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이주향 ( Juhyang Lee ) 한국보건경제정책학회 2022 보건경제와 정책연구 Vol.28 No.2
The purpose of this study is to empirically analyze the relationship between long-term care service use types and medical utilization for those who are certificated as long-term care insurance for the elderly over 65 years of age. We analyzed using the two-part model, and divided the long-term care service users into the home service use group, the facility service use group, and the non-use group, and examined their medical experience and medical use. As a result of the analysis, both the facility service use group and the home service use group showed negative(-) effects on the use of geriatric hospitals, and showed significant reduction in hospitalization costs and number of days in the geriatric hospitals. In particular, the reduction effect in the facility service use group was relatively greater than that of the home service use group, proving the substitution effect between geriatric hospitals and nursing facilities more clearly. Also, both the home service use group and the facility service use group showed a positive(+) relationship with acute hospital utilization, however, in both groups, the cost of hospitalization and the number of days of hospitalization showed a reduction effects. These results suggest that medical utilization and long-term care service affect medical expenses and medical accessibility, as substitutes or supplements to each other. Therefore, it is necessary to review the elderly health policy considering the cost of social insurance, including both health insurance and long-term care insurance, and health results for the elderly who have a desire for medical care and long term care services.
강하렴,Lee Juhyang 대한예방의학회 2023 예방의학회지 Vol.56 No.6
Objectives: This study investigated the relationship between prescribing institutions and medication adherence among patients newly diagnosed with hypertension and diabetes.Methods: This study investigated patients with new prescriptions for hypertension and diabetes in Korea in 2019 with using data collected from general health screenings. A multilevel logistic regression model was applied to explore the relationship between patients’ first prescribing institution and their medication adherence, defined as a medication possession ratio (MPR) over 80%.Results: The overall adherence rates were 53.7% and 56.0% among patients with hypertension and diabetes, respectively. The intraclass correlation coefficients were 13.2% for hypertension and 13.8% for diabetes (<i>p</i><0.001), implying that the first prescribing institution had a significant role in medication adherence. With clinics as the reference group, all other types of hospitals showed an odds ratio (OR) less than 1.00, with the lowest for tertiary hospitals (OR, 0.30 for hypertension; 0.45 for diabetes), and the next lowest in health screening specialized clinics (OR, 0.51 for hypertension; 0.46 for diabetes). Among individual-level variables, female sex, older age, higher insurance premium level, and residing in cities were positively associated with adherence in both the hypertension and diabetes samples.Conclusions: This study showed that the prescribing institution had a significant relationship with medication adherence. When the first prescribing institution was a clinic, newly diagnosed patients were more likely to adhere to their medication. These results highlight the important role played by primary care institutions in managing mild chronic diseases.
스펙트럼영역과 시간영역 빛간섭단층촬영기로 측정한 망막신경섬유층 두께 비교
이주향,송인석,김유정,차용재,엄기방,Juhyang Lee,MD,In Seok Song,MD,Yu-Jeong Kim,MD,Yong Jae Cha,MD,Ki Bang Uhm,MD,PhD 대한안과학회 2012 대한안과학회지 Vol.53 No.1
Purpose: To compare retinal nerve fiber layer (RNFL) thickness measured by time domain (Stratus) and spectral domain (3D) optical coherence tomography (OCT). Methods: Sixty-nine normal subjects and 92 glaucoma patients were included in the present study. Peripapillary RNFL thickness was measured with Stratus fast RNFL scan and 3D optic disc cube scan on the same day. The relationship between RNFL thickness measurements of the two OCTs were evaluated using a Pearson’s correlation analysis. A Bland-Altman plot was used for the comparison of Stratus-OCT and 3D-OCT. Results: In all subjects, average, superior, and inferior quadrant RNFL thicknesses measured by Stratus-OCT were thicker than those measured by 3D-OCT. In contrast, temporal and nasal quadrant RNFL thicknesses measured by 3D-OCT were thicker than those measured by Stratus-OCT. Although there were absolute value differences in RNFL thicknesses, high correlation was observed between Stratus-OCT and 3D-OCT (average: r = 0.897, temporal quadrant: r = 0.728, superior quadrant: r = 0.811, nasal quadrant: r = 0.678, and inferior quadrant: r = 0.905). Bland-Altman plots showed that Stratus-OCT values were greater than 3D-OCT values with relatively high RNFL thickness and the opposite with low RNFL thickness. Conclusions: For thicker RNFL, Stratus-OCT measurements tend to be greater than 3D-OCT, while for thinner RNFL, 3D-OCT measurements tend to be greater than Stratus-OCT. This difference must be taken into account if comparing measurements made with a Stratus-OCT to the measurements of a 3D-OCT. J Korean Ophthalmol Soc 2012;53(1):103-110
