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Synthesis and properties of photoinduced refractive index chnage polymers
전인혜,최미진,김진수,이미혜,조진한,가재원 한국공업화학회 2015 한국공업화학회 연구논문 초록집 Vol.2015 No.0
Refractive index changing materials by photo-irradiation or electrical field were widely utilized to optical, electrical and biological applications. The trans-cis photoisomerization of azobenzene is well-defined and extensively applied process. Irradiation with light produces the cis isomer, which has a bent conformation and much larger dipole moment. As a result of photoisomerization of azobenzene, the polymer bearing azobenzene as a side-chain have a large refractive index change. In this study, we have investigated azobenzene containing photo induced refractive index change polymers. The methacrylate monomers and azobenzene side chain polymers with various ratio were synthesized via radical polymerization. The molecular structure and properties of polymers were characterized by NMR, UV-vis, DSC and GPC. The refractive index change properties of prepared polymers after UV-irradiation were also studied.
장애인 건강주치의 시범사업 평가 및 제도 활성화 방안 연구
박진관,전인혜,김세린 건강보험심사평가원 심사평가연구소 2022 연구보고서 Vol.2022 No.0
The government has introduced and operated the pilot project for primary care for people with disablities May 2018 to improve the health level and medical accessibility of the disabled. Five years after the introduction of the system, the number of participants in the disabled and the attending physician was very low at less than 1% of the total, raising the need for a comprehensive evaluation of the system and measures to revitalize the system. This study measured the effect of diagnosing the operation level of the pilot project and the participating disabled, and prepared a plan to revitalize the system through a questionnaire for the participating disabled and their doctor. Research Method: This study measured the effectiveness of the pilot project by analyzing the current status of participation in the pilot project, changes in medical use behavior and health outcomes of the disabled after participation. In order to evaluate the effect of the system, we compared the results of the participants with group of non-participants through propensity score matching(PSM) and Difference in Difference(DID). Research results: The number of disabled people and doctors participating in the pilot project is 1,182 and 60, less than 0.2% of the total. About Half of the disabled were at the level of '0 to 2 times'. In the case of the doctor, the imbalance was severe as the service provision was concentrated on a small number of people, and more than half of the disabled and their doctors left the service at each stage of the pilot project. According to the survey, the satisfaction level was high in that it provided visiting medical treatment to the disabled who had difficulty moving, but the disabled had low access to the system due to lack of system awareness, cost burden, and lack of professional services such as rehabilitation services. In the case of medical providers, it was difficult to participate in the system due to the lack of expected profits due to the lack of participants in the system, difficulty in preparing labor costs for visiting medical treatment, and excessive work by the doctor. As a result of the evaluation of the effectiveness of the pilot project, outpatient dependence rate of higher medical institutions reduced and Relevance Index(RI) increased after participation in the pilot project, and the effect was higher in the group that actively participated. Conclusion: The pilot project has effect on medical use behaviors and health, and participants' survey results showed high expectation and satisfaction for the pilot project. In particular, the need for the system is very high at a time when the health care of the disabled is neglected due to COVID-19. In order for the performance of such a system to be visible, it is essential to revitalize the system by expanding the demand for the system for the disabled and creating conditions for the doctor to participate in the system.
요양병원 입원환자 분류체계 및 수가수준 정기적 조정기전 마련을 위한 기초연구
이다희,전인혜,김명화,김록영 건강보험심사평가원 심사평가연구소 2021 연구보고서 Vol.2021 No.0
Background: Over the next 10 years, there have been continuous issues related to the classification criteria and fees of inpatients in long-term care hospitals, such as an increase in the ratio of mild and long-term hospitalization, an increase in social hospitalization, and ambiguity in classification criteria. Accordingly, the 7th Health Insurance Policy Deliberation Committee in 2019 reorganized the health insurance fee system for long-term care hospitals from November 2019. At the same time, as a mid- to long-term reorganization plan, a new classification system was proposed to promote functional differentiation according to the disease group and severity of long-term care hospitals. Objective: The purpose of this study is to provide basic data to prepare a long-term care hospital inpatient classification system and a mechanism for adjusting the fee level by identifying problems with the long-term care hospital inpatient classification system and fee level and seeking improvement directions. Results: As of the date of reorganization of the classification system for inpatients in long-term care hospitals (November 1, 2019), 201,260 patients who were consecutively hospitalized were analyzed. The proportion of patients in the selective hospitalization group was expected to be 43.7% (87,928 patients) after the reorganization, but it was confirmed that only 11.4% (22,980 patients) after the actual reorganization. As a result, inpatients in long-term care hospitals could be classified into disease-based dementia, cerebrovascular and nervous systems, cancer, musculoskeletal system, and other patient groups. However, even within the first-stage classification group, additional reflective elements were needed to classify various patient conditions. Factors for detailed grouping, such as age classification, severity, number of days of hospitalization, whether to use a ventilator, and physical function, should be further reviewed to prepare a more specific classification system and fee system. Discussion: This study raised the need for a new classification system reflecting disease groups and patient conditions. It is necessary to understand the actual status of inpatients in long-term care hospitals through simulation studies applying objective functional evaluation tools in the future. It will be necessary to develop a disease group-based patient classification system that reflects objective indicators such as clinical diagnosis of patients, patient condition and function, and level of essential nursing behavior.
어린이 재활의료기관 지정운영 시범사업 성과평가 및 지정규모 확충 방안 연구
박진관,전인혜,김세린,설이서 건강보험심사평가원 심사평가정책연구소 2023 연구보고서 Vol.2023 No.0
This study estimates the number of institutions needed to create a community-centered medical use environment for children's rehabilitation patients, and establishes performance evaluation and development plans for pilot projects introduced to expand children's rehabilitation medical care Estimating the number of institutions needed in 2023 by measuring the number of unmet hospital beds and the number of outpatients in consideration of demand and supply by region. As a result, as of now, there are a total of 11 areas requiring designation, a total of 12 hospitals and 4 clinics in the metropolitan area, 18 hospitals and 1 clinic outside the metropolitan area The performance evaluation of the children's rehabilitation medical institution pilot project was compared and analyzed by matching the participating and non-participating groups, focusing on the improvement of patients' medical use and function, and the institution's medical staff and treatment activities. In the case of children's rehabilitation medical use behavior, the number of visits to the hospital, the number of days of medical use, and the concentration of medical institutions improved, and among them, the improvement effect of new users was found to be high. In the case of cost accessibility, about 1 million won per person for speech therapy, manual therapy, and cognitive therapy can be saved through the application of existing non-insured health insurance. In the case of functional improvement, as a result of examining the clinical effect with a group of specialists along with before-and-after evaluation for patients who have undergone two or more evaluations, the improvement effect on the results of GMFM-66, pediatric balance scale, SELSI, and PRES is appeared to be high Through these achievements, it is expected that this pilot project will play a pivotal role in the children's rehabilitation medical network if the capacity improvement of the institution through the expansion of the pilot project institution and conversion to the main project and the improvement of patients' medical use and function are expanded in the future.