강원도의 한방의료 자원 및 이용현황

우연주 상지대학교 한의학연구소 2019 尙志韓醫論文集 Vol.7 No.1

Objectives: This study was carried out to investigate resources and utilization status of Korean medicine service in Gangwon province based on national health insurance data. Methods: Combining census data and national health insurance data, we calculated Korean medicine service resource index (number of Korean medical doctor per population, number of beds for Korean medicine hospital per population) and utilization index (number of Korean medicine treatment per population, number of Korean medicine admission per population, total amount of insurance payment for Korean medicine service). Results: The number of Korean medical doctor was 2.71, the number of bed was 0.66 and the number of admission was 13.39 per 10,000 person in Gangwon province as of 2019. For 1 person, the number of Korean medicine treatment was 1.84 and the total amount of insurance payment for Korean medicine service was 35,833 won in the past 5 years (2013~2017), indicating that all results were not reached to the overall of national average. Conclusion: Considering the equity in health

근대적 도시 공원으로서 창경원

우연주,배정한,Woo, YunJoo,Pae, JeongHann 한국조경학회 2016 韓國造景學會誌 Vol.44 No.4

This article explores Changgyeongwon's spatial and cultural characteristics that were created there as the first modern urban park in Kyeongseong in the Japanese colonial era. First, in point of comparison regarding a colonial historical view, the study tried to understand the background of Changgyeongwon's establishment as well as three aspects of Changgyeongwon's characteristics as a modern urban park. The study found that; First, foreign envoys and high ranking members had visited Changgeongwon in the early opening period. This shows that this site was a park for foreign propaganda and modern display. Second, Changgyeongwon was altered as a place of enlightenment in the 1920s. This is related to the tendency of Changgyeongwon's increasing popularity around this period. More facilities and events particularly for women and children were offered at that time. Third, investigating the historical records, Changgyeongwon's cultural characters as a park are discussed. Changgyeongwon was an important place creating a modern park culture in Kyeongseong in the colonial era. 이 논문은 창경원을 근대적 도시 공원으로 보고, 창경원의 공간적 성격과 그곳에서 창출된 공원 문화의 특징을 파악하고자 했다. 먼저 창경원 성립의 배경을 파악했으며, 이를 바탕으로 세 가지 측면에서 근대 도시 공원으로서 창경원의 성격을 제시했다. 첫째, 대외적 선전과 과시의 장으로서 창경원의 성격, 특히 개원 초기 해외 사절과 고위 인사들의 방문에 주목했다. 특히 애초에 이곳을 근대적 공원으로 만들고자 계획했던 내용에 바탕을 두고, 근대 도시 공원으로서의 성격을 살펴보았다. 둘째, 계몽과 교화의 장으로서 1920년대 창경원 이용이 보다 대중화 경향을 띠기 시작했다는 점을 파악하고, 여성과 아동을 위한 행사와 새로운 시설의 등장에 주목했다. 셋째, 창경원을 공원으로 인식하고 이용했던 당대의 기록을 조사하여 그 문화적 특징을 파악했다.

국내 만성질환 노인환자의 한의과 진료서비스 이용과 사망률 및 파킨슨병 발생률의 관계연구

우연주 대한예방한의학회 2021 대한예방한의학회지 Vol.25 No.3

Objectives : To investigate the effectiveness of Korean Medicine services use on the all-cause mortality and incidence of Parkinson’s disease(PD) in elderly patients with chronic disease based on the National Health Insurance Service Corhort Database (elderly), called as the NHIS-senior. Methods : This study was a retrospective cohort analysis conducted using the NHIS-senior. Patients with chronic diseases over 65 years old who were not diagnosed PD during 2007–2009 were identified. The case group was defined as patients who used both Korean Medicine and Western Medicine services and the control group consisted of patients who used Western Medicine service only. The all-cause mortality and incidence of PD was analyzed using the Cox proportional hazard model after a propensity score matching(PSM) with a 1:1 ratio. Results : After PSM, the cohort included 47,546 subjects (23,773 in the case group, 23,773 in the control group). Sex, age, comorbidity, severity of disability, and neurology medical service utilization were adjusted in both groups. The mortality was 0.668 times (95% C.I.: 0.646–0.690) lower in the case group than the control group, which was statistically significant (p<0.001). The incidence of PD was 1.051 times (95% C.I.: 0.962–1.148) higher in the case group than the control group, which was not statistically significant(p=0.272). Conclusion : It was not obvious that the use of both Korean Medicine service and Western Medicine services for prevention of PD is benefitial than using only Western Medicine. But it would be possible that using both Korean Medicine and Western Medicine services decreases the mortality than using Western Medicine alone.

