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질적 연구를 통한 대형병원 환자집중의 영향 요인 분석 : 대형병원 의료이용자와 관리자 관점에서
이근정 ( Keun Jung Lee ),엄혜은 ( Hye Eun Eom ),고정애 ( Jung Ae Ko ),박다혜 ( Da Hye Park ) 한국병원경영학회 2021 병원경영학회지 Vol.26 No.1
Purpose: The purpose of this study was to examine the influencing factors of the patient leaning phenomenon in tertiary hospitals. Based on the results of this study, we intended to find implications for improving the problems of the delivery system imbalance in tertiary hospitals caused by patient leaning phenomenon. Methodology/Approach: Qualitative studies were conducted, using focus group interviews and in-depth interviews. The focus group interviews were conducted for 12 users of tertiary hospitals by 2 groups. And in-depth interviews were conducted for 6 tertiary hospital managers. This was considered to be the most effective approach to gather diverse and in-depth information about the influencing factor of patient leaning phenomenon in tertiary hospitals. Findings: In focus group interviews, the reason for choosing tertiary hospitals was the reliability of the hospital(physician, reputation, etc.). And the effect of the policy to strengthen coverage of National Health Insurance and private medical insurance was relatively small. In other words, we found that the individual's desire to receive medical services suitable for one's health status and disease condition was the biggest factor, rather than the cost and policy factors. Practical Implications: We suggested that the appropriate medical care provision should be strengthened according to the role and function of medical institutions. In addition, the education system needs to be reorganized to activate the referral program, expand community medical capabilities, and foster quality primary medical care.
선별급여 도입이 위암수술의 건강보험 진료비 및 진료행태에 미치는 영향
조수진 ( Su Jin Cho ),고정애 ( Jung Ae Ko ),최연미 ( Yeon Mi Choi ) 한국보건행정학회 2016 보건행정학회지 Vol.26 No.1
Background: Selective health benefit was introduced for decreasing economic burden of patients. Medical devices with economic uncertainty have been covered as selective health benefit by National Health Insurance since December 2013. We aimed to analyze impact of selective health benefit to medical expenditure and provider behavior focused on electrosurgery (ultrasonic shears, electrothermal bipolar vessel sealers) for gastric cancer patients covered since December 2014. Methods: We used the National Health Insurance claims data of 2,698 patients underwent gastric cancer surgery between August 2014 and March 2015. Medical cost and patient sharing per inpatient day were analyzed to verify that covering electrosurgery increased medical expenditure and changed provider behavior from open surgery to endoscopic or laparoscopic surgery. Additionally, we analyzed the claim rate of medical device or goods relating gastric endoscopic and laparoscopic surgery. Results: Medical cost and patient sharing per inpatient day were increased after covering electosurgery as selective health benefit (39,724/1,421 won). However, there were no medical expenditure increases after adjusting claim of electosurgery and patient sharing was decreased 1,057 won especially. The coverage of selective health benefit did not increase the claim rate of medical device or goods related endoscopic or laparoscopic surgery, either. Conclusion: Covering electosurgery decreased patient economic burden and did not change of provider behavior. Expanding selective health benefit is needed to decrease economic burden of severe patients. Further study should evaluate the long term effect with accumulated data.
정선근 ( Sun Keun Jung ),김형무 ( Hyung Moo Kim ),고정애 ( Jung Ae Ko ),이왕휴 ( Wang Hyu Lee ) 전북대학교 농업과학기술연구소 2012 농업생명과학연구 Vol.43 No.1
This study was using 15 fungicides for the result of control of ivy stem rot. Dipping method was better than spraying method in pot experiment. Among fungicides tested, mandipropamid SC, cymoxanil+ethaboxam WP and ethaboxam+famoxadone WP suppressed mycelial growth of Phytophthora cinnamomi. mandipropamid SC and metalaxyl+copper oxychloride(Cu) WP effectively inhibited mycelial growth of P. nicotianae. 4 fungicides were shown strong antifungal activity against the pathogens. Especially mandipropamid SC was good at control efficient of stem rot caused by P. cinnamomi and P. nicotianae.
