한의 외래에서 첩약을 포함한 비급여 조제 한약 이용결정요인 분석

김동수,김현민,임병묵,Kim, Dongsu,Kim, Hyunmin,Lim, Byungmook 대한예방한의학회 2018 대한예방한의학회지 Vol.22 No.1

Objectives : This study aimed to analyze the characteristics of uninsured herbal medicine(UHM) users and the economic and social barriers of UHM utilization. Methods : We used the Korea Health Panel Data, representative national survey on medical utilization and cost, provided by National Health Insurance Service and Korea Institiute of Health and Social Affairs. The frequency analysis was used to identify the characteristics of the respondents, and the cross-analysis (${\chi}^2-test$) was used to verify the relationship between their characteristics and the usage of UHM. In order to analyze the determinants of using the UHM considering the individual's characteristics, logistic regression analysis and multiple regression analysis were conducted for those who used the Korean medicine (KM) outpatient service in 2015. Results : The usage of UHM was significantly lower for those (1) who's age of 20 to 65; (2) who have the university or higher education degree; (3) who live in Jeju province, and (4) who bought the herbal medicine for other health related purposes. On the other hand, the usage of UHM for those (1) who have the first quintile of household income; (2) who have the chronic respiratory disease; (3) who have been taking the medicine for health promotion purpose for more than 3 months and (4) who have purchased the food which has health promotion function was significantly higher than others. The patients who have chronic musculoskeletal diseases accounted the most among the UHM users. Conclusions : There was the considerable inequality in the usage of UHM among household income groups, which provides policy rationale for UHM to be covered by national health insurance. To facilitate the coverage expansion, restrictive covering model can be considered for children and adolescents, or for patients with muskuloskeletal diseases who have the high demand for UHM.

한의의료비 자료원의 비교 분석 연구 : 조사 방법 및 2012년 한의원 의료비를 중심으로

김동수,정명수,이은경,고성규,Kim, Dongsu,Chong, Myongsoo,Lee, Eunkyoung,Ko, Seong-Gyu 대한예방한의학회 2015 대한예방한의학회지 Vol.19 No.2

Objective : In order to understand the scale of medicinal expenditure in the Korean medicine, an analysis has been made of Korean National Health Account and statistic archives used to estimate the Korean National Health Account and also of such archives as are contributory to learn the scale of total health expenditures in the Korean medicine. Method : From the Korean National Health Account archives, an analysis has been made of National health insurance statistic annual reports, National health insurance non-payment items, Korean Economic Census (The Service Industy Survey), and Korea Health Panel data. Moreover, in order to know the sales of overall Korean medicine clinics, relevant data have been utilized and cited from investigations into National tax statistics, Korean medicine medical institutions and Korean medicines used, and current states of medicinal herbs and Korean medicine industry. Results : It is found that the average scale of each section of the medical expenditures archives in the Korean medicine in 2012 was KRW 3.5638 billion and that the average medical expenditures in the Korean medicine derived from Total Health Expenditure, The Service Industy Survey, National tax statistic, and Korean medicine industry are approximately KRW 3.3901, 3.4796, 3.7218 and 3.9634 billion. And the average expenditures derived from National health insurance patients and Korea Health Panel data are 2.5162 and 2.2292 billion won and those from the users and consumers of Korean medicines and herbs are 5.6,461 billion won. In order to verify the appropriateness of estimated medical expenditures in the Korean medicine included in the archives, an analysis has been made of uninsured costs which come from the aggregate sales amount surveyed minus health insurance treatment expenditures and it is found that the ratio of insured costs against total health expenditures in 2006 was 50.67% and 41.92% in 2012 and that the ratio based on National tax statistics and The Service Industy Survey was 52.19% and 49.28% in 2006 and 50.54% and 50.64% in 2012 and that the ratio of uninsured costs against Korean medicines and herbs and Korean medicine industry was 37.5% and 58.27% in 2013. Conclusion : It calls for the improvement of the accuracy of an investigation into Total Health Expenditure which comprise the actual conditions of health insurance and Korea Health Panel, the development of statistic schemes for understanding and classifying medical expenditures of all the Korean medicine medicinal institutions like medicinal clinics, and enhanced methods for independent panels to comprehensively collect and analyze the number of sampled Korean medicine medical institutions.

