의료보험청구자료중 뇌혈관질환 상병기호의 정확도에 관한 연구

박종구,김기순,이태용,이강숙,이덕희,이선희,지선하,서일,고광욱,류소연,박기호,박운제,김춘배,Park, Jong-Ku,Kim, Ki-Soon,Lee, Tae-Yong,Lee, Kang-Sook,Lee, Duk-Hee,Lee, Sun-Hee,Jee, Sun-Ha,Suh, Il,Koh, Kwang-Wook,Ryu, So-Yeon,Park, Kee-Ho,Park, 대한예방의학회 2000 Journal of Preventive Medicine and Public Health Vol.33 No.1

Objectives : We attempted to assess He accuracy of ICD codes for cerebrovascular diseases in medical insurance claims (ICMIC) and to investigate the reasons for error. This study was designed as a preliminary study to establish a nationwide surveillance system. Methods : A total of 626 patients with medical insurance claims who indicated a diagnosis of cerebrovascular diseases during the period from 1993 to 1997 was selected from the Korea Medical Insurance Corporation cohort (KMIC cohort: 115,600 persons). The KMIC cohort was 10% of those insured who had taken health examinations in 1990 and 1992 consecutively. The registered medical record administrators were trained in the survey technique and gathered data from March to May 1999. The definition of cerebrovascular diseases in this study included cases which met ore of two criteria (Minnesota, WHO) or 'definite stroke' in CT/MRI finding. We questioned the medical record administrators to explain the error if the final diagnoses were not coded as stroke. Results : The accuracy rate of the ICMIC was 83.0% (425 cases) Medical records were not available for 8.2% (51 cases) due to the closing of hospitals, the absence of a computer system or omission of medical record, etc. Sixty-three cases (10.0%) were classified as impossible to interpret due to insufficient records in 'major clinical symptoms' or 'neurological deficits'. The most common reason was 'to meet review criteria of medical insurance benefits (52.9%)'. The department where errors in the ICMIC occurred most frequently was the department for medical insurance claims in the hospital. Conclusion : The accuracy rate of the ICMIC was 83.0%.

흡연의 경제적 손실분석

박종구,이규식,Park, Jong-Ku,Lee, Kyu-Sik 대한예방의학회 1989 Journal of Preventive Medicine and Public Health Vol.22 No.4

The purpose of this study was to identify and measure the economic costs and benefits due to smoking in Korea. Cigarette smoking is a major cause of morbidity and mortality. In addition to the health risks of smoking, there are important economic consequences. A complete assessment of the economics of smoking requires evaluation of various health, economic, and intangible parameters, including benefits as well as costs of both the production and consumption of tobacco. In this article we focus on costs resulting from the health effects of smoking (expenditures for medical care and the value of productive output lost to morbidity, and premature mortality among smokers), since economic benefits from tobacco industry is offset by expenditures for purchasing tobacco. Two distinct methodologies will be applied to measure the economic costs of smoking cigarette, the human capital and willingness-to-pay approaches. This article used the former method. In 1985, total economic losses due to smoking was estimated as 505.7 billion won, which was composed of morbidity losses 64.9 billion won mortality losses 429.1 billion won and indirect costs 11.7 billion won.

한국인 뇌혈관질환의 위험요인에 관한 메타분석

박종구,강명근,김춘배,김기순,지선하,Park, Jong-Ku,Kang, Myung-Guen,Kim, Chun-Bae,Kim, Ki-Soon,Jee, Sun-Ha 대한예방의학회 1998 Journal of Preventive Medicine and Public Health Vol.31 No.1

