소아청소년 복합만성질환자 수 및 진료비의 변화: 2011-2021년 건강보험청구자료 분석

오정윤,조수진,정진선,조진숙,박춘선 건강보험심사평가원 2023 HIRA RESEARCH Vol.3 No.2

Background: The number of children and adolescents has decreased by more than 3 million over the past 10 years. We analyzed changes in the number of children and adolescents with complex chronic conditions (CCCs) and their medical expenditures between 2011 and 2021. Methods: We used National Health Insurance claims data of patients under the age of 20 from 2011 to 2021. CCCs were classified as pediatric CCCs by Feudtner et al. Patients who repeatedly utilize medical services due to CCCs were defined as patients who sought medical care twice or more within the past 3 years. Their sex, age, CCC categories, and the number of CCC categories were presented using descriptive analyses. Results: The number of children and adolescents with CCCs increased from 345,320 (3.04%) in 2011 to 451,238 (5.33%) in 2021. Patients who repeatedly utilized medical services due to CCCs increased by 71,889 during the same period. The proportion of patients with two or more CCC categories increased from 35.80% in 2011 to 43.67% in 2021. In 2021, patients with other congenital or genetic defect were most common. Medical expenditures associated with CCCs increased from 475,654 million won (12.34%) in 2011 to 768,467 million won (19.11%) in 2021. Conclusion: The number of patients with CCCs and their medical expenditures increased in Korea between 2011 and 2021. The results indicate that consistent national efforts are required to maintain the specialized pediatric care. Further studies are needed to identify pediatric patients who require specialized medical services through various methods.

지역사회거주 노인에서 한국어판 세계보건기구 장애평가조사표의 개발

윤진상,김재민,신일선,양수진,정태길,이형영 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.1

Objectives : This study aimed to develop the Korean version of World Health Organization Disability Assessment Schedule II (WHODAS II-K) with community dwelling elderly population. Methods : The WHODAS II-K was administered to 1204 community residents aged 65 or over in two areas of Kwangju, South Korea, in 2001. For assessing 'health condition', data on physical illness, depression (Korean version of Geriatric Mental State Schedule B3), and cognitive dysfunction (Korean version of Mini-Mental State Examination) were collected. For evaluating 'contextual factors', informations on demographic charactehstics (age, gender, living area, marital state, and religiou), socio-economic status (education, type of accommodation, number of room, previous occupation, and current employment), and social network were obtained. Results : WHODAS II-K showed high levels of internal consistency, split-half reliability, and inter-rater and test-retest reliabilities. In the correlation analyses, scores on the WHODAS II-K were significantly correlated with the unfavorable conditions in the all variables on health condition and contextual factors. Partial correlations of scores on the WHODAS II-K with health condition were significant even after controlling for contextual factors. Conclusion : The WHODAS II-K is a reliable and valid instrument for assessing disability in elderly population since it reflects physical illness, depression, and cognitive impairment, which are common in elderly.

건강보험 청구자료를 활용한 응급의료 이용현황

조수진,최윤정,이재호 건강보험심사평가원 2022 HIRA RESEARCH Vol.2 No.1

지역사회거주 노인에서 한국어판 세계보건기구 장애평가조사표의 개반

윤진상,김재민,신일선,양수진,정태길,이형영 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.1

어린이 공공전문진료센터의 진료 역량: 상급종합병원과의 비교를 중심으로

오정윤,조수진,정진선,조진숙,박춘선 건강보험심사평가원 2022 HIRA RESEARCH Vol.2 No.2

가토 골막과 골막세포의 새체외 및 생체내 골형성 유도

윤택림,정은정,서형연,나수진 대한정형외과연구학회 2003 대한정형외과연구학회지 Vol.6 No.2

도시 쉼터 노숙자의 정신장애 유병율과 삶의 질

한오수,홍진표,하지혜,이철,김창윤,이동우,박종익 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.5

