities. PCC consultation shortened the length of hospital stay by 1.82 (95% CI, 1.07-2.57) days. Conclusion: The systematic review and meta-analysis support the hypothesis that the PCC operation is cost-beneficial. However, when implementing the PCC concept in Korea in the future, it is necessary to prepare an institutional framework to ensure a cost-effective model.

차량궤적데이터 기반 안전대체지표를 통한 고속도로 합류부 영향권 산정 및 검증

한은서,박호철 한국ITS학회 2023 한국ITS학회 학술대회 Vol.2023 No.11

자율주행 현황 및 해제원인 분석 연구 : 미국 캘리포니아 제출보고서 기반

한은서 한국ITS학회 2022 한국ITS학회 학술대회 Vol.2022 No.06

논문편 - 식생활 분야 : 냉장계육의 조리시 메치오닌함량의 변화에 대한 연구

한은해 ( Eun Hae Han ) 대한가정학회 1981 Family and Environment Research Vol.19 No.1