국내외 치과 의료수가 비교현황

류재인(Jae-In Ryu),김철신(Chul-Shin Kim),정세환(Se-Hwan Jung),신보미(Bo-Mi Shin4) 대한치과의사협회 2015 대한치과의사협회지 Vol.53 No.4

The price for health service are decided by very complicated process because many of factors are related with them. The RBRVS(resource-based relative value scale) were used to calculate the Korean health service fees including dental fees. This study aimed to compare dental fees of Korea with other countries, such as Japan, Germany, and the US for evaluating the adequacy. Dental fees were categorized as oral evaluation and imaging, dental treatment including restorative, periodontal, and surgical work, and preventive treatment and compared by each country. The official documents about dental fees were collected from Korea, Japan, Germany, and the US. Each fee was presented as their own currency at first. Then they were converted into Korean won (KRW) by applying the market exchange rates at a specific point of time. Finally the fees were adjusted by purchasing power parities (PPPs) which equalize the different currencies. In general, the level of Korean fees were markedly low compared to those of Japan, Germany, and the US. German fees were similar or higher than that of Japan, and the US. The Korean fees were lower than three other countries 1.2~4.1 times for oral evaluation and 2.2~7.3 times lower for panoramic radiography. The endodontic fees of Japan, Germany, and the US were higher 1.8~15.3 times and 4.0~35.9 times for the deciduous teeth extraction compared to the Korean. In Japan the prophylaxis was 3.2 times more priced than the Korean fee. Exceptionally, the fees for re-evaluation, amalgam filling, and scaling were lower priced in Japan than other countries. This study has limitations on the items in definition and contents of dental practices units which were not exactly comparable and differently determined by countries. However, this study is meaningful because it surveyed the price levels to compare four different countries and then applied PPPs adjustment. This finding can be used to develop the dental RBRVs of Korean national health insurance and will contribute to improving the payment systems of health care.

임상치과 영역 교과목 분석을 통한 통합교육과정에 대한 고찰 : 한국, 일본 일부 치위생학과 사례를 중심으로

신보미 ( Bo-mi Shin ),배수명 ( Soo-myoung Bae ),신선정 ( Sun-jung Shin ) 한국치위생학회(구 한국치위생교육학회) 2019 한국치위생학회지 Vol.19 No.3

The purpose of this study is to analyze the clinical dentistry curriculum in Korea and Japan in order to review the application of integrated curriculum in the field. We collected the clinical dentistry syllabi for 2015-16 of the department of dental hygiene of Korea G University and Japan N University. Using the data from Korea, items that were duplicated and integrated were classified by the subjects covered in clinical dentistry. In addition, through case studies conducted in Korea and Japan, we analyzed and compared the credits, class hours, teaching methods, and evaluation methods, by subject. In Korea the total class hours in clinical dentistry, including clinical practice, was 1,095, and in Japan it was 1,104. In Korea, the syllabus covered by each department consisted of about 200 hours centering on theoretical lectures. In Japan, the integrated form of clinical dentistry was taught, and the instructions included all the contents of clinical dental study and also problem-based learning for approximately 100 hours. To strengthen the competence of dental hygienists as professionals, who are actively involved in dental practice, it is necessary to integrate the education contents of segmented clinical dentistry from the perspective of dental hygiene. It is also important to apply teaching methods that can help students improve their ability to solve problems.

장마 시기 변동과 대기지수의 관계

신보미(Bo-mi Shin),이승호(Seung-ho Lee) 대한지리학회 2023 대한지리학회 학술대회논문집 Vol.2023 No.06

일개 치과내원 환자의 전신질환과 구강건강 간 연관성 및 관련 교육 필요성 인식에 영향을 미치는 요인

신보미(Bo-Mi Shin),최용금(Yong-Keum Choi),배수명(Soo-Myoung Bae),이효진(Hyo-Jin Lee) 한국콘텐츠학회 2018 한국콘텐츠학회논문지 Vol.18 No.8

