• 디지털융복합연구
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• 제17권4호
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• pp.203-210
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• 2019

본 연구는 직업분류에 따른 의료비 지출 영향요인을 분석하였다. 한국의료패널(Korea Health Panel)의 2012년도 데이터를 이용하여 만20세 이상의 성인을 대상으로 결측값을 제외한 총 4,538명을 최종 분석대상으로 하였다. 자료분석은 의료비 지출 영향요인을 분석하기 위하여 로지스틱 회귀분석을 하였다. 연구분석 결과 Model 1은 단순노무 종사자에 비해 농림어업 숙련 종사자, Model 2의 경우 직종의 경우 판매 종사자에 비해 단순노무 종사자에서 의료비 지출 증가에 영향을 주는 것으로 분석되었다. 성별은 남자에 비해 여자, 혼인은 무에 비해 유, 소득계층은 1분위에 비해 4분위, 5분위, 만성질환은 무에 비해 유에서 의료비 지출이 높은 것으로 분석되었다. 따라서, 건강검진 또는 예방활동 활성화를 위한 보건의료정책 및 보건학적 접근에 있어서 직종, 만성질환 등을 반영한 보다 체계화된 접근이 필요하다.

• 보건행정학회지
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• 제30권3호
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• pp.399-408
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• 2020

Background: The purpose of this study was to examine the impact of the regional characteristics on the accessibility of emergency care and the impact of emergency medical accessibility on the patients' prognosis and the emergency medical expenditure. Methods: This study used the 13th beta version 1.6 annual data of Korea Health Panel and the statistics from the Korean Statistical Information Service. The sample included 8,119 patients who visited the emergency centers between year 2013 and 2017. The arrival time, which indicated medical access, was used as dependent variable for multi-level analysis. For ordinal logistic regression and multiple regression, the arrival time was used as independent variable while patients' prognosis and emergency medical expenditure were used as dependent variables. Results: The results for the multi-level analysis in both the individual and regional variables showed that as the number of emergency medical institutions per 100 km² area increased, the time required to reach emergency centers significantly decreased. Ordinal logistic regression and multiple regression results showed that as the arrival time increased, the patients' prognosis significantly worsened and the emergency medical expenses significantly increased. Conclusion: In conclusion, the access to emergency care was affected by regional characteristics and affected patient outcomes and emergency medical expenditure.

• 보건행정학회지
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• 제8권1호
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• pp.135-154
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• 1998

In Korea, the institutional reform for the national medical insurance system is in process. Eventually, three kinds of the national medical insurance system, i.e., medical insurance program for the industrial workers, the govemment employees and the private school teachers, and the self-employeds, would be merged into an unifed system. In this study, I analyzed the annual trends of the finance in the medical insurance system in Korea, in which I found the financial instability especially in the medical insurance program for the self-employeds. The regression analysis was carried out to forecast the accumulated reserve at the end of this year for the medical insurance program for the self-employeds. I also analyzed the economic effect of the merge of the medical insurance program for the self-employeds by using the case of Japan and Korea. I found that the medical insurance for the self-employeds is expected to have financial deficit at the end of the year 1998 after the merge. In onclusion, it seems to be quite difficult to solve the financial instability in the medical insurance program for the self-employeds after it would be merged. That means that there would be a lot of problems on the way to the merge.

• 보건행정학회지
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• 제8권1호
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• pp.266-282
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• 1998

구매(혹은 가입이나 취업)에 관한 의사결정과정에서는 그 대상이 되는 재화나 서비스의 질을 미리 경험하지 못하고 선택을 하므로 필연적으로 불확실성과 불완전 정보에 의한 문제가 발생한다. 본 논문에서는 탈퇴(혹은 이직)와 같은 결별(separation)을 재화나 서비스의 질에 대한 불확실성에서 연유하는 문제를 사후적으로 해결하기 위한 합리적 행동으로 모형화하여 분석한다. 본 논문의 주된 분석대상인 미국의 의료보험에서 소비자가 보험을 구매할 때 기대했던 서비스의 질과 구매후 경험한 실제 서비스의 차이가 클수록 소비자는 기존의 보험으로부터 탈퇴할 유인이 커진다. 따라서 소비자가 구매 의사결정과정에서 서비스 질에 관한 기대치를 덜 정확하게 형성할수록 서비스질 기대치와 실제치의 차이가 줄어들어 소비자의 탈퇴는 감소하는데, 평판(reputation)이 잘 작동하는 시장일수록 소비자가 기대되는 서미스 질을 미리 예측하기 쉬워진다. 본 연구는 개발 소비자를 분석단위로 했던 종전의 연구와는 달리 개별 기업을 분석단위로 하여 시장수준에서 평판이 불완전정보하의 소비자행동에 미친 영향을 분석한 데 의의가 크다.

• 한국병원경영학회지
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• 제26권3호
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• pp.56-67
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• 2021

There are few domestic studies on medical services in medically vulnerable areas where medical use is not met due to a lack of medical resources. The past studies on smart medicine targeting medically vulnerable areas grasp only the overall satisfaction level, or the sub-dimensions of satisfaction are not classified clearly. Also, it lacks consideration of the patient's needs. This study aims to analyze the effect of users' experience of the smart medicine pilot project conducted in medically vulnerable areas on satisfaction and demand. The user's experience was measured by variables in the dimensions of structure, process, and outcome. Among the pilot project participants, 282 subjects responded to the 2019 survey. Using the hierarchical regression method, we tried to find out the determinants of satisfaction and service demands. Experience factors affecting satisfaction were found to be accessibility, certainty, effectiveness, and efficiency. In addition, it was found that the demand in their 60s was high and that accessibility, certainty, effectiveness, and efficiency had a statistically significant effect on the demand. It is expected that the smart medicine pilot project will be effectively operated by well utilizing the factors influencing satisfaction and demand revealed in this study.

