노인의 치과의료서비스 이용에 영향을 미치는 요인

안은숙 ( Eun Suk Ahn ),황지민 ( Ji Min Hwang ),신명숙 ( Myong Suk Shin ) 한국치위생과학회 2015 치위생과학회지 Vol.15 No.1

The purpose of this study was to examine the relationship of predisposing, enabling, need factors and oral health care factors to the dental utilization in 4,521 senior citizens based on the 5th National Health and Nutrition Examination Survey data. As for the relationship of predisposing, enabling and need factors to the necessity of denture, higher academic credential and higher income level that were respectively one of predisposing and need factors led to a higher necessity of denture, and the relationship of these factors was statistically significant. As to influential factors for their dental utilization in Model 1, there were significant differences according to gender, marital status and whether to subscribe to private health insurance or not. In Model 2, the need factors of Model 1 were adjusted. As a result, the respondents who didn``t receive any unsatisfactory dental treatment made 1.35-fold more dental utilization, and the respondents who complained about mastication difficulty made 1.34-fold more dental utilization. There were significant differences according to gender, age, marital status, academic credential, whether to subscribe to private health insurance, unsatisfactory dental treatment experience and mastication difficulty. Age, unsatisfactory dental treatment experience and whether to complain about mastication difficulty or not made statistically significant differences to the dental utilization in Model 3 that involved oral health status. The above-mentioned findings illustrated that the predisposing factors, the enabling factors and the need factors exerted an influence on the elderly dental utilization. As there are a variety of factors to affect elderly dental utilization, its required to make an effort to boost the accessibility of the elderly to dental service in order to improve their oral health of the elderly.

전조작기 아동의 완수동기, 자기조절, 퍼즐맞추기 수행 능력과의 관계

안은숙(Ahn Eun-Suk),김양은(Kim Yang-Eun),양미선(Yang Mi-Sun) 한국영유아보육학회 2010 한국영유아보육학 Vol.0 No.62

본 연구의 목적은 전조작기 아동의 완수동기, 자기조절과 퍼즐맞추기 수행능력을 살펴보고 그 관련성을 규명하는데 있다. 연구대상은 전조작기에 해당되는 2-5세 아동 108명이었으며, 수집된 자료는 SPSS program을 이용하여 평균, 표준편차, 변량분석, 상관관계 분석을 실시하였다. 연구결과 완수동기와 자기조절 능력, 퍼즐맞추기 수행능력은 연령에 따라 차이가 있었으며, 성별에 의한 차이나 연령 및 성별에 의한 상호작용 효과는 없는 것으로 나타났다. 완수동기와 자기조절 능력 간 정적상관을 보였으며, 특히 완수동기와 자기조절 능력의 하위요인 중 자극통제와 낮은 자극 즐거움에서 정적 상관이 나타났다. 또 완수동기와 퍼즐완성율 사이에도 정적 상관이 나타나 완수동기가 높을수록 퍼즐 완성율이 높아짐을 알 수 있었다. The purpose of this study is to investigate the relationship among mastery motivation, self-regulation and puzzle-making of young children. Subjects were 108 children age from two to five. Instruments used in this study were: 1) Preschoolers' mastery orientations(Chung, 2001), 2) Children's Behavior Questionnaire(CBQ)(Rothbart, 1994, 2002), and 3) Bear Puzzle making(Montford and Readdick, 2008). The data analyses use SPSS 18.0 which employs basic statistics, reliability test, Two-way ANOVA and Pearson's correlation analysis. The findings of this study are: First, the older children have higher level of mastery motivation and self-regulation than younger children. Second, the four to five old children are less likely to use trial and error as a puzzle-making strategy and completed puzzles more often and placed more pieces during puzzle-making than two to three olds. In addition, mastery orientation of children have a positive relationship with self-regulation and puzzle making capability.

치과의료 이용의 수평적 형평성 분석

안은숙 ( Eun Suk Ahn ),김민영 ( Min Young Kim ),신호성 ( Ho Sung Shin ) 대한예방치과·구강보건학회 2015 大韓口腔保健學會誌 Vol.39 No.1

Objectives: Health inequity across social classes is closely associated with unequal healthcare utilization, and there have been sustained efforts to improve healthcare accessibility. Public healthcare insurance is one attempt to eliminate such health inequities. The purpose of this study was to examine a horizontal equity index for dental service utilization, which included diverse factors affecting health inequity, such as personal health and social context variables. Methods: The 2008 to 2011 outpatient datasets of the Korean Healthcare Panel were analyzed. Zeroinflated negative binomial regression (ZINB) was conducted to estimate need-adjusted healthcare use with the following independent variables: health outcome (EQ-5D), chronic disease, and the Composite Deprivation Index. The concentration index and horizontal inequality index were calculated for the actual use of dental services and resource use-based dental visits. Results: The ZINB regression analysis showed that age and personal health level on the EQ-5D were significant predictors, and the Composite Deprivation Index was influential. The concentration index for dental service utilization indicated that there was inequity favoring high-income brackets, but there was inequity favoring low-income groups when health level was taken into account. Overall, the horizontal equity index for dental service utilization estimated based on the two values was positive, meaning that there was inequity favoring high-income groups. Conclusions: The use of dental services has been steadily on the rise, and dental service accessibility and public healthcare coverage seem to have expanded. However, when the horizontal equity index for dental service utilization was estimated based on health level, there was inequity, with high-income groups making more use of dental services. Thus, equal access to dental services is not guaranteed, despite the adjustment for need. Methods of increasing dental service use in different income brackets must be carefully considered to remove disparities in the use of dental services.

