음식점 매출변화를 통해 살펴본 금연구역 정책의 경제적 영향 분석

노진원 ( Noh Jin Won ),유기봉 ( Yoo Ki Bong ),이예진 ( Lee Yea Jin ),유솔 ( Yoo Sol ),김성렬 ( Kim Seong Ryeol ) 한국병원경영학회 2017 병원경영학회지 Vol.22 No.4

Purposes: Despite the positive health effects of both smokers and non-smokers, the non-smoking area policy is being negatively evaluated because of the vague fears of declining restaurant sales. The purpose of this study is to analyze the changes in sales of general restaurants(including liquor stores) and other restaurants that are considered to have the most applications of smoking cessation policy among the smoking facilities, and to examine the economic impact of the designation and expansion policies of non-smoking areas. Methodology: This study used the wholesale and retail trade survey data of the Korea National Statistical Office from 2011 to 2014 and analyzed 31,577 restaurants excluding missing values. For statistical analysis, t-test, ANOVA and Difference-in-differences(DID) models were used and the interaction term of area and year was entered. Findings: As the non-smoking area policy had been designated and expanded from December 2012 to December 31 2013, high restaurant sales in 2012 declined sharply in 2013. However, despite the expanding of the no-smoking area from January 1 2014 through December 31 2014, restaurant sales slightly recovered in 2014. In the case of other restaurants, there is no significant change in sales since the start of the policy in 2013. Practical Implications: The decline in restaurant sales due to the designation and expansion of non-smoking areas is temporary and can not be sustained over the long term. This result can be used to positively suggest negative perceptions of the designation and expansion policy of non-smoking areas. Also, this result can contribute to health promotion and smoking cessation policies by protecting non-smokers from the risk of secondhand smoking exposure and inducing smokers to decrease smoking rate and smoking amount.

국내 거주노인의 당뇨 유병현황 및 관련요인 분석

성민지(Min-Jee Sung),김은정(Eun-Jung Kim),이현주(Hyun-Joo Lee),노진원(Jin-Won Noh) 한국콘텐츠학회 2014 한국콘텐츠학회논문지 Vol.14 No.5

최근 한국인의 주요 사망원인 중 당뇨병이 차지하는 비중이 높아졌다. 2011년 국민건강영양조사 결과에 따르면 우리나라 성인 1,176만 명중 10.5%가 당뇨를 앓고 있으며, 65세 이상 인구에서는 21.5%가 당뇨를 앓고 있었다. 본 연구는 당뇨 유병률이 높은 65세 이상 노인의 당뇨병 발생률을 확인하고, 당뇨병 발생과 관련 있는 요인을 찾아낸다. 연구 방법은 한국고용정보원에서 주관하는 고령화연구패널조사의 2006년도 공개용 연간데이터 버전 1.2를 자료원으로 하여 당뇨를 앓고 있는 4,165명을 모집단으로 선정하였다. 분석 도구로 통계프로그램인 IBM SPSS(19.0 version)를 사용하였다. 연구 결과를 요약하면 65세 이상 79세 이하인 사람이 80세 이상 노인보다 당뇨병 진단을 받을 확률이 높았으며 대도시에 사는 사람이 읍면부에 사는 사람에 비해 당뇨병 진단확률이 높았다. 주관적 건강상태 항목에서는 주관적 건강상태가 좋은 사람인 경우와 보통인 경우가 주관적 건강상태가 나쁜 사람에 비해 당뇨병 진단확률이 낮았다. 폐질환을 진단받은 사람은 폐질환은 진단받지 않은 사람에 비해 당뇨병 진단확률이 낮았다. 본 연구결과를 바탕으로 당뇨를 예방 할 수 있는 주요 요인들은 분석하여, 당뇨 발병 저하에 기여할 수 있는 방안을 제안한다. Recently, the Diabetes Mellitus is the major cause of death in Korea. According to the results of v 2011, 34% of adult(over 19 years) are diagnosed as a DM and 21.5% of the aging(over 65 years) are also DM. So in this study, we find out the status of DM prevalence among old people and related factors. Using the results, we will suggest several ways to prevent DM. We use Korean Longitudinal Study of Ageing(2006, version1.2)that those diagnosed with Diabetes Mellitus. We carried out X2 test and Binary Logistic Regression by IBM SPSS 19.65~79 ages(p=0.006, OR=1.482), Urban people(p=0.008, OR=1.366), People diagnosed with Hypertension (p<0.001, OR=1.237), have high probability of Diabetes Mellitus. However, Subjective health condition(good) (p=0.005, OR=0.648), Subjective health condition(normal) (p<0.001, OR=0.335), and People diagnosed with Chronic lung disease (p=0.002, OR=0.778) have low probability of diabetes. Based on the study results, politic proposals were disccused.

