선진 주요국의 의료제도 연구

장원기,정혜선 대한의사협회 의료정책연구소 2003 대한의사협회 의료정책연구소 연구보고서 Vol.- No.-

한국어능력시험에서 문화감지 요소의 적용 연구

장원기 한국말글학회 2010 한국말글학 Vol.27 No.-

건강도시 거버넌스의 구조와 지향

장원기 순천향대학교 순천향의학연구소 2017 Journal of Soonchunhyang Medical Science Vol.23 No.1

The Healthy Cities program is being actively pursued worldwide under the leadership of the World Health Organization as an effort to improve urban health through changes in the physical and social environment. As the core of the Healthy Cities program, governance establishes and implements diverse health plans and healthy public policies through political support, intersectoral cooperation, community participation, and multilevel networks. With the development of Healthy Cities programs, governance has evolved in the direction of autonomy, equity, and integration. These governance orientations should be continuously reflected in Healthy Cities strategies in order to successfully improve citizens’ health.

수처리 적용을 위한 PVdF/GO 하이브리드 나노섬유 분리막의 제조

장원기,윤재한,정화경,정건용,변홍식 한국막학회 2015 한국막학회 총회 및 학술발표회 Vol.2015 No.05

본 연구에서는 산화그래핀(GO)을 기질 고분자인 PVdF에 도입하여 전기방사법으로 나노섬유 형태의 분리막을 제조하고, 수처리용 분리막으로의 활용가능성을 조사하였다. 제조된 GO와 나노섬유 분리막은 SEM, TEM, XPS, FT-IR, Raman spectra등을 이용하여 GO의 도입여부 및 화학적 구조를 분석하였으며, 순수투과도 및 제거율, TMP변화를 상용막인 CPVC(chlorinated Polyvinyl chloride) 평막과 비교분석하였다. 또한, 항균성 향상과 중금속 제거를 위해 금속물질과 복합화를 진행하고, 이에 따른 활용가능성을 조사하였다.

유럽에서의 건강영향평가

장원기 한국보건사회연구원 2008 보건복지포럼 Vol.146 No.-

유럽은 건강영향평가가 활발히 이루어지고 있는 지역으로 특히 북서부 유럽 국가들을 중심으로 다양한 제도적 형태로 발전하고 있다. 개발사업에 대한 건강영향평가가 많은 부분을 차지하며, 일부 국가에서는 정책 전반에 걸친 건강영향검토를 제도화하고 있다. 또한 개별 국가 수준에서 뿐만 아니라 유럽연합 및 세계보건기구 유럽지부 등 지역의 여러 기구의 움직임 역시 건강영향평가의 발전에 기여하고 있다. 유럽의 건강영향평가는 지방정부와 중앙정부를 막론하고 점차 모든 정책영역으로 확산되고 있으며, 형태면에서도 여타 영향평가와의 통합적 영향평가방식으로 변화되고 있다. 즉, 세계보건기구의 구호대로 `모든 정책에서의 건강 추구(Health in All Policies)`를 실현하는 정책도구로서 면모를 갖추어가고 있으며, 정책에 대한 평가 역시 환경과 건강 등 여러 측면을 종합적으로 평가하는 방향으로 나아가는 것으로 보인다.

건강증진 프로그램 효과에 영향을 미치는 프로그램 관련 요소 분석 - 문헌고찰을 중심으로 -

장원기,정경래,김철웅 한국보건행정학회 2002 보건행정학회지 Vol.12 No.1

To find out more efficient ways of implementing health promotion programs and to determine the factors affecting the results of various interventions, we reviewed 73 articles on the effectiveness of health promotion programs. These include the papers on the smoking, alcohol, drug abuse, nutrition(obesity) and stress management etc. Specific interventions evaluated in this review are education based on the lecture or video shows, health-related event activities, modifications of policy or the environment, health risk appraisal etc. By using KIHASA Line of Korea Institute of Health and Social Affairs, National Congress Library Database and MEDLINE, we identified 201 articles published from 1980 to Jun. 1999 and finally selected 73 papers which contain the implementation process, and result of each program. The factors used in the analysis of the programs are (1) characteristics of participants (2) interventions evaluated (3) research design (4) length of programs and evaluation point (5) outcome indices (6) effect of program evaluated by each author. The study results did not prove positive effect of education based on lectures or video shows etc. Rather, it was suggested that lecture-based education has negative effect on the result. Event activity such as contest or health festivals has positive effect, and policy change or environmental change is closely related to the event activity. Also, the result shows that the overall effect of programs for the students is less than that of the programs for the others. The programs conducted over 1-year are more likely to have positive outcomes than shorter ones. And, the outcomes of the programs with controlled research design such as experimental or quasi-experimental study tend to be evaluated inferiorly to those with non-experimental design.

