• 보건의료산업학회지
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• 제12권2호
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• pp.125-134
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• 2018

Objectives : The purpose of this study was to analyze factors related to the functional state of stroke patients after discharge from hospital. Methods : The data was provided from a hospital in Wonju, Gangwon-do. The subjects of the analysis were those who were admitted to the emergency room due to stroke from July to December 2016. The dependent variable was the patient's functional status as measured by the modified Rankin Scale(mRS). Independent variables were demographic factors (age, sex, and marriage status), transportation and distance factors (transportation, travel distance), inpatient factors (lengths of stay, Charlson Comorbidity Index (CCI), Tissue plasminogen activator, National Institute of Health Stroke Scale (NIHSS). Hierarchial regression analysis was applied for the analysis. Results : In the hierarchical regression analysis, Model 3, including socio-demographic factors, transportation, distance factors, and inpatient factors, was the best fitted model. It showed that functional status of stroke patients was positively associated with age, length of stay, CCI, NIHSS, and negatively associated with unmarried status. Conclusions : Results indicated that management of stroke requires care from the pre-disease stage, and a customized education program policy is needed for high-risk stroke patients who are older and have comorbid illness.

• 디지털융복합연구
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• 제17권5호
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• pp.303-309
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• 2019

본 연구는 의료기관 일부 원무행정직의 조직몰입, 조직충성도 및 직무소진과 이직의도 간의 관련성을 파악하고 이직이도에 미치는 융복합적인 영향을 규명하였다. 조사대상은 임의로 선정된 J지역의 27개 의료기관에서 무작위로 추출된 원무행정직 320명으로 하였으며, 자료수집은 2018년 7월 2일부터 2018년 7월 27일까지 구조화된 무기명 자기기입식 설문지를 통해 이루어졌다. 이직의도는 직무소진과는 양의 상관관계를, 조직몰입 및 조직충성도와는 음의 상관관계를 보였다. 공분산구조분석 결과, 직무소진이 높아질수록, 조직몰입 및 조직충성도가 낮아질수록 이직의도를 증가시키는 것으로 나타났다. 이러한 결과를 볼 때, 의료기관 원무행정직의 이직의도를 낮추기 위해서는 직무소진을 낮추고, 조직몰입 및 조직충성도를 높이는 노력이 필요하다. 분석결과는 의료기관 원무행정직의 이직의도를 낮추는 보건행정정책 및 산업보건교육에 활용이 기대된다. 추후연구에서는 의료기관 원무행정직의 이직의도에 영향을 미치는 융복합적인 추가요인에 대한 분석이 필요하다.

• 보건행정학회지
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• 제30권4호
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• pp.467-478
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• 2020

Background: The purpose of this study is to explain the factors influencing the incurrence of catastrophic health expenditure of national health insurance households using panel data observed over a long period. Methods: The study targeted 3,652 households who had no censoring during the 11-year survey period (2007-2017) and householders whose insurance type was consistently maintained as national health insurance. Generalized estimating equations were adopted to identify factors affecting the occurrence of catastrophic health expenditure at 20%, 30%, and 40% threshold levels. A subgroup analysis was conducted by categorizing groups depending on the existence of the elderly in the household. Results: For the last 11 years, the incidence of catastrophic health expenditure in the households without the elderly decreased slightly at all threshold levels, but the households with the elderly seemed to be increased. At baseline, household type showed a statistically significant relationship with all other variables. The results of generalized estimating equations analyses show that household income was not significant at all threshold levels in the households without elderly. On the other hand, in the households with the elderly, the 2nd (odds ratio [OR], 1.33-2.05) and 3rd quintile groups (OR, 1.25-2.55) were more likely to have catastrophic health expenditure compared to the 1st quintile of household income group. Conclusion: As the amount of health expenditures relative to the ability to pay is increasing in households with the elderly, the application of an intervention followed by consistent monitoring is needed. This study found that there were differences in influencing factors according to the presence of the elderly in the households. In particular, in households with the elderly, interesting results have been drawn regarding the occurrence of catastrophic health expenditure in the near-poor, so additional research is required.

• 보건행정학회지
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• 제29권3호
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• pp.248-261
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• 2019

Establishing a healthcare delivery system is key to building a cost-effective healthcare system that can prevent the waste of healthcare resources and increase efficiency. Recently, the rapid increase in the national medical expenditures due to the aging of the population and the increase in chronic diseases has raised the question about the sustainability of the healthcare system including the health insurance system. This is why we need to reform the medical delivery system, including the function setting of medical institutions. Accordingly, gradual and practical efforts based on the recognition of reality are needed for solving the problems and improving the medical delivery system. The first effort is to secure policy measures to establish functions and roles of medical institutions which are the basis of the healthcare delivery system, and a systematic medical use system for appropriate medical use. This approach can be achieved through a reasonable health insurance schemes. Without reasonable reform efforts, it will be difficult for Korea's health care system to develop into a system that can provide cost-effective and high-quality medical services that the people want.

• 한국학교ㆍ지역보건교육학회지
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• 제23권3호
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• pp.15-28
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• 2022

Objectives: This study aims to examine factors affecting depression of adolescents by using the data of the 17th Korean Youth Health Risk Behavior Survey(2020). Methods: The total sample was 54,848 students who are in middle or high school. In this study, sociodemographic variables, health behavior variables, and stress were input to examine the effect on depression. The data was analyzed with χ²-test and hierarchical regression by SPSS statistic program. Results: The results showed that depression was related to sociodemographic factors, health behaviors, and stress factors. In the result of hierarchical regression analysis, it was found that not only stress but also other variables had an effect on depression, which had a statistically significant effect. Conclusions: It was found that there are various causes such as environmental aspects and health behaviors that surround adolescents' depression rather than a single factor such as stress. Also, stress and depression are reciprocal rather than causal. Adolescents should be subdivided into groups such as grade, gender, or academic performance to relieve stress and depression at the same time through specific interventions.

