공중구강보건학 분야 : 원저 ; 용인시 처인구 거동불편노인의 구강보건진료 수요조사

김철신 ( Cheoul Sin Kim ),백대일 ( Dae Il Paik ),김현덕 ( Hyun Duck Kim ),진보형 ( Bo Hyong Jin ),배광학 ( Kwang Hak Bae ) 대한구강보건학회 2007 大韓口腔保健學會誌 Vol.31 No.4

지니계수를 활용한 한국 12세 아동의 구강건강불평등 추이연구

김철신 ( Cheoul Sin Kim ),전지은 ( Ji Eun Jeon ) 대한예방치과·구강보건학회 2013 大韓口腔保健學會誌 Vol.37 No.3

2000년부터 2010년까지 시행된 국민구강건강실태조사 자료를 이용하여 12세 아동의 DMFT 지표로 로렌츠 곡선을 추정하고 지니계수를 산출하여 불평등 추이를 살펴본 결과는 다음과 같다. 1. 우리나라 12세 아동의 DMFT 지수는 시간에 따라 대체로 감소하고 있어 전반적인 구강건강상태가 개선되었다. 2. 그럼에도 불구하고 DMFT를 활용한 지니계수는 2000년 0.53에서 2010년 0.61로 나타나 구강건강불평등이 증가되고 있음을 보여주었다. 이는 대부분 DT와 MT에서의 구강건강불평등 증가에 영향을 받았다. 3. 여전히 구강건강불평등은 증가하고 있어, 이를 해소하기 위해서는 구강건강 수준이 낮은 취약계층을 위한 사회정책이 필요하다고 판단된다. 이후에도 불평등을 줄이기 위해 지속적으로 불평등의 크기를 측정하여 모니터링 하고, 관련 연구가 활성화되어야 할 것이다. Objectives: This study was conducted to analyze the current state and tendency of oral health inequality in 12-year-old Korean children by calculating the Gini coefficient from decayed, missing, or filled teeth (DMFT) data. Methods: Ten-year trends were empirically estimated by calculating the Gini coefficient from the Lorenz curve plotted based on the DMFT data of 12-year-old children, obtained from the Korean National Oral Health Survey from 2000 to 2010. Results: While the oral health improved in general, oral health inequalities increased with the decrease in the number of DMFT each year, and the DMFT-based Gini coefficient increased from 0.53 in 2000 to 0.61 in 2010. The increase in the number of decayed and missing teeth was strongly affected by the increase in oral health inequality. Conclusions: To resolve Korea`s continually increasing oral health inequality, it is necessary to establish support measures for vulnerable populations and to develop and manage a surveillance system for continuous monitoring of oral health inequality in the future.

지역의 사회경제적 상태와 구강건강행위의 관련성: 다수준 분석방법의 적용

김철신 ( Cheoul Sin Kim ),한선영 ( Sun Young Han ),김철웅 ( Chul Woung Kim ) 대한예방치과·구강보건학회 2013 大韓口腔保健學會誌 Vol.37 No.4

Objectives: This study was conducted to identify discrepancies in oral health behaviors among communities in cities, counties, and districts (si , gun, and gu administrative divisions of South Korea) and to determine their correlations with socioeconomic status, examined in terms of the social deprivation index. Methods: Data for 220,258 individuals, covering 247 communities, were extracted from a 2008 community health survey, and the frequency of brushing the teeth after lunch, flossing and interdental brushing was calculated and analyzed. Considering the characteristics of the data collected at individual and regional levels, a multilevel random-intercept logistic regression model was used for the analysis. Results: A regional-level discrepancy was found in after-lunch brushing and the use of auxiliary oral hygiene items, with interclass correlations of 0.03 and 0.04, respectively. In particular, the odds ratio of using auxiliary oral hygiene items in the communities with the lowest socioeconomic status was as low as 0.49, compared to the highest level, thus demonstrating a conspicuous intercommunity difference. Conclusions: The regional-level correlation between socioeconomic status and oral health behaviors indicates the need for the establishment of oral health-related intervention policies based on community characteristics.

