• Fire Science and Engineering
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• v.28 no.3
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• pp.80-86
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• 2014

Based on 2009 Korea Health Panel, this study investigated socio-economic and clinical characteristics associated with emergency medical transport use, and analyzed a simple predictive model of emergency medical transport use. Analysis results were summarized as follows: First, emergency medical transports such as 119 ambulance were more used than private cars, taxis, or walk-in. Second, between a user group and a non-user group of emergency medical transports, there were statistically significant differences in age, the level of education, family composition, house type, household income, the relationship with the head of household, insurance types, the presence of handicap, the presence of chronic disease, reasons to emergency medical service use, and treatment after emergency medical service completed. Third, age, household income, the presence of handicap, reasons to emergency medical service use, and treatment after emergency medical service completed were statistically significant predictors associated with emergency medical transports use. To improve emergency medical service system, the characteristics and predictors associated with emergency medical transports are more concerned.

• 한국노년학
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• v.39 no.3
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• pp.467-484
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• 2019

The purpose of this study is to explore latent classes of longitudinal medical expenses of older people and to analyze its predictors and its effects on subjective health. Among participants of the Korean Health Panel, the sample of this study includes 1,119 people who is 65-year-old or older and reported their medical expenses for nine consecutive years. The analyses were conducted in three steps. First, Growth Mixture Model (GMM) was applied to find distinct subgroups showing similar patterns in medical expenses. The results showed four groups which were classified as high medical expenditure maintenance group, medical expenditure increase group, low medical expenditure maintenance group, and medical expenditure reduction group. Second, the multinominal logistic regression found that the presence of spouse, economic participation, the number of chronic diseases, and the type of health insurance were significant predictors of latent classes in medical expenses. In particular, the greater the number of chronic diseases, the higher the likelihood of belonging to the high medical expenditure maintenance group. In addition, medical benefit recipients are more likely to belong to the low medical cost maintenance and medical cost reduction groups. Third, multiple regression analysis revealed that the older people in the groups with low or reducing expenses reported better subjective health than people with higher expenses. This study has its meanings in exploring the heterogeneity in longitudinal medical expenses among older people and its predictors and its associations with health outcome. The results of this research provide background information in establishing public health policy for older people.

• Journal of Teachers' Pension
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• v.2
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• pp.47-102
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• 2017

오늘날 대다수의 선진 국가들은 고령화 사회에 대비하여 자국의 노후소득보장 제도를 대대적으로 개혁해 오고 있다. 우리나라의 경우에서도 지난 2015년 사학연금제도의 개혁이 이러한 취지에 해당될 수 있을 것이다. 본 연구에서는 고령화 사회의 문제가 단순히 노인부양비용의 증가 그 자체가 아니라, 평균수명의 증가에도 불구하고 늘어나게 된 노후의 삶에 대한 시간적 배분이 근로와 여가에 걸쳐 균형적으로 이루어지지 않고, 사회적 부양을 필요로 하는 노후의 여가만 일방적으로 늘어나고 있다는 점을 문제점으로 지적하였다. 따라서 이러한 차원에서 볼 때 고령화 사회의 문제는 생애근로기간의 연장을 통해서만 효과적으로 극복할 수 있을 것으로 생각된다, 하지만 이와는 반대로 개인별로 건강상태나 가족상황 등의 이유로 생애근로주기의 연장이 불가능한 사람들을 위하여 별도의 제도적 장치가 추가적으로 마련되어야 할 것이다. 종합해 보면, 고령화 사회의 노동시장 문제는 개인별로 다양한 욕구나 능력을 반영하여 각자에게 다양한 선택권을 보장해 줄 수 있는 방향으로 개선되어야 할 필요가 있다. 본 연구에서는 고령화 사회에 대비하여 연금수급연령 상향조정의 필요성을 사학연금제도를 중심으로 살펴보고, 대신 그로 인해 발생할 수 있는 소득공백문제와 연금가입경력 공백문제 등 제반의 충격을 흡수할 수 있는 제도적 장치로서 점진적 퇴직제도의 도입방안을 제안하였다. 개략적으로 사학연금제도에 있어서 점진적 퇴직모형은 법정연금수급연령의 인상 일정에 따라 다음과 같이 운영하는 방안을 제안하였다. 먼저 법정연금수급연령이 60세로 유지되는 2022년까지의 단기적 대책으로서 여기서 점진적 퇴직의 자격연령은 모든 가입자에게 60세로 적용하도록 한다. 이 경우 가입자들의 신분구분에 따라 각각 교수 5년, 교원 2년(문제해결에 대한 정책적 의지에 따라 이행구간을 확장할 수도 있음) 그리고 교직원 0년의 조기의 점진적 퇴직이 허용되므로, 현재 교원이나 교수의 임용대란문제에 효과적으로 대응을 할 수 있는 장점이 있다. 다음으로는 2023년 이후 2033년 사이 법정연금수급연령의 인상단계에 해당되는 기간 동안의 대책으로서 여기서는 교수, 교원, 교직원에게 적용되는 정년연령과 매년도 법정연금수급연령 사이의 기간을 조기의 점진적 퇴직 이행구간으로 정하도록 한다. 그리고 이러한 이행구간에 상당하는 기간만큼 후기의 점진적 퇴직 이행구간을 별도로 설정하여 그에 적절한 혜택이 주어질 수 있도록 한다. 마지막으로 2033년 이후부터는 교수, 교사, 교직원의 신분구분 없이 모두에게 적용되는 사항으로서 65세를 기준으로 그 이전의 5년은 사학연금의 적용을 받는 조기의 점진적 퇴직 그리고 그 이후의 5년은 국민연금의 적용을 받는 후기의 점진적 퇴직이 이루어질 수 있도록 한다. 그리고 전체 10년의 점진적 퇴직 이행구간 동안 개인별로 퇴직시점이나 퇴직형태의 선택이 자유롭게 이루어질 수 있도록 하기 위하여 보험수리의 원칙에 입각한 감액률 또는 가산율의 엄격한 적용을 제안하였다. 그리고 고령계층이 자신의 근로시간을 단계적으로 단축할 수 있도록 하고, 그 과정에서 발생하게 되는 소득의 감소부분은 별도의 제도적 방법(가교연금, 시간가치적립계정 등)으로 충당하도록 하는 방안을 제안하였다. 나아가 점진적 퇴직제도의 운영방식은 근로시간의 단축뿐만 아니라 작업부담의 경감 등에 대해서도 인정을 해주도록 해줌으로써 임금피크제도의 기능과 연계가 가능할 수 있도록 할 것을 제안하였다.

