2015 재난적 의료비 경험률과 추이

김우림 ( Woorim Kim ),박은철 ( Eun-cheol Park ) 한국보건행정학회 2017 보건행정학회지 Vol.27 No.1

Catastrophic healthcare expenditure refers to out-of-pocket spending for healthcare exceeding a certain proportion of a household`s income and can lead to subsequent impoverishment. The aim of this study was to investigate the proportion of South Korean households that experienced catastrophic healthcare expenditure between 2006 and 2015 using available data from the Korea Health Panel, National Survey of Tax and Benefit, and Household Income and Expenditure Survey. Frequencies and trend tests were conducted to analyze the proportion of households with catastrophic healthcare expenditure. Subgroup analysis was performed based on income level. The results of the Household Income and Expenditure Survey revealed that around 2.88% of households experienced catastrophic healthcare expenditure in 2015 and that this proportion was highest in the low income group. Results also showed a statistically significant increasing trend in the number of households with catastrophic healthcare expenditure (annual percentage change=0.92%, p-value <0.0001). Therefore, the findings infer a need to strengthen public health care financing and to particularly monitor catastrophic healthcare expenditure in the low income group.

암환자의 진단-치료 소요기간에 따른 생존분석과 지역사회별 격차 및 시계열적 추이

김우림 ( Woorim Kim ),한규태 ( Kyu-tae Han ) 한국보건행정학회 2021 보건행정학회지 Vol.31 No.1

Background: The Korean government introduced National Cancer Control Program and strengthening national health insurance coverage for cancer patients. Although many positive effects have been observed, there are also many concerns about cancer management such as patient concentration or time-to-treatment. Thus, we investigated the association between the time-to-treatment and survival of cancer patients, and compared regional differences by time trend. Methods: The data used in this study were national health insurance claims data that included patients diagnosed with lung cancer and received surgical treatment between 2005 and 2015. We conducted survival analysis with Cox proportional hazard model for the association between time-to-treatment and survival in lung cancer. Additionally, we compared the regional differences for time-to-treatment by time trend. Results: A total of 842 lung cancer patients were included, and 52.3% of lung cancer patients received surgical treatment within 30 days. Patients who received surgical treatment after 31 days had higher 5-year or 1-year mortality compared to treatment within 30 days (5-year: hazard ratio [HR], 1.566; 1-year: HR, 1.555; p<0.05). There were some regional differences for time-to-treatment, but it was generally reduced after 2010. Conclusion: Delayed surgical treatment after diagnosis can negatively affect patient outcomes in cancer treatment. To improve cancer control strategies, there are needed to analyze the healthcare delivery system for cancer care considering the severity and types of cancer.

정수 및 하수처리 공정에서 오존 및 UV/H₂O₂ 시스템적용 시의 할로겐화 메틸파라벤류의 반응 동역학 및 제거효율 평가

이우림(Woorim Lee),이윤호(Yunho Lee),염훈식(Hoon-Sik Yeom),김희영(Hee-Young Kim),정태욱(Taeuk Jeong),김상구(Sang-Goo Kim),손희종(Heejong Son) 대한환경공학회 2021 대한환경공학회 학술발표논문집 Vol.2021 No.11

Predictors of Mortality in Patients with COVID-19: A Systematic Review and Meta-analysis

김우림,한지민,이경은,Kim, Woorim,Han, Ji Min,Lee, Kyung Eun Korean College Of Clinical Pharmacy 2020 한국임상약학회지 Vol.30 No.3