정선근 ( Sun Keun Jung ),김형무 ( Hyung Moo Kim ),고정애 ( Jung Ae Ko ),강미형 ( Mi Hyung Kang ) 전북대학교 농업과학기술연구소 2012 농업생명과학연구 Vol.43 No.1
아이비줄기썩음병에 대해 저항성을 보이는 아이비 뿌리에서 10종의 미생물을 분리하여 아이비줄기썩음병의 방제를 실험한 결과, 억제 효과가 가장 우수한 미생물은 JA508로 나타났다. 미생물 단일 처리 시 P. cinnamomi에는 66%, P. nicotianae에는 58%의 방제율로 나타났고, 미생물과 mandipropamid SC 혼합처리에서 P. cinnamomi에는 92%, P. nicotianae에는 90%의 방제율을 나타내어 P. cinnamomi와 P. nicotianae에 의한 병의 생물학적 방제제로의 개발 가능성이 높음을 알 수 있었으며, 교호침지의 결과가 화학약제나 미생물을 단독으로 처리한 것보다 방제효과가 우수해 혼용 사용이 최선의 방법이라고 판단된다. JA508의 배양적, 형태적, 생화학적 특성조사와 16SrDNA 염기서열 분석에 의하여 계통유전학적으로 B. subtilis와 98%의 유연관계를 보여 B. subtilis로 최종 동정하였다. Ten bacteria were isolated from ivy root to control ivy stem rot. In the plate test, JA508 was shown the strongest antifungal activity against Phytophthora cinnamomi and P. nicotianae, causal agents of Ivy stem rot. Control efficiencies were shown 66% for P. cinnamomi and 58% for P. nicotianae, when JA508 treated only. When JA508 and mandipropamid SC were treated alternately, control efficiencies were shown 92% for P. cinnamomi and 58% for P. nicotianae. JA508 was identified as Bacillus subtilis based on its cultural, morphological, biochemical characterization and 16S rDNA sequence analysis.
장미꽃의 향기정도에 따른 주요성분 및 꽃잎 세포의 미세구조
이영순(Young-Soon Lee),이윤혜(Yun-Hae Lee),임성희(Seung-Hee Lim),박건환(Gun-Hwan Park),최숙영(Sunk-Young Choi),홍혜정(Hae-Jung Hong),고정애(Jeong-Ae Ko) 한국원예학회 2013 원예과학기술지 Vol.31 No.5
장미 꽃의 향기정도에 따른 주요성분과 향기발산 위치를 구명하기 위하여 본 연구를 수행하였다. 향기정도는 약한 품종(‘필립’과 ‘비너스베리’), 중간 선발계통(‘GR07-135’) 및 강한 품종(‘허니블루’) 3수준으로 구분되었다. 품종과 선발계통 별 주요 향기성분은 ‘필립’은 3,5-dimethoxytoluene(DMT)와 benzene,1,3,5-trimethoxy 성분이었으며, ‘비너스 베리’는 megastigma-4,6(Z),8(E)-triene 성분이었고, ‘GR07-135’는 DMT, benzene,1-ethenyl-4-methoxy 및 phenylethylalcohol 성분이었으며, ‘허니블루’는 germacrene-D와 DMT 성분이 었다. 향축면 표피세포는 원추형의 유두상 돌기 모양이 있었고 배축면 표피세포는 편평한 모양이었다. 3품종과 1선발계통 모두 두꺼운 세포벽이 있었고, ‘허니블루’를 제외한 2품종과 1선발계통은 왁스로 덮인 큐티클층이 있었다. 향축면 표피세포에 ‘필립’은 전분립이, ‘비너스베리’는 오스미움 소체가, ‘GR07-135’은 전분립, 색소체 및 액포가, ‘허니블루’는 색소체낭, 색소체 및 액포가 있었다. 결과적으로 방향성 장미 꽃 향기의 주요성분은 품종에 따라 달랐으며, 생성과 발산은 유두돌기가 있는 향축면 표피 세포내의 색소체와 액포가 관련되어 있었다. Principle component and emission localization of volatile compounds were investigated according to scent intensity of rose flower. Scent intensity in cultivars and bred-line of Rosa hybrida was divided into three levels; light (‘Feel Lip’, ‘Venus Berry’), medium (‘GR07-135’), strong (‘Honey Blue’). The major volatile compounds were different depending on the cultivars and selected line; 3,5-dimethoxytoluene (DMT), benzene, 1,3,5-trimethoxy (‘Feel Lip’), megastigma-4,6(Z),8(E)-triene (‘Venus Berry’), DMT, benzene,1-ethenyl-4-methoxyand, phenylethylalcohol (‘GR07-135’) and germacrene-D, DMT (‘Honey Blue’). The adaxial epidermal cells were conical papillate shape, whereas the abaxial epidermal cells were flat shape. The adaxial epidermal cells of 3 cultivars and 1 selected line were surrounded by thick cell wall and covered by waxy cuticle of 2 cultivars and 1 selected line (except ‘Honey Blue’). The adaxial epidermal cells contained starches in ‘Feel Lip’, osmiophlic droplets in ‘Venus Berry’, starchs, plastids, vacuoles in ‘GR07-135’ and plastoglobules, plastids, vacuoles in ‘Honey Blue’. Based on these results, it appears that plastids and vacuoles in adaxial epidermal cells with conical papillate shape are associated production and emission of volatile compounds in scent R. hybrida.