건강보험 빅 데이터를 활용한 종합병원에서의 포괄수가제 적용 전·후 재원일수와 진료비의 변화

정수진,최성우,Jeong, Su-Jin,Choi, Seong-Woo 한국전자통신학회 2017 한국전자통신학회 논문지 Vol.12 No.2

본 연구는 일 종합병원 산부인과 환자를 대상으로 2013년 7월 1일 포괄수가제가 확대시행 전 후의 재원일수와 진료비를 비교 분석하여 포괄수가제 시행의 효과를 파악하고자 수행되었다. G광역시 소재 일 종합병원에서 2013년 1년간 산부인과 포괄수가제 질병군의 수술(자궁 및 자궁부속기 수술, 제왕절개술)을 받고 퇴원한 환자로, 행위별 수가제 적용 대상자는 2013년 1월~6월까지 입원한 환자 204명이었고, 포괄수가제 적용 대상자는 2013년 7월~12월까지 입원한 환자 194명으로 총 398명의 재원일수 및 진료비를 공분산분석(ANCOVA)하였다. 본 연구결과 재원일수는 행위별수가제에서 6.65(0.13)일, 포괄수가제에서 6.40(0.12)일로 감소하였고(p=0.013), 급여총진료비는 행위별수가제에서 1,726,333(46,331)원, 포괄수가제에서 2,271,115(37,069)으로 증가하였고(p<0.001), 보험자부담금은 행위별수가제에서 1,387,142(41,938)원, 포괄수가제에서 1,800,914(28,300)원으로 증가였다(p<0.001). 급여본인부담금은 행위별수가제에서 339,190(8,404)원, 포괄수가제에서 70,201(9,255)원으로 감소하였고(p<0.001), 비급여비용은 행위별수가제에서 642,243(22,039)원, 포괄수가제에서 197,507(9,091)원으로 감소하였고(p<0.001), 환자 총본인부담금도 행위별수가제에서 981,433(25,947)원, 포괄수가제에서 667,708(13,286)원으로 감소하였다(p<0.001). 본 연구결과 산부인과 환자에 대한 포괄수가제 적용은 재원일수, 비급여비용, 총본인부담금을 감소시켰고, 급여본인부담금, 보험자부담금, 급여총진료비를 증가시키는 효과를 보였다. This study aimed to identify appropriateness and efficiency in the DRG payment system by analysing the hospital length of stay and changes in fees before and after the application of DRG payment system. The subjects of the study were a total of 398 patients consisting of 204 for the fee for service system and 194 for the DRG payment system. They received surgery in the Obstetrics and Gynecology (OBGY) department of a general hospital in G metropolitan city between January and December 2013. The mean hospital length of stay was significantly decreased after application of the DRG payment system(p=0.013). Total fees, insurance charges, and deductions increased significantly(p<0.001), and non-payment charges and total deductions decreased significantly(p<0.001). Application of the DRG payment system reduced length of stay, non-payment charges and total patient's cost sharing and increased out-of-pocket, insurance charges, and total fees.

소아의 흔한 질병 상황에서 식이, 영양의 중요성

정수진,Jeong, Su-Jin 대한소아소화기영양학회 2011 Pediatric gastroenterology, hepatology & nutrition Vol.14 No.1

The influence of nutrition during early life on physical growth as well as mental development has been thoroughly discussed in the literature. The physical dimensions of the body are greatly influenced by nutrition, particularly during the period of rapid growth in early childhood. Nutritional status affects every pediatric patient's response toillness. Good nutrition is important for achieving normal growth and development. It is indicated that permanent impairment of the central nervous system may result from dietary restriction of imbalance during certain periods of life. If children under 3 years of age show a good nutritional status, it may be assumed that they are well nourished. Several common diseases of children such as iron deficiency, chronic constipation and atopic dermatitis are known food related diseases. Patients with chronic illness and those at risk of malnutrition should have detailed nutritional assessments done. Components of a complete nutritional assessment include a medical history, nutritional history including dietary intake, physical examination, anthropometrics (weight, length or stature, head circumference, midarm circumference, and triceps skinfold thickness), pubertal staging, skeletal maturity staging, and biochemical tests of nutritional status. The use of age, gender, and disease-specific growth charts is essential in assessing nutritional status and monitoring nutrition interventions. Nutrition assessment and dietary counseling is helpful for the cure of disease, and moreover, the prevention of illness.

