전립선암의 남성호르몬 박탈 치료와 근치적 전립선적출술의 비용 분석

김장묵 ( Jang Mook Kim ),노미정 ( Mi Jung Rho ),장광수 ( Kwang Soo Jang ),박용현 ( Yong Hyun Park ),이지열 ( Ji Youl Lee ),최인영 ( In Young Choi ) 한국병원경영학회 2018 병원경영학회지 Vol.23 No.3

Purposes: 본 연구는 전립선암 환자의 의료비 지출을 평가하기 위해 남성호르몬 박탈 치료와 근치적 전립선적출술의 비용을 비교하였다. Methods: 본 연구는 스마트 전립선암 데이터베이스(Smart Prostate Cancer Database)의 전립선암 환자 357명의 데이터와 청구데이터베이스에서 의료비 관련 데이터를 도출하였다. 근치적 전립선적출술과 남성호르몬 박탈 치료간 비교를 위해 독립표본 t검정을 실시하였다. 또한 남성호르몬 박탈 치료와 근치적 전립선적출술에 영향을 미치는 요인을 검증하기 위해 다중회귀 분석을 실시하였다. Findings: 치료 후 1년까지 남성호르몬 박탈치료가 근치적 전립선적출술 보다 비용이 낮은 것으로 나타났으며, 치료 후 4년까지 낮게 유지되었다. 그러나 4년이 지나면 남성호르몬 박탈 치료의 누적의료비가 근치적 전립선적출술보다 더 유의미하게 높게 나타났다. 환자의 병기가 높거나 나이가 많은 경우 근치적 전립선적출술보다 남성호르몬 박탈 치료를 할 확률이 더 높았다. Practical Implications: 본 연구는 조기 암 발견이 환자 뿐 아니라 국민건강보험공단의 의료비를 줄일 수 있다는 것을 보여 준다. 또한 의료비를 정확히 평가하기 위해서는 오랜 기간의 정보를 평가해야 하며, 이를 기반으로 평가 및 예측이 필요함을 증명하였다. Purpose: To evaluate the medical expenditures for prostate cancer patients, including out-of-pocket costs, and compared the costs between androgen deprivation therapy and radical prostatectomy treatment. Methodology: This study combined clinical data from 357 prostate cancer patients from the Smart Prostate Cancer Database and the medical expenditure data from the claims and cost databases. We used the independent two-sample t-tests to compare androgen deprivation therapy and radical prostatectomy. Multivariable logistic regression analysis was conducted to identify determining factors for androgen deprivation therapy and radical prostatectomy treatments. Findings: The medical costs of androgen deprivation therapy treatment were much lower than radical prostatectomy treatment at the one year and remained lower until the fourth-year. However, after four years, the accumulated medical expenditures of androgen deprivation therapy become significantly higher than radical prostatectomy treatment. Patients with a higher cancer stage and older age had higher chances of being treated using androgen deprivation therapy treatment than radical prostatectomy treatment. Practical Implications: Our results show that early detection of cancer reduces the treatment cost for both patients and insurance payers. It also demonstrates that cost comparisons should be conducted over long periods of time in order to most accurately assess the costs.

한국형 직장인 신체활동실천모형 개발을 위한 기초연구

장채욱(Jang, Chae-Ouk),김장묵(Kim, Jang-Mook),김도진(Kim, Do-Jin) 한국체육과학회 2016 한국체육과학회지 Vol.25 No.6

This is a basic research for Korean workers physical activity practices models and this research was conducted to examine the fitness of an integrated model, which applies the ecological theory, society, culture and environment to the theory of planned behavior that is based on the social cognitive theory. It was revealed that the integrated model that applies the ecological theory, society, culture and environment to the theory of planned behavior that is based on the social cognitive theory, explained physical activity promotion and regular exercise participation process more properly.

안전벨트 착용과 음주운전의 관계

장하은 ( Ha-eun Jang ),장지민 ( Ji-min Jang ),허민희 ( Min-hee Heo ),노진원 ( Jin-won Noh ),김장묵 ( Jang-mook Kim ) 대한보건협회 2021 대한보건연구 Vol.47 No.3

목적 : 본 연구에서는 인구사회학적 요인을 통제하여 안전벨트 착용에 따른 음주운전 경험 여부의 관계를 파악하고, 연구대상자의 인구사회학적 특성에 따른 음주운전 경험 여부의 영향요인을 확인하고자 하였다. 방법 : 제7기 국민건강영양조사 3차 년도 자료를 활용하여, 만 19세 이상인 설문응답자 중 음주운전과 안전벨트 관련 문항에 응답한 3,312명을 최종 분석 대상으로 선정하였다. 결과 : 평상시 안전벨트 착용 여부와 최근 1년 내 음주운전 여부는 통계적으로 유의한 관련성을 보였으며, 평상시에 안전벨트를 항상 착용하는 사람에 비해 그렇지 않은 사람의 음주운전 경험률이 더 높은 것으로 나타났다. 자동차 음주운전의 영향요인은 성별, 결혼상태, 교육수준, 경제활동 상태, 거주지역으로 나타났다. 결론 : 안전벨트의 착용이 자동차 음주운전과 유의한 관계를 지녔음을 알 수 있으며, 본 연구 결과가 차량 운전자의 안전의식 향상 및 교통안전 정책 수립의 기초자료로 활용되기를 기대한다. Objective : The purpose of this study is to investigate the correlation between the experience of drunk driving and seatbelt usage controlling socio-demographic factors. Methods : A cross-sectional analysis was performed with 3,312 participants among those who answered the data of the third year of the 7th National Health Nutrition Survey. Results : It was identified participants with lower seatbelt usage were more likely to have a drunk driving experience compared to those higher seatbelt usage. Conclusion : We revealed that seatbelt usage has a significant relationship with drunk driving. These results are expected to be utilized for improving safety consciousness of drivers and establishing traffic safety policies.