Vaginal leiomyoma in an adolescent woman
( Hyojin Kim ),( Taewon Jeong ),( Gyeongjin Kim ),( Yeongho Lee ),( Gyeonga Kim ),( Sanggi Hong ),( Sukyeong Beak ),( Jeongbeom Moon ),( Juhyang Lee ) 대한산부인과학회 2016 대한산부인과학회 학술대회 Vol.102 No.-
We report a case of vaginal wall leiomyoma in a young lady. Vaginal wall is a rare area that leiomyoma occurs which has reported approximately 300cases until now whose average age is 35~50years old. But, the patient we report is 18 years old adolescent women with sexually virgin. She presented first at local gynecology clinic with frequent(every two weeks) menstruation and for excluding organic causes rectal ultrasonography was done. Through ultrasonography, 3.5 cm sized vaginal wall mass was observed. The patient was referred to Jesus hospital gynecology clinic. Digital rectal examination was done and it is confirmed that there was no rectal mucosal invasion and there is no tenderness. To know the character of the mass and relationship with surrounding organs, MRI was done. The mass was probably seen leiomyoma and located in rectovaginal septum. The surgery was planned for the pathologic diagnosis and, because the patient was sexually virgin, the mass removal was done by rectovaginal approach. The patient was recovered without complications and final pathologic diagnosis was vaginal wall leiomyoma.
리바운드 안압계, 비접촉 안압계, 골드만 압평안압계의 비교 및 중심각막두께와의 상관성
이주향,성민철,강민호,조희윤,이윤정,Juhyang Lee,Mincheol Seong,Minho Kang,Heeyoon Cho,Yoonjung Lee 대한안과학회 2012 대한안과학회지 Vol.53 No.7
Purpose: To compare the level of accuracy of intraocular pressure (IOP) measurements of a rebound tonometer (RT) Icare?, and non-contact tonometer (NCT), using Goldmann Applanation tonometer (GAT) as a reference to evaluate the influence of central corneal thickness (CCT) on IOP readings in the Korean population. Methods: In a prospective study of 273 eyes, IOP was measured with RT, GAT, and NCT and compared to CCT measurements. Patients were assigned to one of 3 groups based on IOP measurements of GAT and 1 of 2 groups based on CCT. The comparison of the IOP values of RT, GAT, and NCT was performed between the IOP and CCT groups, and the differences among tonometers were evaluated. Results: The RT showed statistically significant correlation with the GAT compared to the NCT. The CCT was related to RT measurements. The RT values compared to the GAT was underestimated in thin corneas and overestimated in thick corneas. Conclusions: There was a significant correlation between the RT and the GAT measurements compared with the NCT. However, RT is influenced by CCT and correlates less with GAT in low IOP ranges, suggesting that corneal thickness should be taken into consideration during such measurements. J Korean Ophthalmol Soc 2012;53(7):988-995
한국과 일본 대학교 구성원의 그린캠퍼스 인식 비교 연구
구자건(Jakon Koo),조용일(Yongil Cho),이승용(Seungyong Lee),김주향(Juhyang Kim),정종철(Jong Chul Jeong),김용범(Yong-Bum Kim) 한국환경교육학회 2012 환경교육 Vol.25 No.2
Green campus means the environmentally-conscious universities that are trying to increase campus sustainability by reducing carbon emissions, expanding eco-friendly activities. This study was carried out to compare the recognition level on green campus between Korea and Japan universities. For investigating the recognition level of students and faculties on green campus, the questionnaire surveys were conducted by personal interviews in Korea and Japan, separately. The 40% and 68% respondents in Korean A and B universities, respectively, pointed out the energy issue as one of the serious environmental problems while the corresponding ratio among Japanese respondents was 44% and 34%. The participation intention for green campus movement in Japanese universities was higher than Korean universities. The 70% or 52% of Korean students in A and B universities, respectively, replied that they did not participate the green campus movement. It is needed to strengthen the educational program to achieve the sustainability of campus in Korea.