• Health Policy and Management
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• v.34 no.1
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• pp.48-58
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• 2024

Background: The purpose of this study was to investigate the association between external medical service use and the characteristics of Chungcheongnam-do patients. We aimed to provide evidence of external medical service use enhance the healthcare delivery system in Chungcheongnam-do. Methods: We used the Health Insurance Cohort DB 2.0 of 2016-2019, and 2,570,439 patients were included in the study. Multivariate logistic regression and multinomial logistic regression were used to identify the association between external medical service use and each patient characteristic. Generalized linear model was used to identify the association between medical costs and external medical service use area. Results: During the study period, 32.2% of inpatients and 12.5% of outpatients had external medical service use in Chungcheongnam-do. In comparison to patients living in Cheonan and Asan, the odds ratio (OR) for external medical services use was higher across all regions. Specifically, hospitalized patients from Gyeryong, Nonsan, and Geumsan (OR, 116.817) and Gongju, Buyeo, and Cheongyang (OR, 72.931) demonstrated extremely high likelihood of external medical service use in the Daejeon area. Furthermore, compared to medical expenses incurred within Chungcheongnam-do, patients with external medical service use in the capitol area (outpatient=17.01%, inpatients=22.11%) and Daejeon area (outpatient=16.63%, inpatients=15.41%) spent more on healthcare services. Conclusion: This study found the evidence of external medical service use among Chungcheongnam-do patients. Further study should be conducted taking into account variables including satisfaction of local medical services, different types of patient diseases, and others. The study's findings may serve as a foundation for policy proposals aimed at ensuring the financial stability of our health insurance system, ensuring the efficient delivery of medical care, and localization of medical care.

• Journal of agricultural medicine and community health
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• v.22 no.2
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• pp.253-263
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• 1997

농촌지역은 도시지역에 비하여 의료자원의 부족으로 보건의료자원의 이용 접근성이 낮다고 할 수 있다. 따라서 일부 농촌지역주민의 질병이환과 이환시 보건의료자원의 이용양상을 분석하는 것은 매우 의의가 있다고 하겠다. 본 연구방법은 포천군 주민의 보건의료자원의 이용과 치료원의 이용 양상을 분석할 목적으로 1995년 8월 4일~20일까지 1,200가구를 대상으로 가구 면접조사를 실시하였다. 분석대상 가구수는 1,019가구였으며 훈련받은 조사원에 의하여 조사되었으며 경기도 포천군 지역은 연세대학교 보건대학원 및 간호대학의 연구사업지역으로 본 분석 자료는 연세대학교 연구자료의 일부를 사용하였다. 연구 결과는 다음과 같다. 성별인구분포는 남자가 49.9%, 여자가 50.1%이고 연령별 분포는 60세 이상이 16.5%로써 전국의 노인인구 비율보다 높았다. 교육상태는 13년 이상 교육이수율이 남자가 여자보다 높았으나 전체 조사 대상 인구는 교육수준이 높았다. 가족 형태는 핵가족이 70.9%로써 농촌지역임에도 매우 높았다. 지난 15일간의 이환상태를 조사한 결과 급성이환율은 5.4%(54/1,000)이며 3개월 이상 만성이환율은 130/1,000으로 나타났다. 급성이환시 증상별 분포는 호흡기계질환이 36.4%, 소화기계가 20.9%, 여러 가지 복합 증상이 33.0%을 나타낸 반면 만성이환율은 관절염 및 류마티즘이 21.2%, 기타 골격계가 12.6%로서 높았다. 급성 이환시 의료이용양상은 포천군관내의 의료기관이용이 62.6%, 약국이용이 15.2%, 보건소 이용이 4.0%였으며 의료기관이 주요 이용자원이었다. 아무 조치를 취하지 않은 비율은 6.1%로서 높지 않았다. 즉 극성질환인 경우 전체이환자의 76.5%가 1회 방문으로 문제를 해결한 것으로 나타난 반면 나머지 23.5%가 2회 이상 의료자원을 이용한 것으로 나타났다. 3개월이상 만성이환자는 포천군관내 의료기관의 이용율이 56.3%, 관외의료관 이용이 19.3%인 반면 한방기관이용이 7.6%로서 급성이환시 한방이용비율인 4.0%보다 높았다. 1회 방문이 67.4%인 반면 2회 이상 보건의료자원을 이용한 비율이 33.6%로서 만성질환 이용시 보건의료자원의 이용 빈도가 높은 것으로 나타났다. 본 분석결과 포천군 주민의 주요 보건의료자원의 이용은 의료기관으로 나타났고 미치료율이 타농촌지역에 비하여 낮았으며 만성질환시 급성이환시보다 한방의료이용이 높았음을 나타났다.

• The Korean Journal of Health Service Management
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• v.8 no.2
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• pp.11-22
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• 2014

This study purposed to analyze the regional variation of the local-out rates of inpatient services. Multiple data sources collected from National Health Insurance Corporation and statistics Korea were merged to produce the analysis data set. The unit of analysis in this study was city, Gun, Gu, and all of them were included in analysis. The dependent variable measured the local-out rate of inpatient cost in study regions. Local environments were measured by variables in three dimensions: provider factors, socio-demographic factors, and health status. Along with the traditional ordinary least square (OLS) based regression model, geographically weighted regression (GWR) model were applied to test their effects. SPSS v21 and ArcMap v10.2 were applied for the statistical analysis. Results from OLS regression showed that most variables had significant relationships with the local-out rate of inpatient services. However, some variables had shown diverse directions in regression coefficients depending on regions in GWR. This implied that the study variables might not have consistent effects and they may varied depending the locations.

• Journal of Digital Convergence
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• v.13 no.10
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• pp.425-436
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• 2015

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.

• Health Policy and Management
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• v.23 no.4
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• pp.387-396
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• 2013

Background: The purpose of this study was to analyze the association between areas of Korea Train Express (KTX) region and external medical service use in Korean society using spatial statistical model. Methods: The data which was used in this study was extracted from 2011 regional health care utilization statistics and health insurance key statistics from National Health Insurance Corporation. A total spatial units of 229 districts (si-gun-gu) were included in this study and spatial area was all parts of the country excepted Jeju, Ulleungdo island. We conducted Kruskal-Wallis test, correlation, Moran's I and hot-spot analysis. And after, ordinary linear regression, spatial lag, spatial error analysis was performed in order to find factors which were associated with external medical service use. The data was processed by SAS ver. 9.1 and Geoda095i (windows). Results: Moran's I of health insurance patients' external medical service use was 0.644. Also, population density, Seoul region, doctor factors positively associated with health insurance patients' external medical service. In contrast, average age, health care organization per 100 thousand were negatively associated with health insurance patients' external medical service use. Conclusion: The finding of this study suggested that health insurance patient's external medical service use correlated for seoul region in korea. The study results imply the need for more attention medical needs in the region (si-gun-gu unit) for health insurance patients of seoul region. It is important to adapt strategy to activation of primary health care as well as enhancing public health institution for prevent leakage of patients to other areas.