한의학 연구에 있어 의료서비스연구가 갖는 의의 고찰

박유리 ( Yu Ri Park ),서상록 ( Sang Rok Seo ),김영진 ( Young Jin Kim ),김유리 ( Yu Lee Kim ),김재효 ( Jae Hyo Kim ),안성훈 ( Seong Hun Ahn ),손인철 ( In Chul Sohn ) 대한경락경혈학회 2010 Korean Journal of Acupuncture Vol.27 No.2

Objectives: Many researchers in western societies raised questions on methodological Limitations of randomized controlled trial (RCT) for studying Complementary and Alternative Medicine (CAM), and they have tried to find alternatives to RCT. Some of them recently have interest in health service research as one of the alternatives. Discussing the significance of health services research in CAM studies will be helpful to guide the researchers in Korea who are also interested in developing an appropriate research methodology for traditional Korean medicine. Methods: Previous studies on methodological issues of studying CAM and health service researches published in western societies until 2009 were searched mainly from Pubmed. The definition, main research domains, and research methods of health service research and the significance of it for researches on CAM were summarized. Results & Conclusions: Health service researches are important in two aspects. First, health service researches evaluate the actual practice of CAM, including the individualized diagnosis as well as treatment and interaction between practitioners and patients. Second, when evaluating the outcomes, they put an emphasis on subjective evaluation by patients as well as objective evaluation by doctors. Thus, it can reflect the treatment goals of CAM which is improving the overall quality of Life and the physical and psychological health. Therefore, health services researches such as descriptive studies, qualitative studies, outcomes studies including economic evaluation, and whole systemic research should be more utilized in order for studying traditional Korean medicine.

한국 일차의료 분야 보건의료서비스 연구의 현황

최용준,이희영,박종헌 대한의사협회 2016 대한의사협회지 Vol.59 No.11

Primary care is a key component of a health care system and many countries have been making efforts to strengthen their primary care. We aimed to outline the status of health service research on primary care in Korea. In Medline and nine Korean databases, we searched the original articles published in peer-reviewed journals through December 2015, and summarized and classified the articles. Their publication year, journal name, research methods and research topics were presented. The main categories of research topics were health care delivery, utilization, quality, workforce, resources, financing, and others. The total number of research papers was 297, and these were mainly published in domestic Korean journals (92.6%). The most frequently adopted research methods were quantitative ones, and various types of data were used. The most two common topics were health care delivery and quality of care. Diversity of data sources, lack of public research funding and low participation of primary care physicians were also found. A clarification of the scope of health services research and refinement of topic classification will be beneficial. In short, this study provides a basis for building a primary care health services research database and can be used as a data source for subsequent research. It is also necessary to set research priorities for the development and evaluation of primary care policy.

Towards Actualizing the Value Potential of Korea Health Insurance Review and Assessment (HIRA) Data as a Resource for Health Research: Strengths, Limitations, Applications, and Strategies for Optimal Use of HIRA Data

김지애,윤석준,김록영,김동숙 대한의학회 2017 Journal of Korean medical science Vol.32 No.5

Health Insurance and Review Assessment (HIRA) in South Korea, also called National Health Insurance (NHI) data, is a repository of claims data collected in the process of reimbursing healthcare providers. Under the universal coverage system, having fee-for-services covering all citizens in South Korea, HIRA contains comprehensive and rich information pertaining to healthcare services such as treatments, pharmaceuticals, procedures, and diagnoses for almost 50 million beneficiaries. This corpus of HIRA data, which constitutes a large repository of data in the healthcare sector, has enormous potential to create value in several ways: enhancing the efficiency of the healthcare delivery system without compromising quality of care; adding supporting evidence for a given intervention; and providing the information needed to prevent (or monitor) adverse events. In order to actualize this potential, HIRA data need to actively be utilized for research. Thus understanding this data would greatly enhance this potential. We introduce HIRA data as an important source for health research and provide guidelines for researchers who are currently utilizing HIRA, or interested in doing so, to answer their research questions. We present the characteristics and structure of HIRA data. We discuss strengths and limitations that should be considered in conducting research with HIRA data and suggest strategies for optimal utilization of HIRA data by reviewing published research using HIRA data.

