디지털융복합연구 (Journal of Digital Convergence)

  • 제15권4호
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  • Pages.327-337
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  • 2017
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  • 2713-6434(pISSN)
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  • 2713-6442(eISSN)
한국디지털정책학회 (The Society of Digital Policy and Management)
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유급 간병서비스 이용 영향요인에 관한 융복합적 연구: Andersen's Behavioral Model

A Convergence Study on Influencing Factors of Paid Care Service: Andersen's Behavioral Model

  • 김한결 (고려대학교 대학원 보건과학과 BK21 플러스 인간생명-상호작용 융복합 사업단) ;
  • 김성국 (고려대학교 대학원 보건과학과 BK21 플러스 인간생명-상호작용 융복합 사업단) ;
  • 심현진 (고려대학교 대학원 보건과학과 BK21 플러스 인간생명-상호작용 융복합 사업단) ;
  • 이희명 (고려대학교 대학원 보건과학과 BK21 플러스 인간생명-상호작용 융복합 사업단) ;
  • 이현실 (보건과학대학 보건정책관리학부)
  • KIM, Han-Kyoul (Department of Public Health Science, Graduate School BK21 Plus Program in Public Health Science, Korea University) ;
  • Kim, Sung Kuk (Department of Public Health Science, Graduate School BK21 Plus Program in Public Health Science, Korea University) ;
  • Shim, Hyun-Jin (Department of Public Health Science, Graduate School BK21 Plus Program in Public Health Science, Korea University) ;
  • Lee, Hee Myung (Department of Public Health Science, Graduate School BK21 Plus Program in Public Health Science, Korea University) ;
  • Rhee, Hyunsill (School of Health Policy and Management, College of Health Science, Korea University)
  • 투고 : 2014.02.01
  • 심사 : 2017.04.20
  • 발행 : 2017.04.28
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초록

현재 입원환자 및 환자 가족의 사적 고용으로 시행되는 유급 간병서비스 실태를 파악하고, 이를 이용하는데 영향을 미치는 요인을 확인하고자 함을 목적으로 한다. 본 연구는 한국의료패널 자료 (2011-2014)를 활용하였으며, 연간 1회 이상 입원서비스를 이용한 경험이 있는 5,110명을 연구대상으로 선정하였다. 본 연구의 자료처리 및 분석을 위해 STATA 12.0 SE를 활용하였으며, 입원환자들의 기본특징을 확인하기 위해 빈도분석을 수행하였으며, 특성에 따른 유급 간병서비스 이용 현황을 확인하기 위해 교차분석 및 t-test를 시행하였다. 마지막으로, 입원환자들의 유급 간병서비스 이용에 영향을 미치는 요인을 확인하기 위해 Andersen's Behavioral Model의 3 범주를 단계적으로 모형에 투입하는 위계적 로지스틱 회귀분석을 실시했다. 분석결과 유급 간병서비스 이용은 여성, 고연령, 장기입원 및 장애가 있을 경우에 더 많은 것으로 나타났다. 반면, 사적고용에서 중요한 가구소득 변수는 유의한 결과를 보이지 않았다. 이 연구결과는 현재 논의 중에 있는 간호간병통합서비스의 대상자 선정에 있어 기초자료로 활용될 것으로 기대된다. 또한, 향후 대상자 선정에 관한 세부적인 논의가 이루어질 필요가 있다.

The purpose of this study is to identify the current state of paid care services and to identify the factors that affect the utilization of private nursing services. This study constructed and utilized the Korean Health Panel data (2011-2014) in the form of panel data, and selected 5,110 patients who had experience using one or more hospitalization services per year. STATA 12.0 SE was used for data processing and analysis of this study. Frequency analysis was performed to confirm basic characteristics of hospitalized patients. Cross-analysis and t-test were conducted to confirm the status of paid care services according to characteristics. Respectively. Finally, panel logistic regression was performed by applying a hierarchical method to stepwise modeling the three categories of Andersen's Behavioral Model to identify factors affecting the use of paid care services for inpatients. The results showed that the use of paid nursing services was higher in women, elderly, long - term hospitalized and disabled. On the other hand, significant household income variables in private employment did not show significant results. The results of this study are expected to be used as basic data for the selection of the nursing care integrated services under discussion. In addition, detailed discussions on the selection of subjects should be made in the future.