본 연구에서는 A치과에 내원하는 환자 중 20-60세에 해당하는 환자 110명을 대상으로 설문조사를 통해 전신질환과 구강건강 간 연관성에 관한 인식 수준과 교육 현황을 파악하였고, 최종 분석에는 92명의 응답을 포함하였다. 연구대상자 중 두 건강상태의 연관성을 인식하고 있는 비율은 48.9%로 나타났다. 또한 연구대상자 중 39.1%는 전신질환과 구강건강의 연관성에 대한 교육을 받은 경험이 있는 것으로 나타났고, 68.5%는 교육이 필요한 것으로 인식하였다. 전신질환과 구강건강의 연관성과 교육 필요성 인식 수준과 관련된 요인을 확인하기 위하여, 로지스틱회귀분석을 실시한 결과 정기적으로 치과를 내원하는 경우 두 질환의 연관성을 인식할 가능성이 3.94배 높았고, 주관적 구강건강수준이 나쁜 경우 교육의 필요성을 인지할 가능성이 5.20배 높았으며, 과거 교육경험 여부는 두 질환의 연관성 인식 및 교육 필요성 인식 수준에 유의한 영향을 미치는 것으로 나타났다. 치과에 내원하는 환자들을 대상으로 치과의료전문가는 교육주체자로서 보다 체계적인 교육방식을 통하여 전신질환과 구강건강 간 연관성에 관한 교육을 필수적으로 수행해야 할 것이다. 이를 위해 치과의료전문가는 진료실 구강보건교육 매뉴얼 및 다양한 매체를 개발해야 하고, 효과적인 교육방법을 모색해야 한다. The purpose of this study was to assess the level of awareness regarding the relationship between systemic diseases and oral health and the importance of education related to this association among dental patients, as well as to identify factors that affect the awareness of the relationship and the perceived need for education. This study was conducted from June 2016 to February 2017. Subjects of this study included outpatients (20–60 years old) from a dental clinic, and only patients who agreed to the survey were included. A total of 110 subjects were included, but the final analysis was based on 92 questionnaires, excluding questionnaires that were inaccurate. Survey questionnaires were completed by self-report and face-to-face interviews with a dental hygienist. The questionnaires covered basic information, awareness of the association between general and oral health, and experience with, and need for education related to, this association. Among the subjects, 48.9% were aware of the association between systemic diseases and oral health. A total of 39.1% of subjects had received education regarding the relationship between systemic diseases and oral health. Subjects who visited dental clinics regularly were 3.94 times (95% confidence intervals [CI]: 1.21–12.84) more likely to be aware of the association between oral health and disease compared with subjects who made only irregular visits to dental clinics. In addition, experience or education was significantly associated with awareness of the relationship between oral health and disease (odds ratio [OR]: 4.64, 95% CI: 1.54 –13.93) and the need for education (OR: 3.98, 95% CI: 1.20–13.12). Thus, the dental professionals should provide education on the relationship between oral health and systemic disease in dental clinics to improve patients’ awareness and oral health behaviors. These results can be used to strengthen education in the dental clinic.

우리나라 성인의 직업 수준에 따른 구강건강불평등 현황

신보미 ( Bo Mi Shin ),배수명 ( Soo Myoung Bae ),유상희 ( Sang Hee Yoo ),신선정 ( Sun Jung Shin ) 한국치위생과학회 2016 치위생과학회지 Vol.16 No.3