우리나라 청소년의 미충족 치과의료 수준 측정

안은숙 ( Eun Suk Ahn ),한지형 ( Ji Hyoung Han ) 한국치위생과학회 2015 치위생과학회지 Vol.15 No.2

The purpose of this study was to examine any possible differences among adolescents in unmet dental care needs according to their demographic and socioeconomic characteristics and oral health status and influential factors on the basis of the fifth national health and nutrition examination survey data. The findings of the study were as follows: Unmet dental care needs were accounted for 19.84 percent. As for the reason, many replied that they couldn`t afford to leave school during school hours, and economic factors. As a result of analyzing what affected their unmet dental care needs, this experience was more common in the older age groups than in the 6∼12 years age group, and the experience was less common in the respondents with a larger income. As for the subjective oral health status, the experience was 0.61-fold and 0.72-fold less in the respondents who perceived their health as fair or good than who thought their health was poor respectively. And there was a tendency that getting regular dental checkups led to 0.22-fold less experience. Given the above-mentioned findings, the kind of policy that makes dental care services more accessible to youth in consideration of socioeconomic circumstances should be carried out. As many of the adolescents couldn`t leave school during school hours, schools should be equipped with dental clinics to improve accessibility to dental care services.

치면열구전색 급여화에 따른 수혜량에 영향을 미치는 요인

안은숙 ( Eun Suk Ahn ),황지민 ( Ji Min Hwang ) 한국치위생과학회 2015 치위생과학회지 Vol.15 No.6

The purpose of this study was to grasp the benefits from pit and fissure sealants and to analyze the factors of influencing the benefit amount by using the raw data of the Korea National Health and Nutrition Examination Survey for 2007∼2013 targeting the subjects aged from 6 years in full to 18 years. The analysis was used STATA 11.0. As a result of the analysis, the following conclusions were obtained. It rose up to 1.24 pieces after carrying out the national health insurance coverage from averagely 0.93 piece until the year in 2007∼2009 (up to November) when is before enforcing the national health insurance coverage in the pit and fissure sealants. The benefits from pit and fissure sealants depending on general characteristics were surveyed to be higher in the higher income level, in the more subscription to health insurance and private insurance, and in the more toothbrushing frequency per day. The factors that have influence upon the benefits from pit and fissure sealants were shown to include whether or not to have the national health insurance coverage in the pit and fissure sealants, income level, health insurance type and private insurance subscription appearance, and one-day toothbrushing frequency. Synthesizing the results, a rise in the benefits from pit and fissure sealants is shown in 2010 based on December 2009 when the national health insurance coverage in the pit and fissure sealants was implemented, but is showing the tendency of declining again from 2011. To increase the benefits from pit and fissure sealants, it is thought that the schemes will need to be discussed such as reinforcing publicity on the national health insurance coverage in the pit and fissure sealants, expanding a support for low-income bracket, and differentiating the outpatient cost sharing according to socio-economic level.

식용 식물로부터 얻은 추출물의 두부, 어묵, 막걸리 변질균에 대한 항균성 검색

안은숙(Eun-Sook Ahn),김문숙(Moon-Suk Kim),신동화(Dong-Hwa Shin) 한국식품과학회 1994 한국식품과학회지 Vol.26 No.6

