通貨總量의 經濟成長 및 인플레이션 豫測力 提高에 관한 硏究

천병철 한국은행 2000 經濟分析 Vol.6 No.1

본 연구에서는 최근의 금융의 자유화 및 개방화 등으로 통화총량을 이용한 거시경제 전망의 精度가 저하된 점을 주시하고 통화총량과 경제성장 및 인플레이션간의 관계를 보다 안정적으로 예측할 수 있는 새로운 방법을 모색하였다. 이를 위하여 최근 계량분석에서 많이 적용하고 있는 시간변화요소를 반영한 switching regression 모형과 칼만필터링 時變母數模型을 이용하였으며 아울러 이 방법들의 상대적 예측력을 평가하기 위해 OLS 모형도 병행하여 사용하였다. 실증분석 결과에 의하면 switching regression 모형이나 칼만필터 시변모수모형이 기존의 OLS 모형보다 예측력 측면에서 우월한 것으로 나타났다. switching regression 모형에서는 MCT나 M3의 단일 계열보다는 M1, M2 및 MCT 또는 M3를 시간에 따라 적절히 변경(switching)한 시계열의 예측력이 높게 나타났다. 시변모수모형에서는 시간이 흐르면서 통화총량을 구성하는 항목들의 예측기여도가 변하고 있음을 보여주었다. 이러한 분석결관느 명목 GDP 및 인플레이션 예측에 있어 통화지표의 예측력을 보다 제고할 수 있는 여지가 있음을 시사하고 있다.

재난의 정의, 분류 및 공중보건학적 의의

천병철 대한의사협회 의료정책연구소 2015 의료정책포럼 Vol.12 No.4

F-12 : Free Paper Presentation ; GeneXpert MTB/RIF를 이용한 노숙인 결핵유병률 측정 및 진단의 유용성 평가

천병철,서해숙,김창기,김희진 대한결핵 및 호흡기학회 2013 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.116 No.0

목적: GeneXpert MTB/RIF (Xpert)는 신속하고 타당도 높은 결핵진단방법으로 전세계적으로 많이 보급되어 있으나 우리나라에서는 아직 그렇지 못하다. 노숙인은 결핵고위험군이나 검체채취의 어려움 등으로 정확한 유병률 측정이 이루어지기 힘들다. 이 연구의 목적은 Xpert를 이용하여 노숙인의 결핵유병률을 측정하고, 고위험군 결핵검진시 Xpert의 진단 타당도와 유용성을 평가하는 것이다. 방법: 2012년 10월 서울역과 영등포역의 노숙인 각각 428명과 317명을 대상으로 전문의 문진, 가슴방사선촬영과 설문조사를 실시하였다. 가슴방사선상 결핵이 의심되는 사람은 객담을 채취하여 객담도말검사, Xpert검사, 배양 및 내성검사를 시행하여 유병률을 구하고 각각의 결과를 상호 비교하였다. Xpert의 결핵 및 RIF내성진단의 타당도는 배양검사를 기준으로 계산하였다. 결과: 검진에 참가한 745명 중 남자가 94.9%였으며, 노숙기간은 5년미만이 44.4%로 가장 많았고, 다음이 10년 이상(32.6%) 순이었다. 가슴방사선상 결핵의심자는 18.5% (138명)이었으며, 이중 도말양성자는 6명(4.3%)이었다. 도말양성자는 모두 Xpert양성이었고, 도말음성자 132명 중 양성자도 12명(9.0%)이어서, 결핵의심자 중 Xpert 양성자는 총 18명(13.0%)이었다. Xpert 진단을 기준으로 노숙인 결핵유병률은 1,000명당 24.2명이었다. 배양을 기준할 경우 노숙인 결핵유병률은 1,000명당 14.8명이었고, Xpert의 민감도와 특이도는 각각 100.0%, 94.5%였다. Xpert에서 RIF내성자 2명은 모두 배양에서 RIF 내성으로 판정되었고, 음성자는 모두 음성이어서 RIF내성에 대한 민감도와 특이도는 모두 100.0%였다. 결론: 노숙인의 결핵유병률은 일반인에 비해 매우 높다. Xpert는 높은 민감도와 특이도, 신속한 결과가 가능한 검사법으로 양질의 검체를 받기 어려운 고위험군에서도 결핵검진에 유용하다.

중동호흡기증후군 유행 시 밀접접촉자의 정의와 관리방안: 2015년 유행의 반성과 교훈

천병철 대한의사협회 2015 대한의사협회지 Vol.58 No.8

Middle East respiratory syndrome (MERS) is an emerging zoonosis caused by the novel MERS corona virus isolated in 2012. Most MERS cases have been reported from Arab countries of the Middle East, including Saudi Arabia, United Arab Emirates, Qatar, and Jordan. There have been a few imported cases in many countries, but the exception is Korea, which reported 186 confirmed cases originating from one imported case in a two-month outbreak in 2015. There are many lessons to be learned from the MERS outbreak in Korea, among them, management of contacts. The definition of “close contact” used by the Korean Centers for Disease Control and Prevention (KCDC) for MERS response was not clear and not compatible with the definition of the World Health Organization. This incorrect definition allowed the KCDC make serious mistakes in contact tracing and management in the early epidemic stage of MERS. After the rapid expansion of the outbreak, the KCDC redefined a “close contact” according to the definition of the US CDC. The total number of close contacts was 16,693 in this outbreak, and they were all forced to conduct a self-quarantine for 14 days after the last contact with a MERS patient. It was not clear whether self-quarantine of close contacts was effective to control the outbreak. Given the lack of prepared guidelines or a social support system for them, these measures for the massive number of asymptomatic contacts caused a great deal of confusion in the field A clear response guideline is needed for contact management based on robust evidence from this MERS epidemic in Korea.

