제 24 차 학술대회 : 11. 담낭절제술 및 총수담관 십이지장 문합술에 관한 실험적 연구

김한중,목돈상 대한외과학회 1972 대한외과학회 학술대회자료집 Vol.- No.-

한 농촌(農村) 지역(地域)의 의료보호사업(醫療保護事業) 평가(評價) -의료이용(醫療利用)을 중심(中心)으로-

김한중,Kim, Han-Joong 대한예방의학회 1978 Journal of Preventive Medicine and Public Health Vol.11 No.1

To examine the result of the government Medical Aid Program which began in January, 1977 as a part of social security policy implementation, all the medical records of the clients and official statistics in the year were analysed. The specific objectives this study pursues include the magnitudes and patterns of morbidity and utilization, and the characteristics of clients. One Korean rural area, Koje county was selected as the study area and subsequently all the clinics and hospitals assigned to work out the Aid Program are the subjects for the survey. A brief summary of the sutdy results as follows: a. The clients of Koje county are 6.4% of the total population in the area, more than the average percentage of the clients in Korea. It reflects on low level of economic status of the residents of the area. b. The population structure of the clients indicates that the large proportions of young and old age group are overwhelming, while the middle age group share very small portions. c. The utilization rates for primary care are 2.0 persons, 11.6 visits and 22.6 treatment days per 100 persons per months. Annual hospitalization is rated as 13.7 cases and 164 days per 1,000 persons, The utilization rates are slightly lower than those expected rates during planning period but eventually become higher than those of general population in rural Korea. d. The factors which influence the utilization rates are identified with client group (low income vs indigent), age and sex. e. The utilization pattern for primary care demonstrates seasonal variation similar to the pattern of general rural population in the low income group, but none in the indigent group. f. The most common diseases revealed at the primary care clinics are the acute respiratory infection (26.9%), acute gastritis (10.8%), skin and subcutaneous infection (6.8%). The cases of acute conditions are outnumbered than the cases of chronic condition. 8. The clinics, hospitals and other related health institutions are well cooperated in dealing health care services in their own capacities. Considering the above results Medical Aid Program generated satisfactory results at least in the utilization aspect.

전국민 의료보험 실시에 따른 사회전체 순편익 분석

김한중,이해종,Kim, Han-Joong,Lee, Hae-Jong 대한예방의학회 1989 Journal of Preventive Medicine and Public Health Vol.22 No.3

A change in the consumer's surplus was measured in order to evaluate the social benefit to be derived from expanding health insurance to the entire population. The most refined and correct way to measure a project's net benefit to society is to determine a change in the consumer's surplus. Benefits from introducing the health insurance program to the uninsured people can be classified into two elements. The first is the pricing-down effect(E1) which results from applying the insurance price system, which is lower than the actual price, to the uninsured patients. The second effect(E2) is a decrease in actual payment because an insured patient pays only a portion of the total medical bill(copayment). We collected medical price information from the data banks of 93 hospitals, and obtained information of medical utilization by referring to the results of other research and from data published by the Korean Medical Insurance Societies. The total net benefit was estimated as \214 billion, comprising the first effect(E1) of \57 billion and the second effect(E2) of \157 billion. The price elasticity of physician visits is less than that of hospital admissions: however, benefits from the increase in physician visits are greater than those from hospital admissions because there are considerably more of physician visits than hospital admissions. The sensitivity analysis also shows the conclusion that expansion of the health insurance program to the entire population would result in a positive net benefit. Therfore, we conclude that the National Health Insurance Program is socially desirable.

