전립선암의 남성호르몬 박탈 치료와 근치적 전립선적출술의 비용 분석

김장묵 ( Jang Mook Kim ),노미정 ( Mi Jung Rho ),장광수 ( Kwang Soo Jang ),박용현 ( Yong Hyun Park ),이지열 ( Ji Youl Lee ),최인영 ( In Young Choi ) 한국병원경영학회 2018 병원경영학회지 Vol.23 No.3

Purposes: 본 연구는 전립선암 환자의 의료비 지출을 평가하기 위해 남성호르몬 박탈 치료와 근치적 전립선적출술의 비용을 비교하였다. Methods: 본 연구는 스마트 전립선암 데이터베이스(Smart Prostate Cancer Database)의 전립선암 환자 357명의 데이터와 청구데이터베이스에서 의료비 관련 데이터를 도출하였다. 근치적 전립선적출술과 남성호르몬 박탈 치료간 비교를 위해 독립표본 t검정을 실시하였다. 또한 남성호르몬 박탈 치료와 근치적 전립선적출술에 영향을 미치는 요인을 검증하기 위해 다중회귀 분석을 실시하였다. Findings: 치료 후 1년까지 남성호르몬 박탈치료가 근치적 전립선적출술 보다 비용이 낮은 것으로 나타났으며, 치료 후 4년까지 낮게 유지되었다. 그러나 4년이 지나면 남성호르몬 박탈 치료의 누적의료비가 근치적 전립선적출술보다 더 유의미하게 높게 나타났다. 환자의 병기가 높거나 나이가 많은 경우 근치적 전립선적출술보다 남성호르몬 박탈 치료를 할 확률이 더 높았다. Practical Implications: 본 연구는 조기 암 발견이 환자 뿐 아니라 국민건강보험공단의 의료비를 줄일 수 있다는 것을 보여 준다. 또한 의료비를 정확히 평가하기 위해서는 오랜 기간의 정보를 평가해야 하며, 이를 기반으로 평가 및 예측이 필요함을 증명하였다. Purpose: To evaluate the medical expenditures for prostate cancer patients, including out-of-pocket costs, and compared the costs between androgen deprivation therapy and radical prostatectomy treatment. Methodology: This study combined clinical data from 357 prostate cancer patients from the Smart Prostate Cancer Database and the medical expenditure data from the claims and cost databases. We used the independent two-sample t-tests to compare androgen deprivation therapy and radical prostatectomy. Multivariable logistic regression analysis was conducted to identify determining factors for androgen deprivation therapy and radical prostatectomy treatments. Findings: The medical costs of androgen deprivation therapy treatment were much lower than radical prostatectomy treatment at the one year and remained lower until the fourth-year. However, after four years, the accumulated medical expenditures of androgen deprivation therapy become significantly higher than radical prostatectomy treatment. Patients with a higher cancer stage and older age had higher chances of being treated using androgen deprivation therapy treatment than radical prostatectomy treatment. Practical Implications: Our results show that early detection of cancer reduces the treatment cost for both patients and insurance payers. It also demonstrates that cost comparisons should be conducted over long periods of time in order to most accurately assess the costs.

중소병원의 내부서비스질의 요인이 고객지향성에 미치는 영향

김성호 ( Sung Ho Kim ),김영훈 ( Young Hoon Kim ),김장묵 ( Jang Mook Kim ),성동효 ( Dong Hyo Sung ) 한국병원경영학회 2012 병원경영학회지 Vol.17 No.2

This study aims to suggest managerial strategies for strengthening their competitiveness via analyzing and determining factors to help improve customer orientation and internal customer satisfaction. Furthermore, this study aims to find out the factors of internal service quality affects job satisfaction and customer orientation. The data was collected in 5 small and medium hospitals on 215 workers who had direct interactions with customers. Through regression analysis, all factors of internal service quality affects job satisfaction, however only two factors, credibility and sympathy appeared to affect customer orientation.

