대한군진의학 학술지 분석을 통한 군진의학 연구 동향

하범만 ( Ha Beom Man ),최진석 ( Choi Jin Seok ) 국군의무사령부 2010 대한군진의학학술지 Vol.41 No.1

Objective : This study was conducted to examine research trends of military medicine in Korea. Methods : The data were collected from 703 theses published in 40 volumes of the journal of the korean military medical association(below KMMA) from 1961 to 2009. Results : As time goes by, the aspect of published papers getting increases as 160, 149, 185, and 209 theses. The status of main researcher is 86.1% of officer, 42.7% of medical doctor by branch, 46.8% of the army by the armed forces. Then it has showed inclination which social position and is various as time passes. In addition, the average authors are 2.64 per one thesis, and 1.33 organizations joined study; it tends to continuously increase those participation. 75.8% of theses includes abstract, 6.5% have key words, and its average key word is 1.8 per each dissertation. Study design takes 65% for descriptive study, 23.2% for experiment study, and 11.8% of review; experiment study has shown tendency to decrease as year passes. Using statistics at study, descriptive statistics are much, but the frequency of using inferential statistics and advanced statistics is much increased as year passes. For the object of study, patients are the most by 33.4%, it is 15.5% of the pilots and special workers. The scale of subject person is below 50 which is 34%, but it has also large-scale study which is over 500 subject people by 14.9%. Specialties of study takes 78.1% for clinical and 21.9% for non-clinical. The way to collect data is following rank: measurement(35%), questionnaire(19.5%), observation and evaluation(17.6%), investigation of medical record(14.9%) The places for gaining source are from not hospital but local-community which is 64.7% with 461 theses, and hospital is 33.4% with 238 pieces. Also, the average number of reference documents is 17.9 for one thesis. Conclusion: For the past 40 years, though KMMA studies have done rapid development in the methodology quantitatively and qualitatively, it is better to improve its quality. Hereafter, analysis for qualitative aspect of paper may have to be achieved.

알까기 인공지능 시스템 “알까고”

이건호 ( Keon-ho Lee ),윤원탁 ( Won-tak Yoon ),박진수 ( Jin-soo Park ),박두순 ( Doo-soon Park ) 한국정보처리학회 2017 한국정보처리학회 학술대회논문집 Vol.24 No.1

최근 인공지능은 딥러닝, 기계학습 등 인공지능 기술이 발전되면서 기술 상용화가 가시화되고 있다. 이에 따라 인공지능분야는 다른 산업의 핵심 기술로 급부상과 함께 여러 글로벌 기업들이 적극적 투자를 실시하고 있는 추세이다. 이렇게 인공지능 기술이 발전하면서 인공지능 기반 기술 개발에서 타산업의 핵심기술로 프레임이 변화 되고 있으며 차세대 ICT 핵심 기술로 인식이 확산되고 있다. 따라서 본 논문에서는 이러한 인공지능 방법중 지도 학습의 의사 결정 트리 알고리즘을 사용하여 AWS(Amazone Web Service) EMR 서버에서 이를 알까기에 적용하여 알까고 게임 시스템을 구현하였다.

병사의 현역병건강보험 이용행태와 이에 영향을 미치는 요인 분석

하범만 ( Beom-man Ha ),박지훈 ( Ji-hoon Park ) 국군의무사령부 2011 대한군진의학학술지 Vol.42 No.1

Objective: The purpose of this study was to investigate enlisted man's health utilization behavior of national health insurance system and it's factors influencing. Methods : Questionnaire was made through literature review, and pilot study. 1,077 enlisted men who utilized civilian medical facility responded to the survey. Data was collected by self-administered questionnaire between Aug. and Sep. 2010, and analysis by SPSS WIN 14.0. employing chi-square, multiple logistic analysis. Results: The rank which enlisted men's first visit to civilian medical facility was a private, and mean number of civilian medical facility visit was 1.73. Most common facilities they used are medical(78.8%), dental(17.5%), and oriental medicine(3.7%). 64.3% of facility they used was near his home. 40.9% of respondents said they selected facility for near the home. 37.3% of respondents said the reason utilizing civilian medical facility was civilian medical facility is superior to military medical facility. 51.4% of respondents didn't satisfy the explanation for this system. Their parents(55.3%) was most influenced on enlisted men's choice of facility. The factors influencing enlisted man's health utilization behavior of national health insurance system were non-combat branch of the service(OR=1.96), having private insurance(OR=1.90), not recognize the burden of medical cost(OR=1.21). Conclusion: In conclusion above results were helpful to develop the policy witch decreasing the costs of health insurance.

