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      • KCI등재
      • KCI등재

        체형지수와 체질량지수가 자살행동에 미치는 영향

        부유경(Yoo-Kyung Boo) 한국산학기술학회 2018 한국산학기술학회논문지 Vol.19 No.9

        본 연구의 목적은 자살에 영향을 미칠 수 있는 일반적 특성들과 동시에 체질량지수(Body Mass Index, BMI)를 통제함으로써 체형지수(A Body Shape Index, ABSI)가 자살생각과 자살시도와 어떠한 관련성이 있는지에 대해 알아보는 것이다. 2013년부터 2015년까지 질병관리본부의 제 6기 국민건강영양조사 자료를 이용하였으며, 자살행동에 영향을 미칠 수 있는 변수들에 대한 정보가 없는 자들을 대상에서 제외한 총 13,155명을 대상으로 카이제곱검정과 다변량 로지스틱회귀분석을 실시하였다. 분석 결과는 BMI에서 ‘비만’에 해당하는 자들이 BMI에서 ‘표준’에 해당하는 자들보다 자살생각과 자살시도가 높았고, ABSI에서는 Q3에 해당하는 그룹이 Q1에 해당하는 그룹에 비해 자살생각이 높았다. 자살시도는 ABSI에서 Q3에 해당하는 그룹이 Q1 그룹에 비해 3.623배(95% CI 1.027-12.772) 높았으며 유의한 결과를 보였다. 본 연구의 결과는 BMI와 비교하여 ABSI가 높이 나타나면 단순히 자살생각보다는 자살시도라는 더욱 극단적인 선택을 할 수 있음을 의미하는 것으로 우리 사회는 ABSI가 높은 자에 대해 사회적인 관심과 적절한 관리를 할 수 있도록 해야 할 것이다. The purpose of this study was to determine the association of the Body Shape Index (ABSI) with suicide ideation and suicide attempts by controlling the body mass index (BMI), as well as general characteristics that may affect suicide . The study has used The Sixth Korea National Health and Nutrition Examination Survey conducted by the Korea Centers for Disease Control and Prevention from 2013 to 2015. A total of 13,155 participants were studied, excluding those who had no information on variables that could affect suicidal ideations and suicidal attempts. The chi-squared test and the multivariate logistic regression analysis were performed. The results of the analysis showed that those who had obesity in BMI were more likely to commit suicide and suicide than those who were in ’standard’ in BMI. In ABSI, Q3 group was more likely to commit suicide than Q1 group . The number of suicide attempt was significantly higher in the group with Q3 in ABSI than in Q1 group (3.623 times (95% CI 1.027-12.772)). The results of this study suggest that a higher ABSI compared to BMI means that it is possible to make a more extreme choice of suicide attempt rather than suicide ideation.

      • KCI등재

        균형성과표를 활용한 전자의무기록시스템의 성과측정 모형개발

        이경희 ( Kyung Hee Lee ),김영훈 ( Young Hoon Kim ),부유경 ( Yoo Kyung Boo ) 한국병원경영학회 2016 병원경영학회지 Vol.21 No.4

