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      • KCI등재후보
      • KCI등재

        한국인 질병의 장애가중치 측정에 관한 연구 : 호주 장애가중치와의 측정 결과 비교를 중심으로 -

        윤석준,이중규,권영훈,이상일,김창엽,박기동,김용익,신영수,도영경,Yoon, Seok-Jun,Lee, Jung-Kyu,Kwon, Young-Hoon,Lee, Sang-Il,Kim, Chang-Yup,Park, Ki-Dong,Kim, Yong-Ik,Shin, Young-Soo,Do, Young-Kyung 대한예방의학회 2004 예방의학회지 Vol.37 No.1

        Objectives: This study aimed to measure the disability weights for the Korean Burden of Disease study, and to compare them with those adopted in the Australian study to examine the validity and describe the distinctive features. Methods : The standardized valuation protocol was developed from the Global Burden of Disease (GBD) study and the Dutch Disability Weights study. Disability weights were measured for 123 diseases of the Korean version of Disease Classification by three panels of 10 medical doctors each. Then, overall distribution, correlation coefficients, difference by each disease, and mean of differences by disease group were analyzed for comparison of disability weights between the Korean and Australian studies. Results : Korean disability weights ranged from 0.037 to 0.927. While the rank correlation coefficient was moderate to high ($r_s$=0.68), Korean disability weights were higher than the corresponding Australian ones in 79.7% of the 118 diseases. Of these, war, leprosy, and most injuries showed the biggest differences. On the contrary, many infectious and parasitic diseases comprised the greater part of diseases of which Korean disability weights were lower. The mean of the differ ences was the highest in injuries of GBD disease groups, and in cardiovascular disease, injuries, and malignant neoplasm of the Korean disease category. Conclusions : Korean disability weights were found to be valid on the basis of overall distribution pattern and correlation, and are expected to be used as basic data for broadening the scope of burden of disease study. However, some distinctive features still remain to be explored in following studies.

      • SCOPUSKCI등재

        한국인 질병의 장애가중치 측정 및 신뢰도 평가

        윤석준,도영경,권영훈,김창엽,박기동,김용익,신영수,이중규,Yoon, Seok-Jun,Do, Young-Kyung,Kwon, Young-Hoon,Kim, Chang-Yup,Park, Ki-Dong,Kim, Yong-Ik,Shin, Young-Soo,Lee, Jung-Kyu 대한예방의학회 2003 예방의학회지 Vol.36 No.2

        Objectives : This study aimed to develop an evaluation protocol of disability weights using person trade-off, and to test the reliability of the developed protocol in a Korean context. Methods : To develop the valuation protocol, the Global Burden of Disease(GBD) and the Dutch studies were replicated and modified. Sixteen indicator conditions were selected from the Korean version of disease classification, which was based on that of the GBD Study, and the person trade-off method referred to the Dutch method. Results : The disability weights were valued in a two step panel sfudy. The first step was a carefully designed group process by three panels, using person trade-off to establish the disability weights for sixteen selected indicator conditions. The second step consisted of interpolation of the remaining diseases, on a disability scale, by the individual members of three panels. The members of three panels were all medical doctors, with sufficient knowledge of the consequences of a broad variety of diseases. The internal consistency of the Korean disability weights was satisfactory. Considerable agreement existed within each panel and among the panels. Conclusions : It was feasible to use a modified evaluation protocol from those used in GBD and Dutch studies, This would provide a rational basis for an international comparative study of disability weights.

      • KCI등재

        충남 아산시 저체중 출생아의 산전 환경 위험요인

        윤석준,안형식,하미나,고경심,전경자,이희영,Yoon, Seok-Jun,Ahn, Hyung-Sik,Ha, Mi-Na,Koh, Kyung-Sim,June, Kyung-Ja,Lee, Hee-Young 대한예방의학회 2004 예방의학회지 Vol.37 No.1

        Objective : In this study, we aimed to produce basic data on the prenatal environmental risk factors of low birth weight infants at a community level. Methods : In 2000, we conducted the direct interview using questionnaire about prenatal environmental risk factors with low birth weight infant-delivered mothers and normal weight infant-delivered mothers in Asan-city, Chungcheongnamdo Province, Korea. The questionsgiven to the mothers included past pregnancy history, menstrual status, disease history before and during the pregnancy, family history, environmental risk factors and exposure history. The responses of the twogroups were compared to calculate the prenatal environmental risk factors of each group. Results : Mothers' smoking was significantly associated with low birth weight infants (adjusted odds ratio(AOR) 3.27; 95% confidence interval (CI) 1.25-8.56) and preterm baby (AOR 4.20; 95% CI, 1.21-14.61). Other environmental risk factors were not significantly different between the two groups. Conclusion: Smoking of mothers can be a risk factor for the delivery of low birth weight infants. These results could provide the basic data on prenatal environmental risk factors of mothers of low birth weight infants and suggest research topics for further community-based evaluation.

