Participation Determinants in the DRG Payment System of Obstetrics and Gynecology Clinics in South Korea

송정국,김창엽 대한예방의학회 2010 예방의학회지 Vol.43 No.2

Objectives: The Diagnosis Related Group (DRG) payment system, which has been implemented in Korea since 1997, is based on voluntary participation. Hence, the positive impact of this system depends on the participation of physicians. This study examined the factors determining participation of Korean obstetrics & gynecology (OBGYN) clinics in the DRG-based payment system. Methods: The demographic information, practice-related variables of OBGYN clinics and participation information in the DRG-based payment system were acquired from the nationwide data from 2002 to 2007 produced by the National Health Insurance Corporation and the Health Insurance Review & Assessment Service. The subjects were 336 OBGYN clinics consisting of 43 DRG clinics that had maintained their participation in 2003-2007 and 293 no-DRG (fee-for-service) clinics that had never been a DRG clinic during the same period. Logistic regression analysis was carried out to determine the factors associated with the participation of OBGYN clinics in the DRG-based payment system. Results: The factors affecting participation of OBGYN clinics in the DRG-based payment system were as follows (p<0.05): (1) a larger number of caesarian section (c/sec) claims, (2) higher cost of a c/sec, (3) less variation in the price of a c/sec, (4) fewer days of admission for a c/sec, and (5) younger pregnant women undergoing a c/sec. Conclusions: These results suggest that OBGYN clinics with an economic practice pattern under a fee-for-service system are more likely to participate in the DRG-based payment system. Therefore, to ensure adequate participation of physicians, a payment system with a stronger financial incentive might be more suitable in Korea.

Citrus Fruit Intake and Breast Cancer Risk: A Quantitative Systematic Review

송정국,배종면 한국유방암학회 2013 Journal of breast cancer Vol.16 No.1

Purpose: We investigated the association between dietary intake of citrus fruits and breast cancer risk. Methods: The PubMed and EMBASE were searched for relevant articles on diet and breast cancer up to January 2012. All of the epidemiological studies that assessed dietary intake of citrus fruits and presented risk estimates of the association between citrus fruits intake and risk of breast cancer were reviewed. Multivariable-adjusted odds ratios (OR) and associated 95% confidence intervals (CI) for highest versus lowest intake of dietary citrus fruits level were extracted. Overall summary OR was calculated by using a fixed-effect meta-analysis. Results: Six case-control studies out of five articles were eligible. Overall summary OR showed a 10% reduction in risk of breast cancer associated with high intake of citrus fruits (summary OR, 0.90; 95% CI, 0.85-0.96; p<0.001); results were consistent across the studies (I 2=0). Visual inspection of the results did not suggest a publication bias. Conclusion: Pooled results from observational studies showed an inverse association between citrus fruits intake and the risk of breast cancer.

유럽건강도시 발전과 국내적 함의

송정국(Jung-Kook Song),고광욱(Kwang Wook Koh),임요환(Yo Hwan Lim) 한국보건교육건강증진학회 2021 보건교육건강증진학회지 Vol.38 No.1

심뇌혈관질환 고위험군 대상 교육프로그램의 효과

송정국(Jung-Kook Song),박형근(Hyeung-Keun Park),홍성철(Seong Chul Hong) 한국농촌의학 지역보건학회 2015 농촌의학·지역보건 Vol.40 No.3