Background: Most meta-analyses of risk factors for severe or critical outcomes in patients with COVID-19 only included studies conducted in China and this causes difficulties in generalization. Therefore, this study aimed to systematically evaluate the risk factors in patients with COVID-19 from various countries. Methods: PubMed, Embase, and Web of Science were searched for studies published on the mortality risk in patients with COVID-19 from January 1 to May 7, 2020. Pooled estimates were calculated as odds ratio (OR) with 95% confidence interval (CI) using the random-effects model. Results: We analyzed data from seven studies involving 26,542 patients in total in this systematic review and meta-analysis. Among the patients, 2,337 deaths were recorded (8.8%). Elderly patients and males showed significantly higher mortality rates than young patients and females; the OR values were 3.6 (95% CI 2.5-5.1) and 1.2 (95% CI 1.0-1.3), respectively. Among comorbidities, hypertension (OR 2.3, 95% CI 1.1-4.6), diabetes (OR 2.2, 95% CI 1.2-3.9), cardiovascular disease (OR 3.1, 95% CI 1.5-6.3), chronic obstructive pulmonary disease (OR 4.4, 95% CI 1.7-11.5), and chronic kidney disease (OR 4.2, 95% CI 2.0-8.6) were significantly associated with increased mortalities. Conclusion: This meta-analysis, involving a huge global sample, employed a systematic method for synthesizing quantitative results of studies on the risk factors for mortality in patients with COVID-19. It is helpful for clinicians to identify patients with poor prognosis and improve the allocation of health resources to patients who need them most.

학생, 부모 및 교사가 인지한 게임 몰입 과정 분석 연구

김소아(Kim, Soah),최원현(Choi, Wonhyon),안우림(An, Woorim) 학습자중심교과교육학회 2020 학습자중심교과교육연구 Vol.20 No.5

본 연구는 학생의 게임 몰입 과정과 게임 행동유형별 경험의 차이를 탐구하고 이해하는 것을 목적으로 한다. 이를 위해 초등학교에 재학 중인 게임선용군 학생 3명 부모 3명, 교사 2명, 게임과몰입위험군 학생 4명, 교사 3명 총 15명을 대상으로 근거이론(Grounded Theory)을 활용하여 분석하였다. 연구는 2018년 12월부터 2019년 3월까지 학교 교실이나 위(Wee) 클래스에서 심층 면담으로 진행되었다. 연구결과, 학생, 부모, 교사가 인지한 게임 몰입 과정의 인과적 조건은 ‘세상에서 제일 재미있는 놀이 도구’, ‘외로움과 스트레스를 겪음’, ‘자신감과 자존감 저하’로 나타났으며, 맥락적 조건은 ‘게임에 쉽게 접근할 수 있는 환경’, ‘게임에 관대한 분위기’로 나타났다. 중심 현상은 ‘게임에 빨려 들어감’, ‘게임의 늪에서 방황’으로 나타났으며, 중재적 조건은 ‘게임의 역기능 인지’, ‘삶에 대한 의지와 자신감’으로 나타났다. 마지막으로 결과는 ‘게임에 함몰’ 또는 ‘새롭고 희망적인 삶으로 거듭남’으로 나타났다. 본 연구는 게임과몰입위험군과 게임선용군 학생의 게임 몰입 과정을 살펴봄으로써, 이들이 게임을 조절하고, 이를 극복할 수 있도록 도울 수 있는 방법을 제언하였다는데 그 의의가 있다. The purpose of this study is to explore and understand the differences in students’ internet game immersion processes and their experiences of different types of game behavior. For the study the three overindulged game player groups(three students, three mothers and two homeroom teachers) and one excessive game player group(four students, three homeroom teachers) in elementary schools were analyzed using Qualitative research methods of Grounded Theory, focusing on how students themselves, their mothers, and their homeroom teachers think about students playing games. The study was done from December 2018 to March 2019 in the classrooms or the Wee Classes by in-depth interviews. Studies have shown that the causal conditions of the game immersion process recognized by students, mothers and teachers were “the most interesting play tool in the world,” “loneliness and stressful,” and “decreased self-confidence and self-esteem,” while contextual conditions were “environment in which games are easily accessible,” and “a generous atmosphere in games.” The central phenomenon appeared to be “wandering into the game” and “wandering in the swamp of the game,” while the mediating conditions were “recognizing the reverse function of the game” and “the will and confidence in life.” Finally, the result turned out to be “fallen into a game” or “reiterate into a new and hopeful life.” This study suggests a way to help the excessive gammer and overindulged gammer to control and overcome game immersion by examine the game immersion process.

