건강보험 청구자료를 이용한 우리나라 뇌졸증 환자의 사회경제적 비용 추계

임승지,김한중,남정모,장후선,장영화,김세라,강혜영,Lim, Seung-Ji,Kim, Han-Joong,Nam, Chung-Mo,Chang, Hoo-Sun,Jang, Young-Hwa,Kim, Se-Ra,Kang, Hye-Young 대한예방의학회 2009 예방의학회지 Vol.42 No.4

Objectives : To estimate the annual socioeconomic costs of stroke in Korea in 2005 from a societal perspective. Methods : We identified those 20 years or older who had at least one national health insurance (NHI) claims record with a primary or a secondary diagnosis of stroke (ICD-10 codes: I60-I69, G45) in 2005. Direct medical costs of the stroke were measured from the NHI claims records. Direct non-medical costs were estimated as transportation costs incurred when visiting the hospitals. Indirect costs were defined as patients and caregivers productivity loss associated with office visits or hospitalization. Also, the costs of productivity loss due to premature death from stroke were calculated. Results : A total of 882,143 stroke patients were identified with prevalence for treatment of stroke at 2.44%. The total cost for the treatment of stroke in the nation was estimated to be 3,737 billion Korean won (KRW) which included direct costs at 1,130 billion KRW and indirect costs at 2,606 billion KRW. The per-capita cost of stroke was 3 million KRW for men and 2 million KRW for women. The total national spending for hemorrhagic and ischemic stroke was 1,323 billion KRW and 1,553 billion KRW, respectively, which together consisted of 77.0% of the total cost for stroke. Costs per patient for hemorrhagic and ischemic stroke were estimated at 6 million KRW and 2 million KRW, respectively. Conclusions : Stroke is a leading public health problem in Korea in terms of the economic burden. The indirect costs were identified as the largest component of the overall cost.

초순수 플랜트의 압력제어 밸브-유량계-압력계를 활용한 이상진단 기술

임승지 ( Lim Seung Ji ),김지혜 ( Kim Jihye ),권병수 ( Kwon Boungsu ),탁세완 ( Tac Se Wyan ),이경혁 ( Lee Kyung-hyuk ) 한국물환경학회 2024 한국물환경학회·대한상하수도학회 공동 춘계학술발표회 Vol.2024 No.-

한국의 공적 상병수당제도 도입논의를 위한 보장기준설계 및 소요재정 분석

임승지(Lim Seung-ji),이용갑(Lee Yong-Gab),김나영(Kim Na-young) 한국보건사회학회 2020 보건과 사회과학 Vol.0 No.54

OECD 36개 회원국 중에서 우리나라와 미국에만 없는 상병수당제도는 건강보장체계 내에서 근로자의 상병으로 인한 근로능력상실에 대해 소득을 보장하는 공적 사회보장제도이다. 이 연구에서는OECD 36개국의 상병수당제도 보장내용을 비교분석해 우리나라에 도입 가능한 모형을 설계하였으며, 모형별 대상자수 및 소요재정을 추계하였다. 2018년 기준, 건강보험공단 전국민 자격 및 진료비청구 자료와 국세청 소득 자료를 연계해 분석한 결과, 15세 이상 소득근로자 2,124만 명 중에서 3일을 초과해 병원급 이상 요양기관에 입·내원한 165만 명에게 보장수준에 따른 제도모형별 최소8,055억 원에서 최대 1조 7,718억 원의 재정이 소요될 것으로 추계되었다. 이 연구는 우리나라 상병수당제도 도입논의를 위한 정책결정의 근거자료가 될 것으로 기대한다. Sickness benefit, neither Korea nor United State does not have among the 36 OECD countries, is a public social security system that guarantees income for the loss of workers’ ability to work due to injury or disease. In this study, we design the models for sickness benefit that could be introduced to Korea by comparing and analyzing the system of sickness benefit in OECD countries and estimate the number of people eligible and the budget required for each model. The results of analysis using the data of insurance eligibility, medical expenses, and tax service is that the requirement of public finance for the sickness benefit will cost at least 805billion won to 1.77trillion won depending on the level of guarantee to 1.65million people who are over 15 and have been hospitalized over 3 days. The study is expected to serve as the basis for the political decisions for the introduction of sickness benefit scheme in Korea.