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참고문헌

  1. Alagraa R, Abujaber A, Chandra P, Doughty J., "Evaluating psychosocial support needs of female cancer patients in the State of Qatar", Qatar Medical Journal, Vol. 1, No. 4, 2015.
  2. Bass, D. M., & Noelker, L. S., "The influence of family caregivers on elder's use of in-home services: An expanded conceptual framework", Journal of Health and Social Behavior, Vol. 28, No. 2, pp. 184-196, 1987. https://doi.org/10.2307/2137131
  3. Branch, L., Jette, A., Evashwick, C., Polansky, M., Rowe, G., Diehr, "Toward understanding elders' health service utilization", Journal of Community Health, Vol. 7, No. 2, pp. 80-92, 1981. https://doi.org/10.1007/BF01323227
  4. Choi, E. S., "Present Situation of Korean Nursing. Korean journal of women health nursing", Vol. 10, No. 3, pp. 190-199, 2004.
  5. Crist, J. D., "Mexican American elders' use of skilled home care nursing services", Public health nursing, Vol. 19, No.5, pp. 366-376, 2002. https://doi.org/10.1046/j.1525-1446.2002.19506.x
  6. Dong Hwan Kim, Han Ju Lee, "Effects on Long-Term Care Hospital Staff Mixing Level after Implementing Differentiated Inpatient Nursing Fees by Staffing Grades", The Journal of Korean Nursing Administration Academic Society, Vol. 20, No. 1, pp. 95-105, 2014. https://doi.org/10.11111/jkana.2014.20.1.95
  7. Dorin, L., Turner, S. C., Beckmann, L., grosse Schlarmann, J., Faatz, A., Metzing, S., Buscher, A., "Which need characteristics influence healthcare service utilization in home care arrangements in Germany?" BMC health services research, Vol. 14, No. 1, 2014.
  8. Eisen, E. A., & Robins, J. M. "Healthy worker effect", Encyclopedia of environmetrics, 2002.
  9. Gunasekara F., Carter K., McKenzie S., "Income-related health inequalities in working age men and women in Australia and New Zealand", Australian and New Zealand journal of public health, Vol. 37, No. 3, pp. 211-217, 2013. https://doi.org/10.1111/1753-6405.12061
  10. Han-Kyoul Kim, Kyoung-Sook Lee, Kwang-Hwan Kim, Yong-Ha Kim, "A Study on Determinats of Cancer Patients's Length of Hospital Stay on Medical Charges Pattern", Journal of the Korea Convergence Society, Vol. 2, No. 4, pp. 53-58, 2011.
  11. Heider D., Matschinger H., Muller H., Saum, KU., Quinzler R., Haefeli WE., Konig HH. "Health care costs in the elderly in Germany: an analysis applying Andersen's behavioral model of health care utilization", BMC health services research, Vol. 14, No. 1, pp. 14-71, 2014. https://doi.org/10.1186/1472-6963-14-14
  12. Horn SD., Sharkey PD., Buckle JM., Backofen J E., Averill RF., Horn RA. "The relationship between severity of illness and hospital length of stay and mortality", Medical care, Vol. 29, No. 4, pp. 305-317, 1991. https://doi.org/10.1097/00005650-199104000-00001
  13. Hyung-Sik Ahn. "The Problems of Private Employment Care and the Necessity of Introducing a New Nursing Care System for Inpatients", Research Institute for Healthcare Policy Korean Medical Association. Vol 11, No. 1, pp. 58-62, 2013.
  14. Jeong-Yeon Kim, "The Selection of the Medical Institutions by Motivation of Medical Service Utilization", Journal of Digital Convergence. Vol. 13, No. 11, pp. 217-230, 2015. https://doi.org/10.14400/JDC.2015.13.11.217
  15. Kim HK., Lee M. "Factors associated with health services utilization between the years 2010 and 2012 in Korea: using Andersen's Behavioral model", Osong public health and research perspectives, Vol. 7, No. 1, pp. 18-25, 2016. https://doi.org/10.1016/j.phrp.2015.11.007