• 보건행정학회지
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• 제29권1호
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• pp.90-97
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• 2019

This study investigated the healthcare status of South Korea and member states of the Organization for Economic Cooperation and Development (OECD). By employing the position value for relative comparison index, healthcare status was measured through the following components: demand, supply, accessibility, quality, and cost. Statistical analysis was conducted through the Mann-Kendall test from analyzing trends from 2000 onwards. Results showed that while Korea, on average, scores higher than the OECD average in most of the investigated components, it is below average in certain indexes including primary care and mental health care. Considering the various health issues that have been raised about these indexes, it is important these components be improved upon by policy-makers.

• 보건의료산업학회지
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• 제12권2호
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• pp.63-73
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• 2018

Objectives : This study aimed investigate general characteristics, vaccination status and health beliefs related to vaccination for herpes zoster and to identify variables. Methods : The structured questionnaire was conducted from March 31, 2016 to April 20, 2016 with 312 outpatients who visited a university hospital. The data were analyzed by frequency analysis, t-test, $x^2-test$, correlation analysis and logistic regression analysis via SPSS statistics 22.0. Results : The vaccination rate of the herpes zoster was 16.0% and the vaccination cost was the most common reason for rejecting inoculation. More highly educated people with more than a university degree(OR=4.28, p=.002), those with higher susceptibility to herpes zoster(OR=1.56, p=.000), those more aware of the benefits of vaccination(OR=1.51, p=.009) and those with lower disability for vaccination(OR=0.74, p=.003) were more likely to be vaccinated. Conclusions : Therefore, to increase the vaccination rate of herpes zoster in adults over 50 years old, continuous publicity and education are needed to emphasize the susceptibility of herpes zoster and the benefit of vaccination. In addition, it is necessary to develop policies at the national level for the expensive vaccination cost that obstructs vaccination.

• 문화기술의 융합
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• 제4권4호
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• pp.187-199
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• 2018

본 연구는 2012년 한국의료패널자료의 보건의식행태에 응답한 만 18세 이상만으로 처리하였으며 전체 2,757명, 남자 2,614명(44.6%), 여자 143명(2.3%)으로 선정하였다. 흡연으로 의료이용 및 의료비지출 자료를 통하여 흡연자의 응급. 입원, 외래 의료이용횟수에 따른 의료비를 통하여 사회적 비용을 추계하였다. 사회적비용은 보건경제학자인 Rice(1968)의 의해 정립된 사회적관점을 채택하여 의료이용에 따른 의료비와, 보험자(공단)비용, 본인부담금, 비급여, 생산성 비용을 합산하여 사회적비용을 산출하였다. 흡연상태별 연간 응급의료이용률은 인구 백명당 흡연자 7.5%, 이용횟수 9.8회 사회적비용은 809,003원으로 나타나고 있다. 흡연상태별 인구 백명당 연간 입원의료이용률은 인구 백명당 흡연자 9.6%, 이용횟수 9회, 사회적비용은 706,870원으로 나타나고 있다. 흡연상태별 연간 외래이용률은 흡연 68.6%, 연간의료이용건수는 9건, 사회적비용은 706,870원으로 나타났다.

• 한국엔터테인먼트산업학회논문지
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• 제14권8호
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• pp.255-264
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• 2020

본 연구는 의료기관 인증 제도를 받은 요양병원 내부 구성원과 양방병원의 내부구성원 297명을 대상으로 설문조사를 실시한 후 SPSS 26.0을 이용하여 인증을 받은 전과 후 차이를 비교 분석하여 구성원 만족도, 직무스트레스, 의료서비스향상이 병원운영 효과에 미치는 영향을 파악하고자 하였다. 요양병원의 병원운영효과는 구성원 만족도와 의료 서비스향상이 높을수록, 병원운영효과는 높아짐을 볼 수 있으며, 양방병원의 경우, 구성원 만족도와 의료 서비스 향상이 높을수록, 직무스트레스는 낮을수록 병원운영효과는 높아짐을 볼 수 있다. 의료기관인증제도의 기본가치 체계가 환자 안전과 의료의 질 향상인 만큼 요양병원은 의무적 인증으로 인증제의 효과가 양방병원보다 높게 나타났을 것으로 사료된다.

• 한국병원경영학회지
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• 제26권2호
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• pp.43-55
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• 2021

Purposes: In this study, we examined the factors which silenced the organizing members and how the factors affects deprivation of employment about the organization culture, the organizational silence, and the turnover intention. Methodology: In order to research, we carry out a survey on 400 employees of small and medium hospitals. Among them, 321 questionnaires were used for actual analysis, excluding insincere respondents, non-responders or duplicate respondents. In order to verify the hypotheses in this study, we conduct the covariance Structural Equation Model(SEM). Finding: We obtained results using following hypotheses. First, ''The organization culture has an effect on the turnover intention.'' Second, ''The organization culture has an effect on the organizational silence'' Third, ''The organizational silence has a influence on the turnover intention.'' Finally, ''When the organization culture mediates the organizational silence, the adaptation relationship of the ornization effectiveness is different.'', as the key hypothesis, showed that the agreement culture, rational culture, and hierarchical culture of the organization culture type were statistically significant. The organizational silence as a parameter has the partial mediating effects(-) because it has direct and indirect effects. Practical Implications: The results of this study showed that the reason for the organizational silence of the organizing members is that the organization culture by a grade of rank is the largest and these the organizational silence affects the turnover intention.