외래진료 민감질환 유질환자 중 장애인과 비장애인의 의료이용률 차이

은상준,홍지영,이진용,이진석,김용익,신영수,김윤,Eun, Sang-Jun,Hong, Jee-Young,Lee, Jin-Yong,Lee, Jin-Seok,Kim, Yong-Ik,Shin, Young-Soo,Kim, Yoon 대한예방의학회 2006 예방의학회지 Vol.39 No.5

Objectives: The purpose of this study was to determine whether the disabled have worse access to primary care than the non-disabled. Methods: We used the National Disability Registry data and the National Health Insurance data for the calendar year 2003, and we analyzed 807,380 disabled persons who had been registered until December 2001 and we also analyzed 1,614,760 non-disabled persons for nine ambulatory care sensitive conditions (ACSCs). The rates of physician visits and hospitalizations for the patients with ACSCs were compared between the disabled and the nondisabled. Multiple logistic regression analysis was used to evaluate the association between medical care utilization and disability and to assess the association between hospitalization and the number of physician visits while controlling for potential confounders. Results: The numbers of physician visits per 100 patients were $0.78{\sim}0.97$ times lower for the disabled than that for the non-disabled with five of nine ACSCs. The numbers of hospitalizations per 100 patients were $1.16{\sim}1.77$ times higher for the disabled than that for the non-disabled with all the ACSCs. While the ORs of a physician visit for the disabled were significantly lower than that for the non-disabled with all the ACSCs (OR: $0.44{\sim}0.70$), and the ORs of hospitalization for the disabled were significantly higher (OR: $1.16{\sim}1.89$). The lower physician visit group (number of physician visits ${\leq}$1) was more likely to be hospitalized than the higher physician visit group (number of physician visits ${\geq}$2) (OR: $1.69{\sim}19.77$). The effect of the physician visit rate on hospitalization was larger than the effect of disability on hospitalization. Conclusions: The results suggest that the disabled were more likely to be hospitalized for ACSCs due to their lower access to primary care.

한국어판 아동용 사회기술 척도(Children`s Self-Report Social Skills Scale)의 개발과 평가

김용석(Yong Seok Kim),홍지영(Jee Young Hong) 한국아동복지학회 2007 한국아동복지학 Vol.- No.24

본 연구는 아동 사회기술의 중요성과 아동용 사회기술 척도의 부족을 인식하고 초등학생을 위해 개발된 Children`s Self-Report Social Skills Scale-(CS4)의 한국어판(CS4-K)을 개발하고 평가하고자 하였다. 본 연구에 참여한 조사대상자들은 총 461명으로 조사당시 초등학교 4~6학년에 재학 중인 학생들이었다. 탐색적 요인분석을 실시한 결과 CS4-K는 CS와 마찬가지로 3가지 요인(사회규범, 호감, 사회적 미숙)으로 구성되어 있는 것으로 나타났다. 21문항으로 구성된 CS4-K의 신뢰도는 양호한 수준이었으며 요인 별로도 대체로 만족스러운 수준이었다. 다만 요인 3의 신뢰도가 일반적 기준에 미치지 못하는 수준이었다. CS4-K는 사회기술 수준이 상대적으로 양호한 일반 아동집단과 상대적으로 저조한 치료중인 아동집단을 잘 구별하였으며, CS4-K는 아동의 사회기술을 측정하는 또 다른 도구인 SSRS0와 높은 정적 상관관계를 보여 CS4-K가 측정하고자 의도하는 아동의 사회기술을 제대로 측정하고 있었다. 또한, CS4-K는 이론적으로 관련 있는 변인들과도 통계적으로 유의미한 관계를 가졌을 뿐만 아니라 이들 변인과 의 관계의 방향도 예견된 방향과 일치하여 사회기술에 대한 아동 자가 보고의 타당성이 입증되었다. 반복적인 평가를 실시하여 CS4-K가 사회복지 실천과 연구를 위해 널리 활용되길 기대한다. The purpose of this study is to develop the Korean version of Children`s Self-Report Social Skills Scale. A total of 461 elementary students participated in this study. Based upon the result of exploratory factor analysis, CS4-K has 3 factors(Social Rule, Likeability, Social Ingenuousness) just like CS4. The Chronbach`s alphas of CS4-K and two subscales(Social Rule, Likeability) are quite high, but that of Social Ingeuousness is somewhat low. Concurrent validity of CS4-K is supported by distinguishing children with and without social skill problems. CS4-K is positively correlated with Social Skills Rating System and has expected relationships with theoretically related variables such as self esteem, school bonding, and problem behaviors. It is suggested that further evaluation on CS4-K be conducted in order to make CS4-K a useful tool for practice and research.