머신러닝 기법을 이용한 활성 슬러지 공정 내 미량오염물질의 그룹별 대표물질 선정 및 흡착계수와 생분해 반응상수 추정

임승지(Seung Ji Lim),Mingizem Gashaw Seid,Wondesen Workneh Ejerssa,채성호(Sung Ho Chae),손문(Moon Son),홍석원(Seok Won Hong) 대한환경공학회 2022 대한환경공학회 학술발표논문집 Vol.2022 No.11

준지도 학습 기법을 이용한 미량오염물질의 그룹화 및 대표물질 도출 연구 : 물리화학적 및 생물학적 제거 특성 기반

임승지(Seung Ji Lim),홍석원(Seok Won Hong),서장원(Jangwon Seo),이지호(Jiho Lee),Mingizem Gashaw Seid 대한환경공학회 2021 대한환경공학회 학술발표논문집 Vol.2021 No.11

시간교환법과 시각화척도 방법을 이용한 폐경 후 에스트로겐 결핍증에 대한 효용 측정

임승지 ( Seung Ji Lim ),강혜영 ( Hye Young Kang ),강영주 ( Young Ju Kang ),이병석 ( Byung Seok Lee ),박형무 ( Hyoung Moo Park ),신동혁 ( Dong Hyeok Shin ) 한국보건행정학회 2007 보건행정학회지 Vol.17 No.4

The present study was conducted to measure health-related utility for post-menopausal symptoms among Korean woman. A survey questionnaire was developed to measure utility based on visual analogue scale(VAS) and time trade-off method (TTO). From January 29 to February 3, 2007, a face-ta-face interview was conducted with 274 women aged 45 to 60 to ask about their subjective utihty for hypothetical health status of mild or severe post-mencpausal symptoms, Among the participants, 160 were recruited from outpatient departments of 3 hospitals and 114 from 2 sports centers located in Seoul, For mild symptom, the average utility score of the respondents was 0.63±0.l4 based on VAS and 0,61±0,26 based on TTO, For severe symptoms, the average utility was 0.39±0.16 (VAS) and 0.44±0,27 (TTO). For severe symptom, a higher utility score was observed for TTO than for VAS, which is consistent with earlier studies and thus supports the validity of the utility measurement in this study. Overall, the severity of post-mencpausal symptoms of the respondents themselves was not significantly associated with the utility score that the respondents answered for hypothetical health status, Multiple regression analysis results showed that the utility score was significantly higher among respondents with older age, higher education, higher family income, and from hospitals. It is expected that the utility score measured in this study will enhance the understanding of the quality of life of women after menopause and will be used to conduct cost-utility analysis of health care interventions to treat post-menopausal symptoms.