This study was conducted to integrate the results of studies which evaluated or identified the risk factors of CVD(cerebrovascular disorders) for Koreans. We retrieved the literature published in Korean by manual search and the English literature by Medline database to identify studies on the relationship between reported risk factors and CVD conducted for the Korean from 1980 to August, 1997. Hypertension and total serum cholesterol were selected as subjects of quantitative meta-analysis on risk factors of CVD in Koreans. The overall effect sizes of the risk of CVD due to hypertension and total serum cholesterol were calculated by common odds ratio(OR) and average standardized mean difference, retrospectively. Before the integration of each effect sizes into common effect sizes, the heterogeneity tests were conducted. Also, sensitivity tests were conducted for the estimated common effect sizes. Regarding hypertension and CVD, a total of 9 epidemiologic studies were identified with a total of 2,271 cases of CVD. The overall OR of hypertension associated CVD was 4.10(95% confidence interval[CI] 3.56 to 4.71). The OR of hypertension associated with hemorrhagic CVD and ischemic CVD were 6.56(95% CI : 4.92 to 8.80) and 3.28 (95% CI : 2.77 to 3.90), retrospectively. The OR of hypertension in relation to hemorrhagic CVD was significantly higher than that of hypertension in relation to overall CVD or ischemic CVD. Regarding total serum cholesterol and ischemic CVD, total 9 epidemiologic studies were identified with a total of 843 cases of ischemic CVD. Average mean difference as an effect size was 0.76, which was judged an important value according to Cohen's criteria. Our data suggested that hypertension was an important risk factor of overall CVD and its subtypes, and that the total serum cholesterol was associated with ischemic CVD in Koreans. For the lack of reliable prospective studies, however, we concluded that further research designed longitudinally would be required in this area.

일부농촌주민의 가정건강요원 이용에 영향을 주는 요인에 관한 연구 -연세 강화보건시범사업지역을 중심으로-

박종구,Park, Jong-Ku 대한예방의학회 1979 Journal of Preventive Medicine and Public Health Vol.12 No.1

The objectives of this study were to identify the determinants of the 1. Home visiting activities by FHWs 2. Utilization of village Family Health Workers(FHWs) 3. Attitudes towards FHWs 4. Knowledge about FHW's activities] among housewives in the Kang Wha Community Health Project area This study was analysed by using path analysis Exogenous variables were 1. Distance between the housewives' houses and that of their local FHW 2. Duration of work of each FHW as FHW in her village 3. Number of preschool children in the households Endogenous variables were 1. Home visiting frequency to each household by FHW 2. Knowledge about FHW's activities 3. Attitude towards FHWs 4. Utilization of FHW] by the housewives The results were as follows: The shorter the distance between client's and FHW's house, the higher the number of preschool children in the household, and the longer the duration of work of FHW as FHW, the higher is the number of her household visits in a given time span. The more frequently the FHW visits a household and the higher the knowledge about FHW's activities in the household, the more positive is the attitude of the housewives to the FHW and the more frequently she visits and utilizes the FHW on her own initiative.

뇌혈관질환 발생 위험요인 구명을 위한 코호트내 환자-대조군 연구

박종구,김기순,이태용,이덕희,고광욱,이강숙,지선하,서일,류소연,박기호,김춘배,Park, Jong-Ku,Kim, Ki-Soon,Lee, Tae-Yong,Lee, Duk-Hee,Koh, Kwang-Wook,Lee, Kang-Sook,Jee, Sun-Ha,Suh, Il,Ryu, So-Yeon,Park, Kee-Ho,Kim, Chun-Bae 대한예방의학회 2001 Journal of Preventive Medicine and Public Health Vol.34 No.2

Objectives : To identify the risk factors of cerebrovascular disorders(CVD) in Koreans using a nested case-control study. Methods : The cohort consisted of beneficiaries who had taken health examinations of the Korea Medical Insurance Corporation (KMIC cohort: 115,600 persons) in 1990 and 1992 consecutively. Four hundred and twenty five (425) cases were selected following the validation of diagnosis among 2,026 reported CVD (160-168) inpatients during the year from 1993 to 1997. Controls were matched (1:1) with age and gender of the cases among inpatients without CVD during the same period. The source of data in this study were the files of the 1990 health examinations and the 1992 health questionnaires, as well as an additional telephone survey undertaken from March to November 1999. Results : In a bivariate analysis and multiple logistic regression analysis, risk factors for total CVD were hyperglycemia and hypertension. Unrespectively, the odds ratio of ex-smoker was significantly lower than that of those who had never smoked. The risk factors for ischemic CVD also were hyperglycemia and hypertension. However, only blood pressure was found to be a risk factor for hemorrhagic CVD. Hypercholesterolemia was not a risk factor for total CVD, ischemic CVD, and hemorrhagic CVD. Conclusion : We concluded that the most important risk factor for CVD (including subtype) in Koreans was hypertension.