        The purpose of this study are suggest to performance measurement model of Electronic Medical Record(EMR) and Key Performance Index(KPI). For data collection, 665 questionnaires were distributed to medical record administrators and insurance reviewers at 31 hospitals, and 580 questionnaires were collected(collection rate: 87.2%). Regarding methodology, Critical Success Factor(CSF) and index of the information system were derived based on previous studies, and these were set as performance measurement factors of EMR system. The performance measurement factors were constructed by perspective using BSC, and analysis on causal relationship between factors was conducted. A model of causal relationship was established, and performance measurement model of EMR system was proposed through model validation. Analysis on causal relationship between performance management factors revealed that utility cognition of the learning & growth perspective factor had causal relationship with job efficiency(β=0.20) and decision support(β=0.66) of the internal process perspective factors, and security had causal relationship with system satisfaction(β=0.31) of the customer perspective factor. System quality had causal relationship with job efficiency(β=0.66) and decision support(β=0.76) of the internal process perspective factors, all of which were statistically significant(P<0.01). Job efficiency of the internal process perspective had causal relationship with system satisfaction(β=0.43), and decision support had causal relationship with decision support satisfaction(β=0.91) and job satisfaction (β=0.74), all of which were statistically significant(P<0.01). System satisfaction of the customer perspective had causal relationship with job satisfaction(β=0.12), job satisfaction had causal relationship with cost reduction(β=0.53) of the financial perspective, and decision support satisfaction had causal relationship with productivity improvement(β=0.40)of the financial perspective(P<0.01). Also, cost reduction of the financial perspective had causal relationship with productivity improvement(β=0.37), all which were statistically significant(P<0.05). Suitability index verification of the performance measurement model whose causal relationship was found to be statistically significant revealed that X<sup>2</sup>/df=2.875, RMR=0.036, GFI=0.831, AGFI=0.810, CFI=0.887, NFI=0.838, IFI=0.888, RMSEA=0.057, PNFI=0.781, and PCFI=0.827, all of which were in suitable levels. In conclusion, the performance measurement indices of EMR system include utility cognition, security, and system quality of the learning & growth perspective, decision support and job efficiency of the internal process perspective, system satisfaction, decision support satisfaction, and job satisfaction of the customer perspective, and productivity improvement and cost reduction of the financial perspective. In this study, it is expected that the performance measurement indices and model of EMR system which are suggested by the author, will be a measurement tool available for system performance measurement of EMR system in medical institutions.

      • KCI등재

        폐기능 장애와 대사 증후군 관련성

        강선희(Sun-Hee Kang),부유경(Yoo-Kyung Boo),안병기(Byung-Ki Ahn) 한국산학기술학회 2017 한국산학기술학회논문지 Vol.18 No.11

        본 연구는 심혈관 질환을 공통적으로 동반하는 폐기능 장애와 대사증후군 관계에 대한 연구이다. 이들 질환이 상호관련성이 있다는 가정 하에 폐기능 장애와 대사증후군간의 상호 관련성 여부를 확인하여 올바른 질환 관리를 위한 초석을 마련하고자 하였다. 자료는 국민건강 영양조사 자료중 2008년부터 2013년까지 6년간 자료를 통합한 53,829건에서, 폐기능 검사를 시행한 만 40세 이상으로 모든 혼란 변수를 통제한 정제된 자료 8,137명(남자, 3,951명, 여자 4,186명)의 자료를 사용하였다. 폐기능 장애는 GOLD(Global Initiative for Chronic Obstructive Lung Disease)기준에 따라 폐쇄성, 제한성으로 구분하였고, 대사증후군은 개정된 NCEP-ATPⅢ(National Cholesterol Education Program-Expert Panel-Adult Treatment Panel Ⅲ)기준을 사용하였다. 연관성 분석은 로지스틱 회귀분석을, 유병률은 교차 분석을 시행하였다. 연구 결과, 연관성 분석에서 폐쇄성 폐질환은 대사증후군과 직접적인 관련성을 보이지 않았으며 제한성 폐질환은 대사증후군과 직접적인 관련성을 보였다. 유병률 분석에서는 폐쇄성 폐질환과 제한성 폐질환 모두 대조군보다 높은 대사증후군 유병률을 보였다. 그러나 제한성 폐질환의 대사증후군 유병률이 폐쇄성 폐질환의 대사증후군 유병률보다 더 높았다. 결론적으로 폐쇄성이 아니라 제한성 폐질환이 대사증후군과 유의한 연관성을 보였고 대사증후군 유병률도 더 높았다. This study was conducted to identify relationships between lung function disorders and Metabolic Syndrome(MetS) that have common comorbidities such as Cardio Vascular Diseases(CVD). According to the hypothesis that there may be a significant relationship between them, analyses were conducted to identify the proper management point for those diseases. Overall, 53,829 data were taken from KNHANES 2008-2013. Included data were PFT(Pulmonary Function Test) done and age over 40. All the 14 confounders applied, only 8,137 cases (M:3,951, F:4,186) were left. Low pulmonary function was divided into two categories, obstructive and restrictive patterns, based on the Global Initiative for Chronic Obstructive Lung Disease(GOLD) criteria, while MetS was defined based on the revised NCEP-ATPIII criteria. The relationships between those diseases were analyzed using logistic regression analysis. In addition, for the prevalence rate, cross-tab analysis were conducted. There were no significant relationships observed between obstructive lung disease and MetS, but a restrictive pattern had a meaningful relationship with MetS. Specifically, MetS showed a higher prevalence rate for both obstructive and restrictive pattern patients than the control group. Restrictive pattern patients showed a higher prevalence rate to MetS than obstructive patients. Overall, restrictive lung patterns showed a meaningful association with MetS, but not with obstructive patterns. Additionally, the prevalence rate of MetS among restrictive patients was higher than among obstructive patients.