극지해역 운항선박기준의 적용상 한계 및 개선방안

임승지(Seung Ji Lim),이윤철(Yun Cheol Lee) 한국해사법학회 2017 해사법연구 Vol.29 No.2

기상이후현상으로 인하여 극지해역을 둘러싸고 있던 해빙이 감소되었고, 항로단축과 자원의 개발 그리고 신사업 등의 극지해역이 지닌 경제적 이점으로 인하여 극지해역으로의 선박 유입량이 증가하게 되었다. 하지만 그동안 극지해역을 운항하는 선박의 안전과 해양환경보호를 위해 존재하였던 국제규범은 상세하지 못하였으며, 법적강제력을 지니지 못한다는 한계를 지녔다. 그러므로 이를 해결한 국제규범이 필요하다는 국제사회의 합의가 도출되었다. 이에따라 국제해사기구(IMO)의 해사안전위원회(MSC)와 해양환경보호위원회(MEPC)를 중심으로 ‘극지해역 운항선박기준(Polar Code)’이 제정되었고, 이는 2017년 1월 1일부로 발효되었다. 극지해역 운항선박기준(Polar Code)은 극지해역의 특수성을 반영한 최초의 상세규범이자 법적강제력을 지닌 강행규범으로서 가치를 지닌다. 극지해역 운항선박기준(Polar Code)의 내용적 구성은 안전조치를 위한 PART I과 오염방지조치를 위한 PART II로 이루어져있으며, 구조적 구성은 각 PART 별로 강행규범인 A편과 권고규범인 B편으로 이루어져있다. 그러므로 이 논문에서는 극지해역 운항선박기준(Polar Code)이 지니는 중요성을 인식한 채, 안전부문, 보안부문, 해양환경보호부문으로 나누어 기준을 면밀히 분석하도록 할 것이다. 이에 따라 극지해역의 특수성을 잘 반영하였는지, 극지해역의 안전과 환경보호라는 목적의 실효성을 충실히 수행할 수 있는지를 중점적으로 살펴볼 것이다. 또한 이러한 과정 속에서 극지해역 운항선박기준 (Polar Code)이 지니는 한계점을 살펴보도록 할 것이다. 극지해역으로의 선박유입량이 점차 증가할 것임을 고려할 때, 극지해역의 선박안전과 환경보호에 대한 국제규범이 지니는 중요성 또한 점차 높아질 것으로 사료된다. 따라서 앞에서 살펴본 한계점을 보완할 수 있는 개선방안을 제시하도록 할 것이다. Global warming is bringing rapid change to the Arctic. The melting of sea ice and glaciers is increasing faster than predicted. Consequently, the number of ships operating in the Arctic Ocean has increased because of the accessibility to the Arctic Ocean and the efficiency from shortening of the sea route. As a result, the interest of the international community in the safety of marine vessels operating in polar waters and the protection of the polar marine environment has begun to be shared. As a result, Maritime Safety Committee at its 94 session adopted the safety-related provisions of the introduction and the whole of parts I-A and I-B of the International Code for Ships Operating in Polar Waters(POLAR CODE), by which it adopted, the new chapter XIV(Safety Measures for Ships Operating in Polar Waters) of International Convention for the Safety of Life at Sea(SOLAS) to make use the provisions of the International Code for Ships Operating in Polar Waters mandatory. Also, Marine Environment Protection Committee at its 68 session adopted the environment related provisions of the introduction, the parts II-A and II-B of the Code and the associated amendments to International Convention for the Prevention of Marine Pollution from Ships(MARPOL) Annexes I(Prevention of Pollution by Oil), II(Control of Pollution by Noxious Liquid Substances in Bulk), IV(Prevention of Pollution by Sewage) and V(Prevention of Pollution by Garbage). Therefore, this paper will review the background of enactment, main contents, legal status and development trends of Polar Code. In addition, the goal of this paper is to identify and analyze the core of standards related to Marine Safety, Marine Security and the Protection of marine environment of Polar Code. Moreover, this paper will draw the limitations of Polar Code, and suggest desirable improvement measures for those limitations related Marine Safety, Marine Security and Marine environment.

외국의 상병수당제도에 관한 비교 연구

임승지 ( Lim Seung-ji ),이용갑 ( Lee Yong-gab ),이정면 ( Lee Jung-myun ) 한국보건사회연구원 2021 保健社會硏究 Vol.41 No.1

국제기구의 권고에 따라 많은 국가들이 상병수당제도를 운영하고 있으나 우리나라는 여전히 도입하지 않고 있다. 코로나19의 여파로 최근 상병수당제도 도입의 필요성이 더욱 커지고 있는 상황에서, 보다 진일보한 근거기반 논의를 위해 우리나라보다 앞서 상병수당제도를 도입·시행하고 있는 국가들을 대상으로 상병수당제도의 유형과 내용을 보다 정확히 파악할 필요가 있다. 본 연구는 보다 광범위한 국제비교를 통해 우리나라에 적합한 제도유형을 탐색하고자 ISSA 및 OECD 회원국 전체의 의료보장 및 상병수당제도에 대한 비교 분석을 시도했다. 연구 결과, 의료보장제도의 사회보장유형에 관계없이 상병수당제도는 대부분 사회보험방식을 채택하고 있었으며, 건강보험 운영주체가 건강보험료의 일부 혹은 별도의 상병수당보험료로 상병수당을 운영하는 국가가 가장 많았다. 보험료로 상병수당을 운영한다고 하더라도 ILO 기준에 따라 상병수당지출의 50% 이상을 정부와 고용주가 부담하고 있었다. 또한 대상자는 대부분의 국가가 직장과 지역을 포함한 모든 근로자를 대상으로 운영하되, 직장근로자의 경우 법정유급휴가를 우선 적용하고 있었다. 상병수당제도의 보장기간은 국가별로 다양했으나 장애연금 수급전 최대 180일 또는 360일 보장이 가장 많았으며, 보장수준은 소득의 50%~70% 수준의 ILO 권고기준을 준용하고 있었다. 본 연구는 상병수당제도 도입논의 과정에서 대상자 규모 및 보장수준 설계의 기초자료로 활용될 수 있기를 기대한다. In accordance with the recommendations of international organizations, most ISSA member countries have put in placesickness benefit programs, with Korea being an exception. The need for sickness benefits has grown since the eruption of the COVID-19 pandemic. This study compared health insurance systems and sickness benefit programs in all ISSA and OECD member countries, with a view to proposing a sickness benefit model suitable for Korea. Regardless of the type of their health insurance, most countries have in place sickness benefits that are provided through a contributory social insurance scheme―either a health insurance scheme or a separate sickness insurance program. Even in the case of a contributory sickness benefit scheme, the government and the employer are expected to pay, in accordance with ILO standards, more than 50% of benefit expenditures. In addition, most of the sickness benefit schemes cover all workers including the self-employed, while in paid sick leave programs in most countries, the priority is given to employees. Although the period of the sickness benefit varied across countries, the maximum period was 180 days or 360 days before receiving the pension, and the level of coverage was based on the ILO recommendation (50% to 70% of income).

