마이크로로프로세서를 이용한 디젤 피에조 인젝터 드라이버 개발

안정훈(Jeonghoon Ahn),이충훈(Choonghoon Lee) 한국자동차공학회 2016 한국자동차공학회 학술대회 및 전시회 Vol.2016 No.11

의료기술평가를 이용한 근거중심 의사결정제도

안정훈 ( Ahn Jeonghoon ) 한국보건경제정책학회 2017 보건경제와 정책연구 Vol.23 No.2

우리나라는 아시아 국가들 중 최초로 2007년 신약등재에 경제성평가를 통한 선별등재제도와 신의료기술평가를 통한 근거중심의 유효성과 안전성평가를 도입함으로써 의료기술평가를 선진적으로 제도화시켰다는 평가를 받고 있다. 이 종설에서는 의료기술평가와 관련된 여러 개념들을 명확히 정리하고 특히 의료기술평가를 통한 근거중심 의사결정제도를 위한 방향설정을 위하여 국내외의 차이점을 중심으로 정리해 보았다. 국외의 제도가 반드시 옳다고 볼 수는 없으나 보건의료 의사결정의 정당성을 위하여 갖추어야 할 조건으로 널리 인용되는 Daniels(2008) 의 해명책임(accountability for reasonableness)의 개념들이 우리나라 제도에서도 반영되는 것이 미래지향적인 방향으로 생각된다. 의료기술평가는 의료기술의 유효성, 안전성, 비용효과성에 관한 다학제적인 종합적 평가연구로 의사결정 자체가 아니라 합리적인 의사결정에 도움을 줄 수 있는 근거제공을 의미한다. 과학적인 연구를 통한 Assessment와 이를 비판적으로 평가하여 의사결정에 이용하는 appraisal 은 구분될 수 있고 각 과정에서 투명성 등 해명책임의 증대를 통하여 보다 합리적인 의사결정에 도달할 수 있다. Korea is the first country to legislate health technology assessment system by introducing positive listing for new pharmaceuticals and new health technology assessment for new procedures and diagnostics since 2007. This review tried to clearly define the concepts related to the health technology assessment. Especially, for setting a direction of evidence based decision making system using health technology assessment in Korea, the differences between domestic system and overseas system were compared. Though the overseas system may not be always correct but improving accountability in the current Korean system seems to be a future direction considering the accountability for reasonableness (A4R) argument by Daniels (2008). Health technology assessment is a multidisciplinary synthetic evaluation research on clinical effectiveness, safety, and cost-effectiveness of the health technology. It is not a decision making itself but a provision of helpful evidences to a rational decision making. Assessment process of scientific research and critical appraisal of the results to use in decision making process can be distinguished. Increasing transparency in these processes can improve accountability for reasonableness in Korea and hence, warrants a rational decision making.

미세먼지(霧霾)가 발생하는 질병과 중의학, 한의학의 관리가능성 - 예방과 치료를 중심으로-

고원준,안정훈,이선동,Koh, WonJoon,Ahn, JeongHoon,Lee, Sundong 대한예방한의학회 2018 대한예방한의학회지 Vol.22 No.1

Objectives : This paper examines the effects of Particulate Matter on human bodies and the possibility of treating them with Chinese or Korean medicines. Methods : This paper categorizes the diseases caused by Particulate Matter, as well as the causes, pathology, prevention methods, and effectiveness of treatments by Chinese and Korean medicines. Based on these results, it analyzes whether such diseases can be managed by Chinese and Korean medicine. Results : Particulate Matter is known to affect respiratory organs, skin, circulatory system, nervous system, gestational diabetes, and other parts of the human body. While studies show evidence that treatments by Chinese and Korean medicines can reduce symptoms of some diseases and improve bodily functions that are damaged by Particulate Matter, there is no statistically significant evidence that they can provide fundamental treatments nor treat irreversible damages. Conclusion : Currently, there is no definite evidence that Chinese and Korean medicine can treat symptoms and diseases caused by Particulate Matter. Therefore, some Korean medicine doctors' arguments that Korean medicine is effective in treating such diseases are problematic, and thus, there is a need for much research in this field.

다문화 가구 여성의 인플루엔자 예방접종 영향 요인 분석

옥시후(Shihoo Ok),안정훈(Jeonghoon Ahn) 숙명여자대학교 아시아여성연구원 2021 아시아여성연구 Vol.60 No.3

가속도 센서를 이용한 CR-DI 인젝터 연료 분사 시작 타이밍 측정

현승훈(Seunghun Hyun),안정훈(Jeonghoon Ahn),김정기(Junggi Kim),이충훈(Choonghoon Lee) 한국자동차공학회 2015 한국자동차공학회 학술대회 및 전시회 Vol.2015 No.11