건강 위험 인식 연구 : 보건학 연구를 위한 함의

유명순 한국보건행정학회 2009 보건행정학회지 Vol.19 No.3

Outbreaks of health risks such as the Influenza A virus (H1N1) are continuing, which highlights the immediacy of risk control strategies to reduce public’s fear and protect the safety of the society. Evidence suggests that success for risk management is basically dependent on the public’s willingness to adopt health behaviors recommended by experts, and the behavioral intention relies on their risk perception. Understanding of how individuals think of and feel about health risks is thereby important. This article aims to provide insights for future study on health-risk perception. The main streams and recent developments of theorizing and research on health risk perception are reviewed. The issues, such as (1) health risk perception is an important component for shaping relevant health policies as it reflects public trust of the institutions managing health risks, (2) despite this significance, however, few attempts have been made to address the meaning of 'perceiving health risks' in health services research, are shed light on. On the basis on the critical discussion of the contributions and the limitations of the literature, this article finishes with a few of research agendas by three levels of analysis in risk perception research.

의료정보 이용 및 공개에 관한 법적기준 -미국 프라이버시 규칙과 피험자보호 규칙의 검토-

김진경,한우석 한양법학회 2009 漢陽法學 Vol.28 No.-

In response to the Health Insurance Portability and Accountability Act of 1996, the U.S. Department of Health and Human Services issued the Privacy Rule in 2003. Since the Privacy Rule allows for the use and disclose of ‘protected health information (PHI)’ under certain circumstances, we reviewed when and how PHI could be disclosed and, to that end, how the individual right is protected under the Privacy Rule. The Privacy Rule permits the use and disclose of PHI with individual’s authorization. However, health services research which usually deal with population-level data would be impracticable if millions of individual authorizations are required. Thus, in addition to the individual’s authorization, the Privacy Rule further allows for the following ways to use and disclose PHI for research purposes: 1) obtain waiver or alteration of the authorization requirement by and IRB or Privacy Board, 2) use de-identified data set, and 3) use limited data set under data use agreement. The Privacy Rule also grants individuals rights, including access to their protected health information, the right to amend, and the right to an accounting of the disclosures of their information. To this end, the Privacy Rule protects the privacy of individual health information, while at the same time allows researchers to have access to the individual health information necessary to conduct the research. The review of federal individual information protections in the U.S. provides insights on establishing appropriate laws and regulations in Korea on individual privacy protection and the use and disclose of personal information for public interest.

보건학 연구에서 연구윤리심의위원회 심의

이선희 한국보건행정학회 2022 보건행정학회지 Vol.32 No.1

With the rising attention dedicated to research ethics, the responsibility of researchers to comply with research ethics is alsohighlighted. Among a number of research ethics obligations that researchers should abide by, an institutional review board (IRB)review is the most essential step to be taken before launching research. As the health service research field grapples with humansubjects, it closely aligns with IRB deliberation. However, it seems that researchers still do not fully understand their obligations ofIRB reviews. Due to the nature of health services research, there are many cases that are exempt from IRB reviews, which often elicitsconfusion in the research field. On that note, we aim to explore the issues regarding IRB reviews that health service researchers needto know.

