일부 도시 저소득층 주민의 사회적 지지와 자가평가 건강수준

임민경,신영전,유원섭,양봉민,김명희,Lim, Min-Kyoung,Shin, Young-Jeon,Yoo, Weon-Seob,Yang, Bong-Min,Kim, Myoung-Hee 대한예방의학회 2003 예방의학회지 Vol.36 No.1

Objectives : To assess the distribution of social support, and explore its effects on self-rated health status in a low income neighborhood of Seoul, Korea. Methods : In September 2001 we conducted a survey in a low income neighborhood of Seoul, Korea, in which 862 residents, aged 18 years or over, participated. We measured the general sociodemographic characteristics, self-rated health status and social support with the instrument developed from Korean translation of the Medical Outcomes Study Social Support survey (MOS-SSS) scale of the US. Logistic regression was used to identify the determinants of social support, and explore its effects on self-rated health status. Results : Lower social class, women or divorced people had much less social support compared to higher social class, men or those never married, respectively. Those families on much lower income also received less social support. Social support has a positive impact on the self-rated health status, which remains statistically significant even when other relevant variables are adjusted. Conclusions : This study suggests that social support has an important role in health, and the socially disadvantaged have lower social support. Therefore, to improve the health status of the poor, it is necessary to encourage community participation, and develop strategies that could strengthen their provision of social support.

청소년의 앉아 있는 시간과 저체중 및 비만의 관계

임민경(Min Kyoung Lim) 한국보건교육건강증진학회 2016 보건교육건강증진학회지 Vol.33 No.5

종합병원에서 진료량과 의료이익의 관계

임민경 ( Min Kyoung Lim ),김정하 ( Jeongha Kim ),김선제 ( Sunjea Kim ) 한국병원경영학회 2021 병원경영학회지 Vol.26 No.3

Purpose: We examined the relationship between operating income and volume of medical services provided at general hospitals in 2018 according to characteristics of general hospitals and measured as operating income(net income) and volume(adjusted inpatient days) covered or non-covered by National Health Insurance(NHI). Methodology: Finance data from income statement reports in 212 general hospitals and the national health insurance claim data of these hospitals were used. The characteristics of the general hospital were divided into structural, operational, financial, and patient aspects. Operating income and volume were divided into covered and non-covered by NHI. Findings: The results showed high volume hospitals tended to be more profitable than low volume hospitals, especially in non-covered services. Operating income was more likely to be sensitive to non-covered services volume than to covered services volume. Practical Implications: It is necessary to understand the volume of services in non-covered, in order to obtain reliable cost information to be used for the fee schedule. Researches on small size hospitals(<160 beds) are needed, with a large variation in the volume of services and a strong tendency to compensate for the loss in the covered part in non-covered part.

(+)-Dihydromyricetin 정제를 위한 분별침전공정 개선

임민경 ( Min Kyoung Lim ),김진현 ( Jin Hyun Kim ) 한국미생물생명공학회(구 한국산업미생물학회) 2014 한국미생물·생명공학회지 Vol.42 No.1

