의과대학 졸업 10년 후 활동의사의 출신대학별 근무지역과 지역별 출신대학 분포

유승흠,손태용,오현주,Yu, Seung-Hum,Sohn, Tae-Yong,Oh, Hyohn-Joo 대한예방의학회 1996 예방의학회지 Vol.29 No.3

The geographical distribution of active physicians who graduated from medical schools before 1985 were studied. Those who had emigrated, hold non-medical jobs, are in the military service, or work as public health physicians and resident staff were excluded from the study. A total of 27,728 physicians were analyzed. Our studies have shown a relationship between the location of the medical schools from the which the physicians have graduated and the geographical regions in which they practice. A statistically significant number of physicians are working near the medical colleges from which they have graduated. That is, those who had graduated from medical schools located in the southern area of the country are presently working in the same region. This relationship was shown to be especially significant for older physicians and female doctors, who work around the area of the medical colleges from which they graduated.

의사인력 배출의 사회적 관련요인

유승흠,박종연,Yu, Seung-Hum,Park, Chong-Yon 대한예방의학회 1990 Journal of Preventive Medicine and Public Health Vol.23 No.4

This study was designed to investigate whether recruitment of physicians and dentists has been restricted to a social network, such as familial or kinship groups. The data was collected through a self-administered questionnaire survey distributed to a sampling of general physicians, specialists (internists, surgeons, other specialists), and dentists in August 1990. The major findings are as follows : 1) Total number of respondents was 405 ; of these, general physicians made up 48.9%, internists 10.4%, surgeons 15.8%, other specialists 4.9%, and dentists 20.0%. 2) 38.5% of the respondents had physicians or dentists in their immediate family or were related in some way to one. Those from urban areas, whose parents were highly educated, and whose father was a professional had more physicians or dentists in their family or kinship. 3) Parents of 7.1% of the respondents, brothers or sisters of 10.1%, grand parents of 1.7%, uncles or aunts of 7.9%, and cousins of 22.0% were physicians or dentists. 4) The majority of physicians or dentists in familial or kinship network specialized n surge, 32.3%, followed by internal medicine ; current worksites were noted as clinics by 30.8%, followed by general hospital, university hospital, and so on. The respondent's ma discipline tended to follow familial or kinship example. Consequently, it was concluded that physicians and dentists have been recruited within restricted familial or kinship network.

보건의료제도 변화에 대한 지역주민의 수용태도 분석

유승흠,손명세,박종연,Yu, Seung-Hum,Sohn, Myong-Sei,Park, Jong-Yeon 대한예방의학회 1989 Journal of Preventive Medicine and Public Health Vol.22 No.1

This study was conducted to analyse attitudes to a new health care system in a rural community. The specific purpose of this thesis was to classify attitudes to the patient referral system in Kangwha county, and to identify factors affecting the attitudes. Sampling was done by a multi-stage stratified cluster sampling method from the population. The data were collected in Kangwha county through a structured interview survey for two weeks in June, 1957. Attitudes to the patient referral system were classified into four types based upon answers to questions about awareness of the system, the recognition for the necessity of the system, and opinions on the improvement of the system. The four types of attitudes were active acceptance(10.2%), partial acceptance (27.2%), refusal(35.8%), and indifference(26.7%). The respondent's age, educational level, age of head of household, medical insurance fee, the number of ill family members, and the percentage of medical utilization by the family were the variables which affected the attitudes. The medical insurance fee, respondent's age, age of head of household, and the percentage of medical utilization by the family were the statistically significant discriminant factors of the four types of attitudes.