허핀달-허쉬만지수를 이용한 병원시장의 경쟁 수준 측정

노진원 ( Jin Won Noh ),권영대 ( Young Dae Kwon ),강성욱 ( Soung Wook Kang ),주지수 ( Ji Soo Joo ) 경희대학교 경영연구원 2007 의료경영학연구 Vol.1 No.1

Objective: A new index, the Herfindahl Hirschman Index (HHI), is developed to measure competition between hospitals within a district. This study investigated the differences in competition between hospitals using the HHI and compared the index with the indirect indices measuring the degree of competition. Method: Hospital markets were divided into small regions using the healthcare catchment area and geographical/administrative boundaries. Annual medical revenue from the income statement is used to analyze the market share of each hospital in its respective market area. Market share was estimated by the ratio of each hospital`s revenue to the total medical revenue of the selected hospitals in the areas investigated. Correlation analysis was performed to compare the HHI with the indirect measurements of the level of competition presently used. Results: The HHI revealed different competitive levels (high, medium, low) over the regions. The result of the analysis for the local government areas was similar. A few small areas within the same healthcare catchment area had disparately larger differences in market share. There was a high correlation between the existing indices that indicate the medical resource allocation in the medical market and the HHI that measures the competition levels. Conclusion: This study could measure the competition levels more macroscopically using an area-based method rather than a hospital-based method. The results justify the use of HHI as an evaluation standard index to represent the level of competition. This index could be used as basic data to verify the effect of the competition between hospitals.

저열 시멘트 상용화 및 실용가능성 검토를 위한 일반 OPC와 강도 및 플로우 비교 실험

노진원(Noh, Jin Won),이지훈(Lee, Ji Hoon),권민수(Kwon, Min SU),홍선기(Hong, Seon Ki),허종완(Hu, Jong Wan) 한국콘크리트학회 2022 한국콘크리트학회 학술대회 논문집 Vol.34 No.2

금연구역 가이드라인 및 실외 흡연실 해외 동향

노진원 ( Jin-won Noh ),이예진 ( Yejin Lee ),유기봉 ( Ki-bong Yoo ),윤진하 ( Jin-ha Yoon ) 대한보건협회 2018 대한보건연구 Vol.44 No.3