본 연구는 한국 성인의 직업 수준에 따른 구강건강상태 및 행태의 현황을 확인하기 위하여 제4기 국민건강영양조사 자료를 이용하여 현재 경제활동을 하고 있다고 응답한19∼64세 성인 중 구강검사, 건강설문조사를 모두 완료한7,676명을 최종 연구대상으로 삼아, 직업계층, 종사상 지위 및 직업분류에 따른 구강건강수준 및 행태의 현황을 분석하여 다음과 같은 결론을 얻었다. 남녀 모두에서 직업계층에 따른 구강건강상태 및 행태의 유의미한 차이를 확인하였고, 특히 비육체직에 비해 육체직 종사자가 치아우식증 유병 위험도가 남자는 1.19배, 여자는 1.67배 높았고, 하루 3회 미만 칫솔질 실천 위험도가 남자는 1.83배, 여자는 2.39배 높았다(p<0.05). 종사상 지위에 따라 구강건강상태 및 행태에서 정규직 종사자에 비해 일용직 종사자의 불건강 위험도가 가장 높았고, 직업분류에 따른 치아우식 유병, 하루 3회미만 칫솔질 실천, 구강검진 미검진, 저작불편호소 위험도는 남자 및 여자 모두에서 관리자, 전문가 및 관련 종사자에 비해 농림어업 숙련종사자의 위험도가 가장 높았다(p<0.05). 근로자의 높은 구강질병 유병수준은 근로손실 및 경제손실을 초래할 수 있고, 이는 개인의 경제적 부담을 가중시킬 뿐아니라, 노년기의 구강건강문제를 심화시킬 수 있다. 직업관련 환경은 개인의 소득, 교육수준과 같은 사회경제적 위치와는 달리, 정부의 직접적인 규제 및 보호가 가능하며, 이로 인한 복지제도 및 환경의 변화는 개인의 삶에 직접적인 영향을 미칠 수 있다. 따라서 추후 노동시장의 변화와 다양한 고용 조건에 따라 구강건강문제를 지속적으로 모니터링하고, 직업군 또는 산업군 내 취약 계층을 발굴하며, 계층 간구강건강의 차이를 매개하는 관련 요인을 확인하여 미시적, 거시적 관점에서의 사업장 구강건강증진을 위한 전략 개발이 필요할 것으로 생각된다. The purpose of this study was to determine the oral health condition and behavioral status of Korean adults according to occupational status. The subjects were 7,676 adults, aged between 19 and 64 years, who completed both oral examination and questionnaire survey, among those who indicated that they were currently participating in economic activities, according to the data from the Fourth Korea National Health and Nutrition Examination Survey. Occupational class and employment status were selected as measures of occupational status. Complex-samples logistic regression models were used to assess the associations among oral health, behavioral, and occupational statuses. We found a significant occupational class-related difference in the oral health and behavioral statuses of both the men and women. In particular, the prevalence odds ratios of untreated dental caries in manual workers were 1.19 and 1.67 times higher than in non-manual workers, for men and women, respectively. As for oral health condition and behavioral status according to employment status, the health risk in temporary employment workers was higher than that in permanent employment workers. As for the prevalence odds ratios of the risk of dental caries, the highest values were observed for tooth brushing fewer than 3 times per day, not undergoing oral examinations, and chewing difficulty complaints. The risk of dental caries for agricultural, forestry, and fishing workers for both men and women was found to be the highest among other workers. Thus, strategies to promote workplace oral health in the microscopic and macroscopic perspectives should be developed to constantly monitor oral health problems, and to identify vulnerable social groups within occupational groups and the related factors that mediate oral health differences.

한국 노인의 자연치아 수와 영양소 섭취상태와의 관련성 -2007~2009년 국민건강영양조사 자료에 근거하여-

신보미 ( Bo Mi Shin ),배수명 ( Su Myoung Bae ),류다영 ( Da Young Ryu ),최용금 ( Yong Keum Choi ) 한국치위생학회 2012 한국치위생학회지 Vol.12 No.3

Objectives: The aim of this study was to evaluate the relation between the state of dental health (number of natural teeth) and nutritional status of Korean elderly using Korean Dietary Reference Intakes, which was an objective standard for nutritional intake based on database of Korea National Health and Nutrition Examination Survey, large scale of sample obtained by the government. Methods: Complex sampling procedure was used to analyze the fourth data (2007-2009) of Korea National Health and Nutrition Examination Survey. When preparing planning file, the estimator of variance as a stratification variance (variance name: kstrata), population of survey unit as a cluster variance (variance name: PSU), and previous exam and nutritional related weighted as a weighted were analyzed by considering reproduced survey and nutritional related total weighted. Complex samples chi-square test was used to estimate the relation between number of natural teeth and inadequate intake and relation factors included in the model were analyzed by complex samples logistic regression analysis. Results : The group of edentulous had a higher risk to intake less nutrient, except calcium, riboflavin and vitamin C than recommended level comparing to reference group which had natural teeth more than 20(phosphate : OR=1.763; 95% CI=1.273-2.443, thiamine : OR=1.748; 95% CI=1.276-2.395, protein: OR=1.610; 95% CI=1.213-2.138). Conclusions: The number of teeth in Korean elderly over 65 years old had a relation with nutritional status in this investigation. Especially, intake level of nutrients was different between the edentulous group and the reference group. Therefore, dental health care is needed from young and middle age to keep health dental condition for through whole life as well as old age. Although the dental condition of the aged is not good, it is evitable to educate them about the relation between dental health and nutritional ingestion to take balanced nutrition, we think.