다이아몬드 단결정 성장기술과 천연 다이아몬드와의 구별법

박종구,문명식,Park, Jong-Ku,Fritsch, E.,Shigley, J.E.,Moon, M. 한국분석과학회 1997 분석과학 Vol.10 No.4

나노분말 기술의 현황 및 전망

박종구,Park Jong-Ku 한국분말야금학회 2004 한국분말재료학회지 (KPMI) Vol.11 No.6

나노분말 기술은 나노기술이 성숙단계에 접어들 것으로 예상되는 2012년 내지 2015년경에 성숙될 기술이 아니라 이미 산업화가 빠른 속도로 이루어지고 있으며 나노기술의 산업화를 선도할 기술이다. 나노분말 기술은 에너지/환경은 물론 IT, BT 산업 등 거의 모든 신산업 분야에 활용되고 있거나 활용될 전망이다. 이러한 이유로 거의 모든 국가들이 수행하고 있는 나노기술개발 프로그램에 나노소재 기술이 중요한 분야로 다루어지고 있고 나노분말 소재기술 분야는 빠지지 않는 기술 분야이다. 우리나라의 나노기술개발 프로그램에서도 예외는 아니다. 많은 수의 연구과제들이 수행되고 있으며 일부 상업화에 접어든 기술들도 있다. 미국, 일본 등 거의 모든 나라에서 다수의 벤처기업들이 나노분말 기술의 상업화에 뛰어들고 있다. EU의 경우는 전체 나노소재 관련 사업체 중 절반에 해당하는 업체들이 나노분말 업체라는 점은 눈여겨 볼만하다. 앞서 살펴보았듯이 나노분말 기술은 그 자체가 하나의 산업을 이끌어낼 기술인 동시에 기존산업을 포함한 소재산업은 물론 나노기술 산업을 바탕으로부터 지탱해줄 기반기술이다. 그만큼 많은 가능성을 갖고 있으며 기술적인 장애가 하나씩 극복될 때마다 기술의 발전속도는 빨라질 것이며 시장 또한 빠르게 확대될 것이다.

일부 한.양방병원 뇌혈관질환 환자의 진료결과 및 만족도의 비교연구 -한양방협진 진료프로토콜의 적용을 중심으로-

박종구,강명근,이성수,김달래,최서영,한창호,유준상,김민기,김춘배,Park, Jong-Ku,Kang, Myung-Guen,Lee, Seong-Soo,Kim, Dal-Rae,Choi, Seo-Young,Han, Chang-Ho,Yoo, Jun-Sang,Kim, Min-Gi,Kim, Chun-Bae 대한한방내과학회 2001 大韓韓方內科學會誌 Vol.22 No.4

Objectives : This study was done to assess the effects of the clinical interchange between the Western Medicine and the Oriental Medicine for ischemic stroke patients. The patient outcomes include changes in neurologic function by modified NIH stoke scale, stroke pattern identification scale, and patient satisfaction, Methods : For the assessment of effects, this study was performed with 178 inpatients who had undergone the stroke care at three hospitals (W Hospital adopted western therapy, S Oriental Hospital adopted Sasang constitution medicine therapy, and H Oriental Hospital adopted mixed therapy according to a joint protocol on Western Oriental medical care) from November 1997 to December 1998. Patients were interviewed or written with self-entered questionnaire forms, and clinical data were obtained, Physicians or oriental doctors wrote clinical questionnaire forms according to the care process. Results : The patient outcomes within three hospitals at 2 stages (at admission and discharge in the modified NIH stroke scale. at admission and second weeks during admission in the stroke pattern identification scale) were found to be decreased, Especially in the results of hierarchical multiple regression analysis, the degree of improvement of modified NIH stroke scale of the stroke patients at W Hospital was significant large than it at S Oriental Hospital. Also, the degree of improvement of stroke pattern identification scale at W Hospital was significantly large than it at other two hospitals. However, the patient's satisfaction score at three hospitals wasn't significantly different. Conclusions : The result of this study suggested that the joint clinical research of Western & Oriental medical practitioners was possible even if there was a conflict between Western Medicine and Oriental Medicine. Therefore Western & Oriental medical practitioners share a mutual responsibility to apply evidence-based practice, to seek scientific empirical proof through randomized clinical trials between the multicenter.