직업군인의 민간의료기관 이용 행태

하범만 ( Beom-man Ha ) 국군의무사령부 2003 대한군진의학학술지 Vol.34 No.1

우리 나라 흡연으로 인한 조기사망의 질병부담

하범만,강종원,장혜정,윤석준,Ha, Beom-Man,Kang, Jong-Won,Chang, Hye-Chung,Yoon, Seok-Jun 대한예방의학회 2001 예방의학회지 Vol.34 No.3

Objective : In this study, we focused on estimating the burden of premature death in Korea caused by smoking using the YLL(years of life lost due to premature death) measurement. Methods : First, we determined parameters: such as age-specific standard life expectancy, age on death, sex, and cause of death by analyzing the national death certificate data and life table collected during 1997. These were provided by the National Statistical Office. Secondly, we estimated the age group- specific years of life lost due to premature death by employing the standard expected years of life lost(SEYLL) measurement. Thirdly, the burden of premature death caused by smoking was estimated using the YLLs measurement which was developed by the global burden of disease study group. Fourthly, We calculated the risk related to smoking using the population attributable risk. Results : The following results were obtained in this study: 1) Premature death that is attributable to smoking in males could be prevented in 60.9%(513,582 person-year) by non-smoking. 2) The burden of premature death by smoking for female was prevented to 17.7%(513,582 person-year) by non-smoking. Conclusion : We found that the YLL method employed in this study was appropriate in quantifying the burden of premature death. This provides a rational basis for planning a national health policy regarding premature deaths caused by smoking and other related risk factors.

장애에 따른 상실생존년수를 활용한 대기중 총먼지와 아황산가스가 심혈관계질환에 미치는 영향 측정

하범만,강종원,권호장,윤석준,Ha, Beom-Man,Kang, Jong-Won,Kwon, Ho-Jang,Yoon, Seok-Jun 대한예방의학회 2002 Journal of Preventive Medicine and Public Health Vol.35 No.2

Objective : To estimate the burden of cardiovascular disease attributable to the total suspended particulates (TSP) and sulfur dioxide ($SO_2$) in Korea using the YLD (years lived with disability) measurement. Methods : Congestive heart failure(CHF) and myocardial infarction (MI) were chosen as the main cardiovascular diseases whose causes are attributable to the TSP and $SO_2$ levels. In order to calculate the YLD (years lived with a disability), the following parameters in the formula were estimated. : the incidence rate, the case fatality rate, The expected duration of a disability and the average age of onset were estimated. The expected duration of a disability and the average age of onset were calculated using the DISMOD method, as developed by the GBD researchers. The burden of cardiovascular disease due to TSP and $SO_2$ was estimated using the number of years that the patient lived with a disability. Results : The VLD of the CHF due to the TSP and $SO_2$ was attributed to the TSP (94.4 person-year) and $SO_2$ levels (35.0 person-year). The YLD of the ME due to the TSP and $SO_2$ was attributed to the TSP (148.4 person-year) and $SO_2$ levels(27.6 person-year). Conclusion : The YLD method employed in this study was appropriate for quantifying the burden of cardiovascular disease. Therefore, it would provide a rational basis for planning a national health policy regarding the disease burden of the risk factors in Korea.

위험도 보정을 통한 병원간 제왕절개 분만율의 비교

이상일,하범만,이무송,강위창,구희조,김창엽,강영호,Lee, Sang-Il,Ha, Beom-Man,Lee, Moo-Song,Kang, Wee-Chang,Koo, Hee-Jo,Kim, Chang-Yup,Khang, Young-Ho 대한예방의학회 2001 Journal of Preventive Medicine and Public Health Vol.34 No.4

Objective : To determine the clinical risk factors associated with the mode of delivery decision and to compare cesarean section rates after adjusting for risk factors identified among Korean hospitals. Methods Data were collected from 9 general hospitals in two provincial regions by medical record abstraction during February 2000. A total of 3,467 cases were enrolled and analyzed by stepwise logistic regression. Performance of the risk-adjustment model (discrimination and calibration) was evaluated by the C statistic and the Hosmer-Lemeshow test. Crude rates, predicted rates with 95% confidence intervals, and adjusted rates of cesarean section were calculated and compared among the hospitals. Results : The average crude cesarean section rate was 53.2%, ranging from 39.4% to 65.7%. Several risk factors such as maternal age, previous history of cesarean section, placenta previa, placental abruption, malpresentation, amniotic fluid abnormality, gestational anemia, infant body weight, pregnancy-induced hypertension, and chorioamnionitis were found to have statistically significant effects on the mode of delivery. It was confirmed that information about most of these risk factors was able to be collected through the national health insurance claims database in Korea. Performance of the risk-adjustment model was good (c statistic=0.815, Hosmer-Lemeshow test=0.0621). Risk factor adjustment did lead to some change in the rank of hospital cesarean section rates. The crude rates of three hospitals were beyond 95% confidence intervals of the predicted rates. Conclusions : Considering that cesarean section rates in Korean hospitals are too high, it is apparent that some policy interventions need to be introduced. The concept and methodology of risk adjustment should be used in the process of health policy development to lower the cesarean section rate in Korea.