한약재의 연도·산지·업체별 가격변동 분석 연구

김동수,임병묵,현은혜,이은경,Kim, Dongsu,Lim, Byungmook,Hyun, Eunhye,Lee, Eunkyung 대한예방한의학회 2019 대한예방한의학회지 Vol.23 No.2

Objectives : This study aimed to analyze price variance by year, region and company of raw herbal medicines to draw payment system for herbal medicine insurances in the National Health Insurance. Methods : To analyse price variance, we used 2015-2017 data of 'Quality test results of imported herbal medicines' provided by Korea Pharmaceutical Traders Association and 'Price data of 56 raw herbal medicines' that was surveyed by the Association of Korean Medicine. We analysed gap of highest price and lowest price those were compared with average price and coefficient of variation(CV) of prices by year, region and company of raw herbal medicines. Results : In analysing 3 years data, the highest price was 23.2% higher, and the lowest price was 19.1% lower than the average price. As of 2018, the average price of domestic produced herbal medicines was 1,8 times higher than that of imported herbal medicines. By companies, the highest price was 117.5% higher, and the lowest price was 57.3% lower than the average price. Conclusions : The price of herbal medicines varied by production year, region and company. This results suggest that comprehensive payment model needs to be considered in modeling the health insurance coverage for herbal medicine decoctions.

남북 전통의학 용어 표준화의 필요성과 향후 과제

김동수,이은희,최문석,Kim, Dongsu,Yi, Eunhee,Choi, Moonseok 대한예방한의학회 2020 대한예방한의학회지 Vol.24 No.3

Background : Mutual understanding between North and South Korea is essential for the engagement of Inter-Korean exchange and cooperation. However, the two Koreas have been divided for 70 years where Korean evolved differently within the two countries. This created a gap in the most basic foundation for mutual understanding, language. Fostering exchange and cooperation in the traditional medicine field requires a higher understanding of the specialized traditional medicine terminologies. Objectives : The purpose of this study is to formulate a future management plan for the "Comparative Terminology of Korean Medicine in South and North Korea," providing a foundation for standardizing Korean medicine terminology of the two Koreas. Methods : The study collected case studies of Korean medicine terminology management and standardization from government and international organization websites and documents. It provided future terminology management strategies based on this data. Results : The project for the standardization of Korean medicine terminology between North and South Korea can be divided into 4 stages according to the level of exchange and cooperation. The first step is to "establish a foundation for terminology standardization." The second step is "term comparison." If the exchanges and cooperation between North and South Korea, the third step will be to promote the "terminology standardization" project through Inter-Korean dialogue. Finally, after incorporating discussion on terminology standardization, the Inter-Korean Medicine Terminology can be published. Conclusions : This requires a system to support and facilitate Inter-Korean medicine exchange and cooperation. It is important to provide a support system that can provide results in a timely fashion by training relevant experts, collecting data and information, communicating with experts in the industry, academia and research institutes. This system will be able to ensure the continuity of the terminology standardization project.

대만 중의 건강보험의 체계와 서비스 질 향상 정책

김동수,권수현,정설희,안보령,임병묵,Kim, Dongsu,Kwon, Soo Hyun,Chung, Seol Hee,Ahn, Bo Ryung,Lim, Byungmook 대한예방한의학회 2016 대한예방한의학회지 Vol.20 No.2

Backgrounds : Taiwan has similar national health insurance (NHI) system for traditional medicine with South Korea. Recently, new quality improvement policies for traditional medicine is being attempted in Taiwan. Objectives : This study aimed to review the Taiwanese NHI system for Chinese Medicine (CM) and introduce quality improvement policies. Methods : Research articles, reports, government publications and year books which handled traditional medicine system and NHI system in Taiwan were searched and collected. The authors analyzed and summarized the contents in a qualitative manner. Results : In Taiwanese NHI system, CM procedures and medication for outpatients are reimbursed through a mix of fee-for-service and global budget payment system. CM shares 4% of total expenditure of NHI in Taiwan. Mostly, the expenses for procedures are reimbursed regardless of disease type, however, in the specialized program for quality improvement, CM doctors have to comply with standard operating procedures (SOPs). Conclusions : Taiwanese NHI system implemented SOP-based new reimbursement system for CM. Yet, the scientific evidences for SOPs are not sufficient, it can be useful references when we develope disease related reimbursement system for Korean Medicine in South Korea.

비급여를 포함한 한의 외래의료이용의 최근(2008-2013) 변화추이

김동수,임병묵,Kim, Dongsu,Lim, Byungmook 대한예방한의학회 2017 대한예방한의학회지 Vol.21 No.1

Objectives : This study aimed to analyze the structure and the trend of utilization and expenditure for Korean Medicine (KM) in Korea. Methods : Data were drawn from the 2008-2013 annual Korea Health Panel (Version 1.2.2), a national representative sample. We combined the data of household members with the data of outpatient KM service use. The volume of KM use was estimated based on the frequency of use and co-payment. Results : The KM utilization rate slightly increased in recent years, and it is presumed to be resulted from the increase of elderly population. Most KM outpatient visits were being concentrated in treating musculoskeletal diseases, and the procedures used frequently were acupuncture, moxibustion, cupping, and physical therapy. The imbalance of KM use between lower income group and higher income group was deepening. Conclusions : To expand restricted disease areas KM covered, the more herbal prescriptions should be insured and the insured form of herbal medicines need to be diversified.