본 연구는 급성 심근경색과 뇌졸중의 고위험군인 노인들을 위하여 마련된 일개 권역심뇌혈관질환센터의 경로당노인 교육프로그램이 급성 심근경색과 뇌졸중 경고증상에 대한 지식수준을 높이는 데에 효과가 있었는지 교육프로그램 수행 1년이 경과시점에서 평가하였다. 2012년 제주특별자치도 제주시의 11개 경로당에서 337명을 편의표집 하였는데, 과거 2010년 해당 경로당에서 진행된 교육프로그램에 참여했었던 159명은 실험군으로 하였고, 교육에 참여하지 않은 178명은 대조군으로 하였다. 경고증상을 정확히 알고 있는지를 알아보고자 두 가지 질환 각각 3개 문항씩 총 6문항에 대하여 질환 별 증상이 맞는다고 생각하는지를 폐쇄형 질문으로 물어 명목형(정확한 인지 여부)으로 구분하였으며 빈도(백분율)로 나타내었다. 참여군과 비참여군 간에 경고증상에 대한 지식수준은 유의한 차이를 나타나지 않았고, 급성 심근경색과 뇌졸중 경고증상에 대한 지식이 최고 수준인 것(우수 인지수준, 경고증상 여섯 개 모두를 정확히 인지)과 경로당노인 교육프로그램 참여여부가 관련이 없는 것으로 나타나 교육 효과는 확인할 수 없었다. 다만 우수 인지수준이 될 오즈값은 교육수준이 초등학교 졸업 이상일 경우 초등학교 미졸업(무학 및 서당)에 대해서 3.01배 높았고(3.01; 1.72-5.26), 매일 빠지지 않고 TV뉴스를 시청할 경우 6일 이하로 시청하는 것에 대해서 2.97배 높게 나타났으며(2.97; 1.68-5.23), 이들은 통계적으로 유의하였다. 참여군에서 교육 참여 이후 높아진 지식수준이 교육 후 1년 시점까지 통계적으로 유의한 차이없이 유지되었던 것과 비참여군에서 지식수준이 참여군 만큼 높은 수준이었던 것은 교육참여와 상관없는 어떠한 교육중재적 요인을 공유하고 있음을 시사하였다. 결론적으로 심뇌혈관질환의 고위험군인 노인을 표적 선택하여 실시하는 일회적 지역사회 방문교육 대신 대중매체를 활용한 반복적 지식전달이 효과 있음을 알 수 있었다. 일회적 지역사회 방문교육의 효과는 지역사회 노인 전체를 대상으로 하는 대중매체 보건교육 캠페인이 잇달아 수반되어야만 그 효과를 장기적으로 유지할 수 있다. Objectives: This study was performed to investigate the effects of a health education program for the aged on knowledge about the warning signs and symptoms of acute myocardial infarction and stroke. Methods: Data from 337 elderly people (159 participated and 178 non-participated) at senior centers in Jeju-si were collected by 1 to 1 interview from January to March 2012, one year after the education program provided. Two stages of study were performed: Cross-sectional, case-control study on the level of knowledge about the warning signs and symptoms; and multivariate logistic regression to fine out predictors of optimal awareness. Results: No significant discrepancy of knowledge level between case and control group was found. The knowledge level as high as a surge was shown in both groups one year later. A surge of knowledge had been shown after the education provided in one month. The factors affecting the optimal level of knowledge were education (Odds ratio 3.01; Confidence Interval 1.72-5.26; P-value <0.001) and 7 days of watching TV news per week (2.97; 1.68-5.23; P<0.001). However, participation in the health education was not significant (1.60; 0.98-2.61; P=0.059). Conclusions: The effects of a targeted program in high-risk groups for cardio-cerebrovascular disease are only guaranteed in the enhancement by a population-based mass-media education campaign.

국민건강증진종합계획의 신체활동분야 계획 변천과 발전방향: 1~4차 계획을 중심으로

송정국(Jung-Kook Song),고광욱(Kwang Wook Koh),김혜숙(Hye-Sook Kim) 한국보건교육건강증진학회 2020 보건교육건강증진학회지 Vol.37 No.1

국내 원전시설의 지진 안정성 평가 절차 및 방법은?

