• 보건행정학회지
• /
• 제29권1호
• /
• pp.40-48
• /
• 2019

Background: As of July 2015, per diem payment was changed from fee for service Therefore, this study aims to analyse changes in medical charges and medical services before and after enforcement of the palliative care, targeting palliative care wards in a general hospital, and provide basic data needed for development of per diem payment. Methods: The subjects of the study were a total of 610 cases consisting of 351 patients of service fee who left hospital (died) from July 2014 to June 2016 and 259 ones of per diem payment at Chosun University Hospital in Gwangju Metropolitan City. Results: The results are summarized as follows. First, after the palliative care system was applied, benefit medical service charges and insurance increased significantly (p<0.001). As benefit medical service charges increased, benefit private insurance payment increased significantly (p<0.001). Second, after the per diem payment was applied, total private insurance payment to medical institutes decreased significantly (p=0.050) and non-benefit also decreased significantly (p=0.001). Conclusion: It is suggested that additional rewards in the obligatory palliative care items should be continuously remedied and monitored to provide good quality hospice palliative care.

• 보건행정학회지
• /
• 제33권3호
• /
• pp.273-294
• /
• 2023

Background: Most developed countries are working to improve their universal health coverage systems. This study investigates regional disparities in unmet healthcare needs and their causes in South Korea. Additionally, it compares the unmet healthcare needs rate in South Korea with that of 33 European countries. Methods: The analysis incorporates information from 13,359 adults aged 19 or older, using data from the Korea Health Panel. The dependent variables encompass the experience of unmet healthcare needs and the three causes of occurrence: "burden of medical expenses," "time constraints," and "lack of care." The primary variable of interest is the region of residence, while control variables encompass 14 socio-demographic, health, and functional characteristics. Multivariable binary logistic regression analysis, accounting for the sampling design, is conducted. Results: The rate of unmet healthcare needs in Korea is 11.7% (95% confidence interval [CI], 11.0%-13.3%), which is approximately 30 times higher than that of Austria (0.4%). The causes of unmet healthcare needs, ranked in descending order, are "lack of care," "time constraints," and "burden of medical expenses." Predictive probabilities for experiencing unmet healthcare needs and each cause differ significantly between regions. For instance, the probability of experiencing unmet healthcare needs due to "lack of care" is approximately 10 times higher in Gangwon-do (13.5%; 95% CI, 13.0%-14.1%) than in Busan (1.3%; 95% CI, 1.3%-1.4%). The probability due to "burden of medical expenses" is approximately 14 times higher in Seoul (4.1%; 95% CI, 3.6%-4.6%) compared to Jeollanam-do (0.3%; 95% CI, 0.2%-0.4%). Conclusion: Amid rapid sociodemographic transitions, South Korea must make significant efforts to alleviate unmet healthcare needs and the associated regional disparities. To effectively achieve this, it is recommended that South Korea involves the National Assembly in healthcare policy-making, while maintaining a centralized financing model and delegating healthcare planning and implementation to regional authorities for their local residents-similar to the approaches of the United Kingdom and France.

• 보건행정학회지
• /
• 제33권4호
• /
• pp.411-420
• /
• 2023

Background: The purpose of this study was to analyze the demand and supply status of patient beds by type of medical institution, categorized into 70 clinical privilege, in order to understand the regional bed supply situation. Methods: Utilizing the 70 clinical privilege defined by the Ministry of Health and Welfare, we calculated bed demand and supply quantities from 2019 to 2021 using data from Statistics Korea and the Health Insurance Statistical Yearbook. The bed demand calculation formula was based on the detailed guidelines for the medical sector by the Korea Development Institute and the 3rd edition of bed supply basic policies announced by the Ministry of Health and Welfare. Additionally, to mitigate distorted bed supply situations caused by factors such as regional levels and patient outflows, we classified bed supply types using the population decrease index indicator published by the Ministry of Public Administration and Security. Results: Among the 70 clinical privilege, it was analyzed that a relatively balanced bed supply situation exists overall, irrespective of the type of healthcare institution. However, in medical institutions at or above the level of hospitals, regions with bed supply ratios exceeding 20% compared to demand, particularly in institutions at or above the level of general hospitals, showed a relatively high rate of demand diversion. Conclusion: We have identified the bed supply types in the 70 clinical privilege in South Korea. Based on the results of this study, we emphasize the need for bed supply policies that consider regional characteristics. It is expected that this research can serve as fundamental data for future efforts aimed at managing or rectifying bed supply imbalances on a regional basis.

