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외래진료 민감질환 유질환자 중 장애인과 비장애인의 의료이용률 차이
은상준,홍지영,이진용,이진석,김용익,신영수,김윤,Eun, Sang-Jun,Hong, Jee-Young,Lee, Jin-Yong,Lee, Jin-Seok,Kim, Yong-Ik,Shin, Young-Soo,Kim, Yoon 대한예방의학회 2006 예방의학회지 Vol.39 No.5
Objectives: The purpose of this study was to determine whether the disabled have worse access to primary care than the non-disabled. Methods: We used the National Disability Registry data and the National Health Insurance data for the calendar year 2003, and we analyzed 807,380 disabled persons who had been registered until December 2001 and we also analyzed 1,614,760 non-disabled persons for nine ambulatory care sensitive conditions (ACSCs). The rates of physician visits and hospitalizations for the patients with ACSCs were compared between the disabled and the nondisabled. Multiple logistic regression analysis was used to evaluate the association between medical care utilization and disability and to assess the association between hospitalization and the number of physician visits while controlling for potential confounders. Results: The numbers of physician visits per 100 patients were $0.78{\sim}0.97$ times lower for the disabled than that for the non-disabled with five of nine ACSCs. The numbers of hospitalizations per 100 patients were $1.16{\sim}1.77$ times higher for the disabled than that for the non-disabled with all the ACSCs. While the ORs of a physician visit for the disabled were significantly lower than that for the non-disabled with all the ACSCs (OR: $0.44{\sim}0.70$), and the ORs of hospitalization for the disabled were significantly higher (OR: $1.16{\sim}1.89$). The lower physician visit group (number of physician visits ${\leq}$1) was more likely to be hospitalized than the higher physician visit group (number of physician visits ${\geq}$2) (OR: $1.69{\sim}19.77$). The effect of the physician visit rate on hospitalization was larger than the effect of disability on hospitalization. Conclusions: The results suggest that the disabled were more likely to be hospitalized for ACSCs due to their lower access to primary care.
은상준,김윤,이은정,장원모,Eun, Sang Jun,Kim, Yoon,Lee, Eun Jung,Jang, Won Mo 한국의료질향상학회 2011 한국의료질향상학회지 Vol.17 No.1
Objectives : The purpose of this study was to determine whether the published AMI report card could reduce in-patient mortality, 7-day after discharge mortality, and length of stay (LOS). Methods : Interrupted time-series intervention analysis was used to evaluate the impact of the report card for AMI care quality in November 2005 in terms of risk-adjusted in-patient mortality, risk-adjusted 7-day after discharge mortality, and DRGs case-mix LOS using the claim data of Health Insurance Review and Assessment Service. Results : Public disclosure of AMI care quality decreased risk-adjusted in-patient mortality and DRGs case-mix LOS by 0.00050% per month and 0.042 days per month respectively, however there was no effect on risk-adjusted 7-day after discharge mortality. Patterns of effect of public disclosure on AMI outcomes were a fluctuating pattern on risk-adjusted mortalities and a pulse impact for 1 month on DRGs case-mix LOS. Conclusions : We found the public disclosure of AMI care quality had decreasing effects on risk-adjusted in-patient mortality and DRGs case-mix LOS, but the size of the effect was marginal.
은상준,박기동,김종균,임정수,황유성,김용익,이진용,Eun, Sang-Jun,Park, Ki-Dong,Kim, Jong-Kyun,Im, Jeong-Soo,Hwang, Yoo-Sung,Kim, Yong-Ik,Lee, Jin-Yong 대한예방의학회 2005 Journal of Preventive Medicine and Public Health Vol.38 No.4
Objectives : The biosafety level (BSL) practiced in microbiology laboratories in Korea according to the laboratory biosafety manual published by the World Health Organization (WHO) was evaluated using the data obtained by a survey. Methods : Under the advise of Clinical Laboratory Physicians, 144 types of microorganisms were screened based on the guidelines of biosafety in microbiological and biomedical laboratories published by the US Center for Disease Control and Prevention and classified into 1-4 risk groups. A questionnaire containing 21 questions in 5 areas was developed using the biosafety manual by published WHO. Of the 1,876 different organizations sent the survey, 563 responded to the survey (response rate: 30.0%). The species of microoganisms handled by as well as the biosafety level in microbiology laboratories were analyzed. Results : There were 123 species of microorganisms handled in microbiology labs in Korea. The BSL required in 512 microbiology labs was answered by the survey responders as the first grade in 33 labs (6.4%), 2nd in 437 (85.4%), 3rd in 42 (8.2%), and 4th in none. The average number of items satisfied was 12.2, showing only a 57.9% satisfactory rate and normal distribution. Conclusions : The state of overall observance of BSL in most microbiology labs of Korea was evaluated as lagging compared with the standard set up by WHO. Therefore, the Korean government need to produce and distribute a biosafety manual in microbiology laboratories and make efforts to prevent this threat through measures such as training in biosafety in microbiology labs.
행정중심복합도시 금빛노을교 및 5생활권 외곽순환도로 설계사례
은상준(Sangjoon Eun),김명우(Myoungwoo Kim),박창규(Changkyu Park),심상철(Sangchul Sim),김종학(Jonghak Kim),손창호(Changho Sohn) 대한토목학회 2018 대한토목학회지 Vol.66 No.8
본 사업은 행정중심복합도시를 경유하는 지역간 통과교통을 5생활권 외곽순환도로를 통해 직접 연결함으로써 환상형 외곽순환도로의 교통을 원활히 하는데 그 목적이 있으며, 이를 위해 교량 1개소, 지하차도 1개소, 터널 1개소, 생태통로 2개소, 교차로 1개소를 포함한 총 연장 5.4km, 왕복 6차로의 외곽순환도로를 건설하는 프로젝트이다. 행정중심복합도시 내 주요 장대교량은 도시구조물 미관기준에 의거 각 생활권별로 특색 있는 도시의 상징물이 되도록 계획하고 있다. 그 중 금강을 횡단하는 금빛노을교는 내부순환도로 아람찬교(금강4교)의 배경교량으로서 교면상 돌출되는 구조물의 높이비가 0.5 이하로 제한되는 요구조건에 부합하고 주변경관과 조화를 이루는 기능성과 독창성이 뛰어난 주경간장 175m의 하이브리드 아치교로 계획하였다. 또한 5생활권을 관통하는 외곽순환도로는 5생활권 내 소음저감을 위하여 총연장 3,835m(터널포함)의 장대 지하도로로 계획하였으며, 장대 지하도로의 특성을 감안하여 운전자의 폐쇄공포감 해소를 위한 썬큰 설치, 주행차량의 안전을 고려한 비상대피공간 확보 및 친환경 지능형 환기방재시스템 등을 도입하였다.
감차적분을 이용한 Mindlin평판의 解析에 關한 硏究
이우현,김철우,전준태,은상준 중앙대학교 기술과학연구소 1994 기술과학연구소 논문집 Vol.24 No.-
In plate analysis, thin plate theory-which neglects the effect of shear deformation-is popular in most case. But the plate thickness is deeper and deeper the results of thin plate theory are worse. This is the reason that as thickness is increased the effect of shear deformation is important. And so this case mindlin plate theory gives good results but it is not good at thin plate. In this research, using reduced integration method-in most cases full integral method is used for every Gaussian point-determine the thin plate and for numerical method Finite Strip Method is used.