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Analysis of the Trend and the Factors Influencing the Usage Before and After the Application of the National Health Insurance for the Magnetic Resonance Imaging

자기공명영상의 건강보험 적용 전·후 이용량 동향 및 요인 분석

  • Gil, Jong-Won (Dept. of Radiology, Dae Jeon Sun Medical Center) ;
  • Choi, Sung-Oog (Dept. of Beauty & Health Care Graduate School, Dae-Jeon Univ.)
  • 길종원 (대전선병원 영상의학과) ;
  • 최성욱 (대전대학교 대학원 뷰티건강관리학과)
  • Received : 2016.04.29
  • Accepted : 2016.08.11
  • Published : 2016.08.31

Abstract

This study was carried out to determine the factors affecting the trend and usage of Magnetic Resonance Imaging before and after the implementation of National Health Insurance. The research materials were the MRI Execution Data, Health Insurance Review Data, and Medical Expenses in the Health Insurance Data from a General Hospital located in Dae-jeon Metropolitan City from 2004 to 2013. The subjects of analysis were 3,754 people in 2004 (prior to the implementation of Health Insurance), and 4,107-8,603 people from 2005-2013(after the implementation of Health Insurance). In terms of analysis, a comparison of the use of MRI before and after implementation of the Health Insurance of User Characteristics and Provider Characteristics were taken as $X^2$, while factor analysis for the elements that affect MRI usage was carried out by Hierarchical Multiple Regression Analysis. According to the results of this study, the level of use decreased temporarily in the initial application stages of the national health insurance, but it soon increased. In particular, the inspection rates for women, the head and neck, those not subject to the application of the national health insurance, internal medicine, and the inpatients increased. The application of the national health insurance for MRI influenced the increasing inspection rates (P<.0001). As the inspection rate for the MRI increased, it is important to expand the application of the national health insurance to reduce the national health expenditure.

본 연구는 자기공명영상(MRI)의 건강보험 적용 전 후 이용량 동향과 이용량에 영향을 미치는 요인을 알아보기 위해 실시하였다. 연구재료는 2004년 1월부터 2013년 12월까지 대전광역시 소재 종합병원(2차 의료기관)의 MRI 실시자료(처방 정보 전달 시스템), 보험심사자료, 건강보험요양급여자료(건강보험심사평가원)를 이용하였고, 분석대상은 2004년(건강보험 적용 전) 3,754명, 2005년 - 2013년(건강보험 적용 후) 4,107명-8,630명 이었다. 분석은 이용자 특성(성별, 연령, 검사부위, 보험유형)과 공급자 특성(진료과, 진료형태)의 MRI 건강보험 적용 전 후 이용량 비교를 $X^2$ 으로 하였고, MRI 이용량에 영향을 미치는 요인분석을 위계적 다중회귀분석으로 실시하였다. 연구결과 건강보험 적용 초기에 한시적으로 이용량이 감소하지만 이후 꾸준히 증가하였다. 특히 여성의 검사 율, Head & Neck의 검사 율, 일반수가적용 환자의 검사 율, 내과의 검사율, 입원환자의 검사 율이 건강보험 적용 전에 비해 증가하였다. 그리고 MRI의 건강보험 적용은 검사 율 증가에 영향을 미치는 것으로 분석되었다(P<.0001). MRI 검사 율이 증가하는 만큼 국민의료비 감소를 위해 건강보험 적용 확대가 적극적으로 이루어져야 할 것이다.