미국 보건의료산업의 공급사슬관리(SCM) 연구동향 고찰을 통한 전략적 도입의 타당성 평가

김성호 ( Sung Ho Kim ),김영훈 ( Young Hoon Kim ),김장묵 ( Jang Mook Kim ),성동효 ( Dong Hyo Sung ) 한국병원경영학회 2015 병원경영학회지 Vol.20 No.3

This paper attempts to critically review the status of supply chain operations in the healthcare field in an attempt to address what has been done in academics as well as the practitioner`s field to gain insight where future research efforts should be addressed. Based on literature set through review on previous studies, literature published within the past 10 years will be reviewed. The purpose of the study can be summarized as follows. First, overviews of healthcare SCM. Second, comparative studies on commercial SCM and healthcare SCM. Third, major tools in SCM. Finally, the barriers of adopting healthcare SCM. The findings of this study reveals potential benefits from using supply chain management tools. Although research and case studies in healthcare industries are not as extensive as in other industries, a clear trend appears to be forming in that deployment of supply chain management indeed generates consumer and provider`s surplus from which the entire society would benefit.

병원근로자의 조직시민행동과 조직효과성 관계 연구

김성호 ( Sung Ho Kim ),김장묵 ( Jang Mook Kim ),서영준 ( Young Joon Seo ) 한국보건행정학회 2014 보건행정학회지 Vol.24 No.2

Background: The organizational citizenship behavior is generally known as the important factor relevant to the organizational effectiveness. This research examined the mediating effect of the organizational citizenship behavior of hospital employees on the organizational effectiveness. Methods: Data were collected from 1,112 employees located in city of Seoul, Kyunggi and Chungnam province through self-administered questionnaires. Collected data were analyzed using IBM SPSS ver. 20.0, frequency analysis, t-test, analysis of variance, regression analysis, and path analysis. The main findings of the study are as follows. Results: First, it was found that many characteristics variables of personality, job, and relationship together affected organizational citizenship behavior of hospital employees. Especially, the following variables of negative affectivity, desire for growth, job value, job significance, and job security were found to have significant effect on the organizational citizenship behavior of hospital employees. Second, the results of path analysis showed that, through the mediating effect of organizational citizenship behavior, personality variables of positive and negative affectivity, and desire for growth, job characteristics variables of job value, job significance, and job security, and relationship variables of organizational support and task interdependence, had significant total effects on the level of job satisfaction of hospital employees. Conclusion: As a result, the organizational citizenship behavior seems to have both direct and indirect effects on the organizational effectiveness of hospital employees. Based on above findings, some theoretical and practical implications were discussed.

사례연구 : 사례연구를 통한 소송이외의 의료분쟁 해결방안의 검토와 개선방안

강의성 ( Eui Sung Kang ),김장묵 ( Jang Mook Kim ),성동효 ( Dong Hyo Sung ),목남희 ( Nam Hee Mok ) 한국병원경영학회 2013 병원경영학회지 Vol.18 No.3

Medical litigation, as a method of resolving medical disputes, has been a huge burden on both the patient and medical institution as it is both costly and time-consuming. The Korea Medical Dispute Mediation and Arbitration Agency has created a dispute mediation process as a method of alternative dispute resolution(ADR). Being in its early stage of implementation, there are still areas requiring improvement as some functions overlap with the Korea Consumer Agency`s damage redress and mediation process. This study examines the problems of existing practices in medical litigation while reviewing the mediation process of the two agencies from legal/administrative aspects, and provides an in-depth analysis of the situation through case studies and interviews. While the Korea Medical Dispute Mediation and Arbitration Agency offers many advantages in resolving medical disputes, there must be a distinct division of roles and mutual cooperation with the Korea Consumer Agency. Considering the increasing amount of compensation in medical disputes, medical professionals are being requested to carry medical malpractice insurance. However, this has yet to become a general trend in the medical field despite the growing social demand. As such, the coverage of medical malpractice insurance should be expanded to prevent medical accidents from escalating into medical disputes, thus acting as a social safety net. This study seeks to examine the methods of medical dispute resolution and to allow institutional provisions to reduce the social costs arising from such disputes.

