http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
국내 호스피스.완화의료 현황 및 활성화 방안 - 호스피스.완화의료 기관 조사를 바탕으로
경민호,장유미,한경희,윤영호,Kyung, Min-Ho,Jang, Yu-Mi,Han, Kyung-Hee,Yun, Young-Ho 한국호스피스완화의료학회 2010 한국호스피스.완화의료학회지 Vol.13 No.3
목적: 본 연구는 호스피스 완화의료 기관 조사와 통계청 자료를 이용하여 호스피스 완화의료 기관 현황과 장애요인, 그에 따른 활성화 방안을 조사하고 분석하여 향후 정책수립을 위한 기초자료를 제공하고자 실시되었다. 방법: 현황조사를 위해 국내 호스피스 완화의료 관련 단체 및 기관을 통해 호스피스 완화의료 제공 기관을 선정 하여 2009년 2월에서 3월까지 설문을 시행하였으며 설문내용은 기관의 일반현황, 대상자, 서비스 제공인력, 시설, 재정, 활성화 방안으로 구성되었다. 또한 필요병상수 및 병상충족률 산출을 위해 통계청의 지역별 인구수 자료를 이용하였다. 결과: 전체 53개 호스피스 완화의료 기관 가운데 42개 기관이 종합병원 이상으로 총 설문대상 기관 중 의원급 기관은 6개였다. 전체 53개 기관 중 18.8%의 기관이 수도권 지역에 분포하고 있었다. 전반적인 호스피스 완화의료 병상충족률은 21.9%로 낮은 것으로 나타났으며 4개 광역시도의 경우 호스피스 완화의료 전용병상이 없는 것으로 보고되었다. 2008년 호스피스 완화의료기관의 사망자는 전체 암사망자의 6.3%에 불과했다. 기관의 재정 관련한 설문에서 86%의 시설이 재정이 부족하다고 답변하였으며 그 외 인력수급 장애요인 및 시설기준 미충족의 원인으로도 재정 부족을 원인으로 꼽은 기관이 과반수를 넘는 것으로 나타났다. 호스피스 완화의료 활성화를 위한 정부의 지원으로 가장 필요한 부분으로 재정지원이었으며(71.2%), 기부문화 활성화 방안으로 기부금 전액 세금 공제(43.1%), 공익재단 설립(23.5%) 등으로 나타났다. 결론: 본 연구는 이처럼 기관의 현황 자료조사 및 설문조사를 통해 국내의 호스피스 완화의료 이용률 및 병상충족률이 낮은 문제점, 지역별 병상충족률 편차가 큰 문제점 등을 파악하였으며 호스피스 완화의료의 장애요인으로 재정부족, 인력수급 장애, 인식부족 등을 파악하였다. 또한 이를 위해 호스피스 완화의료 기관의 재정마련 방안이 필수적이며 인식 부족에 대한 개선 노력도 동시에 이루어질 필요가 있을 것으로 결론지었다. 이 중 재정 부족에 대한 방안으로는 정부의 재정 지원과 기부금 전액 세금공제와 공익재단 설립이 검토해 볼 만한 대안으로 제시할 수 있겠다. Purpose: This study aimed to evaluate the current status of hospice palliative care facilities in Korea. Based on the result, we attempted to suggest activation plans of hospice palliative in Korea. Methods: To conduct a survey, we obtained a list of hospice palliative care facilities from related agencies and academic societies. A survey was conducted from February, 2009 to March, 2009. The survey was consisted of general characteristics of organizations, manpower, facilities & equipments, and so on. In addition, we used data from Statistics Korea to estimate the number of beds required and the bed occupancy rate. Results: Total number of facilities responded to the questionnaire were 53. Forty-two facilities were general hospitals and 6 facilities were clinics among the total 53 facilities, and 18.8% of facilities were located in Seoul, Incheon and Gyeonggido. Overall bed occupancy rate was rather low as 21.9%, and there were 4 provinces where bed occupancy rates were 0%. Deaths in hospice palliative care facilities during 2008 were 6.3% of total deaths from cancers. As for the questions about the financial status of facilities, 86% of facilities were answered financial insufficiency. Also more than half of the facilities gave financial insufficiency as the reason for shortage of human resource supplies and inability to achieve the standard for authorization by the government. Facilities answered in order to activate the hospice palliative care, governmental support is needed, mostly in financial support (71.2%), donation tax deduction (43.1%), and setting up a public utility foundation (23.5%). Conclusion: This study showed low rates of hospice palliative care use and bed occupancy in Korea. Regional variance in bed occupancy rate was significantly high. As a roadblock for these problems, most of the facilities cited financial insufficiency. Therefore, there must be some action plans to boost financial support to activate hospice palliative care in Korea. Finally, efforts to improve these circumstances including lack of understanding about hospice and palliative care, are needed as well.
