Journal of Preventive Medicine and Public Health

  • 제37권2호
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  • Pages.141-149
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  • 2004
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  • 1975-8375(pISSN)
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  • 2233-4521(eISSN)
대한예방의학회 (The Korean Society for Preventive Medicine)
권호 표지

사망전 노인의 전체보건의료비용에서 보완대체요법 비용과 비용분율에 관한 연구

A Study on the Cost and Proportion of Complementary and Alternative Medicine in Total Healthcare Cost among Elderly in the Last 6 Months of Life

  • 이지전 (연세대학교 보건대학원) ;
  • 오희철 (연세대학교 의과대학 예방의학교실) ;
  • 이상욱 (관동대학교 의과대학 예방의학교실)
  • 발행 : 2004.06.01
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초록

Objectives : To evaluate the cost and proportion of complementary and alternative medicines (CAM) in the total healthcare costs among the elderly in the last 6 months of life. Methods : The care-giving families of 301 persons older than 65 years, who died between July 1st and December 31st of 2001, and were also registered in Self-Employed Health Insurance Programs in Seoul, were interviewed. Results : The cost of CAM was 1.09 million Won, which as a proportion of the total healthcare cost was 38.1%. The elderly aged between 65 and 69 year-old, male, living with their spouse, Buddhist and having cancers had higher CAM costs in an ANOVA and simple regression analysis. After controlling of various factors, age was the only significant factor associated with the cost of CAM. The elderly above 80 years old, female, bereaved and Buddhist had higher proportional CAM costs, and the elderly having cancers or cardiovascular diseases had lower proportional CAM costs in an ANOVA and simple regression analysis. After adjusting for various factors, the elderly above 85 years old, female and Buddhist had higher proportional CAM costs, and the elderly having cancers had lower proportional CAM costs. Conclusion : The very old and Buddhist, and/or the ill with no clear diagnosis, may depend more on CAM. Further research will be needed on the meaning and impact of CAM and their costs to public health and the total healthcare system.

키워드

참고문헌

  1. Eisenberg DM, Davis RB, Ettner SL, Appel S, Wilkey S, Van Rompay M, Kessler RC. Trends in Alternative Medicine Use in the United State, 1990-1997: Results of a Follw-up. National Survey. JAMA 1998; 280: 1569-1575 https://doi.org/10.1001/jama.280.18.1569
  2. Green LA, Fryer GE Jr, Yawn BP, Lanier D, Dovey SM. The ecology of medical care revisited. N Engl J Med. 2001; 344: 2021-2025
  3. Nilsson M, Trehn G, Asplund K. Use of complementary and alternative medicine remedies in Sweden. A population-based longitudal study within the northern Sweden MONICA Project. Multinational Monitoring of Trends and Determinantsof Cardiovascular Disease. J Intern Med 2001; 250: 225-233
  4. Maclennan AH, Wilson DH, Taylor AW. Prevalence and cost of alternative medicine in Australia. Lancet 1996; 347: 569- 573 https://doi.org/10.1016/S0140-6736(96)91271-4
  5. Ernst E. The current position of comple mentary/alternative medicine in cancer. Eur J Cancer2003; 39: 2273-2277 https://doi.org/10.1016/S0959-8049(03)00604-X
  6. Wong SS, Nahin RL. National Center for Complementary and Alternative Medicine perspectives for complementary and alternative medicine research in cardiovascular disease. Cardiol Rev 2003; 11: 94-98 https://doi.org/10.1097/01.CRD.0000053452.60754.C5
  7. Yeh GY, Eisenberg DM, Davis RB, Phillips RS. Use of complementary and altemative medicine among persons with diabetes melltus: results of a national survey. Am I Public Health 2002; 92: 1648-1652 https://doi.org/10.2105/AJPH.92.10.1648
  8. Foote-Ardah CE. The meaning of complementary and alternative medicine practices among people with HIV in the United States: starategies for managing everyday life. Soc Health Illn 2003; 25:481- 500 https://doi.org/10.1111/1467-9566.00355
  9. Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Delbanco TL Unconventional Medicine in the United States: prevalence, Costs, and Patterns of Use. N Engl J Med 1993; 328: 246-252
  10. Song MS, Chun KH, Song HJ, Park IW, Yoo SC. Attitudes toward Comple mentary and Alternative Medicine in Suwon City. Korean J Prev Med 1999; 32: 162-169 (Korean)
  11. Lee SI, Khang YH, Lee MS, Koo HJ, Kang W, Hong C. Complementary and Alternative Medicine Use in Korea: Pre valence, Pattern of Use, and Out-of-pocket Expenditures. Korean J Prev Med 1999; 32: 546-555 (Korean)
  12. Lee KS, Ahn HS. Hwang LI, Lee YS, Koo BH Utilization of Alternative Therapies in Cancer Patients. J Korean Cancer Assoc 1998; 30: 203-213 (Korean)
  13. Choi YJ, Chung HW, Choi SY. A Study on the Use of Alternative Medicine for Caner Patients Admitted at a Hospital J Korean Public Health Assoc 1998; 24(1): 167-168 (Korean)
  14. Park HS, Lee YM. A Study on Use of Alternative Therapy in Cancer. Korean J Reh Nurs 2000; 3(2): 212-227 (Korean)
  15. Jun ES, Park KH, Park HK, Lee JW, Yoo DH, Kim SY. Use of complementary therapies for rheumatologic conditions among patients of rheumatologist. J Koren Acad Fam Med 2001; 22(3): 371 385(Korean)
  16. Cheong YS, Park EW,Yoo SM, Kim KS, Jung HW, Shim SK, Kim GH, Lee JM, Park YJ, Yeoum HT. Use of Traditional Medicine and Folk Remedies in Hypertensive Patients J Korean Acad Fam Med 1998; 19: 141-149(Korean)
  17. Lee MS, A Survey of Utilization of Complementary AIternative Medicine in Diabetes Mellitus. J Korean Acad Nurs 2001; 31(1): 7-19(Korean)
  18. 이상욱, 이지전, 박종연.종말기 노인환자의 보건의료 비용과 삶의질. 관옹의대예 방의학교실. 2002
  19. Yi JJ, Lee HN, Ohrr H,Jung HY, Yi SW. A Study on the Association between Healthcare Utilization and the Burden of Families Caring for the Elderly in the Last 6 Months of Life. Korean J Prev Med 2003; 36(4): 325- 331 (Korean)
  20. Http://nccam.nih.gov/health/whatiscam/index .htm accessed on October 20, 2003
  21. Yi JJ, Park KS, Yu SH, Kim JI, Park lY, Yu WG, Yi SW. Medical Service Utilization and Trends among Korean Elderly in the Last One Year of Life Korean J Prev Med 2003; 36(4): 332-338 (Korean)
  22. 박노례. 암 환자의 사망천 1년간 의료이용행태 및 진료비 변동양상 인제대학교 대학원보건학과박사학위논문, 2000