근로자의 건강증진에 대한 체계적 문헌고찰 참여적 실행연구와 지역사회기반 참여연구 중심으로

황원주,하지선,조현희 한국융합학회 2018 한국융합학회논문지 Vol.9 No.12

This study investigated a systematic literature review on local and international literatures focusing on Participatory Action Research(PAR), Community Based Participatory Research(CBPR) in workplace and community. Eighty percent of the 10 studies reviewed included research involving health professionals, community networks, workers, and university researchers. Health promotion programs varied from health and safety awareness, smoking cessation, diabetes management, physical activity, self-efficacy enhancement, cardiovascular disease, musculoskeletal disorders and mental health. PAR, CBPR are required to participate actively in research through community collaboration to promote health. We can solve problems at the community level. And identified sustainable effects when developing and implementing a health promotion program. PAR and CBPR are expected to continuously pursue change by adjusting the scope of individuals, organizations, communities, and institutional dimensions. They are also expected to be implemented for workers in the various workplace. 본 연구는 사업장과 지역사회에서 이루어진 PAR, CBPR을 중심으로 국내·외 문헌을 체계적 고찰을 하였다. 검토된 10개 논문의 연구 참여자는 보건전문가, 지역사회 네트워크, 근로자, 대학 연구자가 포함된 연구가 80%였고, 적용된 실행연구 기반 건강증진 프로그램은 안전·건강관리인식, 금연, 당뇨관리, 신체활동, 자기효능감 증진, 심혈관 질환, 근골격계 질환, 정신 건강 등 다양했다. 건강증진을 위해서는 지역사회 공동 작업을 통해 연구에 주도적으로 참여하는 것이 필수적이며, 이런 과정을 통하여 지역사회 차원의 문제를 해결할 수 있다. 또한 협력하며 건강증진프로그램을 개발하고 적용했을 때 지속가능한 효과를 확인할 수 있었다. PAR, CBPR은 개인과 조직, 지역사회, 제도적 차원의 범위를 조정하여 지속적인 변화를 추구할 것으로 사료되므로 다양한 사업장에서 근로자를 대상으로 활발히 수행되길 기대한다.

Qualitative study on the changes in mental health perceptions among female North Korean defectors in South Korea

신지수,김명희,송인한 한국정신건강사회복지학회 2022 정신보건과 사회사업 Vol.50 No.3

North Korean defectors are known to experience psychological distress due to social factors. We investigated how female North Korean (NK) defectors’ perceptions of mental health problems have changed in North Korea, intermediate countries, and South Korea. Eight female North Korean defectors were interviewed in 2020. A quantitative content analysis was utilized to analyze the interview results. A cross-case analysis was used to find major themes regarding the changes in perception of mental health issues in each migration phase, and four major themes for the perception of mental health issues were identified. Female North Korean defectors had never heard of the term 'mental health' in North Korea and did not look into their own mental health because it was difficult to live without an identity in a third country. They encountered mental health for the first time in Korea and had their own definition of it. Although some subjects approached mental health services on their own when experiencing psychological distress after becoming aware of mental health, others responded negatively to mental health, such as having difficulty sharing their trauma. As a result of this study, it suggests that although the study participants come to Korea and develop an awareness of mental health, there is still a lack of information on mental health services and there are still untreated mental health problems. Based on the results of this study, ways to increase their access to mental health services in Korea are discussed.