연구목적: 실외 금연구역 가이드라인과 실외 흡연실에 대한 해외 동향을 사례중심으로 고찰하고, 이를 바탕으로 국내에 적합한 실외 흡연실 모델을 도출 및 제시하는 것에 목적이 있다. 더 나아가, 간접흡연의 감소효과와 금연정책의 효과평가를 위한 근거 자료를 확보하는 것에 의의가 있다. 연구방법: 금연구역 정책을 시행하고 있는 해외 주요 국가의 금연구역 가이드라인과 실외 흡연실의 사례를 분석하여 얻어진 정보를 분석하여 재구성하고 개념화하는 사례연구를 수행하였다. 또한 연구의 신뢰성과 타당성을 확보하기 위하여 여러 개의 사례를 통해 반복적으로 논리를 확인해가는 다중 사례 연구 방법을 채택하였다. 연구결과: WHO FCTC 8조 가이드라인 및 해외의 금연구역 개념을 검토한 결과, 금연구역 및 담배로부터의 보호는 담배 행위 및 담배로 인한 노출로부터 흡연자 및 비흡연자를 보호하기 위한 적극적 해석을 원칙으로 하고 있음을 알 수 있다. 금연구역 설정을 위한 공간적 개념은 대부분 실내를 넓은 의미로 확정하여 지붕이 있는 공간으로, 밀폐공간은 사면 중 25~75% 벽면으로 둘러싸여 있는 경우로 정의하였다. 또한, 공공장소는 소유권이나 소유자의 접근 권리에도 불구하고 일반인들이 접근 할 수 있는 공간이거나 단체가 사용하고 있다면 공공장소로 정의 내려야 한다고 강조하고 있다. 해외의 금연구역 가이드라인을 분석한 결과, 금연구역 및 담배로부터의 보호는 담배 행위 및 담배로 인한 노출로부터 흡연자 및 비흡연자를 보호하기 위한 적극적 해석을 원칙으로 하였으며, 각 개념의 해석과 적용은 국가별, 또는 같은 국가에서도 지방정부에 따라 다르게 나타났다. 결론: 금연구역 정책의 유지 및 확대를 위하여 과학적 근거를 기반으로 한 담배연기를 완전히 제거할 수 있는 시설이 요구되며, 모든 실내에서 완전 금연을 달성할 수 있는 정책이 제시되어야 한다. 금연 정책의 성취, 이행, 효과에 대한 철저한 감시 및 평가가 수반되어야 하며, 유해한 담배연기로부터 비흡연자를 보호할 수 있는 구체적인 방안의 마련이 요구된다. 또한 정책을 유지할 수 있는 사회적인 지지체계가 구축되어야 한다. Objective: The purpose of this study is to investigate the overseas trend of non-smoking area guidelines and outdoor smoking room based on case study method, and to present the outdoor smoking room model suitable for South Korea. Methods: This case study was conducted to analyze and conceptualize the implementation and expansion of non-smoking area policies, focusing on cases of outdoor non-smoking area guidelines and outdoor smoking roon in major foreign countries. In order to secure the credibility and validity of the results, this study adopted a Multiple Case Study that repeatedly confirm several cases. Results: As a result of analyzing the WHO FCTC Article 8 guideline, non-smoking area is based on the principle of active interpretation to protect smokers and nonsmokers from exposure to tobacco smoke. Most of the spatial concepts for outdoor smoking room are defined as a space with a roof defined by a broad sense of the interior. As a result of analyzing the non-smoking area guidelines and outdoor smoking room in foreign countries, the interpretation and application of the concept of the outdoor smoking room differed according to the national or local government, and it was found to be characteristic of each countries. Conclusion: In order to maintain and expand the non-smoking area policies, a scientific facility is required which can completely eliminate smoke, and a definite policy should be provided to achieve complete smoking cessation in all indoors. The policy monitoring and evaluation should be accompanied on the achievement, implementation and effectiveness of the smoking cessation policies. It is necessary to provide specific measures to protect from harmful smoke. There should be a social support system that can maintain the policies.

병원 원가관리자의 원가인식 및 원가체계 구축 방향

노진원 ( Jin Won Noh ),이해종 ( Hae Jong Lee ),박현춘 ( Hyun Chun Park ) 한국병원경영학회 2014 병원경영학회지 Vol.19 No.1