Pediatric Medication Error Reports in Korea Adverse Event Reporting System Database, 1989-2012: Comparing with Adult Reports

우연주,김형은,정수연,박병주 대한의학회 2015 Journal of Korean medical science Vol.30 No.4

Children have dynamic process of maturation and substantial changes in growth anddevelopment which eventually make the drug safety profiles different from adults. Medication errors (MEs) in pediatrics are reported to occur three times more likely thanadults. The aims of this study were to identify the characteristics of pediatric MEs in Koreaat national level and help raise awareness of risks from the MEs in pediatrics. We conducteda descriptive analysis with the pediatric ME reports in Korea Adverse Event ReportingSystem (KAERS) database from 1989 to 2012 and 208 ME reports in pediatrics were found. Based on KAERS database, the proportion of reported pediatric ME in adverse drug event(ADE) reports was 2.73 times (95% CI, 2.35-3.17) higher than that of adult ME. In 208 MEreports, we found a total of 236 ME-related terms within 19 types of MEs. The mostcommon type of MEs was “accidental overdose” (n = 58, 24.6%), followed by “drugmaladministration” (n = 50, 21.2%) and “medication error” (n = 41, 17.4%). After thenarratives of ME reports were reviewed, we noticed that most of them did no harm topatients, but some cases were needed for medical treatment. Our data suggest that MEs inpediatrics are not negligible in Korea. We expect that this study would increase theawareness of the problem in pediatric MEs and induce the need for further development ofan effective national ME preventing system in Korea.

국제의약분류(ATC) 체계의 국내 한약유래의약품 분류

우연주 한약정보연구회 2018 한약정보연구회지 Vol.6 No.2

The Anatomical Therapeutic Chemical (ATC) Classification for herbal medicine should be grasped in order to study herbal medicine using public open data such as health insurance data or adverse drug event reporting data. In this study, herbal medicinal materials and ingredients from the domestic and foreign pharmacopeia were mapped to herbal medicinal products on the market in Korea, and then herbal medicines were classified ATC codes. As a result, 9,644 herbal medicines and 187 ATC codes were identified and of these, 62 ATC codes consisting of only herbal medicine were included and 2,345 products corresponded. A total of 62 ATC codes could be applied to public open data studies, but they are part of the total herbal medicine, and a new herbal ATC (HATC) code classification is required for the study of herbal medicine.

우리나라의 한약 부작용 규모 추정

우연주,Woo, Yeonju 대한예방한의학회 2020 대한예방한의학회지 Vol.24 No.1

Objectives : The purpose of study was estimation of adverse events [AEs] scale relating herbal medicine in Korea using Korean Medicine Utilization and Herbal Medicine Consumption Survey (National statistics No. 117087). Methods : Using microdata of Korean Medicine Utilization and Herbal Medicine Consumption Survey 2017, the number of inpatients and outpatients who experienced AEs was calculated. The microdata included AEs of all treatment methods that have been performed by visiting Korean medical institutions for one year, so set up the data into three models; model A (in case all treatments were only herbal medicine for one year), model B (in case herbal medicines were a part of all treatment methods in 1 year), model C (in case herbal medicines were a part of treatment methods at least one time in 1 year). The proportion of patients who experienced AEs during the last 1 year was calculated and then, the number of AEs relating herbal medicine was estimated. Results : A total of 1,010 outpatients and 904 inpatients were included in Korean Medicine Utilization and Herbal Medicine Consumption Survey 2017. The number of patients who had experienced AEs in the past 1 year was 0 in the model A, 9 in the model B (5 for outpatients, 4 for inpatients), and 19 in the model C (10 for outpatients, 9 for inpatients). By consideration for the complex sample survey, estimating the number of AEs relating herbal medicine, the model A was 0, the model B was 36,457 patients (0 to 75,526 patients), and the model C was 84,830 patients (26,314 to 143,347 patients). Conclusion : From the results of this study, it was possible to estimate the scale of AEs relating herbal medicines in Korea, suggesting that it is necessary to understand the actual condition of AEs and establish its management system.