연구목적 : 외환위기 이후에 급증한 노숙자 문제는 경제적인 상황의 호전에도 불구하고 만성화하는 경향을 보이고 있다. 쉼터의 노숙자를 대상으로 정신질환의 유병율과 삶의 질에 대한 조사를 시행하였다. 방 법 : 2000년 3월에 서울의 대표적인 쉼터에 거주하는 노숙자220명을 대상으로 인구학적 자료에 대한 설문조사를 한 뒤 Structured Clinical for DSM-Ⅳ(SCID-I)을 이용하여 AxisⅠ의 주요 정신질환을 진단하였다. 또 SmithKline Beecham Quality of Life Scale(SBQOL)를 사용하여 삶의 질정도를 평가하였다. 결 과 : DSM-Ⅳ AxisⅠ의 정신질환 중 기분장애, 정신병적 장애, 물질 사용 장애에 대한 진단 평가 결과 상기정신질환의 전체 평생 유병율은 73.6%, 현재 유병율은 59.1%이었다. 알코올 의존과 남용의 평생 유병율은 59.5%로 가장 높았고, 기분장애와 장애가 각각 39.5%, 3.6%이었다. 삶의 질은 노숙의 기간이나 실직 기간과 유의한 관계가 없었고, 자신이 지각한 건강상태, 자살과거력, 우울장애 유무와 통계적으로 유의하게 상관관계가 있었다(p<0.01). 결 론 : 노숙자에서 정신질환 중 알코올 장애의 유병율이 가장 높았으며, 우울장애가 있는 경우에 삶의 질이 저하되는 것으로 나타났다. Objectives : Homeless people surged after financial crisis tend to be chronic despite late economic recovery. So we tried to estimate prevalence of mental illness and quality of life of the homeless population living in shelter. Method : The study subjects were 220 homeless peoples who stayed at a shelter in Seoul around March 2000. Questionnaires on sociodemographic data were administered to the subjects, and then diagnoses of major DSM-Ⅳ Axis I mental disorders were made using Structured Clinical Interview for DSM-Ⅳ Axis I Disorders(SCID). And quality of life(QOL) was evaluated by SmithKline Beecham Quality of Life(SBQOL). Results : The lifetime prevalence of major DSM-Ⅳ mental disorders(mood disorders, psychotic disorder, and substance use disorder) of 220 homeless people was 73.6%, and current prevalence was 59.1%. The lifetime prevalence of alcohol dependence and abuse was highest, 59.5% and those of mood disorder and psychotic disorder were 39.5%, 3.6% respectively. Quality of life was not significantly correlated with duration of homelessness and unemploy-ment but marital status, self perceive health status, suicidal attempt history were significant factors. The quality of life in the people with mood disorders were estimated to be lower than those with any other diseases(p<0.01). Conclusion : Alcoholism was the most prevalent mental disorder in homeless people and mood disorder was negatively related to the quality of life scale.

내시경적 조임근절개술후에 발생한 췌십이지장 가성동맥류 1예

박수영,김윤정,박진한,전현수,박시형,이영진,이은지,김지현 仁濟大學校 白病院 2010 仁濟醫學 Vol.31 No.-

We reported a case of pancreatic pseudoaneurysm, involving pancreaticoduodenal artery, developed after endoscopic retrograde cholangiopancreatography(ERCP) with endoscopic sphinterotomy. A 54 year old woman was transferred to our hospital due to sustained hematochezia and hypovolemia. A week before admission, she underwent ERCP with endoscopic sphinterotomy for acute cholangitis in local clinics. She developed abdominal pain and hematochezia at 12 hours after the procedures. A post procedure contrast enhanced computed tomography of abdomen demonstrated a pseudoaneurysm in inferior portion of pancreatic head. This was not present on the pre procedure contrast enhanced computed tomography of abdomen and was thought to arise from the pancreaticoduodenal artery as a complication of the pre sphincterotomy. She was brought to our emergency room in a state of hypovolemia. A upper endoscopy showed active bleeding from ampula of vater. An celiac angiography demonstrated pancreatic pseudoaneurysm involving inferior pancreaticoduodenal artery and selective coil embolization of was performed.

부산의 해안지역 초고층 건물이 도시 풍환경에 미치는 영향에 관한 연구

박수진, 윤성환 신라대학교 부산학연구센터 2010 부산연구 Vol.8 No.1

본 연구는 우리나라의 대표적인 해안도시인 부산에 최근 등장한 해안지역의 초고층 건물들에 의한 도시의 풍환경의 영향을 검토하는 것을 목적으로 한다. 해운대구 마린시티 일대를 대상으로 CFD 시뮬레이션을 실시하였으며, 현재의 고층 저밀도로 가정한 모델을 비교 분석하였다. 계산 결과는 수평분포와 수직분포로 구분하여 그 영향을 검토했으며, 해안지역 초고층 건물에 의한 풍환경의 영향은 다음과 같다. 1) 풍환경은 건폐율보다 건물의 높이에 의한 영향이 더 크다. 기류의 수평분포와 수직분포 모두에서 고층건물에 의해 기류가 정체하는 영역이 넓어짐을 볼 수 있다. 2) 건물이 높을수록 도시 캐노피가 형성되는 지점이 높아진다. 저층건물 단지의 경우 건물높이의 약 1.5배 지점에서 도시 캐노피가 형성되었으나, 고층건물 단지의 경우 건물높이의 약 2.5배 지점에서 캐노피가 형성되었다. 도시 캐노피의 높이가 낮을수록 해풍도입을 통한 대류현열확산 효과가 높아지며, 이를 통한 도시 고온화 및 열섬현상 발생 억제에도 유리하다. 이러한 결과를 통해 해안에 인접한 지역에 초고층 단지를 계획할 때에는 이로 인한 도시 풍환경의 변화를 반드시 사전에 고려한 필요가 있음을 제고한다.

슬릿형 댐퍼를 이용한 구조시스템의 구조적 거동

이수진,박지영,오상훈,윤영호 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.1(구조계)

This study was to investigate the structural behavior of braced-frame systems with slit damper. For this study, push-over analysis was carried out to investigate the difference of structural behavior between the braced frame system without slit-plate dampers and the braced frame system with slit-plate dampers. The braced-frame systems with slit plate dampers were more effective than the braced-systems without slit-plate dampers: (1) The plastic hinges which were happened at damper were decentralized each story so that the plastic deformation of the main frames were decreased. (2) The ductilities of the former structure were increased.