Characteristic Features Observed in the East-Asian Cold Anomalies in January 2011

East Asia experienced extremely cold weather in January 2011, while the previousDecember and the following February had normal winter temperature. In this study NationalCenters for Environmental Prediction/National Center for Atmospheric Research (NCEP/NCAR) reanalysis data are used to investigate the characteristic features observed in the meteorologicalfields such as temperature, sea-level pressure, geopotential height, and wind duringthis winter period. In January the planetary-wave pattern is dominated by stationary-wave formin the mid-to-high latitude region, while transient waves are significant in the previous month.To understand the planetary-wave features quantitatively, harmonic analyses have been donefor the 500-hPa geopotential height field. In the climatological-mean geopotential heights thewave numbers 1, 2, and 3 are dominant during the whole winter. In January 2011 the waves ofnumber 1, 2, and 3 are dominant and stationary as in the climatological-mean field. In December2010 and February 2011, however, the waves of number 4, 5, and 6 play a major role andshow a transient pattern. In addition to the distinctive features in each month the planetarywavepatterns dependent on the latitude are also discussed.OAIID:oai:osos.snu.ac.kr:snu2013-01/102/0000002478/2SEQ:2PERF_CD:SNU2013-01EVAL_ITEM_CD:102USER_ID:0000002478ADJUST_YN:YEMP_ID:A004842DEPT_CD:3345CITE_RATE:0DEPT_NM:지구환경과학부SCOPUS_YN:NCONFIRM:

Changes in medical fee and utilization of services before and after the introduction of the long-term health insurance for the elderly

보건정보관리학과/석사[한글]이 연구는 노인장기요양보험제도 도입 전후의 건강보험 진료비 및 의료이용량의 변화와 이에 영향을 미치는 요인에 대하여 분석한 것이다. 장기요양보험 시행 후의 의료이용 실태를 가늠해 봄으로써 장기요양보험의 조기정착과 건강보험제도와 합목적적 역할분담을 모색하고자 하였다.국민건강보험 가입 65세 이상 장기요양 인정자를 대상으로 1인당 전체질환과 노인성질환 연간진료비와 진료일수로 측정된 의료이용량을 분석하였다. 분석대상자는 51,771명으로 장기요양 인정자 201,159명의 25.7%에 해당하며, paired t-test와 GEE 회귀모형 및 다중회귀분석을 실시하였다.연구결과 장기요양보험 실시 후 장기요양 인정자의 평균 연간진료비가 640만원에서 574만원으로 10.3%, 진료일수는 106.0일에서 95.8일로 9.6% 감소하여 통계학적으로 유의하게 낮았다. 노인성질환의 진료비는 435만원에서 405만원으로 6.8%, 진료일수는 64.9일에서 62.7일로 3.4% 줄었으며 전체질환 진료비보다 감소폭은 작았다. 반면 같은 기간 65세 이상 건강보험 전체가입자의 진료비는 303만원에서 323만원으로 6.8%, 노인성질환 진료비는 621만원에서 634만원으로 2.0% 증가하였다.성별로는 여성이 남성보다 장기요양보험 시행 이후 진료비 감소폭이 컸으나 노인성질환에는 남성이 더 컸다. 연령별로는 65세 이상 저연령 구간에서, 거주지역별로는 대도시보다 농어촌에서 진료비가 더 많이 줄었다. 건강상태특성에 따라서는 장기요양등급이 높은 등급에서 진료비 감소폭이 크고, 신체?인지기능은 하위군에서, 치매보다 중풍질환에서 진료비 감소효과가 더 높았다. 노인성질환이나 의료이용량인 진료일수 변화 또한, 정도의 차이는 있었으나 진료비에서와 같은 추세를 보였다. 다만 요양3등급과 신체기능 상위에서 진료비는 오히려 0.5%, 5.3% 증가하였고, 노인성질환과 진료일수에서 증가세는 확대되었다.이 연구에서 노인장기요양보험제도의 도입으로 장기요양 인정자의 진료비 감소와 상대적으로 전체질환에 대체효과, 노인성질환에 보완효과 경향이 있는 것으로 추측할 수 있었다. 중풍질환과 같이 대체효과 작용이 가능한 상병은 건강보험에서 장기요양급여로 전환할 수 있을 것이다. 더불어 장기요양 등급체계 개편 등 양제도의 특성을 조화롭게 활용한다면 효과적인 만성질환 관리방안으로 가능하다. 또한 노인의료비가 후기 고령인구에서 높은 것과는 대조적으로 전기 노인인구에서 높고 감소폭도 컸다. 합리적 의료이용과 연계하여 건강보험 수가체계를 보완하거나 노인의료비 절감방안마련에 참조할 수 있을 것이다. [영문]ope