한국인의 주관적 구강건강불평등 인식수준 및 관련 요인 분석

신보미 ( Bo Mi Shin ),정세환 ( Se Hwan Jung ) 대한예방치과·구강보건학회 2012 大韓口腔保健學會誌 Vol.36 No.3

Objectives: This study aimed to assess the socio-economic inequalities in the self-rated oral health status in the study group of South Koreans, as associated with other factors (health behaviors factors, psychological factors, and oral health status) on the social gradients in the self-rated oral health status. Methods: The cross-sectional data was from the Forth Korea National Health & Nutrition Examination Survey. Subjects were 18,886 people over the age of 6 years who participated in the health interview, dental examination, and dietary survey. They were divided into four groups according to their life course: children (6-11 years), adolescents (12-18 years), adults (19-64 years), and the elderly (65 years and older). The income and education level brackets were selected as measures of socio-economic position (SEP). The complex samples logistic regression models were used to analyze the data. To assess the association of the other factors, additional models (which adjusted for the gender, age, and each of the other factors) were compared to the initial model (which adjusted for the gender and age only). Results: We found that there were socio-economic differences in the self-rated oral health status at all stages of life, and that the differences were up sharply for the vulnerable social groups. Dental care utilization factors and the oral health status mainly affected the socio-economic inequalities of the poor self-rated oral health status group at all stages of life. Socio-eoconomic differences remained statistically significant in the models that controlled for all related factors except the models of household income in adults. Conclusions: There were socio-economic differences in the poor self-rated oral health status at all stages of life. But it is difficult to definitely confirm the pathway of socio-economic inequalities in the selfrated oral health status, because of the limitations of the cross sectional study and the use of restricted variables in this survey. Therefore more extensive longitudinal research is required to better address the pathways that explain the socio-economic inequalities in the self-rated oral health status throughout the life courses in the Republic of Korea.

한국 노인의 20개 이상 자연치아보유율 및 저작불편호소율에 따른 불평등 현황 및 관련요인 분석

신보미 ( Bo Mi Shin ),정세환 ( Se Hwan Jung ) 대한예방치과·구강보건학회 2012 大韓口腔保健學會誌 Vol.36 No.3

Objectives: This study aimed to assess socio-economic inequalities in subjects with 20 or more natural teeth and chewing difficulty in the Korean elderly, and to assess the association of health behavior factors, psychological factors, and oral health status on social gradients of subjects with tooth loss and chewing difficulty. Methods: Cross-sectional data were from the Fourth Korea National Health & Nutrition Examination Survey. Subjects were 3,598 people over the age of 65 years, who participated in a health interview, dental examination and dietary survey. Income status and educational status were selected as measures of socio-economic position (SEP). Logistic regression models were used to assess socio-economic inequalities of subjects with 20 or more natural teeth and chewing difficulty. To assess the association of related factors, a logistic model that was adjusted for each group of variables was compared to those that were not adjusted for it. Results: We found that there were socio-economic differences in subjects with 20 or more natural teeth and chewing difficulty in Korean elderly. The social gradient for subjects with 20 or more natural teeth and chewing difficulty persisted, after adjusting for different factors. While adjusting for oral hygiene factors and smoking factors attenuated the association between 20 or more natural teeth and SEP, adjusting for oral health status and psychological factors attenuated the association between chewing difficulty and SEP. Education status was a more apparent measure than income status, in socio-economic inequalities in oral health among the Korean elderly. Conclusions: Socio-economic inequalities in oral health among the Korean elderly might be important social problems. More extensive longitudinal research to confirm the pathways that explain oral health inequalities among the elderly is required, to develop effective intervention strategies to reduce socioeconomic differences in oral health among the Korean elderly.