본 연구에서는 바이오매스 유래 생리활성물질인 (+)-dihydromyricetin을 효율적으로 정제하기 위하여, 반응액 부피당 표면적(S/V)이 증가된 새로운 개념의 분별침전공정을 도입하였다. 분별침전 24시간에서 반응기 내부 표면적을 증가시키지 않은 경우 순도와 수율은 각각 80.0%와 70.0%인 반면 표면적 증가를 위해 양이온교환수지인 Amberlite 200을 첨가한 경우 순도와 수율은 각각 90.2%와 90.9%로 가장 효과적인 표면적증가물질임을 알 수 있었다. 특히 Amberlite 200의 경우 상대적으로 짧은 침전시간(16시간)에 높은 수율(>90%)로 (+)-dihydromyricetin을 얻을 수 있어 침전에 소요되는 시간을 효과적으로 단축시킬 수 있었다. 동일한 침전시간에서는 표면적증가물질을 첨가하지 않은 경우에 비해 표면적증가물질을 첨가한 경우 침전물의 입자 크기가 감소함을 알 수 있었다. 이러한 연구결과는 기존의 분별침전 방법에 의한 (+)-dihydromyricetin 정제공정의 문제점을 개선함으로써(+)-dihydromyricetin의 대량생산에 매우 유용하게 활용될 수 있을 것으로 판단된다. Fractional precipitation is a simple method for purifying (+)-dihydromyricetin extracted from biomass. However, the fractional precipitation process has been inherently problematic due to the lengthy precipitation time that is required. The fractional precipitation time was shortened and (+)-dihydromyricetin yield was improved by increasing the surface area per working volume (S/V) of the reacting solution through the addition of a cation exchange resin (Amberlite 200, Amberlite IR 120Na, Amberlite IR 120H, or Amberlite IRC 50). Most of the (+)-dihydromyricetin (>90%) could be obtained after about 16 h of fractional precipitation using Amberlite 200. Since high-purity (+)-dihydromyricetin can be obtained at a high yield and the precipitation time can be reduced by increasing the surface area available for precipitation, this improved method is expected to minimize solvent usage and the size and complexity of the high performance liquid chromatography operation required for (+)-dihydromyricetin purification.

증례 : 급성 A형 간염에 동반된 급성 신부전증과 IgA 신병증 1예

이세민 ( Se Min Lee ),김병수 ( Byung Soo Kim ),박건우 ( Gun Woo Park ),임민경 ( Min Kyoung Lim ),맹이소 ( Lee So Maeng ),이승헌 ( Seung Hun Lee ),장윤식 ( Yoon Sik Chang ) 대한내과학회 2004 대한내과학회지 Vol.67 No.-

인터넷 사용목적에 따른 인터넷 과다 사용 청소년들의 일반적 특성과 건강수준 및 건강행태의 차이

고영미(Young-Mi Ko),임민경(Min Kyoung Lim) 한국보건교육건강증진학회 2015 보건교육건강증진학회지 Vol.32 No.5

이차자료원을 활용한 의원 의료서비스 수입 및 비용 산출

김선제 ( Sun Jea Kim ),임민경 ( Min Kyoung Lim ) 한국병원경영학회 2021 병원경영학회지 Vol.26 No.1

Purpose: The purpose of this study is to estimate incomes and costs of the medical clinics by using secondary data. Methodology: The medical incomes and costs were estimated from 405 clinics operated by sole practitioner providing out-patient services among all clinics subject to the Medical Cost Survey on National Health Insurance Patients in 2017, excluding dental clinics and oriental medical clinics. The incomes and costs of the medical clinics were reflected with incomes and costs of health insurance benefits and were calculated by types of medical services (i.e., basic care, surgery, general treatment, functional test, specimen test and imaging test). The costs were classified as follows: labor costs, equipment costs, material costs and overhead costs. Secondary data was used to estimate the incomes and costs of the medical clinics. For allocation bases for costs for each type of the medical service, the ratio of revenue from health insurance benefits by types of medical services was applied. However, labor costs were calculated with the activity ratio by types of medical services and occupations, using clinical expert panel data. Finding: The percentage of health insurance income for all medical income was 73.1%. The health insurance cost per clinic was 401,864 thousand won. Labor cost accounted for the largest portion of the health insurance income was 191,229 thousand won (47.6%), followed by management cost was 170,018 thousand won (42.3%), materials cost was 35,434 thousand won (8.8%), and equipment costs was 5,183 thousand won (1.3%). Practical Implications: This study suggests a method of estimating incomes and costs of medical clinic services by using secondary data. It could efficiently provide incomes and costs to assess an appropriate level of the health insurance fee to the clinics.

