Verapamil로 호전된 SUNCT증후군 1예

송은철,이용석,주건,김동욱,이정주,박성호 대한신경과학회 2001 대한신경과학회지 Vol.19 No.4

과부담 의료비 지출이 빈곤화 및 빈곤 지속에 미치는 영향

송은철,신영전,Song, Eun-Cheol,Shin, Young-Jeon 대한예방의학회 2010 예방의학회지 Vol.43 No.5

Objectives: The low benefit coverage rate of South Korea's health security system has been continually pointed out. A low benefit coverage rate inevitably causes catastrophic health expenditure, which can be the cause of the transition to poverty and the persistence of poverty. This study was conducted to ascertain the effect of catastrophic health expenditure on the transition to poverty and the persistence of poverty in South Korea. Methods: To determine the degree of social mobility, this study was conducted among the 6311 households that participated in the South Korea Welfare Panel Study in both 2006 and 2008. The effect of catastrophic health expenditure on the transition to poverty and the persistence of poverty in South Korea was assessed via multiple logistic regression analysis. Results: The poverty rate in South Korea was 21.6% in 2006 and 20.0% in 2008. 25.1 - 7.3% of the households are facing catastrophic health expenditure. Catastrophic health expenditure was found to affect the transition to poverty even after adjusting for the characteristics of the household and the head of the household, at the threshold of 28% or above. Conclusions: 25.1% of the households in this study were found to be currently facing catastrophic health expenditure, and it was determined that catastrophic health expenditure is a cause of transition to poverty. This result shows that South Korea's health security system is not an effective social safety net. As such, to prevent catastrophic health expenditure and transition to poverty, the benefit coverage of South Korea's health security system needs to the strengthened.

韓國의 宗敎理解를 위한 작은 도움

송은철,강육규 원광대학교 종교문제연구소 1991 한국종교 Vol.16 No.-

의료비 지출이 소득불평등에 미치는 영향

송은철,김창엽,신영전 한국보건행정학회 2010 보건행정학회지 Vol.20 No.3

The degree of income inequality deepened by health care expenditure was useful in assessing the health security level. This exploratory study was conducted to provide a basic evidence to prove the necessity of reinforcement the benefit coverage of South Korea’s health security systems. Data from the Household Income and Expenditure Survey of Korea and Luxembourg Income Study were used. Income inequality indices before and after deduction of health care expenditure were computed, and the degree of the increase in the indices was compared among 13 countries. The degree of decrease against the effect of income inequality reduction policies by health care expenditure was determined. The relationships between the national characteristics and the increase in income inequality were examined. In South Korea, all income inequality indices increased after deducting health care expenditure, but the difference was not high compared to the mean of 13 countries. However, the degree of decrease against the effect of income inequality reduction policies by health care expenditure was high,compared to the mean of 13 countries. The proportion of public sector spending on health care proved to be statistically significant with the increase of income inequality indices (p<0.05). In the context of the continuous increase in health care expenditure, if benefit coverage of health security systems is not reinforced, income inequality will all the more increase due to health care expenditure. In the establishment of the policies for reinforcement of the benefit coverage,income inequality after deduction of health care expenditure should be continuously monitored.

Repetitive Transcranial Magnetic Stimulation for the Treatment of Chronic Post-Stroke Pain-a Pilot Study

송은철 대한뇌졸중학회 2002 Journal of stroke Vol.4 No.2

Department of Neurology and clinical Research Institute, Seoul National University Hospital, Seoul, KoreaBackground : Central post-stroke pain is a difficult condition o manage. Electrical motor cortex stimulation has been studied for more than a decade as a treatment modality of chronic refractory neuropathic pain. Repetitive transcranial magnetic stimulation(rTMS) is a safe and non-invasive technology and regarded as a potential treatment modality of mood disorders, epilepsy and movement disorders. However, few studies demonstrated the efficacy of rTMS for chronic neuropathic pain. We performed a pilot study to examine the therapeutic efficacy of rTMS in the treatment of central post-stroke pain. Method s : We studied 15 patients with central post-stroke pain. rTMS with motor threshold intensity of patients was performed for 10 sessions(5 Hz with the duration of 5 seconds). Visual analog scale(VAS) was assessed before and after the application of rTMS to evaluate the treatment response. Results : rTMS showedno improvement in VAS; pre and post-stimulation VAS levels were not changed(mean value 46¡¾15.0 mm) There was no observed side effects of rTMS. Conclusion : In this study, we could not prove the efficacy of rTMS for central post-strokepain, but further studies with different testing parameters are required. Korean Journal of Stroke 2002;4(2):124~127

재난적 의료비 지출이 빈곤화 및 빈곤 지속에 미치는 영향: 복지패널 2007-2012년 자료 분석

송은철 ( Eun Cheol Song ),신영전 ( Young Jeon Shin ) 한국보건행정학회 2014 보건행정학회지 Vol.24 No.3

Background: The low benefit coverage rate of South Korea`s health security system causes catastrophic health expenditure. And catastrophic health expenditure can be the cause of the transition to and persistence of poverty. This study was conducted to ascertain the effect of catastrophic health expenditure on the transition to and persistence of poverty, using 6 years of the Korea Welfare Panel Study Data. Methods: This study was conducted among the 22,528 households that participated in the Korea Welfare Panel Study, 2007-2012. Catastrophic health expenditure was defined as equal to or exceeds thresholds (10%, 20%, 30%, and 40%) of household`s capacity to pay. The effect of catastrophic health expenditure on the transition to and persistence of poverty was ascertained via multivariate logistic regression. Results: Four-point-seven percent to 20.6% of the households are facing catastrophic health expenditure. Rates of the transition to (relative risk [RR], 18.6 to 30.2) and persistence of (RR, 74.8 to 76.0) poverty of households facing catastrophic health expenditure was higher than households not facing catastrophic health expenditure. Even after adjusting the characteristics of the household and the household head, catastrophic health expenditure was found to affect transition to (odds ratio [OR], 2.11 to 3.04) and persistence of (OR, 1.53 to 1.70) poverty. Conclusion: To prevent catastrophic health expenditure and transition to and persistence of poverty resulting from catastrophic health expenditure, the reinforcement of South Korea`s health security system including the benefit coverage enhancement is required.

