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김윤,박종익,강위창,홍진표 大韓神經精神醫學會 2000 신경정신의학 Vol.39 No.5
연구목적: 정신병원에서 의료보호 환자의 장기 입원으로 인한 입원 진료비의 급격한 증가와 환자의 만성화를 억제하기 위하여 새로운 일당진료비 지불제도를 시행할 예정이다. 이를 위하여 정신과 입원환자에 대한 서비스 제공량에 영향을 미치는 요인을 규명하고자 하였다. 방법: 조사대상 기관은 종합병원급 3개 병원과 정신병원급 3개 병원으로 6개 기관에서 총 575명을 무작위 층화표본추출(stratified random sampling)하여 조사하였다. 조사 대상병원에서 재원기간별, 의료보장 유형별로 약 15∼20명 씩 조사대상을 정했다. 환자에게 1주일 동안 제공되는 서비스 제공량 및 진료비를 조사하기 위하여 환자별 의사면단 등을 포함한 정신치료서비스, 간호서비스, 투약서비스의 내용을 동시적으로 조사하였다. 진료비는 해당 진료서비스의 한국형 RBRVS(Resoure Based Relative Value Scale) 점수를 이용하여 산출하였으며 중증도의 측정은 캐나다에서 개발된 RAI-MH(Resi-dent Assessment Instrument-Mental Health)를 사용하였다. 결과: 서비스 제공량의 분석결과 간호행위료를 제외한 일 평균 서비스 제공량은 연령, 진단군에 따라 유의한 차이를 보이지 않았다. 정신병원의 경우 의료보호 환자는 보험환자의 67%수준이었으며, 같은 의료보험의 경우에도 정신병원은 종합병원의 31% 수준이었다. 보험/보호 환자 모두에서 재원기간이 길어질수록 총 서비스 제공량이 줄어드는 양상이었으며, 재원기간 60일 이내군을 기준으로 180일 이상군을 비교했을 때 59%에서 79% 수준을 보였다. 질병의 중증도와 서비스 제공량 사이에는 상관관계가 거의 없었으며, 정신병원의 의료보험군에서만 약한 상관관계가 나타났다. 결론: 정신 의료 서비스 제공량에 영향을 미치는 요인은 재원기간과 진료비 지불제도, 의료기관 유형, 개별병원이었다. 재원기간별 일당진료비 차등제와 정신의료기관의 질적 수준에 따른 진료비 차등제를 도입함으로서 장기입원을 억제하고 의료보호 초기 환자의 과소서비스를 방지할 수 있다. 중심단어: 정신 의료 서비스 제공량·재원기간. Objectives: The purpose of the study is to investigate the factors affecting adequate provision of mental health care services to the psychiatric patients in mental hospitals and to suggest the introduction of a new reimbursement schedule for treatment of chronic Medicaid patients in order to avoid long-term hospitalization and to meet rising cost. Method: Five hundred and seventy-five psychiatric patients chosen by the stratified random sampling in six hospitals in Korea ; three mental hospitals and three general hospitals, have been classified into three groups : two groups were selected from mental hospitals with the national health insurance system and Medicaid, while only one group from general hospitals with the national health insurance system. They were investigated about mental health care services provided for one week, which are transformed into financial cost by using Korean Resource Based Relative Value Scale points. The severity of their psychiatric symptoms were assessed with RAI-MH(Resident·Assessment Instrument-Mental Health). Results: When the Medicaid was compared to the health insurance in mental hospitals, sixty-seven percent was the relative ratio. Mental hospitals compared to general hospitals under health insurance, it was only 31%. The longer the hospitalization, the lesser services they received in all three groups. Conclusion: The significant factors affecting supply of mental health care services in Korean mental hospitals were duration of hospitalization, type of hospital, type of reimbursement. The introduction of Medicaid system, differentiated by duration of stay, may induce short-term hospitalization and prohibit deficient service care, especially in acute patients under Medicaid system. KEY WORDS: Supply of mental health care services, Duration of stay.
PVD를 활용한 C-ITS 차량 내 경고정보 제공에 따른 주행 및 환경영향 분석
김윤미,김호선,강경표,김승범 한국ITS학회 2023 한국ITS학회논문지 Vol.22 No.5
C-ITS (Cooperative-Intelligent Transportation System) refers to user safety-oriented technology and systems that provide forward traffic situation information based on a two-way wireless communication technology between vehicles or between vehicles and infrastructure. Since the Daejeon-Sejong pilot project in 2016, the C-ITS infrastructure has been installed at various locations to provide C-ITS safety services through highway and local government demonstration projects. In this study, a methodology was developed to verify the effectiveness of the warning information using individual vehicle data collected through the Gwangju Metropolitan City C-ITS demonstration project. The analysis of the effectiveness was largely divided into driving behavior impact analysis and environmental analysis. Compliance analysis and driving safety evaluation were performed for the driving impact analysis. In addition, to supplement the inadequate collection of Probe Vehicle Data (PVD) collected during the C-ITS demonstration project, Digital Tacho Graph ( DTG ) data was additionally collected and used for effect analysis. The results of the compliance analysis showed that drivers displayed reduced driving behavior in response to warning information based on a sufficient number of valid samples. Also, the results of calculating and analyzing driving safety indicators, such as jerk and acceleration noise, revealed that driving safety was improved due to the provision of warning information.
부분방전에 의한 분해생성물 거동 모델링을 위한 예비 연구
표진수(Jin-Soo Pyo),정세훈(Sehun Jung),백승현(Seunghyun Baik),김윤제(Youn-Jae Kim),이종철(Jong-Chul Lee) 대한기계학회 2008 대한기계학회 춘추학술대회 Vol.2008 No.5
The use of gas-insulated switchgear (GIS) has been significantly increased in electric power plants. Each component of GIS is enclosed in a metal chamber, filled with compressed gaseous sulfur hexafluoride (SF?) as an electrical insulating medium. However, partial discharge (PD) or arc discharge, generated by sharp edges or small contaminant particles inside GIS, can cause the electrical breakdown of the system. Therefore, the PD detection in the early stage has become increasingly important in order to avoid the fatal failure of GIS. As Single-walled carbon nanotubes (SWNT) is good to sence decomposition products which are produced by PD, development of SWNT sensor is proceeding recently. In this study, numerical analysis was carried out, using a commercial CFD code, Phoenics, to obtain density distribution of decomposition product in a chamber modeling.