중증질환 치료제에 대한 급여정책을 둘러싼 윤리적 쟁점고찰

배은영 ( Eun Young Bae ),임민경 ( Min Kyoung Lim ),배승진 ( Seung Jin Bae ) 한국보건경제정책학회(구 한국보건경제학회) 2015 보건경제와 정책연구 Vol.21 No.1

본 연구는 중증질환에 대한 급여결정에 관여하는 여러 기준 중 질병의 중증도 기준을 중심으로 이를 둘러싼 윤리 원칙, 그리고 이를 뒷받침하는 실증연구 결과들을 살펴봄으로써 중증질환 급여정책의 방향을 점검하고자 하였다. 선행연구 고찰결과, 흔히 생각하는 것과 달리 치료하지 않을 경우의 기대 여명을 기준으로 자원배분의 우선순위를 부여하는 것은 이론적, 실증적 근거가 충분치 않아 보인다. 기대여명 못지않게 연령 요인이 중요하게 작용하며, 연령 요소와 기대여명을 모두 고려한 연구에서는 연령 요소가 더 큰 영향을 미치는 것으로 파악되었다. 하지만 연령요소를 별도로 고려하지 않았을 때에는 질환의 중증도가 높은 환자에 보건의료자원배분의 우선순위를 부여하는 경향이 있었다. 말기질환이나 암환자의 경우로 상황을 좀 더 구체화하면 많은 대규모 연구에서 말기라는 사실 때문에 더 큰 사회적 가치를 부여하는 것을 지지하지 않는 결과가 나타났다. 또한 질병의 중증도가 동일함에도 암이라는 이유만으로 더 큰 우선순위를 부여하지는 않는 것으로 나타났다. 현실의 의사결정이 보다 근거에 기반한 것이 되기 위해서는 중증도라는 개념으로 포괄적으로 접근하기보다 말기나 암과 같은 보다 구체적 조건에 대한 우리 사회 구성원들의 가치를 도출하는 노력들이 요구된다. This paper sought to explore the trends of rationing health care for very severe disease, by investigating the ethical principles and empirical analyses in setting priority based on disease severity. Contrary to the conventional belief, insufficient theoretical and empirical evidence was found regarding rationing health care based on life expectancy. Rather, not only life expectancy, but also the age of the patients significantly influence in setting priority, and age actually plays more critical role than life expectancy when both factors were considered simultaneously. However, when age was not considered separately, disease severity was substantially considered in setting priority; however, if we focus on patients with cancer of terminal disease, few studies suggested that “being terminally ill” or “having cancer” should have higher priority given disease severity are similar. Our study suggested that current “evidence-based decision making” should strive to derive public preferences on specific conditions such as terminal diseases or cancer, rather than handling “disease severity” as a general and inclusive term.

청소년 폭음과 흡연, 신체활동 부족, 부적절한 체중조절, 성 행태와의 관련성

서수인(Su-In Seo),오진경(Jin-Kyoung Oh),임민경(Min Kyung Lim) 한국보건교육건강증진학회 2017 보건교육건강증진학회지 Vol.34 No.1

의료보호 정신분열병 환자의 의료이용 양상

서수경(Soo-Kyung Suh),신영전(Young-Jeon Shin),남정현(Jung-Hyun Nam),임민경(Min-Kyoung Lim) 대한사회정신의학회 2001 사회정신의학 Vol.6 No.1

