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한국 대학생들의 영어독해에 대한 메타인지 인식과 독해전략 사용에 관한 연구
최숙자(Choi, Sookja),장선미(Chang, Sunmee) 한국영어어문교육학회 2013 영어어문교육 Vol.19 No.4
The present study reports an investigation into Korean EFL university students' metacogntive awareness and reading strategy use according to their English reading proficiency levels. With the use of reading comprehension scores of TOEIC, the students grouped into three levels: low, intermediate, and high. A total of 202 college students responded to a metacognitive awareness questionnaire and an actual reading strategy use questionnaire. The results showed that the students' metacognitive awareness in confidence as a reader, reading difficulties, effective reading strategies, and problem-solving strategies in perceived reading strategy use(problem-solving strategies, global reading strategies, support , reading strategies and local reading strategies) were significantly related to their reading proficiency. The higher level readers showed more confidence as readers and tended to be top-down in their perceptions of effective reading strategies. On the contrary, the lower level readers seemed to struggle more with reading difficulties and tended to be bottom-up in their perceptions of effective reading strategies. And, in terms of awareness of reading strategy use, the high level readers perceived to use problem-solving strategies more frequently than the medium level and the low level readers. The students' metacognitive awareness of reading strategy use appeared to be significantly different from their actual use of the reading strategies. Readers tended to have higher awareness of their readillg strategy use than their actual use of those reading strategies. The results of the study imply that teachers should provide students with an opportunity to raise metacognitive awareness of their reading and reading strategies so that they can be more responsible, strategic and efficient readers for their own reading.
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최숙자 ( Sookja Choi ),권순만 ( Soonman Kwon ) 한국보건경제정책학회(구 한국보건경제학회) 2016 보건경제와 정책연구 Vol.22 No.3
DRG지불제도는 1997년부터 2001년까지 5년간 시범사업을 실시하였고, 이후 2002년부터 (자발적)선택제 방식으로 10년 동안 지속되었으나, 도입이후 DRG지불제도에 대한 평가는 드물다. 이에 본 연구는 DRG지불제도의 정책 효과를 좀 더 정확하고 엄밀하게 평가해 보고자 선택편의(selection bias)에 의한 내생성(endogeneity) 문제를 통제할 수 있는 대표적인 두 가지의 계량적 방법론을 시도하였고, 연구대상자 역시 각 진료과마다 효과가 다를 것으로 판단되어 현재 DRG지불제도를 시행하고 있는 4개 진료과의 대표 질병군(수정체수술, 편도 및 아데노이드 수술, 항문수술, 제왕절개수술)을 선정하여 그 효과를 추정하였다. 포괄수가제가 재원일수에 어떠한 영향을 미쳤는지 혹은 포괄수가제 시행이 우리나라에서는 효과가 있었는지를 확인하기 위해 준실험적방법론으로 헤크만처치효과분석과 ‘시범사업참여여부’와 ‘병의원 개설연한’을 도구변수로 활용한 이단계추정분석을 시행하였다. 그 결과 지불제도 선택변수를 외생변수 및 내생변수로 각각 간주하고 구한 각 추정모형에서 산출된 지불제도의 계수값은 분석방법에 따라 대부분 통계적으로 유의하고 방향도 일관성이 있었으나, 전반적으로 이단계추정모형에 의한 계수값이 외생변수 추정모형에 의한 계수값에 비해 절대값이 커지는 것을 확인할 수 있었다. 이러한 결과는 내생성의 문제가 크게 작용하고 있고, 그로 인해 DRG의 효과가 제대로 측정되지 못하였다는 것을 증명하는 결과이기도 하다. 계량적 방법을 이용한 재원일수의 효과 분석에서는 의원에서 행해지는 편도수술과 병원에서 행해지는 제왕절개수술을 제외하고는 모든 질병군에서 DRG지불제도의 효과가 입증되었고, 그 크기와 영향요인은 질병군마다 다소 상이하였다. The aim of this study was to examine the impact of the participation in the DRG-based payment system on the length of stay (LOS). As the participation was voluntary, this study controlled for endogeneity and selection bias. Using data from the longitudinal claims database from 2002 to 2007 for Cesarean Section (370DRG), Cataract (039DRG), Tonsillectomy/Adenoidectomy (059DRG), and Hemorrhoid procedures (157DRG), this study examined the LOS based on the Heckman`s treatment effect model and Instrumental Variable regression model. Empirical results show that the DRG-based payment reduced the LOS, regardless of whether endogeneity is controlled for in the model. However, the magnitude of the impact of the DRG-based payment on the LOS is greater when the endogeneity is controlled for. This study shows that the DRG-based Prospective Payment system had positive impact on cost containment by reducing LOS. However, further study is necessary to examine the effect of DRG-based payment on total expenditure, mortality, quality of care, patient satisfaction etc.
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요양병원, 노인요양시설의 환자 안전 관리와 의약품 사용
박은자(Eunja Park),이나경(Nagyeong Lee),최숙자(Sookja Choi) 대한약학회 2020 약학회지 Vol.64 No.3
As Korea became aged society, more and more older adults utilized long-term care hospitals or nursing homes. The objective of this study was to examine the priority of policy measures for the improvement of patient (resident) safety of long-term care services in terms of medication use. We conducted an expert survey on September 2017 by e-mail, and analyzed answered questionnaires from 21 experts for long-term care hospitals and 21 experts for nursing homes. About nineteen percent of experts assessed the probability of medication error very high for long-term care hospitals and 38.1% did for nursing homes. The most important and urgent medicine management policy was to manage potentially inappropriate drug for the elderly in both long-term care hospitals and nursing homes. The second important policy was to intensify the monitoring for the patients with polypharmacy for long-term care hospitals and to collect medication information when the elderly were admitted to the nursing facilities for nursing homes. It was necessary to develop more detailed programs and policy measures to reduce the use of potentially inappropriate drug for the elderly in long-term care hospitals or nursing homes.
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