송정국(Jeong-Guk Song) 대한토목학회 2011 대한토목학회지 Vol.59 No.8

제주도 성인의 신체활동 수준

송정국(Jung-Kook Song),고광욱(Kwang Wook Koh) 한국보건교육건강증진학회 2019 보건교육건강증진학회지 Vol.36 No.4

수종의 BRACKET(DBS)제거방법에 따른 법랑질 표면에 대한 주사전자현미경적 연구

송정국,손병화 대한치과교정학회 1985 대한치과교정학회지 Vol.15 No.2

With modification of the acid etch technique and improvements of the physical and mechanical properties of the acrylic resin, the removal of directly bonded attachments and the finishing of the underlying enamel have become an acute clinical problem. This study was to evaluation the efficacy of recently introduced instrumentation and techniques to remove bonded brackets and residual resin, and restore the affected enamel surface to an acceptable clinical condition. Forty-eight premolar which were scheduled for extraction for orthodontic purposes were bonded with brackets using super-C ortho Four additional premolars with untreated surfaces were used as controls . After one weak the brackets were removed and the residual resin removed by hand scaler, green stone, green rubber wheel, sandpaper disc, tungsten carbide bur, Sof-lex disc. Half the experimental teeth were given a final pumicing and then all were extracted and stored in 50 percent ethanol. The scanning electron microscopy was used to evaluated the enamel surface. Following results were obtained; 1. A satisfactory result was obtained by means of the Sof-lex disc. 2. The order of the scratch formation was the procedure using hand scaler, green stone, tungsten carbide bur, sandpaper disc, green rubber wheel, and Sof-lex disc. 3. The procedures using green stone and tungsten carbide bur showed many groove formations and the other procedures showed none. 4. Final pumicing serves effectively to remove residual abhesive and restore the enamel surface.

제주지역 결혼이주여성의 우울감과 삶의 질

강나리,송정국,박준혁,곽영숙 대한우울조울병학회 2016 우울조울병 Vol.14 No.2

Objectives : The purpose of this study was to investigate the depressive symptoms, quality of life and correlates of depressive symptoms in married immigrant women in Jeju. Methods : The subjects were 86 married immigrant women recruited from multicultural family support center in Jeju province. They completed Beck Depression Inventory (BDI), General Health Questionnaire-20 (GHQ-20), and the Korean Version of Short-Form 36-Item Health Survey (SF-36). We investigated demographic factors, Korean language ability and social support of them. Depressed participants were identified by BDI total scores. Demographic variables SF-36, and GHQ-20 were compared between depressed group and non depressed group. And also the correlates of depressive symptoms were investigated. Results : 20.7% of subjects was depressed by BDI. Depressed group showed high levels of parenting stress, lower spouse support and lower adaptation of mother role perceived by themselves than non depressed group. And depressed group had significantly lower scores of social function, vitality and mental health in Sf-36 than non depressed group. Logistic regression analysis revealed that the level of their spouse support was correlated with their depressive symptoms. Conclusion : Our results suggest that mental health screening and intervention systems should be developed for marriage immigrants. And strategies to improve their spouse support is needed.

안면동맥 천공지피판술을 이용한 뺨결손의 재건

강재경,송정국,정현교,신명수,윤병민,Kang, Jae Kyoung,Song, Jung-Kook,Jeong, Hyun Gyo,Shin, Myoung Soo,Yun, Byung Min 대한두개안면성형외과학회 2012 Archives of Craniofacial Surgery Vol.13 No.2

Purpose: To reconstruct the midface, local flaps such as nasolabial flaps have been frequently used. These local flaps, however, have the shortcomings of requiring a secondary operation or limitations in the movement of the flap. Thus, new methods have been developed. This paper reports a case wherein the basal cell carcinoma on the cheek was resected and the skin and soft tissue defect was successfully treated using a facial artery perforator flap. Methods: A 68-year-old female consulted the authors on the basal cell carcinoma that developed on her cheek. The mass was fully resected and revealed a $2.3{\times}2.3cm$ defective region. Using a Doppler ultrasonography, the facial artery path was traced, and using a loupe magnification, the facial artery perforator flap was elevated and the defective region was covered with the flap. Results: The flap developed early venous congestion, but it disappeared without any treatment. Six months after the surgery, the patient was satisfied with the postoperative result. Conclusion: The facial artery perforator flap has a thin pedicle. It offers a big arc of the rotation that allows free movement and one-stage operation. These strengths make the method useful for the reconstruction of the midface among other procedures.