국내 만성질환 노인환자의 한방진료가 생존기간에 미치는 영향연구

우연주 상지대학교 한의학연구소 2020 尙志韓醫論文集 Vol.8 No.1

Objectives: This study was performed to investigate effectiveness of Korean Medicine for elderly patients with chronic disease based on national health insurance data. Methods: This study was a retrospective cohort analysis conducted using the national health insurance data. Patients over 65 years old who were newly diagnosed with chronic disease during 2003–2010 were identified. The case group was defined as patients treated with both Korean Medicine and Western Medicine, and the control group consisted of patients treated with Western Medicine only. From the time of chronic disease diagnosis to December, 2015, the mortality was analyzed using Cox proportional hazard model after propensity score matching with a 1:1 ratio. Results: After Propensity Score estimation and matching, the cohort used in the analysis included 76,332 subjects (38,166 case group, 38,166 control group). Sex, age, index year, comorbidity, severity of disability, and care, and total days of medical treatment were adjusted in both groups. The mortality was 0.598 times (95% CI: 0.585–0.612) lower in case group than control group, which was statistically significant (p < 0.001). Conclusion: : It would be possible that combined treatment with Korean Medicine and Western Medicine for chronic disease is beneficial than Western Medicine alone

중국, 일본, 한국, WHO의 한약 자발적부작용보고체계 현황

우연주,정수연,박병주,Woo, Yeon-Ju,Chung, Soo-Youn,Park, Byung-Joo 대한한방내과학회 2014 大韓韓方內科學會誌 Vol.35 No.2

Drugs may cause adverse effects, and spontaneous adverse drug reaction (ADR) reports have been used as the main method of drug safety evaluation after drugs have been released. The World Health Organization (WHO) collects ADR data reported from pharmacovigilance organizations in each nations. In China, pharmacovigilance centers operate with hierarchical structure at local, provincial and national levels. Also, Japan and Korea each operate their own respective independent pharmacovigilance organizations. WHO is collecting ADR reports for herbal medicine and 15~20% of all ADRs was related to herbal medicine in China. There are status reports of ADRs for herbal medicine in Japan as well. However, in Korea, there is no ADR reporting system regarding herbal medicine. In light of these overseas cases, a spontaneous ADR reporting system for herbal medicine in Korea should be necessary as well.

약물역학분야의 한약연구동향

우연주 대한예방한의학회 2018 대한예방한의학회지 Vol.22 No.3

Objectives : The aim of this study is to investigate the current research trend of herbal medicine based on the published articles in pharmacoepidemiologic journals. Methods : A total of 3 electronic journals, Pharmacoepidemiology and Drug Safety(PDS), Drug Safety and Journal of Pharmacoepidemiology and Risk Management(JPERM) from January 2013 to August 2018 were used for searching articles about herbal medicine. Selected articles were reviewed and classified under 5 categories-collection of adverse events in herbal medicine, statistical modeling and methodology, pharmacoepidemiologic outcome study, drug utilization review(DUR), risk management system and regulation. Results : A total of 8 articles were finally included for analysis. 2 articles were categorized in collection of adverse events in herbal medicine, 1 was statistical modeling and methodology, 2 were pharmacoepidemiologic outcome study and 3 were risk management system and regulation. There was no article in DUR. And then pharmacoepidemiologic research trends of herbal medicine were summarized in classification of 5 categories. Conclusions : To sum up with these 8 articles of herbal medicine in pharmacoepidemiologic journals, herbal medicine was of interesting concern among researchers. The need for research on safety and risk management of herbal medicine is steadily increasing, pharmacoepidemiologic research about herbal medicine must be activated in Korea.

