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.

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.

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.

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.

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.

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

유전 알고리즘을 이용한 콘크리트 아치댐의 설계 최적화

김동수 ( Dongsu Kim ),이상익 ( Sangik Lee ),이종혁 ( Jonghyuk Lee ),정영준 ( Youngjoon Jeong ),서병훈 ( Byunghun Seo ),서예진 ( Yejin Seo ),이드아함드파지 ( Ahmed Fawzy Eid ),최원 ( Won Choi ) 한국농공학회 2022 한국농공학회 학술대회초록집 Vol.2022 No.-

일반적으로 콘크리트 댐 건설에 드는 비용 대부분은 제체에 사용되는 콘크리트이며, 콘크리트 댐의 설계 최적화는 제체의 부피를 최소화하는 목적으로 수행된다. 이러한 관점에서 콘크리트 아치댐은 얇은 아치형의 구조물로, 특정 지형 조건에서는 다른 유형의 콘크리트 댐에 비하여 높은 경제적 효율성을 가진다. 그러나 콘크리트 아치댐의 설계 최적화 과정은 설계변수가 복잡하고 많으며, 목적함수와 제약조건들이 비선형성을 가지므로 많은 계산을 필요로 하게 되어 최적화된 설계 형상을 도출하는 것이 까다롭다. 이에 본 연구에서는 유전 알고리즘(Genetic algorithms)을 이용하여 이중곡률(Double-curvature)을 가지는 콘크리트 아치댐의 설계 최적화를 수행하고자 하였다. 유전 알고리즘은 메타휴리스틱(Metaheuristics) 기법의 한가지로 도함수가 아닌 함숫값만 필요로 하여 불연속적이고 볼록집합이 아닌 집합을 대상으로 하는 설계 최적화 문제를 해결하는데 적합하다. Loop마다 업데이트 되는 설계변수들을 이용하여 댐 구조의 형성과 유전 알고리즘을 수행하는 프로그램을 작성하고, 이를 상용 유한요소해석 소프트웨어를 이용한 응력해석 결과와 연계하여 최적화된 설계안을 도출하였다.

개선된 모집단 초기화 기법을 이용한 콘크리트 아치댐의 형상 최적화

김동수 ( Dongsu Kim ),이상익 ( Sangik Lee ),이종혁 ( Jonghyuk Lee ),서병훈 ( Byunghun Seo ),서예진 ( Yejin Seo ),김동우 ( Dongwoo Kim ),이드아함드파지 ( Ahmed Fawzy Eid ),최원 ( Won Choi ) 한국농공학회 2023 한국농공학회 학술대회초록집 Vol.2023 No.0

콘크리트 아치댐은 일반적인 콘크리트 중력댐과 달리 얇은 아치형의 단면을 가지며 반드시 3차원 형태를 고려하여 설계해야 한다. 특히, 연직 단면과 수평 단면 모두 아치형을 가지는 이중곡률 (double-curvature) 아치댐은 다른 형태의 댐에 비하여 설계 시 고려해야 할 요소가 많고 응력해석이 복잡하지만 보다 적은 양의 재료가 사용되어 경제적인 강점을 가지므로, 전 세계적으로 다수의 아치댐이 건설된 바 있으며 최적 형상을 설계하기 위한 연구가 지속되고 있다. 이에 본 연구에서는 이중곡률을 가지는 콘크리트 아치댐의 형상 최적화를 위하여, 유전 알고리즘 (genetic algorithms)을 기반으로 개선된 모집단 초기화 기법을 적용하는 효율적인 최적화 알고리즘을 개발하고자 하였다. 개선된 모집단 초기화 기법을 적용하기 위하여 축적된 경험 지식과 문헌에서 제시되는 경험식을 조사하여 도메인 지식의 활용성을 검토하였다. 개발된 알고리즘은 아치댐 설계 분야의 도메인 지식을 이용하여 우수한 초기 모집단을 생성하며, iteration 마다 모든 설계안들에 대해 응력해석을 수행하여 제약조건을 검토하고 적합도 (fitness)를 목적함수로써 계산한다. 개선된 모집단 초기화 기법에 의한 최적화 알고리즘의 성능을 검증하기 위하여 기존댐을 시험 대상지로 선정하여 알고리즘 적용 시험을 수행하였으며, 본 연구에서 개발된 알고리즘이 기존의 방법보다 평균 적합도 및 수렴속도 측면에서 더 우수한 성능을 보이는 것을 확인하였다.

ADCP자료를 활용한 GIS기반의 하천 네트워크에서 오염물질의 이송거동모델 개발

김동수(Kim Dongsu) 대한토목학회 2009 대한토목학회논문집 B Vol.29 No.6B

본 논문은 GIS에 기반한 하천 네트워크에서 임의의 두 지점 사이의 우발적으로 유출된 오염물질의 이동과 거동을 모의하기 위해 새로이 개발된 모형인 ARPTM에 관해 기술한다. ARPTM 모형은 특히 ADCP자료로부터 계산된 하천의 동역학적인 계수인 종분산계수와 이송속도를 일차원 하천 이송-확산 모형에 적용하였다. ARPTM은 GIS 기술을 바탕으로 운영되도록 설계되어 자료의 준비에 있어 기존의 GIS 자료 및 기능들을 편리하게 이용할 수 있도록 하였고 효율적으로 모의 결과를 다양한 방식으로 도시하여 사용자들의 오염물질의 이동에 대한 이해의 편리를 도모하였다. ARPTM은 복잡한 하천 네트워크에서 오염물질의 유출지점으로부터 하류의 관심지점까지의 경로를 신속하게 계산하고 오염물질의 이송거리와 이송시간과 그리고 농도를 제공한다. ARPTM은 또한 자료의 제공 및 결과가 효율적으로 최근에 개발된 GIS에 기반한 Arc River 데이터베이스에 저장되도록 하여 궁극적으로 측정 자료, 모델링, 그리고 여러 사이버 툴을 통합하여 오염물질 이동을 시공간적으로 묘사하여 대단위 유역에서 오염물질 유출에 따른 경고시스템의 구축에 활용될 수 있다. This paper describes a newly developed pollutant transport model named ARPTM which was designed to simulate the transport and characteristics of pollutant materials after an accidental spill in upstream of river system up to a given position in the downstream. In particular, the ARPTM incorporated ADCP data to compute longitudinal dispersion coefficient and advection velocity which are necessary to apply one-dimensional advection-dispersion equation. ARPTM was built on top of the geographic information system platforms to take advantage of the technology's capabilities to track geo-referenced processes and visualize the simulated results in conjunction with associated geographic layers such as digital maps. The ARPTM computes travel distance, time, and concentration of the pollutant cloud in the given flow path from the river network, after quickly finding path between the spill of the pollutant material and any concerned points in the downstream. ARPTM is closely connected with a recently developed GIS-based Arc River database that stores inputs and outputs of ARPTM. ARPTM thereby assembles measurements, modeling, and cyberinfrastructure components to create a useful cyber-tool for determining and visualizing the dynamics of the clouds of pollutants while dispersing in space and time. ARPTM is expected to be potentially used for building warning system for the transport of pollutant materials in a large basin.