위암환자에서 의무기록과 행정자료를 활용한 Charlson Comorbidity Index의 1년 이내 사망 및 재원일수 예측력 연구
경민호,윤석준,안형식,황세민,서현주,김경훈,박형근,Kyung, Min-Ho,Yoon, Seok-Jun,Ahn, Hyeong-Sik,Hwang, Se-Min,Seo, Hyun-Ju,Kim, Kyoung-Hoon,Park, Hyeung-Keun 대한예방의학회 2009 예방의학회지 Vol.42 No.2
Objectives : We tried to evaluate the agreement of the Charlson comorbidity index values(CCI) obtained from different sources(medical records and National Health Insurance claims data) for gastric cancer patients. We also attempted to assess the prognostic value of these data for predicting 1-year mortality and length of the hospital stay(length of stay). Methods : Medical records of 284 gastric cancer patients were reviewed, and their National Health Insurance claims data and death certificates were also investigated. To evaluate agreement, the kappa coefficient was tested. Multiple logistic regression analysis and multiple linear regression analysis were performed to evaluate and compare the prognostic power for predicting 1 year mortality and length of stay. Results : The CCI values for each comorbid condition obtained from 2 different data sources appeared to poorly agree(kappa: 0.00-0.59). It was appeared that the CCI values based on both sources were not valid prognostic indicators of 1-year mortality. Only medical record-based CCI was a valid prognostic indicator of length of stay, even after adjustment of covariables($\beta$ = 0.112, 95% CI = [0.017-1.267]). Conclusions : There was a discrepancy between the data sources with regard to the value of CCI both for the prognostic power and its direction. Therefore, assuming that medical records are the gold standard for the source for CCI measurement, claims data is not an appropriate source for determining the CCI, at least for gastric cancer.
경민호(Min-Ho Kyung) (사)한국CDE학회 2012 한국CDE학회 논문집 Vol.17 No.4
We present a novel GPU algorithm to compute outer cell boundaries of 3D arrangement subdivided by a given set of triangles. An outer cell boundary is defined as a 2-manifold surface consisting of subdivided polygons facing outward. Many geometric problems, such as Minkowski sum, sweep volume, lower/upper envelop, Bool operations, can be reduced to finding outer cell boundaries with specific properties. Computing outer cell boundaries, however, is a very time-consuming job and also is susceptible to numerical errors. To address these problems, we develop an algorithm based on GPU with a robust scheme combining interval arithmetic and multi-level precisions. The proposed algorithm is tested on Minkowski sum of several polygonal models, and shows 5-20 times speedup over an existing algorithm running on CPU.
Charlson Comorbidity Index를 활용한 고관절치환술 환자의 건강결과 예측
최원호 ( Won Ho Choi ),윤석준 ( Seok Jun Yoon ),안형식 ( Hyeong Sik Ahn ),경민호 ( Min Ho Kyung ),김경훈 ( Kyung Hun Kim ),김경운 ( Kyeong Uoon Kim ) 한국병원경영학회 2009 병원경영학회지 Vol.14 No.1
The objectives of the present study is to examine the validity of Charlson Comorbidity Index(CCI) based on medical record data; to utilize the index to determine outcome indexes such as mortality, length of stay and cost for the domestic patients whose have received total hip arthroplasty. Based on medical record date, 1-year Mortality was analyzed to be 0.664 of C statistic. The R2 for the predictability for length of stay and the cost was about 0.0181, 0.1842. Fee of national health insurance and total cost including the cost not covered by insurance, also had statistically significance above 3 points of Charlson point score(p=0.0290, 0.0472; p.≤0.05). The 1-year mortality index, length of stay and cost of the total hip arthroplasty patients which was obtained utilizing CCI have a limitative prediction power and therefore should be carefully analyzed for use.