일부 부모협동보육시설 보육교사 대상의 시설내 구강건강증진 환경에 관한 조사

김철신 ( Cheoul Sin Kim ),한선영 ( Sun Young Han ),김아름 ( Ah Reum Gim ),배수명 ( Soo Myong Bae ),정세환 ( Se Hwan Jung ) 한국치위생과학회 2008 치위생과학회지 Vol.8 No.4

일부 성인의 만성질환과 구강건강 연관성에 대한 인식조사

김철신 ( Cheoul-sin Kim ),최용금 ( Yong-keum Choi ) 한국치위생과학회 2017 치위생과학회지 Vol.17 No.1

인구사회학적 특성과 건강행태 및 스트레스 정도에 따른 만성질환과 구강건강의 연관성에 대한 인식도에 차이가 있는지를 알아보고자 20대부터 50대까지의 성인을 대상으로 분석하여, 다음과 같은 결론을 얻었다. 연구대상자의 만성질환과 구강건강과의 연관성에 대한 인식도는 구강건강과 당뇨와의 연관성이 3.29로 가장 높게 인식하고 있었으며, 고혈압과의 연관성은 2.82로 가장 낮은 인식도를 보였다. 특히 `항고혈압제 약의 부작용으로 구강건조증, 잇몸출혈, 치유지연, 잇몸비대 등이 나타날 수 있다`라는 항목은 전체 항목에서 1.52로 가장 낮은 인식도로 나타났다. 인구사회학적특성에 따른 만성질환과 구강건강과의 연관성에 대한 인식도를 분석한 결과 직업에 따른 인식도 차이는 통계적으로 유의하였는데 공무원, 전문직 집단에서 가장 높은 인식도를 보였다(p=0.015). 이상의 연구 결과를 종합해볼 때 만성질환과 구강건강의 연관성에 대한 일반인들의 인식을 전환시켜야 할 필요성이 있으며, 치과진료실에서는 구강보건교육 시 단순한 구강건강관리뿐만 아니라 통합적인 건강관리의 방향으로 만성질환을 포함한 전신과 구강건강과의 연관성에 대한 교육을 강화하여 수행할 필요성이 있을 것으로 판단된다. The aim of this study was to investigate adult individuals` perceptions on the association between chronic diseases and oral health provide basic data required for motivating individuals to follow ideal oral health behaviors and boost their interests in oral disease prevention and treatment. Subjects in their 20s to 50s were selected through the convenience sampling method and eleven questions were set as factors and answered via self-administered questionnaires. To determine statistical significance, analysis of variance was used with the level of significance set at 0.05. The subjects` perception of the association between chronic diseases and oral health were analyzed with respect to their health behaviors. Individuals with relatively higher stress levels demonstrated higher levels of perception levels (p<0.05). Public education regarding the association between chronic diseases and oral health has not been ideally effective in South Korea. Thus, the general public`s perceptions of the association between chronic diseases and oral health should be revised. In addition aspects regarding this matter should be enhanced within oral health education programs which often only focus on demonstrating the importance of oral health management so that individuals can get sufficient information on the association between chronic diseases and oral health.

영리병원도입 정책의 추진경과

김철신(Cheoul-Sin Kim) 대한치과의사협회 2011 대한치과의사협회지 Vol.49 No.9

Policy of for-profit hospitals permission has provoked debate on how to enhance health care system and medical service : industry. The government says that for-profit hospitals could help improve the quality of medical care and develop medical tourism. On the other hand, Medical care related NGO insist that for-profit hospitals will not fix the existing medical problems in Korea, only create new ones. Recently, a type of for-profit hospitals emerged in dentistry and caused much trouble. Accordingly, We try to carefully look at for-profit hospitals related policy and debate.

한국 노인의 구강건강수준에 따른 영양섭취 상태 -2009년 국민건강영양조사 자료에 근거하여-

김철신 ( Cheoul Sin Kim ),배수명 ( Soo Myoung Bae ),신보미 ( Bo Mi Shin ) 한국치위생학회(구 한국치위생교육학회) 2011 한국치위생학회지 Vol.11 No.6

Objectives: The purpose of this study was investigation of quality and quantity of nutritional intake related oral health status among Korean elders. Methods: The nutrient intake and the dietary quality was evaluated on the basis of the Dietary Reference Intakes For Koreans(KDRIs). Chi-square test for Complex Samples was used to determine the relationship between oral health and inadequate nutrient intake in Korean elders. The complex samples general linear model was used to test difference of average value difference of nutrient intake percentage compared to dietary reference intake(DRI), energy intake rate from three major nutrients, average mean adequacy ratio(MAR) and index of nutritional quality(INQ) related oral health status. Age, sex and total energy intake was compensated for this analysis. PASW 18 was used for statistical analysis. Results: We could found the difference of the nutrient intake and the dietary quality related oral health status among Korean elders. Especially, Nutrient intake percentage and component ratio of protein among energy intake rate from three major nutrient was lower as oral health status became worse. The percentage of subjects with nutritional intakes under showed highest level in worst oral health status. As oral health status became worse, average mean adequacy ratio(MAR) was lower and the number of nutrient of which index of nutritional quality(INQ) was under 1 was more. Conclusions: From the result above, this study clearly shows the level of oral health affecting the inequalities of eating and the food for the people. And the various propose of oral health policies is needed for vulnerable groups who needs solution to solve the problem of inequality of food distribution where intensive distribution of nutrition problem occurred. Sufficient, safe, and a variety of healthy food intake is a fundamental right of our people. And also, to apply this policy in reality, institutional arrangements and organizations, and specific performing system will be needed. (J Korean Soc Dent Hygiene 2011; 11(6):833-841)