연구목적: 1992년부터 1998년까지 7년간 우리나라 의료보호 정신분열병 환자수, 치료유병률 및 구성변화와 의료이용 양상의 변화를 파악함으로써, 정신질환과 관련한 의료보호 정책수립과 시행에 필요한 기초적인 자료를 제공하고자 한다. 방 법: 1992년 1월 1일부터 1998년 12월 31일까지 의료보호관리공단의 의료보호 청구자료와 의료보호통계연감을 가지고 의료보호 청구명세서에서 주상병이 정신분열병인 의료보호 대상자를 대상으로 하여, 환자의 특성과 이용양상을 살펴보았다. 결 과: 1) 의료보호 대상자 중 정신분열병 환자수는 1992년 24,373명이었으나 1998년에는 32,285명이었다. 치료유병률도 1992년 대상자 100명당 1.12명에서 1998년에는 2.44명이었다. 치료유병률은 여성에 비해 남성이 높았다. 연령군별로는 모든 연도에 걸쳐 30-39세군의 치료유병률이 가장 높았다. 유형별 치료유병률은 시설수용자가 가장 높았다. 2) 의료보호 정신분열병 환자는 남성이 여성보다 높은 비율을 차지하였으며 연령별로는 입원, 외래모두에서 젊은 군의 비율이 증가하고 있었다. 유형별로는 입원군에서는 거택보호환자의 비율이, 외래군에서는 시설수용자군의 비율이 높았으나 점차 거택보호대상자군의 비율이 높아지고 있었다. 3) 의료보호 정신분열병 환자의 이용률, 1인당 내원일수, 진료일수 및 1인당 진료비는 입원서비스의 경우, 1996년과 1997년에 모두 급격히 증가하는 양상이었고, 외래서비스는 1995년부터 급격히 감소하는 경향을 보였다. 성별로는 입원서비스에서 여성이 차지하는 비율이 높았지만 외래서비스에서는 남녀간 차이가 분명하지 않았다. 연령별로는 입원서비스에서 50대군, 외래서비스에서는 3·40대군이 가장 높았다. 유형별로는 입원서비스에서 거택보호대상자, 외래서비스에서는 시설수용자가 차지하는 비율이 높았다. 결 론: 의료보호 대상자 군내에서 정신분열병 환자의 비율과 진료비가 지속적으로 증가하고 있는 것으로 나타나 의료보호 정책상의 정신분열병 환자에 대한 효과적인 관리의 중요성이 더욱 커지고 있다. 1995년부터의 입원서비스 이용의 급증과 외래서비스 이용의 감소가 관찰되었는데 이는 병상수의 증가, 의료보호 기간의 연장 등과 같은 정책요인이 작용하였을 것으로 추측된다. Objective:To understand the trend in the numbers of schizophrenic patients, treatment prevalence, composition and health care utilization of schizophrenic patients under the Medical Aid Program(Sch-MA) from 1992 to 1998, and to provide basic information necessary to establish and conduct the Medical Aid Program. Method:The analysis is based on claims data of the Medical Aid Program from 1992 to 1998. Results:1) The number of schizophrenic patients among of beneficiaries of the Medical Aid Program are 24,373 in 1992, and has gradually increased to 32,258 in 1998. The treatment prevalence is 1.12 per 100 persons in 1992, and has gradually increased to 2.44 per 100 persons. Sex and age differences are both present. Treatment of men through Sch- MA is more prevalent than that of women, and the prevalence of treatment of patients in the age bracket 30-39 is the highest. 2) Sch-MA is composed of more male than female patients, and this trend is more prominent in patients that used admission services. Among patients that used outpatient services, younger groups have increased in size gradually. Among patients that used admission services, patients in type-1 households form the largest group, and among the patients that used outpatient services, institutional residents form the largest group. However, the number of Sch-MA (type-1) patients has increased from year to year. 3) Service utilization rates, visit days per person, prescribing days per persons, and the medical costs per person in utilization of admission services have increased since 1995, and was highest in 1996 and 1997. In contrast, the utilization of outpatient services, service utilization rates, visit days per person, prescribing days per person, and medical costs per person have decreased since 1995. Utilization of admission services is highest among 50-59 years-olds, and utilization of outpatient services is highest among 30-39 years-olds, with 40-49 years-olds utilization being higher than that of 50-59 years-olds. Utilization of admission services is highest among those utilizing type-1 household, and utilization of outpatient services is highest among the institutional residents. Conclusion:The proportion of schizophrenic patients among the Medical aid clients and the cost of service utilization is increasing continually. Therefore the importance of effective policy and management for Sch-MA is also increasing. Especially, the rapid increase in the utilization of admission services and the rapid decrease in the utilization of outpatient services since 1995 which has been observed, may be due to policy factors such as the increase in the number of beds and the prolongation of the duration of service utilization.