• 문화기술의 융합
• /
• 제5권4호
• /
• pp.137-145
• /
• 2019

2012년 한국의료패널 조사 참여자 중에서 암으로 응급, 입원, 외래 서비스를 한 번이라도 이용한 적이 있는 사람 308명이 선정 되었다. 암 환자 1인당 연평균 총직접비용은 환자 의료비, 공단부담금, 비급여 비용을 합산하여 분석하였다. 암 환자가 암으로 지출한 1인당 연평균 총 직접비용 분석 결과는 암 환자 1인당 연평균 총직접비용은 약 129,093,792이고, 남성은 158,100,612원, 여성은 110,482,075이다. 건강보험가입자의 경우 암으로 인한 1인당 총직접비용은 평균 183,095,125원이고 의료급여 수급자는 46,241,705원이었다. 가구 소득별로 보면, 가구 소득 1분위에 속한 환자의 경우 1인당 연평균 총직접비용은 112,459,971원이었고, 2분위에 속한 환자는 137,910,890원, 3분위에 속한 환자는 149,556,570원, 4분위 112,730,461원, 5분위는 142,926,331원이였다.

• 한국기계기술학회지
• /
• 제13권1호
• /
• pp.1-9
• /
• 2011

The present study aimed to compare and analyze the particulars of and difference in medical expenses and their composition ratio for 2,026 patients hospitalized at 2 types of medical institutions (443 at a clinic and 1,583 at a hospital) in Jeonju-si, Jeollabuk-do under coverage of automobile insurance during 2009. From the analysis, it became evident that there were differences in individual characters of inpatients covered by automobile insurance, and details, composition and composition ratio of medical treatment for them depending on types of medical institutions. There was no difference, however, between the total and average medical expenses per capita even when markup rate was applied to the automobile insurance by types of hospitals. The ratio of radiotherapy and physical therapy in the composition of medical expenses was found to be extraordinarily high in clinics compared to that of hospitals. The composition ratio of the fixed cost including charge for hospitalization also turned out to be fairly high in all medical institutions.

• 한국엔터테인먼트산업학회논문지
• /
• 제14권7호
• /
• pp.559-570
• /
• 2020

본 연구는 의료기관 인증 제도를 받은 요양병원과 양방병원의 내부구성원을 구분하여 인증이 구성원만족도, 직무 스트레스, 병원운영 효과, 의료서비스 향상에 미치는 영향을 파악하고자 하였다. 요양병원이 양방병원보다 인증제도가 구성원만족도, 병원운영효과, 의료서비스 효과에서 높게 나타났으며, 양방병원 구성원이 직무 스트레스에 대해선 높게 나타났다. 요양병원 및 양방병원 모두 인증에 따른 구성원 만족도, 병원 운영효과, 의료서비스 효과는 정(+)적인 결과를 나타났다. 요양병원은 2013년부터 의무적 인증으로 인증제의 효과가 실증적으로 높게 나타났을 것으로 사료된다. 따라서 본 연구는 인증제가 의료서비스 향상에 미치는 영향을 분석함으로써 꾸준한 의료의 질 관리가 병원경영 효율화 및 환자의 만족도 향상에 기여하고자 한다.