활동기준원가(Activity Based Cost)를 적용한 치과 임플란트 원가산정

신호성,안은숙,Shin, Ho-Sung,Ahn, Eun-Suk 대한치과보철학회 2013 대한치과보철학회지 Vol.51 No.4

연구 목적: 의료환경의 변화에 따라 새로운 의료관리에 대한 필요성과 함께 의료기관의 원가관리에 대한 관심이 증가되었다. 본 연구는 치과의료기관에서 빈번하게 제공되는 치과 임플란트 서비스를 직원의 활동에 근거하여 자원 또는 원가를 배부하는 활동기준원가(Activity-Based Cost, ABC) 방법을 적용하여 원가를 산정하기 위해 시행되었다. 연구 대상 및 방법: 수도권 소재의 A 치과의료기관을 대상으로 치과 임플란트 원가산정을 실시하였다. 해당 기관의 총비용을 확인하기 위해 1사분기 세무회계자료를 사용하였고 기관 내에서 이루어지는 활동을 파악하기 위하여 활동분석표 작성을 요청하였다. 자료를 바탕으로 치과 임플란트에 해당하는 직접원가와 간접원가를 분리하고, 간접원가의 왜곡을 최소화하기 위해 원가동인(Cost driver)을 파악하여 활동별로 비용을 배분하는 활동기준원가 분석을 실시하였다. 결과:치과 임플란트 원가를 직접비와 간접비로 나누어 비교한 결과 각각 35.8%, 49.5%로 나타났다. 치과 임플란트 1개당 원가는 1,579천원 정도로 산정되었고, 임플란트 수술 및 시술 전 후 활동이 포함된 보철 시술 진료영역에 47만원(30%)이 소요되어 가장 많은 부분을 차지하였다. 연수 및 치과학 교육 등의 활동도 기타 진료에 비해 상대적으로 높은 비중을 나타내었다. 결론: 과학적인 치과 임플란트의 수가 산정을 위해서 치과 임플란트와 관련된 직접적인 진료 술식 이외에 시술 전 후 준비활동 등에 대한 고려가 충분히 이루어져야 한다. 임플란트 시술 전 후의 활동 및 교육, 연수활동 등은 간접비에 포함되는 부분이나 진료의 질을 담보하고 환자의 만족도를 향상시키기 위해 반드시 필요할 활동으로 이러한 활동들을 고려한 합리적 수가 산정이 필요하다. Purpose: There is a growing concern for the cost management of medical institutions. The purpose of this study was to estimate Activity-Based Costing (ABC) for dental implant cost. ABC refers to allocating resources or cost based on the activities of services. Materials and methods: A dental institution located in the metropolitan area was selected in this study. The tax accounting data of the institution were utilized to confirm total cost, and the institution was asked to make out clinical activities to figure out what activities were carried out. The direct cost and indirect cost for dental implant were separately estimated, and cost driver was analyzed to estimate the indirect cost accurately. Results: The rates of the direct and indirect cost respectively stood at 35.8 and 49.5 percent. The cost for a dental implant was found to be approximately 1,579 won, and the cost of prosthetic surgery and treatment that included implant surgery accounted for the largest portion of the cost, which was 470 thousand won (30%). And the weight of training and education on dentistry was relatively higher than that of the other kinds of treatment. Conclusion: In order to ensure accurate and scientific costing for dental implant, not only direct medical procedure but every pre- and post-procedure activity should fully be taken into account. Pre-activities, post-activities, education and training are included in the indirect cost, but all these activities are mandatory and associated with the quality of treatment and the satisfaction level of patients.

시판 요구르트의 특성 비교 연구

김문숙(Moon-Suk Kim),안은숙(Eun-Suk Ahn),신동화(Dong-Hwa Shin) 한국식품과학회 1993 한국식품과학회지 Vol.25 No.4

칫솔질 교육 후 치면세균막 지수와 수행도의 변화

김기은 ( Ki Eun Kim ),안은숙 ( Eun Suk Ahn ),한지형 ( Ji Hyoung Han ) 한국치위생과학회 2015 치위생과학회지 Vol.15 No.2

This study was conducted to examine O`leary index, patient hygiene performance (PHP) index, and toothbrushing practice assessment in subjects of college students in 20s who had been randomly selected. The purpose of this study is to examine if it is easy for rolling method which is recommended by many dental professionals in Korea to implement and to effectively remove dental plaque. Also, the correlations between dental plaque index and toothbrushing practice assessment with the course of time was confirmed, after instruction session on toothbrushing was provided. STATA 11.0 (StataCorp) was used for analysis. There was no significant difference on the three ways of O`leary index, PHP index, and toothbrushing practice assessment in using rolling method, bass technique and toothpick method when comparing the average resulting from first to third instruction session on toothbrushing. O`leary index, PHP index, and toothbrushing practice assessment were inspected with Kruskal-Wallis test which is used for non-parametric statistics. They were checked three times: the first, before the toothbrushing instruction was given; the second, two weeks after the toothbrushing session was given; and the third, 4 weeks after the session. The results are as follows: O`leary index stood at the lowest in the first experiment but showed the highest in the second (p=0.0001). PHP index was the highest level in the first trial and decreased in the second time, but increased again in the last examination (p=0.0001). Toothbrushing practice assessment also showed a similar tendency with PHP index (p=0.0001). In conclusion, rolling method is not the best option for everyone, and it is thought that more various toothbrushing ways need to be reviewed and recommended to people. Also, institutional framework is required for the continuous education on toothbrushing to be in place as the effectiveness of the education is decreased with time.

팽화미의 첨가가 요구르트 특성에 미치는 영향

김문숙(Moon-Suk Kim),안은숙(Eun-Suk Ahn),신동화(Dong-Hwa Shin) 한국식품과학회 1993 한국식품과학회지 Vol.25 No.3