Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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One-year evaluation of the national health screening program for infants and children in Korea

영유아 건강검진 시행 초기 1년의 결과 분석

  • Moon, Jin Soo (Department of Pediatrics, Inje University Ilsan Paik Hospital) ;
  • Lee, Soon Young (Department of Preventive Medicine and Public Health, School of Medicine, Ajou University) ;
  • Eun, Baik-Lin (Department of Pediatrics, Korea University College of Medicine) ;
  • Kim, Seong Woo (Department of Rehabilitation Medicine, NHIC Ilsan Hospital) ;
  • Kim, Young Key (Department of Psychiatry, NHIC Ilsan Hospital) ;
  • Shin, Son Moon (Department of Pediatrics, Kwandong University College of Medicine) ;
  • Lee, Hye Kyoung (Department of Pediatrics, Seoul Veterans Hospital) ;
  • Chung, Hee Jung (Department of Pediatrics, NHIC Ilsan Hospital)
  • 문진수 (인제대학교 의과대학 소아과학교실) ;
  • 이순영 (아주대학교 의과대학 예방의학교실) ;
  • 은백린 (고려대학교 의과대학 소아과학교실) ;
  • 김성우 (국민건강보험공단 일산병원 재활의학과) ;
  • 김영기 (국민건강보험공단 일산병원 정신과) ;
  • 신손문 (관동대학교 의과대학 소아과학교실) ;
  • 이혜경 (서울보훈병원 소아청소년과) ;
  • 정희정 (국민건강보험공단 일산병원 소아청소년과)
  • Received : 2010.02.18
  • Accepted : 2010.03.02
  • Published : 2010.03.15
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Abstract

Purpose : Results of the Korea National Health Screening Program for Infants and Children, which was launched in November 2007, were evaluated for future research and policy development. Methods : Data from a total of 2,729,340 cases were analyzed. Five visiting ages, such as 4, 9, 18, 30, and 60 months, were included. Several parameters such as stunting, obesity, and positive rate of developmental screening were also analyzed. Telephone survey was performed in 1,035 users. For the provider survey, 262 doctors participated in our study. Results : The overall participation rate of users was 35.3%. This participation rate showed a decrement tendency to old age and low income. Only 6.9% of users participated in oral screening. Health screening was performed mainly in private clinics (82.6%). The recall rate of 4 months program users at the age of 9 months was 57.3%. The positive rate of screening was 3.1%, and was higher in the low-income group. By telephone survey, users reported that questionnaires were not difficult (94%) and overall satisfaction was good (73%). Longer duration of counseling was related with more satisfied users. Counseling and health education were helpful to users (73.2%). Doctors agreed that this program was helpful to children (98.5%). Conclusion : Korea National Health Screening Program for Infants and Children was launched successfully. Participation rate should be improved, and a quality control program needs to be developed. More intensive support following this program for children of low-income families may lead to effective interventions in controlling health inequality. Periodic update of guidelines is also needed.

목 적 : 2007년 11월 15일부터 시작된 영유아 건강검진의 시행 일년간의 검진 결과를 분석하고, 설문조사를 통하여 수검자와 검진의사의 의견을 조사하여, 향후 영유아 건강검진의 개선 및 발전 방향을 알아보고자 하였다. 본 연구는 국민건강보험공단과 질병관리본부의 지원 하에 수행되었다. 방 법 : 2007년 11월 15일부터 2008년 10월 16일까지 4개월, 9개월, 18개월, 30개월, 5세 검진 대상자 총 2,729,340명의 검진 자료를 분석하였다. 수검자는 1,035명을 대상으로 전화 설문조사를 시행하였고, 262명의 검진의사를 대상으로 설문조사를 시행하였다. 결 과 : 전체 수검률은 35.3%이었다. 수검률은 월령이 증가하면서 감소하는 경향을 보였으며, 성별에 따른 수검률의 차이는 없었다. 구강검진은 6.9%의 수검률을 보였다. 소득이 가장 높은 그룹의 수검률이 가장 낮았고, 의료급여 수급자에서도 낮았다. 검진은 의원에서 82.6%의 수검이 이루어졌다. 4개월 수검자 중 9개월 재 수검자로 계산한 재 수검률은 57.3%이었다. 전체 수검자의 3.1%가 종합판정에서 유소견율을 보였으며, 소득분위가 낮은 그룹에서 유소견율이 높았다. 수검자 설문조사에서는 문진표가 어렵지 않다고 하였고(94%), 검진과정도 73%에서 대체로 만족할 만한 수준이라 응답하였다. 상담 시간 5-10분간 상담을 받은 수검자의 84.2%, 10분 이상 상담을 받은 수검자의 94-95%에서 상담시간에 만족한다고 답하였다. 응답자의 73.2%에서 상담과 교육이 도움이 되었다고 응답하였다. 건강교육은 77.1%에서 수검되었고 설명서도 73.7%에서 수취되었다. 검진의사는 결과 통보서를 작성하는 것에 어려움이 없었고(80%), 현 수가의 적절성은 51.1%가 매우 낮거나 낮다고 응답하였다. 검진의의 98.5%에서 현 검진이 어린이 건강증진에 도움이 된다고 하였으며, 94%가 앞으로도 지속적으로 참여하겠다고 응답하였다. 결 론 : 영유아 건강검진은 시행 첫 일년 동안 성공적으로 시작되었다. 향후 수검률의 향상과 질 관리가 필요하며, 소득분위가 낮은 계층에 대한 지원이 요청된다. 검진의 완전 전산화와 최소 5년 주기의 정기적인 가이드라인의 개정이 필요하다.

Keywords

Acknowledgement

Grant : Short-term Effects of Health Promotion Program of Infant & Children in Korea: An analysis

Supported by : Management Center for Health Promotion

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