40세 이후의 사망에 영향을 주는 요인에 관한 코호트내 환자-대조군 연구

박종구,고상백,김춘배,박기호,왕승준,장세진,신순애,강명근,Park, Jong-Ku,Koh, Sang-Baek,Kim, Chun-Bae,Park, Kee-Ho,Wang, Seung-Jun,Chang, Sei-Jin,Sin, Soon-Ae,Kang, Myung-Guen 대한예방의학회 1999 Journal of Preventive Medicine and Public Health Vol.32 No.3

Objectives: This study was conducted to identify the factors influencing the mortality of Koreans over the age of 40 by a nested case-control study. Methods: The cohort consisted of the beneficiaries of Korea Medical Insurance Corporation for Government Employees & Private School Teachers and Staff(KMIC) who received health examinations of KMIC in 1992 and 1993 retrospectively. At that time, they were more than 40 years old. The cases were 19,258 cohort members who had died until December 31, 1997. The controls were 19,258 cohort members who were alive until December 31, 1997. Controls were matched with age and sex distribution of the cases. The data used in this study were the funeral expenses requesting files, and the files of health examinations and health questionnaires gathered in 1992 and 1993. To assess the putative risk factors of death, student t-test, chi-square test, multiple logistic regression analysis were used. Results : In multiple logistic regression analysis, independent risk factors of death were as follows; systolic blood pressure, diastolic blood pressure, blood glucose, AST, urine glucose, urine protein, alcohol drinking(frequency), cigarette smoking and perceived health status, intake of restoratives and blood transfusion showed positive associations with death; coffee consumption showed negative associations with death; and body mass index and serum total cholesterol showed J-shaped association with death. Conclusions: Regarding the direction of association, the result of analysis on the data restricted to '96-'97 was same as that of '93-'97. But in some variables such as obesity, serum cholesterol, the odds ratios of death in the data of '96-'97 were higer than those of '93-'94, which suggested that the data of '93-'94 was bearing effect-cause relationship. We concluded that it suggested further researches using long-term follow-up data to be needed in this area. 공 교의료보험 적용대상자들 중 1992년 건강검진 수검 피보험자와 1993년 건강검진 수검 피부양자를 대상으로 사망에 영향을 미치는 요인에 관한 코호트내 환자-대조군 연구를 실시한 결과는 다음과 같다. '93-'97년도 자료의 분석에서 사망과 정상관 관계를 보인 변수는 수축기 혈압, 이완기 혈압, 혈당, AST, 요당, 요단백, 음주('자주 마신다'), 흡연, 건강인지, 영양제 복용, 수혈이었다. 사망과 역상관 관계를 보인 변수는 커피 음용이었다. 비만도와 혈중 콜레스테롤은 사망과 J형의 상관관계를 보였다. '96-97년 자료만을 이용하여 분석한 경우도 '93-'97년 자료와 관련성의 방향은 동일하였으나, 비만$(25-30kg/m^2)$과 콜레스테롤(240 mg/dL이상)의 사망 예방효과는 '93-'97년 자료에 비해 '96-'97년 자료에서 감소함으로써 '93-'94년 자료에 결과-원인 관계가 일부 개재되었을 가능성을 배제할 수 없었다.

예방의학회지(1997년)에 게재된 원저논문 영문초록의 질 평가

박종구,김춘배,Park, Jong-Ku,Hannibal, Desmond,Kim, Chun-Bae 대한예방의학회 1999 Journal of Preventive Medicine and Public Health Vol.32 No.1

Objectives. The purpose of this study was to evaluate the quality of abstracts of original articles. Methods. This subjects selected total 63 abstracts of the original articles of the Korean Journal of Preventive Medicine in 1997. The quality of abstracts was measured against a checklist of evaluation criteria, which were divided into eight categories and the numbers of inappropriate words (including grammar) according to criterionbased survey. A score for each abstract was obtained by dividing the number of criteria presented by the number applicable. The overall mean score was also determined. Results. The overall mean score of abstract quality was 0.55 out of 1. Of the abstracts subject selection 83% didn't include specific technical descriptors. Of those that gave conclusions 92% didn't address study limitations and 78% made no recommendations for future study. The overall mean number of inappropriate usage of words (including grammar) per abstract was 14.1. The overall mean number of English words was 283. In the multiple regression analyses, the research career of the first author and the number of English words to the number of inappropriate usage of words were statistically significant. Also, in the secondary regression model, the number of English words to the quality score of abstract was only statistically significant. Conclusions. Most of the abstracts provided some information pertaining to each evaluation criterion. However, they did not provide sufficient details to enhance the reader's understanding of the article. On the basis of the study the abstracts need improvement in its description of the reported subject selection, statements of limitations and recommendations, etc. The Korean Society for Preventive Medicine will recommend a proposal for more informative abstracts in Korean J Prey Med and will take into consideration the introduction of foreign review of abstracts. Future studies should address these issues and compare the quality of abstracts between different journals and their time of publication.