치과의사의 국민건강보험에 대한 교육경험 실태 조사

김경미 ( Kyung Mi Kim ),마득상 ( Deuk Sang Ma ),정세환 ( Se Hwan Jung ),김철신 ( Cheoul Sin Kim ),박덕영 ( Deok Young Park ) 대한구강보건학회 2014 大韓口腔保健學會誌 Vol.38 No.1

Objectives: The purpose of this study was to investigate Korean dentists` perceived experience with and contents of education on National Health Insurance, and their competence in the practice of cases involving a health insurance claim. Methods: A survey was conducted with 600 dentists who secured their dentist license during 2000-2004. A systemic stratified sampling, with "school graduated from" as a stratum, was conducted on a population of 3,947 dentists, using the register of the Korean Dental Association. A survey request and questionnaire sample was mailed, and responses were collected using a web-based replying method. The impact of the experience of education related to health insurance on the frequency of, and perceived competence on health insurance claims was analyzed using the chi-square test. Results: Only 21% dentists replied that they had educational experiences related to health insurance when they were dental students, and the content of this education was ``health insurance system`` (69%) and ``health insurance law`` (59%). Only 28% of the respondents replied that they had practiced cases related to health insurance claims at dental schools. The rate of dentists who had educational experiences related to health insurance after their graduation was 73%. The experience of education related to health insurance and the perceived competency on handling health insurance claims showed a statistically significant correlation (P<0.01). Conclusions: It is necessary to develop a standardized curriculum related to health insurance and health insurance claims in dental schools.

일부 도시 초·중등 학생들의 재료별 영구치 충전율 변화

공욱성(Wook Sung Kong),김철신(Cheoul Sin Kim) 대한치과의사협회 2017 대한치과의사협회지 Vol.55 No.5

The aim of the study was to analyze the distribution of dental filling materials for carious permanent teeth of school children in a city. The study was designed as time-serial study, using the data of the dental survey for children aged 8-, 10- and 12-year children living in Gimhae city. The samples were selected by stratified clusters sampling. The number of surveyed samples in depth-analysis for types of dental filling materials were 567 in 2009 and 331 in 2013, respectively. They had dental restorations on one or more teeth. The changing pattern of used dental filling materials was analyzed between 2009 and 2013. Statistical analysis was conducted according to variables related to dental filling material type; DMFT and DMFS index, number of fissure sealed teeth and surface and surveyed year. Amalgam filling rate decreased from 27.9% in 2009 to 18.8% in 2013, while filling rate of tooth-colored materials increased from 56.1% in 2009 and 68.9% in 2013. Amalgam filling rate was a negative correlation with filling rate of tooth-colored materials or gold and number of fissure sealed teeth and a positive correlation with DMFT index. Filling rate of tooth-colored materials was a negative correlation with filling rate of amalgam or gold and DMFT index and a positive correlation with number of fissure sealed teeth. The light-curing composite resin should be included in the reimbursement range of National Health Insurance to solve an inequity of dental health care services.

노인틀니 보험화에 대한 인식과 틀니 사용실태 조사

한선영(Sun-Young Han),김철신(Cheoul-Sin Kim) 대한치과의사협회 2012 대한치과의사협회지 Vol.50 No.7

The aim of this study was to investigate the recognition on the national health insurance and the actual condition of denture among the elderly in Seoul city. This survey was performed on 710 of the elderly aged over 60 years and visited the senior welfare centers. The recognition of the elderly on the national health insurance of denture was 61.7%, but there was a low recognition on the details. The elderly had started using dentures from 66.24 years old. The average used period of the past denture was 7.09 years. In conclusions, the provider is required to promote the insurance coverage of denture to increase the coefficient of utilization of the elderly. Also, further studies for the extending coverage of the details are needed.