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DRG 지불제도가 재원일수와 퇴원 후 외래방문일수에 미치는 영향: 2004-2007년도 제왕절개술을 중심으로
손창우,정설희,이선주,권순만,Shon, Chang-Woo,Chung, Seol-Hee,Yi, Seon-Ju,Kwon, Soon-Man 대한예방의학회 2011 예방의학회지 Vol.44 No.1
Objectives: The purpose of this study was to examine the impact of Diagnosis-Related Group (DRG)-based payment on the length of stay and the number of outpatient visits after discharge in for patients who had undergone caesarean section. Methods: This study used the health insurance data of the patients in health care facilities that were paid by the Fee-For-Service (FFS) in 2001-2004, but they participated in the DRG payment system in 2005-2007. In order to examine the net effects of DRG payment, the Difference-In-Differences (DID) method was adopted to observe the difference in health care utilization before and after the participation in the DRG payment system. The dependent variables of the regression model were the length of stay and number of outpatient visits after discharge, and the explanatory variables included the characteristics of the patients and the health care facilities. Results: The length of stay in DRG-paid health care facilities was greater than that in the FFS-paid ones. Yet, DRG payment has no statistically significant effect on the number of outpatient visits after discharge. Conclusions: The results of this study that DRG payment was not effective in reducing the length of stay can be related to the nature of voluntary participation in the DRG system. Only those health care facilities that are already efficient in terms of the length of stay or that can benefit from the DRG payment may decide to participate in the program.
GIS 공간분석을 활용한 도시거주자 비만에 영향을 미치는 신체활동 및 식품 환경 연구
손창우,윤난희 알코올과 건강행동학회 2021 알코올과 건강행동연구 Vol.22 No.1
Objectives: As the obesity rate has been increasing in Seoul, it is emphasized to make efforts for obesity prevention and management. The purpose of this study is to examine the effect of built environmental factors affecting the physical activity and dietary behaviors on obesity among the population in Seoul using GIS spatial analysis. Methods: GIS spatial analysis was conducted to identify the influence of built environmental factors affecting physical activity and dietary behaviors, and socioeconomic environmental factors on obesity. The data of 92,357 Seoul residents and their living environment were obtained from multiple sources and used. Results: After controlling age, sex, residential type, and officially assessed land and housing price of the study population, those who lived far from the subway station were more likely to be obese. Those who lived in the community with higher intersection density or lower steepness of the slope were more likely to be obese. In terms of the food environment, a significantly positive relationship was found between higher access to the high-calorie food and obesity. Conclusions: In order to effectively prevent and manage obesity, it is necessary to make a supportive environment to facilitate people’s healthy behaviors through multidisciplinary and multi-sectoral efforts.
손창우,장성희,장영주,서태일,Son, Chang-Woo,Jang, Sung-Hui,Jang, Young-Ju,Seo, Tae-Il 한국금형공학회 2015 한국금형공학회지 Vol.9 No.1
Recently, life expectancy increased in the development of medicine, the need for health has increased. Market for medical equipment is growing rapidly to an increase in the interest in health and aging worldwide. It is a device intended for ultra sensitive cleavage process of bone during joint replacement surgery on a technical advanced surgery, finishing, and hole. Domestic demand of the hand piece is a necessary condition on an ongoing basis. However, hand piece was made on the basis of the experience of many years in the country Japan, Germany, and the United States has spread to more than 90% domestic market. Feel the need for the development of the hand piece in the country, many companies are trying to in-house production hand piece. In an attempt to solve the problems with the hand piece of the present, in this paper, it was supposed to be a study of rechargeable hand piece to replace the existing pneumatic.
손창우,이헌재,유가량,신흥묵 한의병리학회 2005 동의생리병리학회지 Vol.19 No.3
This study was performed for the investigation of vasodilatory efficacy and its underlying mechanisms of Jagumhuan(JGH), a herbal remedy. JGH produced completely endothelium-dependent relaxation and relaxed phenylephrine(PE)-precontracted aorta in a concentration dependent manner. The magnitude of relaxation was greater in PE induced contraction than that of KCl, suggesting involvement of K+ channel in the relaxant effect. Both glibenclamide(10-5M), a KATP channel inhibitor and indometacin, a cyclooxygenase inhibitor, completely prevented this relaxation. The relaxation effects of JGH, involve in part the release of nitric oxide from the endothelium as pretreatment with L-NAME, an NOS inhibitor, and methylene blue, a cGMP inhibitor, attenuated the responses by 62% and 58%, respectively. In addition, nitrite was produced by JGH in human aortic smooth muscle cells and human umbilical vein endothelial cells. The relaxant effect of JGH was also inhibited by 55.41% by tetraethylammonium(TEA; 5mM), a KCa channel inhibitor. In the absence of extracellular Ca2+, pre-incubation of the aortic rings with JGH significantly reduced the contraction by PE, suggesting that the relaxant action of the JGH includes inhibition of Ca2+ release from intracellular stores. These results indicate that in rat thoracic aorta, JGH may induce vasodilation through ATP sensitive K+ channel activation by prostacyclin production. However, the relaxant effect of JGH may also mediated in part by NO pathways and Ca2+ activated K+ channel.