소아, 청소년 비만 약물 치료의 올바른 이해

정수진,Jeong, Su Jin 대한소아소화기영양학회 2009 Pediatric gastroenterology, hepatology & nutrition Vol.12 No.suppl1

The incidence of childhood obesity has increased dramatically. Childhood obesity is an increasing health problem because of its strong associations with chronic health problems in children and adults. These health problems significantly contribute to the development of common chronic diseases in later life, including hypertension, type2 diabetes, hyperinsulinemia, coronary heart disease, and other psychological disorders. So it is an important issue to prevent and treat obesity during childhood and adolescent. Diet and exercise are the cornerstones of treatment for obesity and related complications. For obese children, some clinical trials have shown improvement with diet, exercise, and /or behavioral interventions. Promising interventions for high-risk individuals, such as bariatric surgery and novel pharmacological agents, also require rigorous assessment with attention to long-term patient important outcomes. There are various pharmacological approaches to the treatment of obesity in the adolescent population some of which have FDA approval. In the article we discuss pharmacological approaches to guide the treatment of obesity in the pediatric population, including risks of treatment, monitoring of potential side effects.

공동주택 거주자의 에너지사용의식에 따른 에너지사용행동 특성분석

정수진,한정원,Jung, Su-Jin,Han, Jeong-Won 한국주거학회 2013 한국주거학회 논문집 Vol.24 No.3

As household energy consumption has increased, serious environmental problems, such as resource depletion and global warming, are becoming global issues. It is essential to conduct the energy use of residents living in apartments in order to come up with alternative solutions for energy savings. Therefore, this study examined the energy use awareness of apartment residents and their energy use behavior by various types of awareness. To understand their energy use behavior according to the awareness of the subjects, the energy awareness dimension was created with five factors and they were subject to a cluster analysis; then, the subjects were categorized into three groups. Finally, the difference of energy use behavior was examined by groups of energy awareness. G1 represents the group that is indifferent to energy savings and believes that convenience is an important factor. Also, with respect to energy use behavior, this group tends to pursue convenience. G2 is the group that is conscious of energy use costs thereby enduring some inconvenience, and shows savings behavior in daily life and household affairs. Although, G3 is very aware of the significance for the necessity of energy saving, their energy saving behavior is relatively negative. Regarding these different characteristics of each resident group in their energy saving awareness and behaviors, diverse methods and promotion in energy education are required. Furthermore, an effective energy policy should be established based on the understanding of energy consumption.

Synthesis and Characteristics of the Organic Layered Structure Material of $(C_4H_9NH_3)_2Fe_xPb_1-xCl_4$

정수진,인리주,오응주,조웅인,김규홍,요철현,Jeong, Su Jin,In, Ri Ju,O, Eung Ju,Jo, Ung In,Kim, Gyu Hong,Yo, Cheol Hyeon Korean Chemical Society 2001 Bulletin of the Korean Chemical Society Vol.22 No.7