血管腫

金漢仲 중앙대부설한국의과학연구소 1977 한국의과학 Vol.9 No.1

대규모 단층특성을 고려한 최적 댐위치 및 형식 선정

김한중,유영권,김영근,임희대 한국암반공학회 2012 터널과지하공간 Vol.22 No.4

영주다목적댐은 낙동강 중·하류 갈수기 하천유지용수 확보와 낙동강 본류 및 내성천 연안지역의 홍수재해방어, 경북북부지역의 안정적인 용수공급을 위하여 계획되었다. 일반적으로 댐설계시 단층은 댐 안정성에 있어 매우 중요한 리스크 요소이므로, 단층의 공학적 특성은 반드시 고려되어야만 한다. 본 댐의 경우 지반조사결과 댐하부에 대규모의 단층대가 확인됨에 따라 댐의 장기적인 안정성을 확보하기 위하여 댐위치 및 댐형식에 대한 보다 공학적인 검토가 요구되었다. 본 연구에서는 노두와 시추조사시 확인된 대규모 단층대가 확인됨에 따라 단층대의 공학적 특성을 규명하기 위하여 다양한 지질조사 및 현장시험을 실시하였다. 이와 같은 단층대 특성을 반영하여 단층의 영향을 최소화할 수 있는 최적의 댐 위치를 선정하였으며, 단층대를 포함한 기초지반의 특성을 반영하여 좌안에는 콘크리트 중력식댐을 우안에는 콘크리트 차수벽형 석괴댐형식의 복합댐을 선정하였다. 또한 단층처리 및 기초지반 그라우팅을 실시하여 댐 구조물의 안정성을 확보하도록 하였다. Youngju multipurpose dam is planned to minimizing the damage by flood and obtaining the water for industrial use in Nakdong river region. Faults in rock mass have strong influences on the behaviors of dam structure. Thus, it is very important to analyse for the characteristics of fault rocks in dam design. However, due to the limitation of geotechnical investigation in design stages, engineers have to carry out the additional geological survey including directional boring to find the distribution of faults and the engineering properties of faults for stability of dam. Especially, the selection of location of dam and type of dam considering fault zone must be analyzed through various experimental and numerical analysis. In this study, various geological survey and field tests were carried out to analyse the characteristics of the large fault zone through the complex dam is designed in foundation region. Also, the distribution of structural geology, the shape of faults and the mechanical properties of fault rock were studied for the reasonable design of the location and type of dam for long-term stability of the complex dam.

한국인 안면화상에 대한 임상적 연구

김한중 대한성형외과학회 1978 Archives of Plastic Surgery Vol.5 No.2

Burn-related death and injury become one of the major health problems today:from quarter to one-third of all burns are facial burns. In the process of healing burn injury, contractures and hypertrophic scars are two frustrating sequelae of thermal injury. The two complications are so followed by not only deformity in outlook but difficulties to physical excercise as well that they make student-patients feel alienated from friends and, because of the defective body image, expecting development of harmonious personality is rarely possible. Adults of the kinds, also, often encountet inability against their social activities. Timely local management, therefore, on these complictions is mostly significant. We have undertaken analysis of our clinical experiences on facial burns and a review of the literatures. During the last eight years, from January, 1970 to December, 1977, 478 cases of facial burned patients had seen created at surgical departments in University Hospital of Ewha, Korea and Chungang, and are summarized as follows; 1) Males were affected more often tan females: 309 against 169 cases. 2) Incidence of facial burned patients reached 41.1% of the whole (487 among 1161). 99 patients among 478 were only facial burns and 379 had injury upon combined areas together with on their faces. 3) Under 14 year-old group occupied 31.2% (31 among 99) of only facial burned patients and 67.2% (255 among 379) of facial and combined area burns. 4) Seasonal distribution (cases) : spring 109, summer 127, autumn 111, winter 121. 5) To see the elements of 99 only facial burned group, eyelids burns were 34 and the most. 6) Neither early excision nor skin graft is adquate in cases of facial burns. 7) Open methods are desirable for local management on facial burns and adapting topical agent is rather useless.

시간활동 접근법에 의한 면 보건요원의 업무량 분석

김한중,김문식,Kim, Han-Joong,Kim, Moon-Shik 대한예방의학회 1977 Journal of Preventive Medicine and Public Health Vol.10 No.1