의과대학 예방의학 성적의 비교 분석

유승흠,노재훈,정상혁,남정모,Yu, Seung-Hum,Roh, Jae-Hoon,Jung, Sang-Hyuk,Nam, Chung-Mo 대한예방의학회 1989 Journal of Preventive Medicine and Public Health Vol.22 No.2

The purpose of this study was to find a better evaluation methody by comparison and analysis of the subdivision-score for preventive medicine with other subjects and the total score. Among the 475 students who were second grade in 1983, 1984 and 1985, we analyzed the stores for all subjects at Yonsei University College of Medicine obtained by 443 students, with the exception of 32 students who had had a temporary absence from school, failed or had been expelled. And we analyzed the score for preventive medicine of 162 students who were second grade in 1987 and 179 students who were second grade in 1988. Statistical analysis of the above data was done using the correlation analysis, chi-square test and discriminating index. The results were as fellows: 1. The correlations of the subdivision of preventive medicine in 1984, 1987 and 1988 were statisticall significantly high(r=0.36-0.56). 2. The grades obtained for preventive medicine and for other subjects except pediatrics (clerkship) were not independent. 3. The discriminating indices that determined whether or not a pertinent evaluation was made were 0.42 in 1983, 0.52 in 1984 and 0.54 in 1985. These results were classified as excellent. These results suggest that the score of a subject is determined not by the characteristics of the subject, but by the amount of personal study.

의료보험 통계자료를 이용한 최근 우리나라 질병구조 변화관찰 - 의료보험관리공단 자료를 중심으로 -

유승흠,정상혁,Yu, Seung-Hum,Jung, Sang-Hyuk 대한예방의학회 1990 예방의학회지 Vol.23 No.3

Accumulated data on medical care utilization among the insured in Korea Medical Insurance Corporation can explain the health status of the population. The purpose of this study was to analyze a change of the disease-mix and utilization pattern by controlling the size of the population enrollment. Major findings of the study are as follows : 1. The changes of inpatient disease-mix a. Utilization rate was 139.2% in 1988 against 1980. b. Disease groups higher than the average utilization rate included neoplasms, endocrine, nutritional and metabolic diseases and immunity disorders, mental disorders etc. Meanwhile, disease groups seen less often were infections and parasistic diseases, diseases of blood and bloodforming, diseases of the digestive system etc. c. Utilization rate was up 106.3% in 1988 compared to 1985, and diseases above that average level were ill-defined intestinal infections, chronic liver disease and cirrhosis, diabetes mellitus, essential hypertension, etc. d. The disease-mix by institution in 1988 compared to 1985 shows that chronic disorders rank high in general hospitals whereas opthalmologic, obstetric, and orthopedic diseases rank high in private clinics. 2. The changes of outpatient disease-mix a. Utilization rate was up 175.2% in 1988 compared to 1980. b. Disease groups higher than the average utilization rate included neoplasms, endocrine, nutritional and metabolic diseases and immunity disorders, mental disorders etc. And disease groups seen less often were infections and parasistic diseases, diseases of the respiratory system, diseases of the genitourinary system. etc. c. Utilization rate was up 104.0% in 1988 compared to 1985, and diseases above that average level were gastric ulcer, diseases of hard tissues of teeth, etc. And diseases seen below that average level were acute nasopharyngitis(common cold). acute upper respiratory infections of multiple or unspecified sites, etc. It was concluded that medical care utilization level was increased, and that, from 1980 to 1988, disease-mix shifted to the chronic disorders. Chronic disorders accounted for more medical care utilization in general hospitals.

서울올림픽대회 기간중 스포츠의료 이용에 관한 분석

유승흠,손명세,이영두,박은철,김춘배,Yu, Seung-Hum,Sohn, Myong-Sei,Lee, Young-Doo,Park, Eun-Cheol,Kim, Chun-Bae 대한예방의학회 1989 예방의학회지 Vol.22 No.1