학교급식 식재료 시장조사 가격의 적정성 분석 -서울특별시 학교급식을 중심으로-

김윤두 ( Yoon Doo Kim ) 아시아.유럽미래학회 2012 유라시아연구 Vol.9 No.3

서울시 내 학교급식을 실시하는 1,300여 학교는 입찰, 수의계약 등을 통하여 독립적으로 학교급식 식재료를 구입하는 경우 필수적으로 필요한 품목의 기초단가 산정을 실시하여야 하며, 이때 학교에서 가장 주요한 기준이 되는 것이 서울시학교보건진흥원에서 제공하는 ‘학교급식 식재료 시장조사 가격’이다. 그러나 지금까지 학교급식 식재료 가격결정에 있어 매우 중요한 역할을 하고 있는 ‘학교급식 식재료 시장조사 가격’에 대한 객관적인 적정성 분석 등 합리적 실행 여부에 대한 검토가 실시되지 못하였다. 이에 본 연구에서는 부적절한 학교급식 식재료가격 결정을 개선함으로써 보다 양질의 학교급식이 제공될 수 있는 기회를 확대하기 위하여 학교급식의 현황 및 시장조사 가격의 적정성분석과 서울시 내 모든 학교를 대상으로 한 설문조사분석을 통하여 학교급식에 이용되는 식재료 가격이 보다 객관적이고 합리 적으로 결정될 수 있는 개선방안을 제시하고자 하였다. 연구결과 현재 학교보건진흥원에서 제공하고 있는 식재료 시장조사가격은 일선 학교의 영양(교)사에게 가장 중요한 참고자료를 제공하는 것으로 조사되었으나 자료의 적정성에 대해서는 부정적인 의견이 많은 것으로 조사되었다. 세부적으로는 조사대상에 있어 소매단계 가격만을 대상으로 함으로써 공급업체의 유형에 따라 지나친 초과이윤이 발생할 수 있는 가능성이 있음으로 도매단계 가격을 제공할 수 있는 조사대상을 포함시키는 개선안을 제시하였으며, 공급업체 가격정보 제공시에도 표본이 되는 공급업체의 대상과 표본 수를 확대함으로써 보다 객관적인 정보를 제공하는 방안을 제시하였다. 조사품목 수에 있어서도 현실적으로 효율적인 조사가 될 수 있도록 현장조사 품목은 축소하되 온라인 정보수집을 통한 조사품목을 병행하여 현행 품목수준을 유지하는 방안을 제시하였으며, 조사주기는 현행처럼 월 1회를 유지하되 가격변동이 심한 농수산물에 대해서는 월 2회로 개선하고 두 번째 가격정보 제공은 현장 방문조사가 아닌 온라인 정보수집 조사를 통하여 제공하는 방안을 제시하였다. 조사방법은 현재의 방문조사 위주에서 온라인상 가격정보 수집을 병행하는 방안을 제시하였으며, 이때 소매가격은 방문조사, 도매가격은 방문조사와 온라인상 가격정보수집을 병행하고 학교급식 공급업체 가격정보는 NEIS를 통하여 조사하는 방법을 제시하였다. 본 연구의 의미와 목적이 매우 중요함에도 불구하고 본 연구결과는 연구범위, 분석자료 등의 측면에서 다음과 같은 몇 가지 한계점을 가지고 있으며, 향후 이러한 한계점을 보완하기 위한 추가연구가 필요할 것으로 판단된다. 첫째, 분석 자료의 문제로서 본 연구의 기초자료로 사용된 NEIS 자료의 학교별 양식차이, 입력오류등 일부 부정확성을 나타내고 있는 자료로 인하여 이를 분석에서 제외함으로써 보다 신뢰성 높은 분석이 이루어지지 못한 측면이 있다. 둘째, 학교급식 식재료로 사용되는 농축산물의 경우 단순가공 비중이 일정부분을 차지하고 있어 시장조사가격 이외에 품목별, 가공유형별 유통비 정보를 제공하여야 일선 학교의 영양(교)사들의 기초금액산정에 필요한 정확한 정보를 줄 수 있으나 본 연구에서는 시장조사 품목의 가공유형별 유통비용은 분석되지 못한 한계를 나타내고 있다. 1,300 schools in Seoul should take a calculation of basic unit price for ingredients when they purchase the ingredients independently by using a bid or a private contract, referring to “The Market Research Price of Ingredients of School Food Service” prepared by Seoul School Health Promotion Center. However, “The Market Research Price of Ingredients of School Food Service”, playing a critical role in setting the price of ingredients of school food service, had not been properly analyzed in terms of its objective appropriateness and the feasibility of its price. Therefore, this study aimed at suggesting the better ways of how to set the price of ingredients more reasonable and objective by taking an investigation of the state of lunch meals, an analysis on the appropriateness of market price of ingredients, and a survey targeting all schools in Seoul. We hope that the result of our study would help increasing the chance of providing the quality of school food service by improving the price-setting procedures of ingredients of school food service. As the result, now, market research prices of food ingredients invest that are to be providing from Seoul School Health Promotion Center is investigated to providing the most important references to nutrition teachers of the schools. However, for the appropriateness of the information, that is investigated they have a lot of negative opinions Detailed surveyed suppliers, depending on the type of target retail Prices only step by wholesale price step improvements that can cause excessive exceed profits proposed, the vendor pricing information provided even when the sample by expanding the number of samples that target suppliers and suggested improvements to provide more objective information. This study provide to field research items reduce for realistically efficient research, and, research items to collected online information keep current level items. It suggested that the research period will maintain by once a month like the current. However, The agricultural products and fishery products of large prices fluctuating have to investigate twice a month, and second research have to be online research instead of field research. In how to survey, by running parallel with visit survey and the online of price information collected, the retail price is visit survey, wholesale prices run parallel with visit survey and the online Prices information collected. And supplier pricing information was presented how to investigate through the NEIS. The meaning and purpose of the present study is very important although the results of this study has several limitations as follows in terms of the scope of research, analysis, etc., are considered necessary complement to these limitations in the future for further research. First, we have the aspects that have not been done by excluding them from the analysis more reliable analysis because of inaccuracies of the difference between school-specific form of the NEIS data used as the basis of this study, typing errors, etc. Second, the case of agricultural and livestock foods used as school food service ingredients, is taking proportion of simple processing up. And except market research price, we can give necessary accurate information to calculate the basis amount of nutritionists that if you need. But distribution costs for processing of market research items by type have not been analyzed in this study. And shows the limitations.