애플리케이션 내 토큰 관리를 통해 사용자 개인정보 보안

김유림(Yurim Kim),임장혁(Janghyeok Im),김우림(Woorim Kim),서의정(Euijeong Seo),신은영(Eunyoung Shin),최유찬(Yoochan Choi) Korean Institute of Information Scientists and Eng 2024 한국정보과학회 학술발표논문집 Vol.2024 No.6

개발효과성(Development Effectiveness)의 정책적 타당성에 관한 연구

김은주(Eunju Kim),김우림(Woorim Kim) 국제개발협력학회 2011 국제개발협력연구 Vol.4 No.2

본 연구는 최근 원조효과성을 대신하여 새로운 원조정책 패러다임으로 제시되고 있는 개발효과성(Development Effectiveness)에 대한 개념정의를 시도하고, 이를 기초로 정책 현장에서 개발효과성을 향상시킬 수 있도록 정책대안을 모색하였다. 먼저 원조효과성과 개발효과성에 대한 기존 연구를 비판적으로 검토하고, 나아가 새로운 정책방향이 대두된 배경으로서 국제개발협력체제 역학구조의 변화를 살펴보았다. 본 연구는 개발효과성 개념을 개발도상국의 정책적 주도성이 보장된 가운데 원조정책을 통해 개발도상국이 추구하는 경제적․사회적 측면에서 포괄적 발전을 이룩하는 것으로 파악하였다. 이에 따라 원조효과성의 판별도 개발효과성의 맥락에서 평가되어야 하며, 이같은 유기적 연결을 위해서는 수원국의 정책주도성(ownership)과 원조사업의 적절성(relevance), 그리고 원조사업의 중대성(significance) 등을 중시해야 한다. 이러 한 논의를 바탕으로 본 연구는 개발효과성을 제고하기 위한 원조사업수행 원칙을 제시하고, 정책현장에서 활용할 수 있는 가발전분석과 국별협력전략수립 방안에 대한 정책적 함의를 제시하였다. This paper attempts to define the concept of “Development Effectiveness” which has been discussed as a new policy paradigm in the international development community. We also aim to suggest policy implications based on this new definition in the field. In doing so, we critically examine the literature on aid effectiveness as well as development effectiveness and then examine the changing aid architecture which resulted in a new policy paradigm. The “Development Effectiveness” is defined as to achieve comprehensive development of economic and societal aspects through aid policies while policy ownership of the developing countries is ensured. Aid effectiveness can be evaluated in the context of development effectiveness and thus we suggest important principles to interlink the two concepts such as ‘policy ownership’ of the recipient countries, ‘relevance’ of aid policy, and ‘significance’ of its impact. The paper finally suggests the principle of aid policy in order to improve development effectiveness and then highlights the importance of country studies and country partnership strategies for new development cooperation strategies of Korea.

개발효과성 관점에서 개발협력사업 평가체계의 분석 - 독일,영국,한국의 개발협력사업 평가에 대한 비교를 중심으로 -

장효진 ( Hyojin Jang ),김우림 ( Woorim Kim ),권혁주 ( Huckju Kwon ) 한국정책학회 2015 韓國政策學會報 Vol.24 No.3

본 연구는 ``개발효과성``이라는 새로운 원조패러다임의 관점에서 독일과 영국 그리고 한국의 개발협력사업 평가체계에 대한 비교분석 결과를 토대로 한국의 개발협력사업 정책평가체계에 대한 시사점을 도출하고자 한다. 최근 선진원조기관은 미시적인 원조효과성 평가의 한계를 개선하기 위해 원조가 개발도상국의 궁극적인 발전에 얼마나 영향을 미치는지를 평가하고 환류하기 위한 평가설계를 개발하고 있고, 이를 중심으로 평가체계를 전환하고 있다. 한국은 2010년 OECD-DAC에 가입함으로써 공여국으로서 수원국의 개발수요에 부응하는 원조모델을 설계하고 구축해야 하며, 새로운 모델을 제시할 것이라는 기대도 받고 있는 입장이다. 그러나 본 연구결과에 의하면 우리나라의 원조사업평가는 아직까지 프로젝트 사업평가와 운영상 효율성 측면의 평가에 초점이 맞춰져 있는 바, 향후 개발효과성을 반영한 평가체계의 개선이 필요하다고 판단된다. This study analyses aid evaluation systems in Germany, the United Kingdom, and South Korea from the comparative perspective in order to provide policy implications for the Korea’s case. In recent years, aid organizations in many advanced donor countries have admitted the limitations of micro-level evaluation system based on the concept of aid effectiveness. In turn, with the concept of development effectiveness, they have devised new evaluation design to address the extent to which foreign aids have contributed in developing countries’ national development and provide feedback to future policy-making based on the results of evaluation. Meanwhile, South Korea has received attention from the aid society to suggest new aid model corresponding to developing countries’ needs. This is because that South Korea is the first country which successfully turned into a donor from an aid recipient as joined the Development Assistance Committee (DAC) in the Organisation for Economic Co-operation and Development (OECD) in 2010. However, the result shows that, in South Korea, most ODA policies have been evaluated at the project level and aid organizations still focuses on operational effectiveness. In this sense, there is room for South Korea to improve its aid evaluation system, incorporating the concept of development effectiveness into the system.