DRG 지불제도 도입에 따른 의료보험청구 행태 변화

강길원,박형근,김창엽,김용익,하범만,Kang, Gil-Won,Park, Hyoung-Keun,Kim, Chang-Yup,Kim, Yong-Ik,Ha, Beom-Man 대한예방의학회 2000 예방의학회지 Vol.33 No.4

Objectives : To evaluate the impacts of the DRG payment system on the behavior of medical insurance claimants. Specifically, we evaluated the case-mix index, the numbers of diagnosis and procedure codes utilized, and the corresponding rate of diagnosis codes before, during and after implementation of the DRG payment system. Methods : In order to evaluate the case-mix index, the number of diagnosis and procedure codes utilized, we used medical insurance claim data from all medical facilities that participated in the DRG-based Prospective Payment Demonstration Program. This medical insurance claim data consisted of both pre-demonstration program data (fee-for-service, from November, 1998 to January, 1999) and post-demonstration program data (DRG-based Prospective Payment, from February, 1999 to April, 1999). And in order to evaluate the corresponding rate of diagnosis codes utilized, we reviewed 820 medical records from 20 medical institutes that were selected by random sampling methods. Results : The case-mix index rate decreased after the DRG-based Prospective Payment Demonstration Program was introduced. The average numbers of different claim diagnosis codes used decreased (new DRGs from 2.22 to 1.24, and previous DRGs from 1.69 to 1.21), as did the average number of claim procedure codes used (new DRGs from 3.02 to 2.16, and previous DRGs from 2.97 to 2.43). With respect to the time of participation in the program, the change in number of claim procedure codes was significant, but the change in number of claim diagnosis codes was not. The corresponding rate of claim diagnosis codes increased (from 57.5% to 82.6%), as did the exclusion rate of claim diagnosis codes (from 16.5% to 25.1%). Conclusions : After the implementation of the DRG payment system, the corresponding rate of insurance claim codes and the corresponding exclusion rate of claim diagnosis codes both increased, because the inducement system for entering the codes for claim review was changed.

일차의료기관의 이동 현황과 이에 영향을 미치는 요인에 대한 연구

신순애,이진석,김창엽,김용익,하범만,Shin, Soon-Ae,Lee, Jin-Seok,Kim, Chang-Yup,Kim, Yong-Ik,Ha, Beom-Man 대한예방의학회 2001 예방의학회지 Vol.34 No.3

Objectives : To understand the current status of the opening, closing and relocation of primary medical institutes in Korea and identify the underlying decision factors. Methods : Sources of analyzed data included the medical institutional master file at the National Health Insurance Corporation(1998, 2000) and Regional Statistic Annual Bulletins. To investigate changes including the opening, closing and relocation, a total of primary medicalinstitutions(16,757 in 1998, 19,267 in 2000) were analysed. Results : Between 1998 and 2000, there was a 15.0%(2,510) increase in the number of primary medical institutions and the rate of increase in the rural area was higher than the urban area, and higher for specialty clinics than primary practice. However, these findings did not suggestany improvement in the maldistribution of primary medical institutions. During the time period studied, newly opened and closed primary medical institutions numbered 4,085 and 1,573, respectively. Additionally, institutions thatrelocated numbered 2,729, or 16.3% of all primary medical institutions in operation in 1998. These openings and closings were more frequent among young doctors. As a result of our analysis on the underlying regional factors forrelocation, the factors that were statistically significant were local per capita tax burden and the number of schools per ten thousand persons. !n, the case of institutional factors, movements were significantly associated with gender and the location of primary medical institutions. Conclusions : In order to establish effective long-term intervention for primary medical institutions, further study and monitoring of primary medical institutions and the identification of factors influencing opening location and relocation is necessary.

1990년부터 1996년까지 국내 일부 의학연구 학술지에 발표된 암 관련 논문 초록의 분석

김창엽,이영성,강철환,유근영,강길원,하범만,강영호,Kim, Chang-Yup,Lee, Young-Sung,Kang, Chul-Whan,Yoo, Keun-Young,Kang, Gil-Won,Ha, Beom-Man,Khang, Young-Ho 대한예방의학회 2001 Journal of Preventive Medicine and Public Health Vol.34 No.3

Objective : To explore the status of cancer research in the Republic of Korea. Methods : Thirty-eight medical journals, published in Korea between 1990 and 1996, were reviewed for abstracts relating to cancer research. Of the 5,899 eligible abstracts related to cancer, 4,732 were collected and evaluated. Results : Including first author and first two co-authors, a total of 7,427 authors were identified. Those who published an average of one or more article per one year were defined as cancer researchers for this study. This group, however, accounted for a small proportion of the total (3.1%). Analysis of the selected abstracts showed that the study goals in more than half focused on pathophysiologic mechanisms. Studies that were designed to use causal relationships such as cohort studies and randomized controlled trials were rare. A greater number of analytic and experimental studies were found in abstracts published by the cancer researcher group. More advanced study designs that explored causal relationships and analytic procedures were found in abstracts published later than those abstracts published from 1990 to 1992. Conclusion : Our findings show that researchers who published more articles adopted more advanced study designs. This study provides primary data that can be used to compare the status of cancer research in future studies.