Keywords

References

  1. Nok-Haeng Lee, Young-Jin Park, Youn-Sik Park, "Active Noise Control for Target Point Inside Bore Using Property of MRI Noise", Transactions of the Korean society for noise and vibration engineering, Vol. 24, No. 1, pp. 62-68, 2014. DOI: http://dx.doi.org/10.5050/KSNVE.2014.24.1.062
  2. Young-Hae Park, "Comparison of Claustrophobia, Noise Sensitivity and Vital Signs according to Anxiety Sensitivity Level before and after MRI", Korean Journal of Adult Nursing, Vol. 20, No. 6, pp. 950-959, 2008.
  3. Jun-Chul Jo, "A Study on the Correlation between Magnetic Resonance Imaging and Body Mass Index", Unpublished mater's thesis, Graduate School of Public Health Science Eulji University, Daejeon, 2009.
  4. Jung-Hee Kim, Ho-Yong Lee, "Survey on The Benefit Coverage Rate of National Health Insurance in 2005", Health Insurance Forum, Vol. 5, No. 4, pp. 42-58, 2006.
  5. Min-Jeong Park, Yeong-Sun Choi, Yun-Hui Tae, Jae-Hyeok Choi, Su-Jin Baek, Ho-Yong Lee, "Management Strategies for Uninsured Medical Expenses", National Health Insurance Service, 2007.
  6. Ho-Yong Lee. "Survey on The Benefit Coverage Rate of National Health Insurance in 2008", National Health Insurance Service, 2010. Available From : http://www.mohw.go.kr/front_new/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&CONT_SEQ=228443&page=1.
  7. Min-Jeong Park, Yeong-Sun Choi, Yun-Hui Tae, Jae-Hyeok Choi, Su-Jin Baek, Ho-Yong Lee, "Survey on The Benefit Coverage Rate of National Health Insurance in 2010", National Health Insurance Service, 2011.
  8. Seon-Hee Kim, "Factors associated with the utilization according to implementation of insurance coverage for MRI : based on a general hospital", Graduate School of Public Health Yonsei University, 2006.
  9. Il-Soon Kim, Yong-Ho Lee, Seung-Hum Yu, Kyung Suh, Han-Joong Kim, "Changes in Medical Utilization Pattern before and after Medical Insurance Program", Korean public health research, Vol. 6, No. 1, pp. 31-38, 1980.
  10. Chong-Rock Suh, Seung-Hum Yu, Ki-Hong Chun, Chung-Mo Nam, "Analysis of utilization and profit for CT and MRI after implementation of insurance coverage for CT", Korean Journal of Hospital Management, Vol. 2, No. 1, pp. 1-21, 1997.
  11. Seon-Hee Kim, Chun-Bae Kim, Kyung-Hee Cho, Im-Ok Kang, "Is the Utilization of MID Services affected by the Implementation of Insurance Coverage: Based on Claim Data of a General Hospital", Korean Journal of Health Policy and Mangemnet, Vol. 18, No. 2, pp. 1-18, 2008. DOI: http://dx.doi.org/10.4332/KJHPA.2008.18.2.001
  12. Eun-hoe Goo, "A Study on Usefulness of Diffusion Tensor Imaging (DTI6D) in Brain Ischemic Disease", Journal of the Korea Academia-Industrial cooperation Society, Vol. 14, No. 1 pp. 223-228, 2013. DOI: http://dx.doi.org/10.5762/KAIS.2013.14.1.223
  13. Ho-Beom Lee, Kwan-Woo Choi, Soon-Yong Son, Jung-Whan Min, Jong-Seok Lee, Beong-Gyu Yoo, "The increase of blood vessels using a signal during the image acquisition phase T1 shortening effect", Journal of the Korea Academia-Industrial cooperation Society, Vol. 16, No. 7 pp. 4704-4710, 2015. DOI: http://dx.doi.org/10.5762/KAIS.2015.16.7.4704
  14. Tae-Wan Won, "Sparganosis existed for more than three years that misdiagnosed as a breast cancer", Journal of the Korea Academia-Industrial cooperation Society, Vol. 16, No. 8 pp. 5508-5512, 2015. DOI: http://dx.doi.org/10.5762/KAIS.2015.16.8.5508
  15. Jung-He Lee, Moo-Sik Lee, Jee-Hee Kim, Tae-Young Moon, Yong-Ha Kim, Kwang-Hwan Kim, "Analysis of Factors which Affect the Medical Utilization Fee after an Increase of Health Insurance Benefits for Patients with Serious Illnesses", Journal of academia-industrial technology, Vol. 11, No. 4, pp. 1504-1510, 2010. DOI: http://dx.doi.org/10.5762/KAIS.2010.11.4.1504