지역보건행정체계 개편방향

장원기 한국보건사회연구원 2000 보건복지포럼 Vol.47 No.-

우리나라 의료규제의 내용별 유형 분류 : 대규모 규제완화시기의 존속 규제 분석

장원기 한국보건사회학회 2004 보건과 사회과학 Vol.15 No.-

After the foreign currency crisis happened in the end of 1997, Korean government have conducted a massive deregulation in the whole area of the society. This study analysed the surviving regulations in health care area for the purpose of understanding the location and types of the regulations. A great amount of regulations were found through the whole course of the national health care delivery system and health care resource development system: entry, input, production process, output, and exit. The majority of the regulations are quality regulations, and price regulation under the national health insurance system plays an important role as well. Besides, occupational health and safety regulations, regulations for securing the access of health care, and regulations for human right were found including a peculiar case of facility investment limitation for direct control of national health care expenditure. Unlike the regulations in general economic area, price and quality of services and products in health care are regulated massively all over the system, continually increasing the quality of health care and curbing the cost of the national health care system. So, it can be said that, by the regulations, government does not confine its role to compensate market failure, but actively intends to maximize the efficiency of national health care system.

CarboMEdics 기계판막을 이용한 심장판막 치환술의 임상 연구

장원기,구자홍,조중구,김공수 대한흉부심장혈관외과학회 2000 Journal of Chest Surgery (J Chest Surg) Vol.33 No.1

Background: The CarboMedics prosthetic heart valve was produced in an attempt to improve the existing valve designs and was especially concerned with easily the implantation and further reduction of turbulence. Precise positioning of the valve in situ was achieved by the abilityof the valve to rotate relative to the sewing ring. Improved monitoring is possible due to increased radiopacity and the dacron sewing ring is coated with carbon to reduce pannus overgrowth. The leaflets have an opening angle of 78 degrees that apparently allows a rapid synchronous closure The aim of this study was to analyze the clinical performance of the CarboMedics valve prostheses(45 mitral 13 aortic and 7 double aortic-mitral valve replacement) were implanted in 65 patients(mean age 48.75$\pm$9.74 years) Result: The operative mortality was 3.1%(2/65) causes of death were low cardiac output syndrome. Total follow up was 1831 patient-months and mean follow up was 29.06$\pm$10.97 months/patient. No structural failure hemorrhage valve thrombosis and late death have been observed. Embolism occurred at a rate of 0.65%/Patient-year. Actuarial survival and thrombo-mbolism free rate at 36 months were 96.9% and 98.4% respectively. Consclusions: The CarboMedics valve stands for low valve related complicatons.

임상전문분야별 의사 설문조사를 통한 병원서비스 평가 방법 연구

장원기,문옥륜,Jhang, Won-Gi,Moon, Ok-Ryun 대한예방의학회 1996 Journal of Preventive Medicine and Public Health Vol.29 No.4

A physician survey was done by mailing for the purpose of performing hospital services evaluation and ranking. A slightly over one thousand samples were drawn from the list of professional societies, and 324 physicians(about 32 percent) replied. This study has focused on developing easy and simple method to evaluate hospital services, and providing patients with useful information. Hospital service structure and process were evaluated without outcome evaluation, because it is difficult to obtain reliable data regarding health services outcome indicators. Clinical specialty was targeted to evaluate, and three specialties were chosen, that is obstetrics & gynecology, cardiology, and proctology. Among 16 structural indicators, four indicators were finally chosen in each specialty by respondent specialists. And then using these indicators, structural score was calculated for study hospitals. For process evaluation, physicians were requested to nominate five most famous hospitals. The nomination score and structural score were summed up to produce final score and hospital ranking. This method is very easy to conduct rather than other hospital services evaluation methods prevailing in Korea. And it is more useful for patients to choose hospitals, according to his/her own purpose, because it gives high ranking hospitals with specific clinical specialty.