• Health Policy and Management
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• v.34 no.2
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• pp.178-184
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• 2024

Background: This study aimed to determine the effectiveness of drug utilization review (DUR) evaluation indicators on safe drug use by comparing the changes in DUR inspection rates and drug duplication prescription prevention rates between the pre- and post-implementation of the DUR evaluation indicators of the Healthcare Quality Evaluation Grant Initiative. Methods: This study used DUR data from the Health Insurance Review and Assessment Service in 2018 (pre-implementation) and the evaluation results of the Healthcare Quality Evaluation Grant Initiative in 2023 (post-implementation). The dependent variables were the DUR evaluation indicators, including DUR inspection rate and drug duplicate prescription prevention rate. The independent variable was the implementation of the DUR evaluation indicators, and the control variables included medical institution characteristics such as type, establishment classification, location, DUR billing software company, and number of beds. Results: The results of the analysis of the difference in the prevention rate of drug duplicate prescriptions between the pre- and post-implementation of the DUR evaluation indicators of the Healthcare Quality Evaluation Grant Initiative showed that the prevention rate of drug duplicate prescriptions increased statistically significantly after the implementation of the DUR evaluation indicators. Conclusion: The policy implications of this study are as follows: First, ongoing evaluation of DUR systems is needed. Second, it is necessary to establish a collaborative partnership between healthcare organizations that utilize DUR system information and the organizations that manage it.

• Journal of agricultural medicine and community health
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• v.27 no.2
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• pp.75-86
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• 2002