It is necessary to calculate prime cost of medical services accurately in order to evaluate the adequacy of medical fee. This paper aims to identify cost analysts. perception on prime cost of medical services and needs in establishing a cost accounting system in hospitals, proposing future directions and guidelines for the calculation of medical fee. A self-administered questionnaire and telephone survey on operation of a hospital cost-accounting system was conducted in November, 2012, among cost analysts currently working in the hospitals and hospital administrators planning to implement the hospital cost-accounting system. Our study shows that most of the cost analysts were aware of the importance of calculating prime cost and responded that collection of the prime cost data from government is necessary although they are less likely to provide the data in the future concerning the risk of data misuse and data security. They also responded that lack of budget allocation and excessive workload were the main reasons for not estimating the prime cost and operating cost management information system. Results show that hospital cost analysts considered the data accuracy is the most critical factor in calculating prime costs of medical services. However, there was no investment budget allocated in some hospitals or limited to less than 100 million, indicating that hospitals are reluctant to invest on implementing the cost accounting system. Respondents stated the organization that collects the prime cost of medical services among hospitals should display strong analytical capabilities, ensure data security, and maintain independence, which is most demanded. There are 57 hospitals that calculated the prime cost of medical services for 2012 by each medical department and 20 hospitals that calculated the prime cost by fee-for-services, aiming to establish a cost accounting system. Our results indicate that hospitals should voluntarily provide the accurate prime cost for medical services in order to properly evaluate the adequacy of medical fee. Consequently, it is critical to establish an independent organization to collect and appraise the data. It is also recommended that government should implement various policies to encourage hospitals to participate in the data collection to achieve the data accuracy and representativeness

성인여성의 사회·경제적 수준이 불안·우울증상에 미치는 영향

김진동(Jin-Dong Kim),정민영(Min-Young Jung),김경범(Kyoung-Beom Kim),노진원(Jin-Won Noh) 한국콘텐츠학회 2016 한국콘텐츠학회논문지 Vol.16 No.8

본 연구의 목적은 대한민국 성인 여성의 불안 및 우울증상 경험여부와 사회•경제적 수준 간의 관계를 알아보는 것이다. 이를 위해 국민건강영양조사 제6기 1차년도 원시자료를 이용하였고, 성인여성 3,453명을 최종 연구대상으로 선정하였다. 건강변수를 보정한 후 사회경제적 수준과 불안 및 우울증상간의 관계를 규명하기 위해 이분형 로지스틱 회귀분석을 실시하였다. 분석 결과, 불안 및 우울증상 경험 여부에 영향을 미치는 변수는 ‘나이, 결혼상태, 교육수준, 소득수준, 경제활동 참가여부, 주관적 건강상태, 평소 스트레스 인지 정도’인 것으로 나타났다. 위의 결과를 토대로 대한민국 성인여성의 사회•경제적 수준과 불안 및 우울증상 경험여부 사이에는 연관성이 있는 것으로 결론지었으며 저소득, 저학력, 미취업 여성들을 위한 우울증 예방 및 관리 프로그램이 필요할 것으로 판단된다. The purpose of this study is to investigate the relationship between Korean womens experience of anxiety & depression and socioeconomic level. We used Korea National Health and Nutrition Examination Survey VI-1 data. Study population were consisted of 3,453 female adults, and used a binary logistic regression analysis to identify the relationship between socioeconomic status factors and experience of anxiety & depression after adjusting health factors. It was identified the variables that affect experience symptoms of anxiety & depression is age, marital status, education, income level, economic activity, health condition and stress. Based on the analysis, Korean womens socioeconomic level and anxiety & depression experience concluded to be associated. Thus, the program for low income, unemployed and low educated level women is needed.

민간의료보험 가입 여부가 본인부담 진료비의 주관적 부담 수준에 미치는 영향

홍진혁(Jin Hyuk Hong),노진원(Jin-Won Noh),박기수(Kisoo Park),이예진(Yejin Lee),권영대(Young Dae Kwon) 한국콘텐츠학회 2017 한국콘텐츠학회논문지 Vol.17 No.6