SNS 기반 모바일 정신건강서비스 플랫폼 이용경험에 관한 현상학적 연구

이솔지(Sol Ji Lee) 사단법인 한국안전문화학회 2024 안전문화연구 Vol.- No.27

본 연구는 정신건강사회복지전문가가 개발하고 서비스를 제공하고 있는 모바일 정신건강서비스 플랫폼 이용경험에 관한 현상학 연구로 서비스 이용자들의 이용경험의 본질과 의미를 깊이 있게 탐색하여 한국의 정신건강서비스 전달체계에서 모바일 정신건강서비스 플랫폼의 필요성과 전문적인 모바일 정신건강서비스 플랫폼의 활용에 대한 실질적인 정책적, 실천적 제언을 제시하고자 하였다. 이를 위해 1년 이상 해당 플랫폼을 지속적으로 이용하고 있는 12명의 연구참여자를 대상으로 자료를 수집하였으며 현상에 대한 경험의 본질과 의미를 깊이 있게 분석하고자 Giorgi의 현상학적 관점을 적용하여 자료를 분석하였다. 분석결과 7개의 구성요소와 20개의 하위 구성요소가 도출되었으며 구성요소는 문제의 시작과 망망함 속 발버둥, 내가 이용한 정신건강서비스 그리고 부정적 기억들, 우연히 마주한 공간에서 경험한 다양한 정신건강서비스, 모바일 정신건강서비스 플랫폼을 지속해서 찾는 이유, 심리적 안정과 실제적인 변화와 회복, 개인 모바일 정신건강서비스 플랫폼의 한계, 공공 정신건강서비스와의 파트너십으로 함께가기가 도출되었다. 이러한 분석결과를 토대로 본 연구의 결론과 그에 따른 실질적인 제언들을 제시하였다. This study is a phenomenological study on the experience of using a mobile mental health service platform developed and provided by mental health social welfare experts, and was conducted to provide practical policy and practical suggestions for the necessity of a mobile mental health service platform and the use of a professional mobile mental health service platform in Korea's mental health service delivery system. To this study, data were collected from 12 research participants who have been continuously using the platform for more than a year, and the data were analyzed by applying Giorgi's phenomenological perspective to deeply analyze the nature and meaning of the experience of the phenomenon. As a result of the analysis, 7 components and 20 sub-components were derived, and the components were found to struggle in the beginning and despair of the problem, mental health services I used and negative memories, various mental health services experienced in accidental spaces, reasons for continuing to find the mobile mental health service platform, psychological stability and practical change and recovery, limitations of personal mobile mental health service platforms, and partnerships with public mental health services. Based on these analysis results, the conclusions of this study and practical suggestions were presented.