K2NiF4-type organic-based perovskites of the (C4H9NH3)2FexPb1-xCl4 (x=0.00, 0.25, 0.50, and 0.75) system have been synthesized using a low-temperatu re solution method under a flowing argon gas. When stoichiometric butylamine, iron chloride, and lead chloride are mixed, a yellow solution are obtained from slow cooling of 90 to -10 $^{\circ}C.$ The final product is a plate-like yellow crystal. The X-ray crystallographic analysis has been carried out using XRD in the range of $5^{\circ}{\leq}$ 2${\theta}$ ${\leq}80^{\circ}.$ The local symmetry around the absorbing Pb atom of the samples has been determined by the EXAFS spectroscopic study. The crystals assign to orthorhombic system by the XRD analysis. The FT-IR spectra are analyzed in the range of 600 to 3300 cm-1 . DSC and TGA are measured to detect thermal stability between 30 and 300 $^{\circ}C.$ Two endothermic peaks are detected in all samples. The electrical conductivity has been measured using the four-probes technique for the (C4H9NH3)2FexPb1-xCl4 system in 300-460 K. Photoluminescence phenomenon was also investigated at room-temperature.

변환효율 향상을 위한 횡방향 가변 셀밀도법을 사용한 자동차용 촉매변환기의 수치적 설계

정수진,김우승,Jeong, Su-Jin,Kim, U-Seung 대한기계학회 2000 大韓機械學會論文集B Vol.24 No.12

The optimal design of auto-catalyst needs a good compromise between the pressure drop and flow uniformity in the substrate. One of the effective methods to achieve this goal is to use the concept of radially variable cell density. But this method has not been examined its usefulness in terms of chemical behavior and conversion performance. In this work, two-dimensional performance prediction of catalyst coupled with turbulent reacting flow simulation has been used to evaluated the benefits of this method n the flow uniformity and conversion efficiency. The results showed that two cell combination of 93cpsc and 62 cpsc was the most effective for improved pressure drop and conversion efficiency due to balanced space velocity and efficient usage of geometric surface area of channels. It was also found that large temperature difference between the bricks in case that the edge of the frontal face of brick has too much lower cell density(less than 67% of cell density of the center of the brick). This study has also demonstrated that the present computational results show the better prediction accuracy in terms of CO, HC and NO conversion efficiencies compared to those of conventional 1-D adiabatic model by comparison with experimental results.

소아 만성 복통의 진단적 평가 -기능성 복통과의 감별점을 중심으로-

정수진,Jeong, Su Jin 대한소아소화기영양학회 2008 Pediatric gastroenterology, hepatology & nutrition Vol.11 No.suppl2

Chronic abdominal pain, defined as long-lasting intermittent or constant abdominal pain, is a common pediatric problem encountered by primary care physicians and medical subspecialists. Chronic abdominal pain in children is usually functional, i.e., without objective evidence of an underlying organic disorder. Functional abdominal pain is categorized as functional dyspepsia, irritable bowel syndrome, functional abdominal pain, abdominal migraine, and aerophagia according to the Rome II criteria for pediatric functional gastrointestinal disorders. There is insufficient evidence to state that the nature of abdominal pain or the presence of associated symptoms can discriminate between functional and organic disorders. The presence of alarming symptoms or signs, such as weight loss, gastrointestinal bleeding, persistent fever, and chronic severe diarrhea, is associated with a higher prevalence of organic disease. Most children with chronic abdominal pain are unlikely to require diagnostic testing; such children often need pharmacologic and behavioral therapy.

연결어미 "-고"의 다의적 쓰임에 대한 인지적 해석

정수진(Su Jin Jeong) 언어과학회 2011 언어과학연구 Vol.58 No.-

The aim of this paper is to establish the links between the basic meaning of connective ``ko`` in Korean and its various abstract uses based on Cognitive Linguistics. It will be concluded that the type of abstract extensions of connective ``ko`` is not random. On the contrary, it is systematically based on its implicative meaning derived from the structure of the correlative event. A systematic organization of connective ``-ko`` will provide the nature of the meaning function of connective ``-ko`` and an effective tool for exploring the meaning structure of other connectives. This paper will focus on the type of the correlative event of the temporal structure, on the aspect of meaning and usage of connective ``ko``, and its extension which is shifted from the external relations of the correlative event into internal, abstract, cognitive situation. (Daegu Haany University)