ENSO-related PDO, and its changes due to global warming

ENSO-related PDO, and its changes due to global warming2

Characteristic Features Observed in the East-Asian Cold Anomalies in January 2011

East Asia experienced extremely cold weather in January 2011, while the previousDecember and the following February had normal winter temperature. In this study NationalCenters for Environmental Prediction/National Center for Atmospheric Research (NCEP/NCAR) reanalysis data are used to investigate the characteristic features observed in the meteorologicalfields such as temperature, sea-level pressure, geopotential height, and wind duringthis winter period. In January the planetary-wave pattern is dominated by stationary-wave formin the mid-to-high latitude region, while transient waves are significant in the previous month. To understand the planetary-wave features quantitatively, harmonic analyses have been donefor the 500-hPa geopotential height field. In the climatological-mean geopotential heights thewave numbers 1, 2, and 3 are dominant during the whole winter. In January 2011 the waves ofnumber 1, 2, and 3 are dominant and stationary as in the climatological-mean field. In December2010 and February 2011, however, the waves of number 4, 5, and 6 play a major role andshow a transient pattern. In addition to the distinctive features in each month the planetarywavepatterns dependent on the latitude are also discussed.N

The influence of ENSO on decadal variations in the relationship between the East Asian and Western North Pacific Summer Monsoons

A recent study suggested that the relationship between the East Asian summermonsoon (EASM) and the western North Pacific summer monsoon (WNPSM) hasexperienced a decadal change around 1993-1994. Based on a longer-term integrationof a hybrid coupled model, the present study investigates decadal variations in therelationship between the EASM and the WNPSM. Apparent decadal variations in theabove relationship have been identified in the model simulation. The authors haveanalyzed the spatial pattern and variability during strong and weak EASM-WNPSMcorrelation periods. The purpose of this study is to understand potential reasons fordecadal variations in the relationship between above two sub-monsoons. It is foundthat the precipitation variability associated with the WNPSM (ENSO) is enhancedover the East Asia and western North Pacific regions during periods when theEASM-WNPSM relationship is strong (weak). The results suggest that ENSO candestructively interfere with the relationship between the EASM and the WNPSM.1

Characteristics of ENSO in IPCC&quots 20th-Centrury Climate Simulations: Regularity of the Periods

We have used 'mean deviation of the power spectrum' in order to quantify the irregularity of the period. In particular, the coupled climate models exhibit relatively regular ENSO periodicity while some have the spread ENSO power spectra. The former four models are referred to as 'regular models' and the later four models as 'irregular models'.2

The relationship betwwen ENSO and PDO under the global warming

We examine changes in El Nino and ENSO/PDO relationship under the global warming using coupled climate models participating in the IRCC AR4. While the spatial structure of both the ENSO and PDO is altered little, the temporal structure for the ENSO-PDO relationship is changed remarkably. Under the global warming the relationship between ENSO-PDO during the boreal winter becomes stronger so that there would be more frequent in phase occurrece of ENSO and PDO. Since PDO could constructively interfere with the ENSO-related climate when ENSO and PDO are in phase, one may expect strong climate signal to ENSO in the midlatitude in the future.2

The origin of low frequency modulation of ENSO amplitude in a CGCM

The dominant El Nino and Southern Oscillation period increased from 2-3 years during 1960-1975 to 4-6 years after the late 190s. The amplitude of ENSO also tends to increase. However, the causes of ENSO amplitude modulation on decadal timescales are currently unknown. Recently, Moon et al (2004) suggested that changes in ENSO statistics is due to redistribution of baroclinic energy by change of vertical stratification in the equatorial Pacific, but they did not provide why the vertical stratification changes on decadal timescales. In this study we use the results from simulation to investigate the change in the equatorial subsurface structure and its impact on the ENSO decadal modulation.2

Vertical structure variability in the tropical Pacific and its relation to ENSO modulation in a CGCM

We study the relationship between changes in the equatorial stratification and low frequency ENSO modulation in a coupled general circulation model (CGCM). The stratification is intensified at upper levels in the western and central equatorial Pacific ocean during periods of high ENSO amplitude. Furthermore, changes in the stratification are connected with a westward-equatorward propagation of subsurface temperature anomalies originating in the central-south tropical Pacific. The analysis of the wind stress projection coefficient onto the oceanic baroclinic modes suggests that the contribution of the higher modes increases in the western and central equatorial Pacific during periods of high ENSO amplitude. This result supports the hypothesis of oceanic tunnels from the South tropical Pacific to explain the low frequency ENSO modulation.1