  16. Korea Institute for Health and Social Affair, "Social institutionalization plan of caregiving service for medical institutions", Ministry of Gender Equity & Family. 2006.
  17. Li YN., Nong Dx., Wei B., Feng QM., Luo Hy., "The impact of predisposing, enabling, and need factors in utilization of health services among rural residents in Guangxi, China", BMC Health Services Research, Vol. 16, No. 1, pp. 592-600, 2016. https://doi.org/10.1186/s12913-016-1825-4
  18. Lopez-Casasnovas G., Soley Bori, M., "The Socioeconomic Determinants of Health: Economic Growth and Health in the OECD Countries during the Last Three Decades", International journal of environmental research and public health, Vol. 11, No. 1, pp. 815-829, 2014. https://doi.org/10.3390/ijerph110100815
  19. Ministry of Health and Welfare, "Research on institutionalization of care service", Korea Institute for Health and Social Affair, pp. 1-272, 2010.
  20. Ministry of Health and Welfare, "Standard Operation Guideline of Comprehensive Nursing Care Service", National Health Insurance Service, 2016.
  21. Na Mi Hwang, "Institutionalization of caregiving service issues and tasks", Korea Institute for Health and Social Affair, Vol. 47, pp. 1-8, 2010.
  22. Na Mi Hwang. "An Analysis of the Debates on Introduction of Public Caregivers' Services in Acute Medical Centers", Health and welfare policy forum, pp. 60-71, 2010.
  23. OECD, "OECD Health Data", 2013.
  24. Park JM. "Equity in the utilization of physician and inpatient hospital services: evidence from Korean health panel survey". International Journal for Equity in Health, Vol. 15, No. 1, pp. 159-167, 2016. https://doi.org/10.1186/s12939-016-0452-3
  25. Ryoung Choi, Byung-Deog Hwang. "Care Education Present Condition for Caregivers and Awareness on Legislation on the Caregivers System", Korean Academy of Care Management, Vol. 13, pp. 1-19, 2014.
  26. Scharlach AE., Gustavson K., Dal Santo TS., "Assistance received by employed caregivers and their care recipients: Who helps care recipients when caregivers work full time?", Gerontologist, Vol. 47, No. 6, pp. 752-762, 2007. https://doi.org/10.1093/geront/47.6.752
  27. Shah D., "Healthy worker effect phenomenon", Indian journal of occupational and environmental medicine, Vol. 13, No. 2, pp. 77-79, 2009. https://doi.org/10.4103/0019-5278.55123
  28. Soon-Duck Cho, Seong-Eun Heo, Deog Hwan Moon, "A Convergence Study on the Hospital Nurse's Perception of Patient Safety Culture and Safety Nursing Activity", Journal of the Korea Convergence Society, Vol. 7 No. 1, pp. 125-136, 2016. https://doi.org/10.15207/JKCS.2016.7.1.125
  29. Sun-Ju You, Yun-Kyoung Choi., "Institutionalization of a Patient-Sitter Program in Acute Care Hospital", The Korea Contents Society, Vol. 13, No. 6, pp. 370-379, 2013.
  30. Teng YH., Teng JJ., Lee MY., Hsieh MH., Chen YJ., Lin JY., Lee MC. "Determinants of emergency medical utilization among the elderly population in Taiwan: A national longitudinal cohort study", Archives of gerontology and geriatrics, Vol. 56, No. 2, pp. 364-369, 2013. https://doi.org/10.1016/j.archger.2012.10.012
  31. Yamada T., Chen CC., Murata C., Hirai H., Ojima T., Kondo K., "Access Disparity and Health Inequality of the Elderly: Unmet Needs and Delayed Healthcare", International journal of environmental research and public health, Vol. 12, No. 2, pp. 1745-1772, 2015. https://doi.org/10.3390/ijerph120201745
  32. You Sun Ju, Chang Hyun Sook, Kim Myu Kyung, Choi Yun Kyoung, Sung Young Hee, Kim Eul Soon, Kwag Weol Hee. "Study of the Utilization Strategy of Nursing Personnel by Types of Medical Institutions", Journal of Korean Clinical Nursing Research, Vol. 13, No. 1, pp. 157-172, 2007.