경증만성질환자 대상 종합병원급 의료기관 이용이 환자의 의료비에 미치는 영향

배서우 ( Seowoo Bae ),안정훈 ( Jeonghoon Ahn ) 한국보건경제정책학회 2021 보건경제와 정책연구 Vol.27 No.3

본 연구는 한국의료패널데이터 자료를 활용해 당뇨병 및 고혈압 환자들의 종합병원 이용여부가 본인부담금, 건강보험 부담금 및 처방약제비를 포함한 연간 총의료비에 미치는 영향을 파악하였다. 선택편의를 최소화하기 위해 종합병원 이용군과 미이용군 간 성향점수매칭 후 의료비 차이를 분석하였다. 연구 대상은 2015년 외래에서 당뇨병 및 고혈압을 주진단 받은 환자로, 당뇨병이나 고혈압 합병증이 없고 건강상태가 상대적으로 양호한 - 찰슨 동반상병지수(CCI) 1점 이하 - 환자들을 외래진단 당시 종합병원 이용군과 미이용군으로 분류하여 종합병원 이용여부가 2015~17년 의료비에 미치는 영향을 검정하였다. 분석 결과, 당뇨병의 경우 종합병원 이용군일수록 2015~17년 의료비가 유의하게 증가했고(β=0.528, p<0.001; β=0.278, p<0.001; β=0.209, p<0.01), 고혈압은 2015년 의료비만 유의하게 증가하였다(β=0.213, p<0.01). 하지만, 대상 질환과 관련이 적은 고비용 환자들의 영향을 줄이기 위해 의료비 상위 5% 대상자를 제외하여 재분석한 결과, 고혈압에서는 2015년 의료비에도 유의한 영향을 미치지 않는 것으로 나타났다(β=0.078, p=0.189). 본 연구 결과에 의하면 종합병원 이용유무가 종별가산율 이상으로 당뇨병 환자의 의료비를 유의하게 증가시킨 것으로 나타났고 이 효과가 2년 이상 지속된 반면, 고혈압에서는 고비용군의 영향까지 보정한 결과, 영향을 미치지 않는 것으로 나타났다. The study observed an impact of mild chronic patients visiting general hospital on their annual medical expenses, using Korea Health Panel data. In order to reduce selection bias, we observed the difference of medical costs between general hospital used group and unused group using propensity score matching. The subjects were patients who were mainly diagnosed with diabetes or hypertension in outpatient in 2015, who don’t have any complications and their health status relatively fair - CCI ≤ 1 -, were classified into general hospital used and unused groups in 2015. The difference in 2015-2017 medical expenses between two groups were analyzed. As a result, among the patients with diabetes, general hospital visiting significantly increased medical costs in 2015~17 compared to no visiting group (β=0.528, p<0.001; β=0.278, p<0.001; β=0.209, p<0.01). Among the patients with hypertension, general hospital visited patients showed significantly higher medical costs only in 2015 (β=0.213, p<0.01). However, after reanalyzing the data with top 5% high cost patients trimmed, the impact of visiting general hospital for hypertension became insignificant in 2015 (β=0.078, p=0.189) whereas significant impacts of general hospital visiting among the patients with diabetes did not change. According to the results of the study, the use of general hospital significantly increased medical costs for patients with diabetes patients beyond the “additional rate by size of medical institution”, and this impact lasted for more than 2 years, whereas there was no significant impact remained for the patients with hypertension after trimming high cost patients (top 5%).

제2형 당뇨병 환자에서 메트포르민 병용 시 DPP-4 억제제 복용에 따른 당뇨망막병증 발생 위험

최은미(Eunmi Choi),정수연(Soo Youn Chung),김봉기(Bonggi Kim),안정훈(Jeonghoon Ahn),한순영(Soon Young Han) 대한약학회 2020 약학회지 Vol.64 No.5

This study examined whether using dipeptidyl-peptidase-4 inhibitors (DPP4i) increases(or lowers) the risk of diabetic retinopathy compared to sulfonylurea (SU) or thiazolidinedione (TZD) as an add-on therapy to metformin (Met) in patients with type 2 diabetes (T2D). A nationwide, population-based cohort study was conducted using the Korea national health insurance claims database from 2011 through 2015. From the cohort, 146,137 adults with T2D were identified as having been treated with oral glucose-lowering agents (DPP-4i, SU, TZD) in addition to Met therapy between 2012 and 2014. Cox regression analysis was used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for diabetic retinopathy. Total 16,517 cases of diabetic retinopathy occurred; 9,721 in DPP-4i+Met group, 659 in TZD+Met group and 6,137 in SU+Met group. The crude incidence rate was 54.8 cases per 1,000 person-years in DPP-4i+Met group compared with 47.1 in SU+Met group. Compared to SU as an add-on therapy to Met, DPP-4i significantly reduced the risk of diabetic retinopathy: the adjusted HRs was 0.87 (95% CI, 0.84-0.90). People with diabetes are at high risk of developing diabetic retinopathy. Since diabetic retinopathy is a serious complication that affects vision, managing diabetic retinopathy can improve the quality of life for diabetes patients. Our study showed that DPP-4i did not increase the risk of diabetic retinopathy compared to SU when used as a combination therapy with Met.