This study was conducted to investigate the changes in patients and medical services before and after the Separation of Prescription and Dispensing in Health Center. For the purpose of this study, prescription data of 5,890 prescribed patients in March 2000(before the Separation of Prescription and Dispensing) and 3,496 prescribed patients in March 2001(after the Separation) in 4 Health Centers located in Gyeongsangbuk-do and Gyeongsangnam-do were collected. For investigation of the change of character of prescribed patients and the disease, sex, age, chief diagnosis, the hind of medical insurance, days of visit, days of prescription were investigated by using National Health Insurance claim data. And for investigation of change of prescription, prescribed drugs per each claim, the use rate of antibiotics, injection, and high-price antiphlogistic drug were investigated for acute respiratory disease and musculoskeletal disease. The major results were as follows: For the changes of prescribed patients of each disease, patients with acute respiratory disease were decreased by 49.7% after the Separation of Prescription and Dispensing than before the Separation of Prescription and Dispensing and patients with hypertension(18.1%), patients with musculoskeletal disease(70.5%), patients with diabetes(8.5%), patients with digestive organ disease(71.2%), patients with chronic respiratory disease(76.4%) were decreased. But patients with urethritis were increased by 66.7%. The mean Health Center visited days of prescribed patients decreased significantly after the Separation of Prescription and Dispensing than before in both male and female(p<0.01) and in health insurance patients(p<0.01). For the each of the disease, hypertension, diabetes, musculoskeletal disease decreased. The mean prescribed days increased after the Separation of Prescription and Dispensing than before(p<0.01). According to the kine of disease, the mean prescribed days increased after the Separation of Prescription and Dispensing than before in all the diseases except the urethritis(p<0.01). For acute respiratory diseases, number of prescribed drugs per each claim decreased significantly after the Separation of Prescription and Dispensing(4.7 drugs) than before(4.9 drugs) and the prescription rate of injection decreased significantly from 63.8% to 7.70%, and the prescription rate of antibiotics decreased significantly from 337% to 19.1%(p<0.01). For musculoskeletal diseases before and after Separation of Prescription and Dispensing, number of prescribed drugs per each claim decreased significantly from 3.7 to 3.2 and the prescription rate of injection decreased significantly from 64.9% to 1.7%, and the prescription rate of high-price antiphlogistic drugs increased significantly from 29.1% to 397%(p<0.01). In consideration of above findings, the mean visited days decreased and on the contrary, the mean prescribed days per each prescription increased after Separation of Prescription and Dispensing than before in health centers. For the prescription pattern of physicians, number of prescribed drugs and the prescription rates of injection and antibiotics per each claim decreased, but the prescription rate of high-price antiphlogistic drugs increased after Separation of Prescription and Dispensing.

• Journal of agricultural medicine and community health
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• v.36 no.4
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• pp.227-237
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• 2011

Objectives: This study was conducted to investigate the utilization and its determinants of rehabilitation services of people with disabilities in a rural area. Methods: From March 2 to April 1, 2011, we interviewed 101 disabled people with either physical disabilities or brain lesions. The subjects completed questionnaires about the utilization of rehabilitation services, general characteristics (age, sex, marital status, education level, economic status, health insurance, housing, and employment) and disability characteristics (type, level, comorbidity, reason for the occurrence of the disability, self-rated degree of disability, and daily life care giver). Frequency, Pearson's chi-square test, and a multiple logistic regression were used for statistical analysis. Results: This study showed that 70.3% of the people in this rural area with disabilities were using rehabilitation services. The two most common reasons for not using the services were "doubt about the effectiveness of the service" and "no facilities nearby." The facilities that the disabled people were currently using, in the order of most used to least, were general hospitals or clinics, rehabilitation centers, oriental medicine clinics, and public health centers. Only 19.7% of those who received rehabilitation responded that they were satisfied with the service. Significant factors in the utilization of rehabilitation services were sex, employment, self-rated economic status, and the reason for the occurrence of the disability. Women, people who were currently working, people who were of middle or higher economic status, or people who had acquired a disability were significantly more likely to use the services. Conclusions: A large number of people with disabilities in a rural area use rehabilitation services at present, but accessibility and satisfaction were low. Quantitatively and qualitatively, rehabilitation services for disabled people in a rural area should be centered around Community-based Rehabilitation (CBR). Effective strategies, for example reaching those who have not used the rehabilitation services, will be needed to improve services in rural areas.

• The Journal of the Korea Contents Association
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• v.9 no.4
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• pp.265-274
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• 2009

This study aims at examining the actual condition of recognition of dental caries(ACRDC), presenting a scheme to improve the recognition, and providing basic data necessary to prevent oral diseases, Dental caries (DC) which one of the three most important chronic diseases in Korea. A survey was conducted on ACRDC for about 390 people twenty and over who visited dental clinics for dental treatment 336 questionnaires with exception of omitted answer were used for statistical analysis. Many of them had never heard of DC and most of them failed to recognize it. People who experienced DC had a dental clinic as a main information channel and they were significant differences in those obtaining information through other channels(p=0.008). Univariate logistic regression analysis for effects on ACRDC demonstrated that possibility of subjects in their twenties recognizing DC more accurately than those in their forties Odds ratio(95% confidence Interval) was 2.06(1.16-3.66)(p=0.000), with the possibility of professionals recognizing the disease more accurately than those with other kinds of occupation 5.49(2.52-11.93)(p=0.000), showing statistically significant relevance. As for medical security, possibility of work insurance being related to more accurate recognition of dental caries than others was 1.95 (1.03-3.71)(p=0.003), with the possibility of subjects whose dental state was very good recognizing dental caries more accurately than those whose dental state was very bad 6.40(1.57-26.03) (p=0.002), showing statistically significant relevance. For prevention of DC, an education through experts working at a dental clinic are necessary for those in their twenties and over, who were other than professionals, who were insured for medical security via other than work insurance, and whose dental state was bad.