This study made a descriptive analysis of the cumulative amount and rate of sports medical care utilization during the 24th Seoul Olympic Games by the participating athletes, officials, etc. The sports medical care utilization was a component of the total medical care use and was basically caused by the prevention and treatment of sports injuries. The analytic data were derived from the Olympic Health Management Information System(OHMIS) of the SLOOC and the Korea Athlete Trainer Association(KATA). These were analyzed according to the quantity of physician visits and the utilization rate, which was the amount of utilization divided by the total number of participating persons. The results were as follows: Firstly, the sports medical care utilization by the persons participating in the Seoul Olympics amounted to 17.9% of the total medical care utilization. The venue medical services utilization accounted for 54.7% of the total physician visits, which was larger than the village medical center's utilization. The number of physician visits per hundred persons during the 2 week period in the venue clinic was 3.03 and that of the village medical center was 2.51, therefore, the total was 5.54. Secondly, athletes accounted for 82.3% and officials 12.2% in the sports medical care utilization by participants. These results were because athletes, who were directly related to the games, called extremely often on the physicians. The utilization rate of sports medical care by athletes was 34.29. Thirdly, the sports medical demand according to type of therapy could be ranked from high to low in the following order: sports massage, thermal therapy, and electrical stimulation treatment, etc. The department of physical therapy in the village medical center was used a great deal. Fourthly, the trend of daily sports medical care utilization by the athletes showed a bell shape centering around the opening day of the Seoul Olympic Games. The utilization rate of athletes was 2.3; however, that of officials was 0.6. Lastly, the sports medical demand was calculated according to the continents, and Central America, Africa and Middle-East Asia proved to have a higher rate of sports medical care utilization than the more powerful and industrialized continent or regions.

인구구조의 변화에 따른 의료비 추계

유승흠,정상혁,남정모,오현주,Yu, Seung-Hum,Jung, Sang-Hyuk,Nam, Jeung-Mo,Oh, Hyohn-Joo 대한예방의학회 1992 예방의학회지 Vol.25 No.3

It is very important to estimate the future medical care expenditure, because medical care expenditure escalation is a big problem not only in the health industry but also in the Korean economy today. This study was designed to project the medical care expenditure in view of population age change. The data of this study were the population projection data based on National Census Data(1990) of the National Statistical Office and the Statistical Reports of the Korea Medical Insurance Corporation. The future medical care expenditure was eatimated by the regression model and the optional simulation model. The significant results are as follows : 1. The future medical care expenditure will be 3,963 billion Won in the year 2000, 4,483 billion Won in 2010, and 4,826 billion Won in 2020, based on the 1990 market price considering only the population age change. 2. The proportion of the total medical care expenditure in the elderly over 65 will be 10.4% in 2000, 13.5% in 2010, and 16.9% in 2020. 3. The future medical care expenditure will be 4,306 billion Won in the year 2000, 5,101 billion Won in 2010, and 5,699 billion Won in 2020 based on the 1990 market price considering the age structure change and the change of the case-cost estimated by the regression model. 4. When we consider the age-structure change and inflation compared with the preceding year, the future medical care expenditurein 2020 will be 21 trillion Won based on a 5% inflation rate, 42 trillion Won based on a 7.5% inflation rate, and 84 trillion Won based on a 10% inflation rate. Consideration of the aged(65 years old and over) will be essential to understand the acute increase of medical care expenditure due to changes in age structure of the population. Therefore, alternative policies and programs for the caring of the aged should be further studied.

의료소비자가 인지하는 의료서비스 질의 구성 차원

유승흠,조우현,김동기,이윤환,문기태,Yu, Seung-Hum,Cho, Woo-Hyun,Kim, Dong-Kee,Lee, Yun-Whan,Moon, Ki-Tae 대한예방의학회 2000 예방의학회지 Vol.33 No.4

Objectives : To examine various dimensions of consumer ratings of health care service with factor analysis and to find which factors influence the overall quality of health care service. Methods : A cross-sectional study was conducted on outpatients of a general hospital located in Sungnam City. A self-administered questionnaire was used to assess the consumer's ratings of health care service received. The response rate was 92.8% with a total of 537 persons completing the questionnaire. Factor analysis was performed on 34 items evaluating the quality of health care service. Items were grouped into 5 dimensions as a result of factor analysis and the reliability and validity of influence on patient service assessment were evaluated for each dimension. Results : The 5 dimensions were as follows, 1) physician services, 2) non-physician services, 3) process 4) facilities, and 5) cleanliness A positive correlation with the quality of health care service was found for the dimensions of non-physician services and process, while no significant correlation was found for the dimensions of physician services, facilities, and cleanliness. Conclusions : The result of this study may provide basic information for the development of future self-administered questionnaires of consumer ratings and for the evaluation of quality improvement activities in hospital outpatient settings.