한국인의 사회경제적 불평등에 따른 주관적 건강수준의 차이와 건강행태 기여요인 분석

김민경,정우진,임승지,윤수진,이자경,김은경,고난주,Kim, Min-Kyung,Chung, Woo-Jin,Lim, Seung-Ji,Yoon, Soo-Jin,Lee, Ja-Kyoung,Kim, Eun-Kyung,Ko, Lan-Ju 대한예방의학회 2010 예방의학회지 Vol.43 No.1

Objectives: The study is investigated socioeconomic variations in self-rated health status and contribution of health behavioral factors in Korea. Methods: A nationally representative sample (2,800 men and 3,230 women aged 20-64 years) from the 2005 Korea National Health and Nutrition Surveys was analyzed using logistic regression. Results: Self-rated health was lower among lower socioeconomic groups compared with higher socioeconomic groups, with gender being irrelevant. This association was attenuated when health behavioral and socio-demographic factors were adjusted. When each health behavioral factor was considered separately, mediators such as smoking in men, and stress or exercise in women explained a large part of the decreased socioeconomic health inequalities. Conclusions: In Korea, subjective health inequalities arise from different socioeconomic status, but this difference is decreased by health behavioral factors. Therefore, socioeconomic inequity in self-rated health status can be corrected more effectively by promotional health behaviors.

제2형 당뇨병 환자의 혈당 비조절 관련 요인분석: 국민건강영양조사(2010-2012) 자료이용

박진현 ( Jin Hyun Park ),임승지 ( Seung Ji Lim ),임은실 ( Eun Shil Yim ),김영대 ( Young Dae Kim ),정우진 ( Woo Jin Chung ) 한국보건행정학회 2016 보건행정학회지 Vol.26 No.2

Background: Glycemic control is an effective way to reduce the cardiovascular complications of diabetes, but more than half of the adults with diabetes in Korea are improperly controlling their glycemic levels. The purpose of this study is to identify the factors associated with poor glycemic control in type 2 diabetes patients. Methods: This study analyzed 1,261 subjects ≥30 years old diagnosed with type 2 diabetes who participated in the fifth Korean National Health and Nutrition Examination Survey (2010-2012). Poor glycemic control rates were defined as hemoglobin A1c (HbA1c) level ≥7%. To shed light on the causes of poor glycemic control, socio-demographics, diabetes severity, health status, and health behavior factors were adjusted and logistic regression was done. Results: Of the total 1,261 patients, 53.0% of patients with type 2 diabetes had HbA1c ≥7%. After running a logistic regression model, the odds ratio of poor glycemic control was higher in high school graduates than elementary school graduates; in people living in Chungcheong and Jeolla/Jeju than those living in Seoul; in the group with diabetes for over 5 years had diabetes less than 5 years; in a group with insulin and oral hypoglycemic agent treatment than non-treatment; in a group with hypertriglyceridemia than without hypertriglyceridemia; and in the group with slept less than 6 hours slept 7-8 hours. Conclusion: We need a comprehensive public health policy to reduce the poor glycemic control rates in type 2 diabetes patients. We should recognize the education levels, duration of diabetes, diabetes treatment, hypertriglyceridemia, and sleep duration were associated with poor glycemic control.