• 보건행정학회지
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• 제32권1호
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• pp.53-62
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• 2022

Background: This study was designed to examine regional proportions for people who experienced unmet health care needs due to reduced mobility or unhealthiness and factors associated with experience of unmet health care needs by them. Methods: A total of 11,620 people were retrieved from the Korea Health Panel data (2014-2018). Regional proportions for people who experienced unmet health care needs due to reduced mobility or unhealthiness were estimated using cross-sectional weights and the factors associated with them were analyzed using generalized estimating equation. Results: The number of people who experienced unmet health care needs due to reduced mobility or unhealthiness was estimated as 278,083 in 2018. Women, the aged (65+), below elementary school, single as marital status, low income, bad self-rated health, people with disabilities, and long-term insurance beneficiaries were statistically significantly associated with experience of unmet health care needs due to reduced mobility or unhealthiness. Conclusion: Given high and dispersed demand for visiting health care, government need to expand the infrastructure and finance to facilitate visiting health care.

• 보건행정학회지
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• 제32권2호
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• pp.180-189
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• 2022

Background: Social support contributes directly and indirectly to maintaining physical, mental, and social well-being. The aim of the study was to identify the impact of social support on self-rated health among Korean industrial accident workers. Methods: This study used data from the panel study of workers' compensation insurance (PSWCI). The final subjects were 2,759 workers who responded to a 2018 to 2020 PSWCI. Social support was defined as social contact with friends, neighbors, family, and social participation activities like religious activity, social activity, and club activity. Multivariate logistic regression analysis was performed to investigate causal relationships between social support and self-rated health using a generalized estimating equation model. Results: Proportion of workers' good self-rated health steadily increased (2018: n=1,447, 63.2%; 2019: n=1,542, 66.2%; 2020: n=1,653, 67.3%). Higher levels of social contacts with friend (worse: reference; same: β=0.442) and higher levels of social activity (yes: reference; no: β=-0.173) were especially associated with good self-rated health. Conclusion: This study confirmed social support positively influenced self-rated health among the self-rated health of industrial injured workers. The results of this study suggested that recovery policies that the government served should include programs enhancing social support for improving health among industrial injured workers.

• 보건의료산업학회지
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• 제13권3호
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• pp.149-162
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• 2019

Objectives: The purpose of this study was to identify differences in characteristics of the people who frequently drink alone between those in old-city regions and those in other regions in Busan, focusing on socio-demographic factors and the level of drinking according to the types of stress. Methods: The analysis confirmed the differences based on Busan Social Statistics Data in 2012, 2014, and 2016. Frequencies by each variable were presented, and ${\chi}^2$ and logistic regression analysis were also used in the analysis. Results: The residents of Busan showed higher odds ratios of "frequent drinking alone" when they felt considerably higher-than-normal levels of stress. In addition, in the residents of old-city regions, the odds ratios of those who frequently drank alone were not different between people who could easily relieve stress, who experienced economic stress, or who had relationship stress and people who did not. However, higher odds ratios of frequently drinking alone were reported when such participants felt some stress related to work, family, relationships, and so on. Conclusions: Interventions for the appropriate relief of stress caused by different reasons, as well as other stress-relieving methods, should be implemented for the people's benefits.

• 한국학교ㆍ지역보건교육학회지
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• 제19권3호
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• pp.95-108
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• 2018

Objectives: The purpose of this study was to investigate the actual conditions and operational problems of Health Promotion Model School' in high school. Methods: We conducted a content analysis of 2014 results report and staffs' responses of five high schools among 85 'Health Promotion Model Schools' led by Ministry of Education from 2012 to 2014. Results: The study examined the operational process of health promoting schools in five stages; system development, needs survey & current status survey, school health policy development, program development & execution, and evaluation. Every step was found to be inadequate. In addition, the study discovered three key factors in operating health promoting schools and examined the status of each factor; connection with the curriculum, connection with the community, and consensus among members. Three factors were also applied poorly. Compared to elementary school, high school showed a lack of all respects. Health promoting school staffs have faced difficulties in linking community resources, organizing and operating a working committee, conducting surveys and assessing health problems, preparing self-assessment or external evaluation, and developing strategies and programs. In order to solve the operational problems, active cooperation of all teachers is urgent. Conclusion: 'Health Promotion Model School' conducted in high school is not considered to have faithfully implemented WHO's concept of health promoting school. In the future, incentive policies for health promoting school teachers should be actively reviewed.

• 보건행정학회지
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• 제29권1호
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• pp.86-89
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• 2019

Catastrophic health expenditure refers to spending more than a certain level of household's income on healthcare expenditure. The aim of this study was to investigate the proportion of households that experienced catastrophic health expenditure between 2006 and 2017 with the National Survey of Tax and Benefit (NaSTaB) and between 2011 to 2016 using Households Income and Expenditure Survey (HIES) data. The results of the NaSTaB showed 2.16% of households experienced the catastrophic health expenditure in 2017. In trend analysis, the NaSTaB revealed a statistically significant decreasing trend (annual percentage change [APC] = -2.01, p<0.001) in the proportion of households with the catastrophic health expenditure. On the other hand, the results of the HIES showed 2.92% of households experienced the catastrophic health expenditure in 2016. Also, there was a slightly increasing trend (APC= 1.43, p<0.001). In subgroup analysis, groups with lower income levels were likely to experience catastrophic health expenditure. In conclusion, further public support system is needed to lower experience these healthcare expenditures and monitor the low income group.