전립선비대증의 진료지침 개발을 위한 한국문헌의 메타분석

유승흠,김춘배,강명근,송재만,Yu, Seung-Hum,Kim, Chun-Bae,Kang, Myung-Geun,Song, Jae-Mann 대한예방의학회 1997 예방의학회지 Vol.30 No.3

This study is to provide evidence-based recommendations for the most-effective treatments of benign prostatic hyperplasia based on patient preference or clinical need, and to meta-analyze the Korean literatures for the development of BPH treatment guidelines. For these analyses, extensive literature searches (208 articles), with priority given to the Korean Journal of Urology, were conducted from 1960 to August, 1996. Meta-analysis, like all statistical analysis, has two main functions: data summarization (qualitative meta-analysis) and smoothing o. pattern recognition (quantitative meta-analysis). As well, critical reviews and syntheses with the mean and 90-percent confidence intervals for the likelihood were used to evaluate empirical evidence and significant outcomes of the BPH treatment literatures (106 articles). For this task, the Methodologic Panel for BPH Guidelines was composed of multidisciplinary experts in the field. The results of the study were summarized as follows: For all that watchful waiting is an appropriate treatment strategy for the majority of patients with prostatism, we couldn't find the Korean literatures which carried this article. The literatures on alpha-1-adrenergic receptor blockers provide no evidence to suggest that any one alpha blocker is more effective than another. The finasteride reduces the size of the prostate, on average, and leads to a small yet perceptible reduction in sysptoms. Of all treatment options, prostate surgery with transurethral resection of the prostate (TURP), transurethral incision of the prostate (TUIP), and so on, offers the best chance for symptom improvement. However, surgery also has the highest rates of significant complications. Therefore, surgery need not always be a treatment of last resort. Balloon dilation of the prostatic urethra is clearly less effective than surgery in relieving symptoms, but it is associated with fewer complications. Emerging technologies for treating BPH include lasers, coils, stents, thermal therapy and hyperthermia. Established technologies will also be reanalyzed as results of new trials are reported. Although this study has some limitations due to lacking for good quality literatures, ' it provides a cornerstone for our medical research. It represents the most current scientific knowledge regarding the clinical epidemiology including treatment of BPH. It will be revised and updated as needed.

건강진단 대상질환 선정 및 건강진단의 정확성 평가

유승흠,노재훈,이해종,정상혁,Yu, Seung-Hum,Roh, Jae-Hoon,Lee, Hee-Jong,Jung, Sang-Hyuk 대한예방의학회 1989 Journal of Preventive Medicine and Public Health Vol.22 No.1

The purpose of this study was to select the manageable diseases which are prevalent in Korea for periodic health examinations and to evaluate the sensitivity and specificity of periodic health examination in detecting these diseases. The data was derived from reimbursement data of the Korea Medical Insurance Corporation over a two year period (April 15, 1986 to April 14,1988) and interviews with Yonsei Medical School professors. This study demonstrated that: 1. The manageable diseases which were selected for periodic health examinations are pulmonary tuberculosis, viral hepatitis, diabetes mellitus, syphilis groups, essential hypertension, renal disease groups, and iron deficiency anemia. 2. The sensitivity of the health screening for each disease was as follows: pulmonary tuberculosis 51.5%, viral hepatitis 60.3%, diabetes mellitus 64.7%, syphilis groups 63.3%, essential hypertension 49.9%, renal disease groups 44.0%, and iron deficiency anemia 80.9%. We conclude that peiodic health esaminations should focus on the manageable diseases that we have defined. The number of items in periodic health screening tests and hospital quality control should be increased for the diseases with a demonstrated low sensitivity.