Evaluation on the Accuracy of Vaccination Card for National Immunization Program in a 2005 Population-Based Survey in Nonsan, Korea

Moo-Sik Lee(이무식),Jee-Hee Kim(김지희),Kwang-Hwan Kim(김광환),Jee-Young Hong(홍지영),Jin-Yong Lee(이진용),Keon-Yeop Kim(김건엽) 한국농촌의학 지역보건학회 2011 농촌의학·지역보건 Vol.36 No.2

목적 : 이 연구는 국가예방접종률 산출 및 조사방법론 개발을 위한 기반을 조성하기 위하여 예방접종률 파악을 위한 자료원 중 영유아 예방접종 수첩기록의 정확도를 평가하기 위하여 수행되었다. 대상 및 방법 : 연구대상은 2005년 1월 31일을 기준으로 충청남도 논산시에 주민등록상 거주하는 생후 12-35개월 영유아 전체로 하였다. 연구대상자가 거주하는 가구를 2005년 2-4월까지 방문하여 보호자의 동의를 얻어 예방접종 수첩기록을 조사하였다. 예방접종 수첩기록의 정확도를 평가하기 위하여 2005년 5-7월까지 예방접종을 시행한 의료기관 및 보건소의 접종관련 기록을 확보하여 예방접종 접종 여부 및 접종 일자의 기록 일치 여부를 확인하였다. 비교 대상 예방접종은 결핵(BCG), B형간염, 디프테리아/파상풍/백일해(DTaP), 홍역/유행성이하선염/풍진(MMR), 폴리오, 일본뇌염, 수두, 인플루엔자, B형 헤모필루스 인플루엔자 뇌수막염(Hib), A형간염, 폐구균으로 총 11종을 대상으로 하였다. 결과 : 예방접종 수첩의 예방접종 여부 및 접종 일시 기록의 정확도는 BCG는 69.5% 및 80.1%였으며, B형 간염은 1차 41.3% 및 89.7%, 2차 76.6% 및 82.1%, 3차 79.7% 및 79.0%였으며, DTaP는 1차 79.9% 및 87.5%, 2차 80.8% 및 87.3%, 3차 82.5% 및 85.1%, 4차 79.9% 및 83.5%였으며, 폴리오는 1차 79.5% 및 88.1%, 2차 79.8% 및 86.2%, 3차 82.1% 및 84.8%였으며, MMR은 83.2% 및 84.0%였으며, 일본뇌염 1차는 80.7% 및 83.1%였으며, 수두는 74.9% 및 83.7%였으며, 인플루엔자는 74.1% 및 55.3%였으며, Hib 1차는 72.7% 및 90.7%였으며, A형 간염 1차는 79.5% 및 88.4%였으며, 폐렴구균 1차는 73.2% 및 90.3%로 나타났다. 결론 : 여러 가지 연구의 제한점에도 불구하고, 예방접종 수첩의 상당한 수준의 신뢰도를 확인하였으나 수첩의 예방접종력 정확도 및 타당도에 대한 추가 연구가 필요할 것으로 판단된다. The aims of this study were to survey, evaluate the accuracy of personal immunization record of vaccination card, and to establish the applicability of personal immunization record for presuming population based immunization rate and evaluation method. In 2005, a population-based survey of 12-35 months old children was carried out in Nonsan, Korea. We conducted household survey and provider check using questionnaire and checklist to obtain data on immunization status for children. Total 11 vaccinations were checked in vaccination card such as BCG, hepatitis b, polio, chickenpox vaccine. For estimating accuracy of immunization status and dates of immunization, we estimated correspondence rate between data from personal vaccination card and data from medical records and immunization registry data. Accuracy of the child"s vaccination card by type of National Immunization Program vaccine in whole medical institutions were from 41.8% to 83.2%. Accuracy for the date of vaccination of vaccination card in National Immunization Programme vaccine were from 55.3% to 89.7%. In spite of this study limitations, this study verified the validity of vaccination record of vaccination card substantially, but suggests more efforts to reassure the validity of vaccination card.