강릉시 초등학교 6학년 아동의 스트레스와 구강보건행태 및 구강건강수준과의 연관성

신보미 ( Bo Mi Shin ) 대한예방치과·구강보건학회 2010 大韓口腔保健學會誌 Vol.34 No.3

Objectives. The objective of this study was to assess the association between stress, oral health knowledge, oral health behavior and oral health status among 6th grade primary school students in Gangneung city. Methods. A cross-sectional study design was used. The sample consisted of 643 students(341 male; 302 female). The data were collected from a self-reported questionnaire survey and from an oral examination approved by the Gangneung Office of Education. The questionnaire included information about stress, oral health knowledge, oral health behavior, oral symptoms and perceived oral health status. The presence of caries was investigated by a well-trained dentist. Data were analyzed by Mann-Whitney U analysis. Results. The level of stress among 6th grade primary school students was relatively low (1.85 out of 4). The level of stress was higher in students who had a lower frequency of brushing their teeth (p<0.05), a high frequency of ingesting sweets and carbonated beverages (p<0.01), experiences smoking (p<0.01) and bad perceived oral health status (p<0.001). Conclusions. The level of stress in school children affect their oral health behavior and status. However, it is difficult to generalize from the results because of limitations of the study. Therefore, more extensive research is required to more completely explain the influence of stress on oral health behavior and status in school children.

근대역사문화공간을 활용한 관광목적지의 사회적 책임(DSR)에 관한 연구-IPA를 활용하여-

신보미 ( Shin Bo-mi ),한주형 ( Han Ju-hyoung ) 동북아관광학회 2021 동북아관광연구 Vol.17 No.1

본 연구는 근대역사문화공간을 활용한 관광목적지의 사회적 책임(DSR)에 대하여 관광객의 인식을 바탕으로 평가하고자 한 연구이다. 전국 6개 근대역사문화공간을 방문했던 경험이 있는 관광객을 대상으로 설문조사를 실시하였고, DSR 활동에 대하여 중요도와 성취도 차이를 IPA를 활용하여 평가하였다. 연구결과를 요약하면 다음과 같다. 근대역사문화공간의 DSR활동에 대하여 관광객들은 전반적으로 중요도에 비해 성취도를 낮게 평가하는 것으로 나타났다. 또한 IPA결과, ‘유지 영역’에는 ‘지역경제 활성화’등의 경제적 책임과, ‘관광객의 권리 보호’ 등 법적 책임 속성이 포함되었고, ‘집중 영역’에는 ‘관광을 통한 고용창출’이 포함되었다. 또한, ‘저순위 영역’에는 ‘주민을 위한 기반시설 개선’ 등 사회적 책임 속성과 ‘효율적 에너지 사용’ 등 환경적 책임 속성들이 포함되었으며, ‘과잉 영역’에는 ‘관광으로 수익창출’과 ‘지역주민 존중’이 해당되었다. 본 연구를 통해 근대역사문화공간 관광지의 균형 있는 보존과 활용을 위한 시사점을 제시하였다. This study aims to evaluate the destination social responsibility (DSR) in a context of modern historical and cultural heritage sites based on tourists' perception. A survey was conducted on tourists visiting six heritage tourism destinations, and the importance-performace analysis (IPA) was applied to explore the differences for DSR activities. The followings are the results of the study. The level of performance of DSR activity in the heritage tourism destinations has been shown to be generally lower than the level of importance. As a result of the IPA, the quadrant of 'keep up the good work' included economic responsibilities such as 'boosting the local economy' and legal responsibility attributes such as 'protecting the rights of tourists', while the quadrant of 'concentrate here' included 'creating local employment through tourism'. In addition, the quadrant of "low-priority" included social responsibility attributes such as "improving infrastructure for residents" and environmental responsibility attributes such as "efficient use of energy," while the quadrant of "possible overkill" included "creating profits from tourism" and "respecting local residents." Through this study, we present suggestions for the balanced preservation and utilization of modern historical and cultural heritages.