      • SCOPUSKCI등재

        건강생활년을 이용한 우리 나라 주요 암 질환의 질병부담 측정

        윤석준,김창엽,신영수,최용준,Yoon, Seok-Jun,Kim, Chang-Yup,Shin, Young-Soo,Choi, Yong-Jun 대한예방의학회 2001 Journal of Preventive Medicine and Public Health Vol.34 No.4

        Objectives : This study introduced the healthy life-year(HeaLY), a composite indicator of disease burden, and used it to estimate the burden of major cancers in Korea. Methods : We collected data from the national death certificate database, the national health insurance claims database and the abridged life table. This data was used to create a spreadsheet and estimate the burden of major cancers by sex in terms of HeaLYs. Results : The burden of 10 major cancers for males was 2,248.97 person-year in terms of HeaLYs. Stomach cancer, liver cancer, and lung cancer were responsible for 75.2% of the burden of 10 major cancers. The disease burden of 10 major cancers for females was estimated to be 1,567.58 person-years. About two thirds of HeaLYs lost were from stomach cancer, liver cancer, lung cancer, colorectal cancer, and breast cancer. The rankings among 10 major cancers were somewhat different in terms of both HeaLYs and deaths as the HeaLY method considers both mortality and morbidity. Conclusions : Despite the limitations of the data sources, we conclude that HeaLY can aid in setting policy priorities concerning major cancers by estimating the disease burden of these cancers. Time-series analysis of the disease burden using HeaLY and DALY will elucidate the strengths and weaknesses of both methods.

      • SCOPUSKCI등재

        우리 나라 전산화단층촬영기(CT)의 도입에 영향을 미치는 요인에 관한 연구

        윤석준,김선민,강철환,김창엽,신영수,Yoon, Seok-Jun,Kim, Sun-Mean,Kang, Chul-Hwan,Kim, Chang-Yup,Shin, Young-Soo 대한예방의학회 1997 예방의학회지 Vol.30 No.1

        High price equipment is one of the major factors that increases national health expenditure in developed countries. Computerized Tomography(CT), one of the important high price equipment, has been concerns of health service researchers and policy makers in many countries. In Korea, CT, first introduced in 1984, have spreaded nationwide with rapid speed. Though the Committee for Approving Import of High Price Medical Equipment, founded in 1981, tried to regulate the introduction of high price medical equipment including CT, the effort resulted in failure. The exact situation of diffusion of the high price equipment, however, was not yet investigated. We aimed at the description of the diffusion of CT in Korea and analysis of influencing factors on hospitals for the adoption of CT. We mainly used the database of CT, made in 1996 by the National Federation of Medical Insurance for the purpose of insurance payment for CT. Also characteristics of hospitals were gathered from yearbooks published by the central and local governments and by the Korean Hospital Association. We calculated the cumulative number of the CT per one million population year by year. In turn, multiple linear logistic regression was done to find out the contributing factors for the adoption of CT by each hospital. In the logistic regression model, it is regarded as dependent factor whether a hospital retained CT or not in 1988 and 1993. The major categories of the independent factors were hospital characteristics, environmental factors and competitive conditions of hospitals at the period of the adoption. The results are as follows: Number of CT scanners per one million persons in Korea marked more higher level compared with those of most OECD countries. Major influencing factors on the adoption of CT scanners were hospital characteristics, such as hospital referral level, and competitive condition of hospitals, such as number of CT scanners per 10,000 persons in each district where the hospital was located. In Korea, CT diffused with rather rapid speed, comparable with those of the United States and Japan. The major factors contributing on the adoption of CT for hospitals were competitive condition and hospital characteristics rather than regional health care need for CT. In conclusion, a kind of regulating mechanism would be necessary for the prevention of the indiscreet adoption and inefficient use of high price equipment including CT.

      • KCI등재후보
      • SCOPUSKCI등재

        장애에 따른 상실건강년수를 활용한 우리 나라 주요 암질환의 질병부담에 관한 연구

        윤석준,장혜정,신영수,Yoon, Seok-Jun,Chang, Hye-Jung,Shin, Young-Soo 대한예방의학회 1998 예방의학회지 Vol.31 No.4

        우리 나라의 주요사망원인에 해당하는 암질환을 대상으로 YLD를 측정하여 주요암질환간 질병부담의 우선 순위 측정하고 이의 활용범위를 알아보고자 수행한 본 연구에서 다음과 같은 결과를 얻었다. 우리 나라 남성의 암으로 인한 질병부담의 우선 순위 위암(4081.4년), 간암(3104.2년), 대장 및 직장암(3086.2년), 식도암(1511.9년), 폐암(1166.7년), 췌장암(1093.8년), 방광암(665.6년), 전립선암(421.7년), 백혈병(397.2년), 임파선암(259.7년)으로 계산되었다. 여성의 경우 암으로 인한 질병부담의 우선 순위 위암(2707.1년), 식도암(1536.7년), 간암(1468.5년), 자궁암(1311.8년), 난소암(974.3년), 췌장암(763.5년), 유방암(724.5년), 폐암(689.9년), 백혈병(351.3년), 임파선암(241.1년)로 계산되었다. 이러한 결과는 본 연구에 사용한 연구재료 및 연구 방법의 불완전성에도 불구하고 향후 보건의료정책의 우선순위결정, 즉 한정된 자원을 보다 더 효율적으로 활용하는데 보다 구체적인 정보를 계량적으로 제공해 줄 수 있다는 점에서 중요한 의의를 갖는다고 하겠다. This study was carried out for the burden of disease of major cancers assessment using years of lives with disability in Korea. With the years of lives with disability, this indicator was applied in order to estimate burden of major cancer disease. For this work, We also estimated incidence rate, remission rater case fatality rate, average age of onset, expected duration with disability in each cancer disease. As sources of information, national health insurance data and national mortality registration data were analyzed. The results of the study are as follows; The top five causes of the burden of major cancer disease are evaluated as stomach cancer, liver cancer, colon and rectum cancer, esophageal cancer, lung cancer in male. The top five causes of the burden of major cancer disease are evaluated as stomach cancer, esophageal cancer, liver cancer, uterine cervix cancer ovarian cancer in female. The process of evaluating the burden disease of major cancers in Korea has not finished with this paper. This study should be seen as the first in a series in Korea. It is necessary to analyse with more accuracy the assumptions behind the methodology.

      • KCI등재

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