Journal of Digital Convergence (디지털융복합연구)

The Society of Digital Policy and Management (한국디지털정책학회)
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Analysis on geographic variations and variational factors in expenditures for hypertension

고혈압 의료비 지역 간 변이 및 변이 요인 분석

  • Received : 2015.08.21
  • Accepted : 2015.10.20
  • Published : 2015.10.28
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Abstract

This study is to investigate how the expenditures for hypertension is affected by socioeconomic, health care resources, and health behavior factors with a special emphasis on geographic variations and to provide the data about regional management for hypertension. To analyze, we combined a unique data set including key indicators from Medical Service Usage Statistics 2012 by Region by National Health Insurance Corporation, Annual Community Health Survey 2012 by Korea Centers for Disease Control and Prevention and other government organizations at the 247 small administrative districts. We found that the average expenditures of hypertension in 249 small districts is 62,000 won and coefficient of variation is 30.0. Major factors of differences in hypertension expenditure is population density, marital status, household income, number of hospital per 100 thousand, medical expenses outside the jurisdiction, drinking rate, moderate and over-intensity physical activity, and hypertension diagnosis rate. The results of decision tree was that there were significant differences between regions in hypertension diagnosis rate, household income, marital status, number of hospital per 100 thousand, obesity rate, drinking rate. This study concluded that determinants of geographic variations in hypertension spending are not only health resources and socioepidemic characteristics but health behaviors.

본 연구는 우리나라의 고혈압 의료비의 지역별 변이와 지역의 사회학적, 의료공급, 건강행태 등의 변이 요인을 규명함으로써 이를 기반으로 지역별 고혈압 관리 사업 방안 마련에 기초자료를 제시하는 것이다. 이를 위해 전국 시 군 구 247개 지역을 대상으로, 2012년 지역별 의료이용 통계자료(국민건강보험공단), 지역사회건강조사(질병관리본부) 및 국토해양부 자료를 이용 분석하였다. 연구결과 전국 247개 시 군 구의 고혈압 건강보험진료비는 평균 6만2천원이었고 변동계수는 30.0으로 지역 간 높은 고혈압 의료비 변이를 보였다. 주요 변이 요인으로는 인구밀도, 유배우자율, 평균가구원수입, 인구십만명당병원수, 관외의료비비율, 월간음주율, 중증도이상신체활동실천율, 평생의사진단율 등으로 나타났다. 의사결정나무를 이용한 분석 결과 평생의사진단율, 평균가구원수입, 유배우자율, 인구십만명당병원수, 비만율, 월간음주율에서 유의한 차이가 있었다. 본 연구의 결과 고혈압 의료비의 지역 간 변이요인으로는 의료공급이나 인구사회학적 특성뿐만 아니라 건강행태에 있음을 확인하였고 이는 고혈압의료비 절감을 위한 지역보건사업 정책 결정에 참고가 될 수 있을 것이다.

Keywords

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