중소병원의 내부서비스질의 요인이 고객지향성에 미치는 영향

김성호 ( Sung Ho Kim ),김영훈 ( Young Hoon Kim ),김장묵 ( Jang Mook Kim ),성동효 ( Dong Hyo Sung ) 한국병원경영학회 2012 병원경영학회지 Vol.17 No.2

This study aims to suggest managerial strategies for strengthening their competitiveness via analyzing and determining factors to help improve customer orientation and internal customer satisfaction. Furthermore, this study aims to find out the factors of internal service quality affects job satisfaction and customer orientation. The data was collected in 5 small and medium hospitals on 215 workers who had direct interactions with customers. Through regression analysis, all factors of internal service quality affects job satisfaction, however only two factors, credibility and sympathy appeared to affect customer orientation.

서울시 의료기관의 외국인환자 유치 준비실태 -병,의원을 중심으로-

성동효 ( Dong Hyo Sung ),진기남 ( Ki Nam Jin ),김장묵 ( Jang Mook Kim ) 한국병원경영학회 2012 병원경영학회지 Vol.17 No.4

The purpose of this study is to examine the preparation of medical institutions for medical tourism and its effects. The sample of this study were 99 case which were selected from Korea Health Industry Development Institute list. Data were collected through the mail questionnaire survey from Sept. 15 to Oct. 30 in 2010. The collected data were analyzed using Chisquare test, t-test. The main findings of study are as follows: Using Chisquare test, we found statistically significant differences in resources prepared for medical tourism between hospitals and clinics. In general, hospitals were well prepared in human resources(e.g., proportion of employees with foreign language capability) and physical resources(e.g., helpdesk, brochures) compared to clinics.

정밀의료 생태계 구축을 위한 데이터 수집 및 연계 국내 동향

신재승(Shin, Jae Seung),정아름(Jung, Ah Reum),오상윤(Oh, Sang Yoon),김장묵(Kim, Jang Mook) 한국웰니스학회 2020 한국웰니스학회지 Vol.15 No.1

정밀의료 생태계 구축의 핵심 원동력인 개인의 의학적, 유전적, 분자적, 환경적 요인에 대한 데이터는 다양한 기관과 다수의 개인에게서 생성된다는 특징이 있기 때문에, 데이터를 활용하기 위해서는 데이터의 연계 및 통합이 우선되어야 한다. 본 종설은 정밀의료 생태계 구축을 위해 현재 진행되고 있는 데이터 수집에 대한 인프라, 정책, 시범 사업, 연구 등의 국내 동향을 살펴보는데 그 목적이 있었다. 데이터 수집 및 연계에 대한 국내의 동향을 살펴봤을 때, 기술적 인프라, 데이터 활용 · 연계 인프라, 인력적 인프라 등의 보완이 절실하다. 특히 데이터 수집 연계에 대한 정책 및 법률적 기반은 매우 미비한 상태로, 데이터 수집과 연계에 대한 필요성과 현재 법적 제한의 상충된 입장 내에서 여러 가지 한계에 직면하고 있는 실정이다. 현재 국가에서 시행되고 있는 데이터 플랫폼 시범서비스에 대해서는 향후 추진 성과를 지켜볼 필요가 있으며, 국가뿐만 아니라 기업 입장에서도 정밀의료 및 헬스케어산업에서 중요한 역할을 하는 전문 인력 양성에 적극적으로 참여해야할 필요가 있다. 현재로서는 정밀의료 생태계에서 큰 축을 담당하는 환자유래건강데이터(PGHD; patients generated health data)의 수집이 가장 미비한 것으로 판단된다. 향후 환자 유래건강데이터를 효율적으로 수집하고 이를 전자 의무 기록(EMR; electro medical record)과 연계하는 시도가 필요하다. Data on individual medical, genetic, molecular, and environmental factors is a necessary in a precision medical ecosystem. Since data is generated from various institutions and many individuals, the linkage and integration of data should be a priority for precision medical care. The purpose of this review was to examine domestic trends such as infrastructure, policy, pilot project, and research on data collection. The technical infrastructure, data utilization and linkage infrastructure, and human resources infrastructure are urgently needed. In particular, the policy and legal foundations for data collection linkages are inadequate and face various limitations. For the data platform pilot service currently in the country, it is necessary to observe the future progress. A healthcare companies should actively participate in the training of professional manpower. There is a lack of collection of patient generated health data(PGHD). In the future, patient-derived health data will need to be efficiently collected and linked to an electronic medical record(EMR).

동하중의 특성을 고려한 거대 구조물의 동적해석

심재수,김장묵 慶熙大學校 1994 論文集 Vol.23 No.-

There are many dynamic analyses for elastic complex structures. Generally, Mode superposition method is used in dynamic analyses, but it couldn´t consider characteristics of load. So, many researchers tried to improve this method, as a result of that, characteristics of load was considered in dynamic analysis by use of special Ritz vectors. And another researches show that influences of such load are nearly static when frequency of load is much less than natural frequency of system.(It is basic idea of Mode acceleration method.) Therefore, the purposes of present research are to program and to verify the Ritz algorithm involving Mode acceleration method.