보건소 표준 업무 분류체계 개발

홍남수(Nam-Soo Hong),이주형(Ju-Hyung Lee),김창훈(Chang-Hoon Kim),홍지영(Jee Yong Hong),권근상(Keun-Sang Kwon) 한국보건교육건강증진학회 2019 보건교육건강증진학회지 Vol.36 No.4

영유아의 예방접종 및 그 관련요인

이무식,김은영,김건엽,이진용,장민영,홍지영,Lee, Moo-Sik,Kim, Eun-Young,Kim, Keon-Yeop,Lee, Jin-Yong,Jang, Min-Young,Hong, Jee-Young 한국농촌의학지역보건학회 2012 농촌의학·지역보건 Vol.39 No.4

이 연구는 지역단위 예방접종률 시범조사를 통해 획득한 다양한 예방접종 자료를 분석하여 예방접종의 수진 관련 요인을 파악, 분석하였다. 2005년 2월부터 4월까지 일개 도농복합 지역사회 영유아 전수를 대상으로 해당 연령의 영유아들이 거주하는 가구를 조사자가 직접 방문하여 보호자를 대상으로 설문조사하였으며, 접종조사력에 대한 확인은 예방접종수첩자료를 우선적으로 하고, 없을 시에는 보호자의 기억력에 의존하여 조사하였다. 또한 2005년 5월부터 7월까지 지역 가구조사에서 확인된 예방접종 의료 기관을 대상으로 예방 접종력 확인 조사를 실시하였는데, 논산 및 대전지역 병의원에 대해서는 조사자가 직접 방문하였고, 타지역의 경우 우편 설문조사를 시행하였다. 예방접종수첩에 근거한 국가필수예방접종률은 DTaP 4차(79.3%)를 제외하고 92.7~96.4%였으며, 국가예방접종 완전접종률은 74.0%, 4:3:1 시리즈 완전접종률은 77.1%였다. 국가필수예방접종의 완전접종은 주 양육자가 부모인 경우(19개월 이상 영유아에서 교차비 0.59, 95% 신뢰구간 0.39-0.87), 출생순위가 셋째 이상에 비해 빠를수록(24개월 이상 영유아에서 교차비 1.79, 95% 신뢰구간 1.05-3.03) 접종률이 유의하게 높았다. 4:3:1 시리즈 완전접종은 19개월 이상 영유아에서 주양육자가 부모인 경우(교차비 0.58, 95% 신뢰구간 0.38-0.88), 출생순위가 첫째아일수록(교차비 1.94, 95% 신뢰구간 1.21-3.14) 접종률이 높았으며, 24개월 이상 영유아에서는 출생순위가 첫째아에서(교차비 2.23, 95% 신뢰구간 1.27-3.91) 유의하게 높았다. 90% 미만의 예방접종률을 보인 부적절한 수준의 예방접종에 대한 대책이 필요하며, 완전접종률을 높이기 위해서는 양육하는 부모의 존재와 출생순위 파악과 이에 대한 중재대책이 필요할 것이다. Objectives: Understanding the predictor of immunization status in childhood is critical issue to improve National Immunization Program (NIP). The aims of this study were to verify the status of up-to-date or complete immunization coverage and to investigate its related factors. Methods: As of 2005, according to local residence registry data, there were 2,188 children who aged 12 to 35 months in Nonsan city, Korea. We conducted household survey for aged 12 to 35 months children, using questionnaires to obtain data on the status of immunization such as BCG, DTaP (diphtheria, tetanus, and pertussis), Polio, and MMR (mump, measles, rubella). Finally 1,472 participated in the survey. The operating definitions used in this study were following; "Complete immunization rate" refers to the rate of children who received all immunization within recommended age intervals fully "on-time"; "The 4:3:1 series" means status of receiving the fourth diphtheria-tetanus-pertussis (4 DTP), the third Polio (3 Polio), and the first measles-mumps-rubella (1 MMR) doses. Multivariate logistic regression analyses were used to determine factors affecting complete vaccination coverage of children. Results: Immunization rates of vaccine based on the vaccination card were from 92.7% to 96.4% except 4th DTaP (79.3%). Complete immunization rate of Korea NIP was 74.0% and that of the 4:3:1 series was 77.1%. A parent as primary caregiver (OR 0.59, 95% CI 0.39-0.87 at 19-35 months of children's age) and first-born children (OR 1.79, 95% CI 1.05-3.03 at 24-35 months of children's age) were significantly related to complete immunization coverage of Korea NIP. And a parent as primary care giver (OR 0.58, 95% CI 0.38-0.88 at 19-35 months of children's age) and first-born children (OR 1.94, 95% CI 1.21-3.14 at 19-35 months, OR 2.23, 95% CI 1.27-3.91 at 24-35 months of children's age) were significantly related to complete immunization rate of 4:3:1 series. Conclusions: Government should take actions to increase complete immunization rate. In particular, intervention on the secondary caregiver and non-first-born children should be needed.