말기 암환자에서의 호스피스 완화의료 비용효과 분석: 병원 기반 호스피스 완화의료 치료와 일반 병동 치료의 비교

주영준 ( Yeong Jun Ju ),김우림 ( Woorim Kim ),최윤수 ( Yoon Soo Choy ),이주은 ( Joo Eun Lee ),이상아 ( Sang Ah Lee ),장지은 ( Jieun Jang ),박은철 ( Eun-cheol Park ) 대한내과학회 2019 대한내과학회지 Vol.94 No.3

Background/Aims: Although there is growing interest in hospice-palliative care, little information is available on the effects of such care in South Korea. Addressing this research gap, i.e., determining the cost-effectiveness of hospice-palliative care in South Korea, will help guide policy. Thus, the aim of this study was to evaluate the cost-effectiveness analysis of hospice-palliative care in adults diagnosed with terminal cancer. Methods: We used a Markov model to construct a decision tree, for an analysis comparing the general ward with the hospice- palliative ward in terms of patient quality of life and cost-effectiveness. Cost and quality of life were estimated based on published Korean studies. Cost-effectiveness was calculated as the incremental cost relative to the incremental effect. Additionally, a one-way sensitivity analysis was performed to test the robustness of the results. Results: Hospice-palliative ward care was more cost-effective than general ward care. The incremental cost was 290,401 Korean won (KRW) and the incremental effect was -0.25. The incremental cost-effectiveness ratio was -1,174,045 KRW. A similar pattern of results was obtained in the sensitivity analysis. Conclusions: Our results suggest that hospice-palliative ward care is more cost-effective than general ward care. (Korean J Med 2019;94:273-280)

지역별 암모니터링 지표 개발을 위한 다차원적 암모니터링 지표 프레임워크: 암 환자 생애 연속성에 기반하여

권정아 ( Jeoung A Kwon ),김재현 ( Jae-hyun Kim ),장지은 ( Jieun Jang ),김우림 ( Woorim Kim ),전미선 ( Miseon Jeon ),정승연 ( Seungyeon Chung ),신재용 ( Rajaguru Vasuki ),( Jaeyong Shin ) 한국보건행정학회 2020 보건행정학회지 Vol.30 No.4

Cancer is a disease which has the huge burden in worldwide, and cancer is the number one cause of death in Korea. At this point, the new framework for cancer monitoring index is required for regional cancer monitoring. Especially, cancer survivors are the important target which is rapidly increasing recently, also cancer survivor’s quality of care should be considered in the cancer monitoring index framework. To develop the Multidimensional Cancer Monitoring Index considering cancer survivor’s quality of care, we took into account cancer continuum which including prevention, detection, diagnosis, treatment, survivorship, assessment of quality of care and monitoring cancer patient, and end-of life care for stage. For target, components of health care delivery system such as patient, family, provider, payer, and policy maker are included. Also, Donabedian model which is a framework for examining health services and evaluating quality of health care such as structure, process, and outcome is applied to contents. This new cancer monitoring framework which includes multidimensional components could help to develop regional cancer monitoring index, and to make national cancer management and prevention policy in the future.