개항기 한국인의 공원관 형성

우연주,배정한,Woo, Yun-Joo,Pae, Jeong-Hann 한국조경학회 2011 韓國造景學會誌 Vol.39 No.6

개항(1876년)을 기점으로 우리나라에 존재해 온 공원의 태동기 역사를 규명하고자 한 본 논문은 개항기 한국인의 공원관 형성과 도시 공원의 성립에 관해 고찰하였다. 즉, 서구로부터 도입된 공원 개념을 받아들이는 입장에서 한국인들이 그것을 어떤 태도로, 어떤 시각으로 바라보았으며, 어떠한 방식으로 수용하고자 했는지를 파악해 보고자 했다. 이를 위해 개항 이후 최초로 외국의 근대 문물을 시찰하고 그 내용을 기록으로 남겼던 수신사의 "수신사기록"에서부터 해외 유학생들의 견문 기록 중 가장 대표적인 저작으로 볼 수 있는 유길준의 "서유견문"과 윤치호의 "윤치호일기", 그리고 한국 최초의 자주적 공원인 '독립공원' 조성에 관한 기록을 남기고 있는 "독립신문"을 비롯한 서재필과 독립협회의 몇 가지 기록들을 면밀히 검토했으며, 가능한 한 1차 문헌에서 관련 내용을 발굴하고 해석하는데 중점을 두었다. 그 결과, 개항기 한국의 근대적 개혁을 이끌었던 지식인들 사이 공원 의식이 생겨나고, 그것을 발전시켜 나가는 모습을 파악할 수 있었다. 수신사의 공원 인식에서부터 유길준의 공원의 필요성 인식, 그리고 윤치호의 공원에 대한 문화적 예술적 관심에 이르기까지, 공원관이 확대되고 심화되어 가는 과정이 확인되었다. 특히 서재필과 독립협회가 주도적으로 참여한 독립공원은 사회적 의미와 상징을 담은 공간으로 운동, 휴식, 위생, 계몽을 위한 도시 공원이었으며, 이러한 공원을 비롯한 도시 녹지의 필요성에 관한 내용이 지속적으로 대중들에게 전달되고 있었다. 즉, 일제 강점기가 시작되기 훨씬 이전부터 한국인들에게는 공원에 대한 의식과 견해가 형성되었으며, 단순한 모방과 이식이 아니라 충분한 이해와 사회적 필요성을 바탕으로 공원이 등장한 것으로 볼 수 있다. 한국 공원의 근간을 이루는 태동기 역사를 규명하고자 했던 본 논문은 분명히 존재하고 있었지만, 지금까지 소홀히 다뤄져 왔던 한국 공원의 뿌리를 규명했다는 점에서 그 의의를 지닐 수 있을 것이다. This research explores the Korean perspective on parks and the beginning of urban parks in the port opening period. The purpose of the study is to understand how Koreans viewed and accepted the idea of a park as imported from western culture and with what attitudes. Analyzed sources included: "Susinsa's Record"(修信使記錄) by Susinsa(修信使) who wrote the inspection records of foreign modern cultures for the first time after the port opening, "Seoyukyunmun"(西遊見聞) by Yu Kil-jun(兪吉濬) and "Yun Chi-ho's Diary"(尹致昊日記) by Yun Chi-ho(尹致昊), which are representative works by students sent abroad, as well as some records of Seo Jae-pil(徐載弼) and The Independence Club(獨立協會) such as "The Independent"(獨立新聞), which contains the records of 'IndependencePark'. This research is focused on the literature that reexamins and interprets the related data from primary sources. As a result, it was found that the people who led the modern reformation in the Port Opening period adopted and developed social thinking regarding parks. Indeed, it was possible to witness the gradual sophistication of the concept of a park from the time of Susina's thoughts on parks to that of Yu Kil-jun's support for the need and importance of parks and Yun Chi-ho's cultural and artistic interest in parks. Also, Seo Jae-pil and the Independence Club drove the development of Independence Park, which was designed to incorporate social values and symbols while also serving to meet the needs of recreation, leisure, hygiene, and enlightenment. The Independence Club consistently advocated for the necessity of open spaces and delivered this message to the public via article writing. In short, even prior to the Japanese colonial period, Koreans shared thoughts and exchanged opinions on parks. Parks were to be created not just as a copy or transplant of western parks, but were constructed based on social demands and necessity. As few studies have taken the approach of identifying this origin of Korean parks, thus, this research which traces back the origin of Korean parks, is significant.