This study attempts to examine the performances of Myun Health Workers-the frontline workers in the Korean rural health care delivery system. The time-activity approach was mainly utilized as a measuring tool. This study was undertaken in September 1976 with 35 Myun Health Workers at the Kang Wha County. The pretested time-activity approach sheets were filled out daily for one month by those Myun Health Workers themselves. Statistical means and variances of analysis were utilized for statistical method in comparing some activities and functions converged into time distribution Findings: 1. The workers's average working hours derived in this study is 8 hours and 48 minutes per day, which takes half an hour longer than normal schedule. 2. They spend 56% working hour for direct services, in other words, the main function, 22% for supportive function, and 22% for other activities, the unrelated health services. 3. Considering the total working hours of main function, out-center activity is far more than in-center services with the ratio of 70% to 30% respectively, which proves, therefore, that the main activity of the workers is home visiting. 4. It takes 20 minutes purely for home visiting and takes 14 minutes for transportation. 5. This research also indicates that such factors as characteristics of the health workers and myun influence in shaping the structures of the worker's function and activity: a. The workers whose working site is located in myun office spend 15% among total working hours in carring out official myun activities, which is incidentally unrelated to health services, while the health subcenter have no rooms for administrative jobs for myun office. b. The workers whose office is in health subcenter contribute much time in doing main function and those working in special project distribute more time in performing supportive function. c. The types of workers are another dominant factor to influence the components of worker's functions and activities. MCH workers and MPW I spend much time for manipulating main function. d. MPW II, whose function is reorganized by special project in 2 myuns shows different pattern of time distribution compared to the TB worker orFP worker in the ordinary area. MPW II distributes their time evenly in performing MCH program, T.B. Program, F.P. program and education activity, while the unipurpose workers engage in carring out only their dominant role. e. Another variables which involve the variation of the worker's activity can be illustrated with the variables like target population, size of myun and convenience for transportation, among which the latter two are remarkable factors in determining the time for out-center service.

手部火傷의 臨床的 硏究

金漢仲 梨花女子大學校 韓國生活科學硏究院 1979 韓國生活科學硏究院 論叢 Vol.23 No.-

수부는 전체 체표면적의 2%를 차지하는 적은 면적이지만 그 기능면에서는 대단히 중요한 역할을 하며 화상에 의한 수부의 피부 손실은 대개의 경우 전신 화상의 일부로서 나타나기 때문에 화상 초기 전신상태에 치중하다보면 흔히 소홀히 다루어지게 되어 수부기형을 초래하는 수가 많다. 따라서 수부에 화상을 받으면 초기부터 기능면을 고려하여 치료에 임하여야 한다. 저자는 1974년 1월부터 1978년 12월까지 만 5년간 이화여자대학교 의과대학 부속병원에 입원 가료를 받았던 수부 화상 환자 81예에 대한 임상적 연구 결과 다음과 같은 결론을 얻었다. 1) 성별 발생빈도는 남자 56명, 여자 25명으로 청장년군의 사회활동과 관계가 있어 남자에서 높았다. 2) 연령별 발생빈도는 수부화상 81예 중 4세 이하가 28명으로 가정에 일어난 우발사고였는데 이는 보호자의 소홀한 보호와 부주의였다. 3) 수부화상 81예 중 수부에만 국한된 화상은 8예로서 전신화상의 일부로서 수부화상이 주로 나타남을 보여주었다. 4) 수부화상시 조기 관절운동을 시행하여 관절 강직을 예방하여야 하며 운동이 불가능할 때에는 functional postion으로 수부를 유지시켜야 하고 심한 2도 내지 3도 수부화상시는 조기 소가 절제와 피부이식을 시행하여 기형을 최소로 줄이는 좋은 결과를 얻을 수 있다. In general, the functional limitation of the burned hand is determined by the thermal injury ; however, infection, pressure necrosis, inactivity, poor postioning, subsequent scarring and contractures are intimately related to functional disability. The goal of treatment of the burned hand is the prevention of deformitites and maintenance of function. We have undertaken an analysis of our clinical experiences on the burned hand and a review of the literature. During the last five years, from january 1974 to December 1978, 81 cases of burned hand have been treated at the surgical department of Ewha Womans University Hospital.

의료비 결정요인 분석을 위한 계량적 모형 고안

김한중,이영두,남정모,Kim, Han-Joong,Lee, Young-Doo,Nam, Chung-Mo 대한예방의학회 1991 Journal of Preventive Medicine and Public Health Vol.24 No.1

A multiple regression analysis using ordinary least square (OLS) is frequently used for the projection of health expenditure as well as for the identification of factors affecting health care costs. Data for the analysis often have mixed characteristics of time series and cross section. Parameters as a result of OLS estimation, in this case, are no longer the best linear unbiased estimators (BLUE) because the data do not satisfy basic assumptions of regression analysis. The study theoretically examined statistical problems induced when OLS estimation was applied with the time series cross section data. Then both the OLS regression and time series cross section regression (TSCS regression) were applied to the same empirical da. Finally, the difference in parameters between the two estimations were explained through residual analysis.

환경 여건변화에 따른 지역보건행정 체계와 기능의 발전 발향

김한중,Kim, H.J. 대한예방의학회 1991 Journal of Preventive Medicine and Public Health Vol.24 No.2