미국 보건의료산업의 공급사슬관리(SCM) 연구동향 고찰을 통한 전략적 도입의 타당성 평가

김성호 ( Sung Ho Kim ),김영훈 ( Young Hoon Kim ),김장묵 ( Jang Mook Kim ),성동효 ( Dong Hyo Sung ) 한국병원경영학회 2015 병원경영학회지 Vol.20 No.3

This paper attempts to critically review the status of supply chain operations in the healthcare field in an attempt to address what has been done in academics as well as the practitioner`s field to gain insight where future research efforts should be addressed. Based on literature set through review on previous studies, literature published within the past 10 years will be reviewed. The purpose of the study can be summarized as follows. First, overviews of healthcare SCM. Second, comparative studies on commercial SCM and healthcare SCM. Third, major tools in SCM. Finally, the barriers of adopting healthcare SCM. The findings of this study reveals potential benefits from using supply chain management tools. Although research and case studies in healthcare industries are not as extensive as in other industries, a clear trend appears to be forming in that deployment of supply chain management indeed generates consumer and provider`s surplus from which the entire society would benefit.

인후두위산역류증(Laryngopharyngeal Reflux: LPR)의 치료에 대한 RabeprazoleSodium(Parietd)의 임상효과와 안전성 검토

정광윤,전병선,고상현,권기환,권순영,권중근,김동영,김상철,김성완,김영모,김영호,김윤환,김장묵,Jung, K.W.,Jun, B.S.,Ko, S.H.,Kwon, K.H.,Kwon, S.Y.,Kwon, J.K.,Kim,, D.Y.,Kim,, S.C.,Kim,, S.W.,Kim,, Y.M.,Kim,, Y.H.,Kim,, Y.H.,Kim,, J.M. 대한기관식도과학회 2004 大韓氣管食道科學會誌 Vol.10 No.2

Background and objective : Rabeprazole is a new generation proton pump inhibitor, which has a rapid onset after first dose, predictable efficacy in all patients regardless of CYP2C19 genotype status, and less nocturnal acid breakthrough. The aim of the study is to investigate clinical efficacy and safety of rabeprazole sodium (Pariet 10mg qd)when administered once daily to patients with laryngopharyngeal reflux(LPR) disease. Methods : Among the patients who had visited the Department of Otolaryngology, those with LPR symptoms, had undergone laryngoscopy. Symptoms and endoscopic laryngeal sings were recorded initially, at 1 month, 2 months, 3 months, and more than 3 months, All patients were evaluated for clinical efficacy on the basis of symptom scores, reflux finding score(RFS), and side effects. Results : In general, most symptom scores and RFS improved over the time. Efficacy of the Pariet on LPR-related symptoms were $63.2\%,\;77.5\%,\;78.7\%,\;and\;90.9\%$ before 4 weeks, 4 to 8 weeks, 8 to 12 weeks, and after 12 weeks respectively. Efficacy on the RFS were $61.8\%,\;78.4\%,\;82.9\%,\;and\;85.5\%$ before 4 weeks, 4 to 8 weeks, 8 to 12 weeks, and after 12 weeks respectively. Pariet was well tolerated and was associated with few drug-related side effects. Conclusion Because of its efficacy and safety, Pariet may prove to be an alternative to currently available proton pump inhibitors.

사이버 메디컬 시스템에 대하여

김장묵,Kim, Jang-Muk 한국가톨릭의료협회 2001 한국가톨릭병원협회지 Vol.31 No.-

이하선 상피-근상피 암종 1예

강기훈,김장묵,송태현,차영진,Kang, Ki-Hoon,Kim, Chang-Muk,Song, Tae-Hyun,Cha, Young-Jin 대한기관식도과학회 2000 大韓氣管食道科學會誌 Vol.6 No.1

Epithelial-myoepithelial carcinoma(EMC) is a rare low grade malignant salivary gland neoplasm that most commonly occurs in the parotid gland but can also arise in minor salivary glands. It is a distinct neoplasm characterized by tubular and solid growth patterns and a dual cell population including an inner larger of cuboidal to columnar epithelial cells which are peripherally bounded by a layer of myoepithelial cells with distinctly clear cytoplasm. The clinical course is characterized by a high incidence of local recurrence and not infrequent distant metastasis. The differential diagnosis included acinic cell tumor, adenoid cystic carcinoma, mucoepidermoid carcinoma, sebaceous carcinoma and pleomorphic adenoma. We report a case of EMC of left parotid gland in a 55-year-old woman.