Economic burden of otitis media and a survey of physicians for its practice and claim codes in Korea

천병철,손우연,정원주,이환종 대한의사협회 2013 대한의사협회지 Vol.56 No.1

Otitis media (OM) is one of the most common pediatric infectious diseases. The burden of OM is known in many countries, but data for Korea has not been collected. The primary objective of this study was to evaluate the disease burden of OM in both children and adults. The Health Insurance Review and Assessment database study was analyzed to estimate the clinical and economic burden of OM and acute OM (AOM) for 2004. OM was defined as all cases coded H65,H66, or H67 and AOM cases coded H65, H65.0, H65.1, H65.9, H66, H66.4 or H66.9. For AOM,repeated visits within 30 days were considered to be one episode. Age specific incidence, and direct and indirect costs were estimated. A survey on pediatricians and otolaryngologists who most frequently diagnosed OM was carried out. The objective was to evaluate the accuracy of the claims made for OM and to examine the diagnosis and treatments of OM. A total of 5,964,587claims for OM and 2,924,532 AOM episodes were reported. The incidence of outpatients presenting AOM was 60.9/1,000. The incidence of AOM was highest in children aged 1 year (736.9/1,000). The overall hospitalization rate due to AOM was 2.8/10,000, with a peak of 29.4/10,000 (1 year). The total cost incurred by AOM in Korea was estimated to be around 606.3billion Korean won (KRW; 1,000 KRW is approximately US$1.00). The total cost of admissions was approximately 22.9 billion KRW, and the average cost of admission per person was about 1,690,000 KRW in a year. The cost of outpatient visits was 583.4 billion KRW, and 199,000 KRW per person. According to a survey of pediatricians and otolaryngologists on the accuracy of the OM diagnostic code, treatment, and prescription habits, the first-line diagnosis of AOM seemed to be fairly accurate. OM, including AOM, causes a considerable clinical and economic burden in Korea.

사람에서 조류인플루엔자 유행과 인플루엔자의 대유행

천병철 대한수의학회 2011 대한수의학회 학술대회발표집 Vol.2011 No.-

직장 건강증진사업 : Issues and Strategies 논점과 전략

천병철 서울大學校 保健大學院 1997 國民保健硏究所硏究論叢 Vol.7 No.2

Since the publication of the Lalonde Report in 1974, the concept of health promotion have been introduced into many health-related fields. In this report, he emphasized the self-imposed risls and environment as the determinants of major 5 diseases, and the change of the helath behavoir and environment would reduce the premature mortality from diseases. Health promotion programs have been developed within 3 main groups- schools, worksite, commuities - in USA. The employed persons are those at greatet risk for premature morbidity and mortality, those who occupies about 1/4 of whole population and those who makes social productivity. It is optimal to apply health promotion progam to worksite, because it is effective, easily accessible and even beneficial to both the employees and the employers. The examples of typical worksite health promotion programs are smoking cessation, hypertention control, nutrition, weight control, stress management, exercise and fitness and other assitance programs concernig alcohol, drugs and accident prevention. In other aspecs, these programs are too much individualized, not concordant with pre-existing occupational health system, restricted participation of the employees and lack of carefully performed cost-benefit analysis. In Korea, the problesm of worksite health promotion is more comples. The major proportion of the workers sork for small or very small worksites, and many of them for service industries. Less than half of the company have the worksite health manager. There are insufficient survey for the health needs of employees and emplyers, and many other problems- discordant with pre-existing system, lack of evoluations etc. It is need to concrete firm base to establish suitable worksite health promotion programs before imitating other contries's programs.

우리나라 감염병관련 법률 및 정책의 변천과 전망

천병철 대한감염학회 2011 Infection and Chemotherapy Vol.43 No.6

The history of modern infectious disease control in Korea could be divided into 4 era by its characteristics; the Opening and Korean Empire era (1896-1910), Japanese Colonial Rule and US military government era (1910-1948), Korean government era before 2000 (1948-2000) and After 2000 (2000-present). In the Opening and Korean Empire era, the first form of communicable disease prevention act was issued in 1899, including the first 6 notifiable communicable diseases in Korea; cholera, smallpox, dysentery, diphtheria and epidemic typus. Before establishment of administrative department for infectious disease, Japanese Colonial Empire took the police power away and set the colonial sanitary police system in 1907. During the Japanese Colonial Rule, the sanitary police system was forcefully active not only to control the epidemics but also fortify the colonial governmentalism. But during the colonial era, the incidence of water-borne diseases like typhoid fever and dysentery had increased, and the respiratory diseases both diphtheria and tuberculosis also had increased. This forceful sanitary police system had influenced the communicable prevention act and health policy for over 50 years after the colonial era. In 1954 the Korean government proclaimed the communicable prevention act. Since then the government increased the number of national notifiable diseases and refined the related acts by public needs. In 2000, the communicable prevention act was fully amended to satisfy the modern public health principles not the sanitary policy rules. And the revised act named 'Infectious Diseases Control and Prevention Act' was proclaimed in 2010. The globalization, emerging and re-emerging infectious disease, climate change, change of health behavior, development information technology, unification of Korean peninsula would be the next challenges of infectious disease control and prevention in Korea.

[주제발표 1] 감염병 위기대응체계 개선

천병철 대한의사협회 의료정책연구소 2015 의료정책포럼 Vol.13 No.3

Understanding and Modeling the Super-spreading Events of the Middle East Respiratory Syndrome Outbreak in Korea

천병철 대한감염학회 2016 Infection and Chemotherapy Vol.48 No.2