Homecare Kit를 활용한 수면무호흡 진단 서비스 개발

김동수(Dongsu-KIM),김도영(Doyoung-KIM),김동현(Donghyeon-KIM),김동겸(Donggyeom-KIM),김민규(Mingyu-KIM),김일곤(Ilgon-KIM) 한국정보과학회 2017 한국정보과학회 학술발표논문집 Vol.2017 No.12

목재-콘크리트 합성슬래브의 구조 안정성 평가

김동수 ( Dongsu Kim ),정영준 ( Youngjoon Jeong ),이상익 ( Sangik Lee ),이종혁 ( Jonghyuk Lee ),서병훈 ( Byunghun Seo ),오정권 ( Jungkwon Oh ),최원 ( Won Choi ) 한국농공학회 2020 한국농공학회 학술대회초록집 Vol.2020 No.-

기후변화와 같은 환경 문제가 대두되며 건설 분야에서도 친환경 재료의 중요성이 주목받고 있다. 특히, 우리나라는 국토의 63%가 산림으로 이루어져 풍부한 산림자원을 보유하고 있기에 목재를 이용한 목조건축 산업에 대한 투자와 목구조 부재의 개발을 위한 연구가 활발히 이루어지고 있다. 그러나 설계기준이 정립되어있는 철근콘크리트 구조물과 달리, 목재와 함께 다른 재료가 결합한 합성보·합성슬래브에는 구조기준을 적용할 수 없어 구조설계에 어려움이 따른다. 따라서, 본 연구에서는 국산 낙엽송을 이용한 목재-콘크리트 합성슬래브를 설계하고 이에 대한 구조 안정성 평가를 수행하고자 하였다. 연구 대상으로는 목재, 콘크리트, 구조용 합판으로 구성된 합성보를 여러 겹 접합하여 제작한 정사각형 합성슬래브를 사용하였다. 슬래브의 하중 분담률을 고려하여 2방향 슬래브로 구조해석을 수행하였으며, 두 방향 모두 인장·압축 응력, 전단응력, 처짐량 허용기준을 만족하는 것으로 나타났다. 한편, 본 연구에서 사용한 합성슬래브는 콘크리트-합판 접합부에 스크류 (Screw)를 사용하지 않는 대신 합판에 천공 작업을 하여 목재 활용을 극대화하고 프리패브 (Pre-fab) 공법이 용이하도록 설계되었으며, 이를 위해 콘크리트-합판 접합 구멍 주위 절점에서의 인장·압축 응력 및 전단응력을 유한요소 해석 프로그램을 통해 검토하고 천공 개수 및 직경을 최적화하였다.

디젤엔진의 DPF 재생 시 입자상 물질의 크기 분포 및 개수 특성

김동수(Dongsu Kim),이정우(Jeongwoo Lee),이준용(Junyong Lee),이승하(Seungha Lee),이승현(Seunghyun Lee),이정연(Jungyeon Lee),이윤우(Yoonwoo Lee),최회명(Hoimyung Choi),민경덕(Kyungdoug Min) 한국자동차공학회 2012 한국자동차공학회 학술대회 및 전시회 Vol.2012 No.11

EGR is a promising technique to meet the demand of stringent emission regulations. For example, the new upcoming emissions regulation, EURO 6, requires reduction of NOx emissions by 55% while maintaining the same level of PM emissions. However, reducing NOx emissions by applying a higher EGR rate inevitably yields higher PM emissions due to NOx-PM trade-off relationship. Hence, increased PM emissions caused by the use of higher EGR rate lead to more frequent DPF regeneration. Therefore, it is necessary to have a look at emission characteristics during the regeneration event. However, most of recent studies focus on downstream emissions of after-treatment system. Thus, in this research, not only the distribution of downstream PM particle size is studied but also the distribution of upstream PM particle size is investigated so that future strategies and data for DPF regeneration can be established. In general, DPF regeneration is favored at high speed and load conditions.

UAV 기반 SfM을 이용한 2차원 수치모델링을 통한 횡월류 저류지 홍수조절효과 평가

김동수(Kim, Dongsu),권영화(Gwon, Yeonghwa) 대한토목학회 2023 대한토목학회 학술대회 Vol.2023 No.10