한국형 직장인 신체활동실천모형 개발을 위한 기초연구

장채욱(Jang, Chae-Ouk),김장묵(Kim, Jang-Mook),김도진(Kim, Do-Jin) 한국체육과학회 2016 한국체육과학회지 Vol.25 No.6

This is a basic research for Korean workers physical activity practices models and this research was conducted to examine the fitness of an integrated model, which applies the ecological theory, society, culture and environment to the theory of planned behavior that is based on the social cognitive theory. It was revealed that the integrated model that applies the ecological theory, society, culture and environment to the theory of planned behavior that is based on the social cognitive theory, explained physical activity promotion and regular exercise participation process more properly.

사례연구 : 사례연구를 통한 소송이외의 의료분쟁 해결방안의 검토와 개선방안

강의성 ( Eui Sung Kang ),김장묵 ( Jang Mook Kim ),성동효 ( Dong Hyo Sung ),목남희 ( Nam Hee Mok ) 한국병원경영학회 2013 병원경영학회지 Vol.18 No.3

Medical litigation, as a method of resolving medical disputes, has been a huge burden on both the patient and medical institution as it is both costly and time-consuming. The Korea Medical Dispute Mediation and Arbitration Agency has created a dispute mediation process as a method of alternative dispute resolution(ADR). Being in its early stage of implementation, there are still areas requiring improvement as some functions overlap with the Korea Consumer Agency`s damage redress and mediation process. This study examines the problems of existing practices in medical litigation while reviewing the mediation process of the two agencies from legal/administrative aspects, and provides an in-depth analysis of the situation through case studies and interviews. While the Korea Medical Dispute Mediation and Arbitration Agency offers many advantages in resolving medical disputes, there must be a distinct division of roles and mutual cooperation with the Korea Consumer Agency. Considering the increasing amount of compensation in medical disputes, medical professionals are being requested to carry medical malpractice insurance. However, this has yet to become a general trend in the medical field despite the growing social demand. As such, the coverage of medical malpractice insurance should be expanded to prevent medical accidents from escalating into medical disputes, thus acting as a social safety net. This study seeks to examine the methods of medical dispute resolution and to allow institutional provisions to reduce the social costs arising from such disputes.

대용량 전력변환용 사이리스터 디지털 점호제어

이영복(Y.B. Lee),김장묵(J.M. Kim),임익헌(I.H. Lim),류호선(H.S. Ryu),송승호(S.H. Song) 전력전자학회 2003 전력전자학술대회 논문집 Vol.2003 No.7(2)

The conventional analog-based firing circuit can be Implemented by comparing a linearly decreasing periodic sawtooth waveform synchronized to the ac line, With a voltage corresponding to the desired converter delay angle This circuit requires a large number of components (resistance and capacitor) and careful adjustment of the synchronization circuity in tills paper a novel firing circuit is proposed for thyristor switch is elements The proposed circuit is Implemented on the basis of the analog cosine method using FPGA and microprocessor<br/>

병원근로자의 조직시민행동과 조직효과성 관계 연구

김성호 ( Sung Ho Kim ),김장묵 ( Jang Mook Kim ),서영준 ( Young Joon Seo ) 한국보건행정학회 2014 보건행정학회지 Vol.24 No.2

Background: The organizational citizenship behavior is generally known as the important factor relevant to the organizational effectiveness. This research examined the mediating effect of the organizational citizenship behavior of hospital employees on the organizational effectiveness. Methods: Data were collected from 1,112 employees located in city of Seoul, Kyunggi and Chungnam province through self-administered questionnaires. Collected data were analyzed using IBM SPSS ver. 20.0, frequency analysis, t-test, analysis of variance, regression analysis, and path analysis. The main findings of the study are as follows. Results: First, it was found that many characteristics variables of personality, job, and relationship together affected organizational citizenship behavior of hospital employees. Especially, the following variables of negative affectivity, desire for growth, job value, job significance, and job security were found to have significant effect on the organizational citizenship behavior of hospital employees. Second, the results of path analysis showed that, through the mediating effect of organizational citizenship behavior, personality variables of positive and negative affectivity, and desire for growth, job characteristics variables of job value, job significance, and job security, and relationship variables of organizational support and task interdependence, had significant total effects on the level of job satisfaction of hospital employees. Conclusion: As a result, the organizational citizenship behavior seems to have both direct and indirect effects on the organizational effectiveness of hospital employees. Based on above findings, some theoretical and practical implications were discussed.