      • KCI등재

        코딩시뮬레이션을 이용한 의사 및 심사간호사와 의무기록사의 질병코딩 차이 연구

        배순옥 ( Soon Ok Bae ),강길원 ( Gil Won Kang ),부유경 ( Yoo Kyung Boo ),이영 ( Young Lee ),최해선 ( Hae Sun Choi ),최혜영 ( Hye Young Choi ) 한국보건정보통계학회 2015 보건정보통계학회지 Vol.40 No.3

        Objectives: The objective of this study is to investigate the difference in disease coding of doctors, medical insurance review nurses and medical record administrators who are directly involved in disease coding in hospital. Methods: Thirteen virtual medical records were developed for common diseases. The study subjects were requested to select principal diagnosis and other diagnoses for the each record. The survey was conducted through web pages specially developed for coding simulation. 29 doctors, 74 medical insurance review nurses, and 100 medical record administrators participated in this survey. Results: There was large difference in the concordance rate between the study subjects’ answer and coding guidelines published by the National Statistical Office. Concordance rate was high in medical record administrators (93.6%) but low in doctors (43.1%) and medical insurance review nurses (35.6%). The difference was noticeable in the way of using Z codes as principal diagnosis. Also large difference existed in the way of coding symptom under treatment and underlying disease. Conclusions: This study shows that there are large differences in disease coding depending on the occupation. To decrease this difference, it is needed to refine the coding guidelines and strengthen the education about them.

      • KCI등재후보

        사망진단서(사체검안서) 상의 선행사인으로부터 사망통계의 원사인이 선정되는 비율 : 3개 대학병원에서 교부된 사망진단서를 중심으로

        박우성,박석건,정철원,김우철,탁우택,김부연,서순원,김광환,서진숙,부유경 한국의료QA학회 2004 한국의료질향상학회지 Vol.11 No.1

        Background : To exatnine the problems intolved in writing practice of death certificates, we cotnpated the determination of underlying cause of death for wital statistics using recorded underlying cause of death in issued death statistics. Methods : We collected 688 rnortality certificates issue in year of 2,000 from 3 university hospitals. And we also collected vital statistics from ministry of statistics. The causes of death were coded by experienced medical record wpecialists. And causes of death determined at ministry of statistics for national vita statistics were mapped to causes of death recorded at each death certificates. The rate that underlying causes of death for vital statistics were derived from underlying causes of death recorded at issued death certificaties sere analysed. Results : 64.5% of underlying cause of death for could be derived from underlying cause of death recorded at issued death certificates, 8.6% derived from intermediate cause of death, and 3.9% derived from direct cause of death. In 23% of cases, underlying cause of death could not be derived using issued death certificates. The rate that underlying cause of death for vital statistics could be derived from underlying cause of death recorded at death certificates was different between 3 university hospitals. Ane the rate was also different between death certificates and postmortem certificates. We classified the causes of death using 21 major categories. The rate was different between diseases or conditions tha caused death too. Conclusion : When we examined the correctness of death certificate writing practice using abpve methods, cortectness of writing could not be told as satisfactory. There was difference in correctness of writing between hospotals, between death certificates and postmortem certificates, and between diseases and conditions that caused death. With this results, we suggested some strategy to improve the correctness of death certificate writing practice.

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