• 융합정보논문지
• /
• 제12권5호
• /
• pp.159-167
• /
• 2022

2018년 11월 보건복지부가 지역사회 돌봄 사업을 제20대 국정과제로 채택하였음에도 프로젝트의 성과나 동향을 보고하는 체계적인 검토가 이루어지지 않았다. 본 연구는 커뮤니티 케어 시범사업과 관련한 기존 근거를 체계적으로 검토하였으며, 그 결과 원저 18편과 평론 43편이 최종 선정되었다. 원저의 경우 수요조사(n=4) 및 모델제안(n=4), 터치포인트 활용(n=3), 공간설계 및 건축모델(n=3), 인력양성 및 역할 설정(n=2), 우선 순위 목표(n=1) 및 연구 동향 연구(n=1)등이 있었으며, 리뷰 문헌의 경우 노인에 대한 문헌이 가장 많았고(n=12), 장애인 및 정신질환에 관한 문헌은 상대적으로 적었다(n=2). 지역사회 돌봄 시범사업이 시행된 지 1년 정도밖에 되지 않아 본 사업과 관련된 근거가 부족하고 사업의 성과를 정량적으로 보고한 연구가 부족한 실정이다. 본 연구는 노인뿐만 아니라 장애인, 정신질환자, 노숙자에 대해서도 더 많은 연구가 필요함을 시사한다.

• 한국학교ㆍ지역보건교육학회지
• /
• 제20권2호
• /
• pp.13-24
• /
• 2019

Objective: Recently, Korean adolescent has the problems of nutrition unbalance due to bad eating habits. Also, single-parent and step-parent families have consistently increased because of the increase of divorce rates. Adolescent who lives with a single or step family tends to have unhealthy behaviors and habits. The purpose of this study was to analyze relationship between family structure and irregular breakfast among Korean adolescent. Method: We analyzed 60,040 participants from Korean Youth Risk Behavior Web-based Survey 2018. Study variables included family structure and irregular breakfast. Control variables were sex, school, economic status, parent education levels, drinking, smoking and nutrition education. In terms of this study, descriptive, Chi-square and multivariate logistic regression analysis were performed. Results: After adjusting for socio-demographic variables among boys, family structure was associated with irregular breakfast (living with both parents reference group vs living with single-parent : OR 1.250, 95% CI: 1.142, 1.368). Among girls, after adjusting for control variables, family structure was also associated with irregular breakfast (living with both parents reference group vs living with no both parents : OR 1.409, 95% CI: 1.065, 1.865). Conclusion: According to this study, family structure would be a risk factor of adolescent breakfast habit. Nutrition programs for adolescent should consider these factors.

• 한국산업보건학회지
• /
• 제32권4호
• /
• pp.449-455
• /
• 2022

Objectives: In order to provide basic data for future researchers, this study aims to explore future tasks after reviewing the changes in port safety management due to the enforcement of the Special Act on Port Safety. Methods: The provisions of the Special Act on Port Safety were analyzed and the latest literature related to port safety management was reviewed. Results: There are two major changes that have stemmed from the Special Act on Port Safety: 1. The scope of application for port participants has been expanded, safety education has been made compulsory, and safety management plans have been established and implemented for each business site. 2. The government is operating a port safety consultative body for each port and has hired one port safety inspector for each of the eleven local maritime and fisheries offices across the country. Future tasks include elaboration of port safety accident statistics, strengthening shipping companies' responsibility for stevedore safety, the unification of contracts, and government interest and support for port safety facilities. Conclusions: The primary feature of the Special Act on Port Safety is the emphasis on autonomous safety management by participants in port transportation. In addition, the enactment of the special law has allowed the Ministry of Maritime Affairs and Fisheries to actively intervene in port loading and unloading safety.

• 한국학교ㆍ지역보건교육학회지
• /
• 제23권4호
• /
• pp.1-15
• /
• 2022

Objectives: The purpose of this study was to examine the mediating effect of Stress coping method in the relationship between Covid-19 stress and academic burnout of university students in the long-lasting Covid-19 situation. Methods: The subjects of this study were 323 college students and data were collected by on-line questionnaire survey. The collected data was analyzed using SPSS 23.0 and t-test, ANOVA, multiple linear regression analysis were conducted. Also mediation analysis was performed according to the Baron & Kenny method. Results: The results were as follows. First, students with high Covid-19 stress had high academic burnout by regression analysis. Second, in the stress coping method, the active coping method lowered academic burnout, and the passive coping method increased academic burnout. Third, the active coping method showed a partial mediating effect in the relationship between Covid-19 stress and the academic burnout(p<.01). Conclusions: In order to help college students cope with academic burnout caused by Covid-19 stress, it is recommended to guide students to use active coping method through counseling and education. Ultimately, it is necessary to support students to use various coping methods according to their situation appropriately.