액체크로마토그래피를 이용한 벌꿀 중 테트라싸이클린계 항생물질의 정량분석 및 잔류조사

이성모 ( Sung Mo Lee ),박은정 ( Eun Jeong Park ),홍지영 ( Jee Young Hong ),김정임 ( Jung Im Kim ),이정구 ( Jung Goo Lee ),황현순 ( Hyun Soon Hwang ),김용희 ( Yong Hee Kim ) 한국가축위생학회 2005 韓國家畜衛生學會誌 Vol.28 No.3

Oxytetracycline, tetracycline, chlortetracycline and doxycycline in honey were separated by solid phase extraction(SPE) and determined with high performance liquid chromato-graphy(HPLC) with UV/Visible detector. Analysis was carried out using following conditions; XTerra C8 column(3.9 × 150 ㎜ i.d. 5㎛), mobile phase composed of 0.01M oxalic acid : methanol : acetonitrile(820:80:100, v/v/v), isocratic pump at a flow rate of 0.9 ㎖/min. and 50㎕ of injection volume, UV/Visible detector with wavelength of 360㎚. The calibration curves of four tetracyclines showed linearity(γ2>0.999) at concentration range of 100~1,000ng/㎖. The recoveries in fortified honey represented more than 70% with low coefficient of variation(<10%) for concentration range of four tetracyclines. The detection limits for oxytetracycline, tetracycline, chlortetracycline and doxycycline were 13.8, 14.6, 26.2 and 24.9ng/g in acacia honey, respectively. We also monitored tetracyclines residue in domestic honey[n=38, acacia(20), wild flower(18)] and foreign honey[n=22, legally distributed(13), illegally distributed(9)] using modified CharmⅡ screening and HPLC confirmation methods. Seven of the 60 samples(11.7%) were suspect positive using modified CharmⅡ screening test. Chlortetracycline residue was found in one foreign honey(illegally distributed) tested at concentrations of 0.22 ppm. Conclusively, for more effective control of tetracyclines used in beekeeping should be further survey for residues in honey and also national guidelines(maximum residue limit:MRL) and methods should be obligatory.

영유아의 예방접종 및 그 관련요인

이무식(Moo-Sik Lee),김은영(Eun-Young Kim),김건엽(Keon-Yeop Kim),이진용(Jin-Yong Lee),장민영(Min-Young Jang),홍지영(Jee-Young Hong) 한국농촌의학 지역보건학회 2012 농촌의학·지역보건 Vol.37 No.4

Objectives: Understanding the predictor of immunization status in childhood is critical issue to improve National Immunization Program (NIP). The aims of this study were to verify the status of up-to-date or complete immunization coverage and to investigate its related factors. Methods: As of 2005, according to local residence registry data, there were 2,188 children who aged 12 to 35 months in Nonsan city, Korea. We conducted household survey for aged 12 to 35 months children, using questionnaires to obtain data on the status of immunization such as BCG, DTaP (diphtheria, tetanus, and pertussis), Polio, and MMR (mump, measles, rubella). Finally 1,472 participated in the survey. The operating definitions used in this study were following; “Complete immunization rate” refers to the rate of children who received all immunization within recommended age intervals fully “on-time”; “The 4:3:1 series” means status of receiving the fourth diphtheria-tetanus-pertussis (4 DTP), the third Polio (3 Polio), and the first measles-mumps-rubella (1 MMR) doses. Multivariate logistic regression analyses were used to determine factors affecting complete vaccination coverage of children. Results: Immunization rates of vaccine based on the vaccination card were from 92.7% to 96.4% except 4th DTaP (79.3%). Complete immunization rate of Korea NIP was 74.0% and that of the 4:3:1 series was 77.1%. A parent as primary caregiver (OR 0.59, 95% CI 0.39-0.87 at 19-35 months of children"s age) and first-born children (OR 1.79, 95% CI 1.05-3.03 at 24-35 months of children"s age) were significantly related to complete immunization coverage of Korea NIP. And a parent as primary care giver (OR 0.58, 95% CI 0.38-0.88 at 19-35 months of children"s age) and first-born children (OR 1.94, 95% CI 1.21-3.14 at 19-35 months, OR 2.23, 95% CI 1.27-3.91 at 24-35 months of children"s age) were significantly related to complete immunization rate of 4:3:1 series. Conclusions: Government should take actions to increase complete immunization rate. In particular, intervention on the secondary caregiver and non-first-born children should be needed.