연속된 사건에 대한 한국어와 영어의 표현 양상

정수진 ( Su Jin Jeong ),이주익 ( Ju Ick Lee ) 한민족어문학회 2013 韓民族語文學 Vol.0 No.65

본 논문은 개념화자의 해석 방식이 언어 표현의 구조와 의미에 반영된다는 인지언어학의 관점에서 한국어와 영어의 복문을 대상으로 하여 각 언어의 개념화자가 연속된 두 사건을 해석하는 방식을 비교하고 그 차이를 밝힌 것으로, 주요 내용은 다음과 같다. 첫째, ‘전경-배경 할당 방식’에 있어서는 한국어와 영어 모두 Talmy가 제시한 보편적 원리에 따르고, 한국어 및 영어의 개념화자가 시간적·논리적으로 연속된 두 사건을 해석하는 방식은 ‘선행/원인-배경 배경’과 ‘후행/결과-전경 전경’으로 동일하다. 둘째, 개념화자의 ‘시선 이동의 방향’ 측면에서는 한국어 및 영어의 개념화자가 연속된 두 사건을 해석하는 방식에 차이가 나타난다. 한국어의 개념화자들은 객관적 상황에 존재하는 사건 그 자체를 중심으로 발생 순서에 따라 해석하는 경향이 있는 반면에, 영어의 개념화자들은 객관적 상황에 존재하는 사건을 자신의 주관에 따라 재구성하여 사건의 발생 순서와 다르게 해석하는 경향이 있는 것으로 파악된다. 다시 말해, 한국어 복문의 어순은 ‘배경종속절 종속절 종속절+전경주절 주절 주절’로 고정되지만, 영어 복문의 어순은 ‘전경주절 주절 주절+배경종속절 종속절 종속절’과 ‘배경종속절 종속절 종속절+전경주절 주절 주절’로연속된 사건의 발화 순서에 제약이 없다. 이는 한국어와 영어의 개념화자의 해석 방식, 구체적으로 시간적·논리적으로 연속된 두 사건에 대한 개념화자의 시선 이동 방향의 차이가 언어 표현에 그대로 반영된 결과이다. In light of cognitive linguistics, a variety of linguistic expressions reflect how a language user construes a given context such as event and situation. In this respect construals of the same situation can vary depending on individuals and languages. From the perspective this paper explores construal and perspectival modes in terms of directions of viewing sequential events in Korean and English complex sentences. The findings are as in the following. First, there is no difference between Korean and English in Figure-Ground alignment. complying with Talmy`s universal principles of events in an interevent relation. Moreover, when it comes to events in a relation of temporal sequence and causality, the earlier-occurring event and the causing event act as Ground, and the later-occurring event and the resulting event act as Figure in both Korean and English. Second, in terms of positional changes of Figure-Ground within a complex sentence, Korean and English have differences with each other. This study reveals that the directions of one`s viewing two events in sequence and with causality result in those distinctions between languages. Korean speakers seem to have the tendency to view the events in question in accordance with time order of events occurring. On the other hand, English speakers appear to have some flexibility in observing the events depending on their own perspectives in that their direction of viewing correspond to the direction of the referent events occurring and conversely, the opposite correlation can exist between the directions. That is, in terms of clause order within a complex sentence, only the sentential structure ``Ground in a subordinate clause + Figure in a main clause`` appears in Korean while English permits both the sentential structures such as ``Ground in a subordinate clause + Figure in a main clause`` and ``Figure in a main clause + Ground in a subordinate clause. The rationale behind this is that when it comes to two events in sequence and with causality, there exist clear-cut differences of direction of viewing them between Korean and English speakers, which are directly projected onto their language expressions.

색상과 톤, 넥타이 폭이 남성복 이미지에 미치는 영향

정수진(Su-Jin Jeong),최수경(Su-Koung Choi) 한국의상디자인학회 2010 한국의상디자인학회지 Vol.12 No.3