우리나라는 전 국민 건강보험 의료체계를 근간으로 하고 있으나, 보장성이 낮아 많은 국민들이 높은 의료비의 재정적 부담 완화를 위해 민간의료보험에 가입하고 있다. 본 연구에서는 민간의료보험의 가입 여부가 개인의 본인부담 진료비 지불에 대한 주관적인 부담 수준에 미치는 영향을 분석하였다. 보건의료정책방향 관련 대국민 실태조사 자료를 활용하여 총 1,564명을 연구 대상자로 선정하였으며, 관련성 파악을 위해 이분형 로지스틱 회귀분석을 실시하였다. 연구 결과, 민간의료보험 가입 여부는 본인부담금의 주관적 부담수준과 유의한 관련이 있었으며(p<.0001), 민간의료보험 미가입자가 가입자에 비해 주관적 부담 수준이 더 높았다(OR, 1,190; 95% CI, 1,188-1,192). 고연령, 저소득층의 민간의료보험 가입률이 낮음을 감안할 때, 경제적 부담을 대비하는 민간의료보험의 순기능 강화와 형평성 문제 해결을 위한 민간의료보험의 역할 재정립이 필요하다. Although the National Health Insurance, many people sign up for private health insurance to alleviate their financial burden. In this study, we analyzed the relationship between private health insurance and subjective financial burden about cost sharing. To confirm the effect we conducted the binary logistic regression by utilizing the Health Care Policy related to public survey. The private health insurance have a significantly association with the subjective financial burden about cost sharing. People who uninsured to purchase private health insurance were more likely to have the burden. Therefore, given the low participation rate of private medical insurance for high age and low income group, we suggest the need for redefining the role of private insurance to enhance the function and resolve equity issues to prepare for the burden.

산업분류와 만성질환 유무와의 관계

홍진혁 ( Jin Hyuk Hong ),유기봉 ( Ki Bong Yoo ),김선호 ( Sun Ho Kim ),김충우 ( Chung Woo Kim ),노진원 ( Jin Won Noh ) 한국병원경영학회 2016 병원경영학회지 Vol.21 No.4

Purposes: The industry has specialized and fragmented than in the past. As a factor of economic growth and industrialization, the number of people employed in primary industry decreased and the number of people employed in secondary and third industry continuously increased. In modern times, incidence of chronic disease is increasing according to industrial development. So, the purpose of this study was to analyze the chronic disease according to Clark`s industrial classification. Methodology: Data were derived from the 2012 Korea Health Panel. The sample was made up of 7,132 adult participants aged 20 or over selected Korea Health Panel by probability sampling from Korea. Binary logistic regression analysis was conducted to examine the main factors associated with chronic disease. Findings: The significant factors associated with chronic disease were gender, age, marital status, household member, education level, insurance type, disability, BMI, and industrial classification. Female, elderly, divorced(including bereavement, missing and separation), one-person households, less than high school graduation, medical aid, disability, obese and primary industry were confirmed chronic disease increases. Practical Implications: The study finds that primary industry`s prevalence of chronic disease was higher than secondary and third industry. Therefore, this study aims to management and effort of the worker who engaged in the primary industry. Policy development is required to address inequality or popularization of the differences in these factors by conducting a study to define the working conditions and socio-economic factors between industry.

상급종합병원과 종합병원의 민원처리 담당 직원의 직무 스트레스 비교 분석

홍진혁 ( Jin Hyuk Hong ),권영대 ( Young Dae Kwon ),노진원 ( Jin Won Noh ),박주민 ( Ju Min Park ),백승준 ( Seung Jun Back ) 한국병원경영학회 2014 병원경영학회지 Vol.19 No.2

Although stress has been implicated to be a risk factor that can threaten physical and mental health, there have been no sufficient studies that analyze the different levels of stress among employees working in the different levels of the hospitals. We aim to identify the general characteristics of hospitals at different levels, to compare the stress levels among customer service representatives working in the tertiary care hospitals as well as acute general hospitals. In addition, we also wanted to analyze the relationship between the types of hospitals and the stress level. The work stress was measured using the Korean Occupational Stress scale. Study subjects. demographic characteristics and lifestyle factors were analyzed using analysis of frequency and multiple regression analysis. Our study revealed that the levels of medical facility were significantly associated with the levels of job stress(P = 0.043), and the stress levels of employees working in the acute general hospital.s medical facilities were higher than those who were working in tertiary care facilities. We also found that those with higher depression level tended to have higher job stress (P < 0.001). Therefore, it is urgent to implement some kind of job stress interventions, especially in the acute general hospital.s medical facilities. Moreover, further studies including social and policy research are necessary in order to analyze the overall impact of stress on physical and mental health and to reduce health inequalities among healthcare workers.