재난적 의료비 예방을 위한 포괄적 의료비 상한제: 비용 추계를 통한 적용 가능성을 중심으로

송은철 ( Song Eun Cheol ),신영전 ( Shin Young Jeon ) 한국보건사회연구원 2015 保健社會硏究 Vol.35 No.2

한국 건강보장제도의 낮은 보장성은 재난적 의료비의 원인이 되며, 재난적 의료비는 빈곤화의 원인이 될 수 있다. 재난적 의료비와 이로 인한 빈곤화를 예방하기 위한 정책이 필요하며, 그 정책의 하나인 포괄적 의료비 상한제의 적용 가능성을 검토하기 위해 연구를 진행하였다. 한국의료패널 2011년 자료를 이용하였으며, 재난적 의료비는 지불 능력에서 의료비가 차지하는 비율이 10~40% 이상 일 때로 정의하였다. 포괄적 의료비 상한제의 적용 단위를 설정하고, 그 기준을 소득 10분위별로 추정하였으며, 투입되는 추가 비용을 산출하였다. 5.9~23.7%의 가구가 재난적 의료비를 지출하고 있는 것으로 나타났다. 개인 및 가구 단위로 적용하는 경우 상한제의 효과가 가장 컸으며, 추정된 분위별 상한액은 재난적 의료비 기준이 10%인 경우는 0.0~285.0만원, 20%인 경우는 0.0~607.6만원, 30%인 경우는 0.0~1,095.2만원, 40%인 경우는 0.0~1,701.4만원이었다. 재난적 의료비 기준이 10%인 경우 15.9~26.3조원, 20%인 경우 11.9~19.7조원, 30%인 경우 9.3~15.4조원, 40%인 경우 7.8~12.8조원의 추가 비용이 필요한 것으로 추계되었다. 포괄적 의료비 상한제적용 시 재난적 의료비 발생률은 0.1~0.2%로 감소하며, 추가로 소요되는 비용은 전 국민이 한해 동안 민간의료보험료로 지출한 43.4조원의 18.0~60.6%로 나타났다. 포괄적 의료비 상한제 적용으로 건강보장제도의 보장성 강화와 함께 재난적 의료비의 예방이 가능할 것이다. The low benefit coverage rate of South Korea`s health security system can cause catastrophic health expenditure, and catastrophic health expenditure can be the cause of impoverishment. This study was conducted to ascertain the applicability of the comprehensive health expenditure ceiling system to prevent catastrophic health expenditure and impoverishment using cost estimation. The applicability was ascertained by analysis on data from the Korea Health Panel, 2011. Catastrophic health expenditure was defined as equal to or exceeding the thresholds (10%, 20%, 30%, and 40%) of the household`s capacity to pay. Ceiling limits of health expenditures were estimated by income groups, and the additional costs were also estimated. 5.9 - 23.7% of the households are facing catastrophic health expenditure. The estimated ceiling limits of the comprehensive health expenditure ceiling system were 0.0-2.9 (T/y≥10%), 0.0-6.1 (T/y≥20%), 0.0-11.0 (T/y≥30%), and 0.0- 17.0 million won (T/y≥40%). The estimated additional costs were 15.9-26.3 (T/y ≥10%), 11.9-19.7 (T/y≥20%), 9.3-15.4 (T/y≥30%), and 7.8-12.8 trillion won (T/y≥40%). The additional costs were estimated to 18.0 - 60.6% of total private health insurance premiums. There is a need for application of the comprehensive health expenditure ceiling system to prevent catastrophic health expenditure and impoverishment.

Statin과 연관된 중증근육무력증

김일곤,송은철,하충건 대한신경과학회 2010 대한신경과학회지 Vol.28 No.1

Neurotoxic Syndrome Developed after Taking Sertraline and Risperidone

김정민,이순태,송은철,정근화,신동인,정학재,주건,김만호 대한신경과학회 2007 Journal of Clinical Neurology Vol.3 No.3

Neuroleptic malignant syndrome and serotonin syndrome share many common clinical features, and the term “Neurotoxic syndrome” can be used when a clear distinction cannot be made between the two. Here we present a case of 19-year-old man who experienced serotonin syndrome caused by sertraline intake, and consecutive neuroleptic malignant syndrome by risperidone. This case suggests that these two syndromes can be concomitantly induced in some patients who are susceptible to these drugs. Clinicians may have to pay close attention to this problem when prescribing drugs to patients who previously showed sensitivity to CNS-acting drugs.

낙동강 중류수계의 수심별 모니터링을 통한 수질 변동특성(Ⅱ)

양종욱,기명섭,송은철,황승만,이재균,임병무 대한환경공학회 2017 대한환경공학회 학술발표논문집 Vol.2017 No.11