• 제목/요약/키워드: 보건 경제학

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의.약분업 왜 안 되나\ulcorner -경제학적 일고- (Why the Prescribing-Dispensing Services Are Not Separated in Korea\ulcorner -An Economic Approach-)

  • 변재환
    • 보건행정학회지
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    • 제2권2호
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    • pp.179-193
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    • 1992
  • This paper attempts to explain why the prescribing-dispensing services are not seperated in Korea. The main reason why physicians and pharmacists do not compromise, even though the two parties support the seperation policy in public, is contended to be that both parties would lose their interests if the policy were implemented. Physicians' loss from giving up their vested rights to dispensing would be larger than their gain from an increase in the number of prescriptions. Pharmacists' loww from being forced not to to sell medicines without prescriptions would also be larger than their gain from prohibiting physicians from dispensing. The net ganier form the seperation policy would be the patients. Therefore, the seperation policy would not be implemented unless political pressure from general public surpasses that from physicians and pharmacists.

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Lyme질환의 경제적 비용분석 (The Economic Costs of Newly Diagnosed Lyme Disease)

  • ;정기택
    • 보건행정학회지
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    • 제4권2호
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    • pp.126-147
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    • 1994
  • Lyme 질환은 미국 코넷티컷주의 라임지방에서 관절염증상을 보이는 소아과환자에게서 1975년 처음 발견되었다, 사슴, 누루, 개 등에 기생하는 진드기에 의해 전염되며, 발병초기에는 감기증상을 수반한 황소의 눈과 비슷한 붉은 반점이 생긴다. 적기에 치료하지 않으면, 관절염, 심장질환, 안면신경마비 등으로 악화될 수 있다. 본 논문의 목적은 두가지로 나누어 볼 수 있다. 먼저, 진단초기의 Lyme질환과 관련된 의료 및 기타 경제적 비용을 저렴하게 계측할 수 있는 방법론을 개발하고 그 유효성을 검증하는 것이다. 둘째로 lyme질환의 비용에 대한 여러종류의 총괄적 계측치를 제공하고 발병의 위험요인을 색출하는 것이다. 본 논문에서는 차트분석이나 임상연구 등 고가의 비용이 수반되는 분석기법 대신에 Lyme질환 다발지역에 대한 설문조사를 실시하고 그 유효성을 재설문조사를 통해서 검증하는 방법을 사용하였다. 자료분석상의 난점은 조사대상자마다 응답하지 않은 항목(Missing Value)이 다르기 때문에, 총 비용을 계산할 때 모든 항목에 응답한 조사대상자만을 사용한다면 표본의 크기가 너무 작아지는 것이었다. 이에 대한 대안으로 총비용 및 부분별 비용의 합을 계산할 때 표본의 일부가 응답하지 않은 항목에 대해서는 그 항목에 응답한 나머지 조사대상자의 응답치 평균을 대체하는 방법을 사용하였다. 통계적 분석결과, 질환의 증상시작부터 설문조사시기까지 Lyme질환과 관련된 사회적 총비용은 US$ 6400으로 추정되었다. 이중에 200가량은 환자의 보호자와 관련된 비용이고 나머지는 환자와 관련되 것이다. 총의료비용의 평균은 계산방법에 따라서 US$ 3000-4200의 범위를 보였다. 응답되지 않은 항목을 해당항목에 대한 응답치평균으로 대체하였을 때 총의료비평균은 US$ 4108이었다. 시간비용을 생산성손실에 대한 사회적 가치와 실제임금 손실의 두가지 방법에 의해 계산되었다. 실제임금손실은 생산손실의 사회적 가치의 약 30%에 불과하였다. 본 논문의 결과는 의료비용 및 비용과 생산성손실에 대한 정보가 지역보건담당자에 의한 전화설문조사에 의해 경제적이고도 일관성 있게 수집될 수 있다는 근거로 해석될 수 있다.

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휴식과 운동 중 COVID-19 대응 보건용 마스크 착용이 호흡·심혈관계 반응 및 착용감에 미치는 영향 (Effects of Wearing COVID-19 Protective Face Masks on Respiratory, Cardiovascular Responses and Wear Comfort During Rest and Exercise)

  • 정재연;강찬혁;성유찬;장세혁;이주영
    • 한국의류산업학회지
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    • 제22권6호
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    • pp.862-872
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    • 2020
  • This study explores the effects of facemasks on respiratory, thermoregulatory, cardiovascular responses during exercise on a treadmill and at rest. Five male subjects (25.8 ± 0.8 y, 171.8 ± 9.2 cm in height, 79.8 ± 28.1 kg in weight) participated in the following five experimental conditions: no mask, KF80, KF94, KF99, and N95. Inhalation resistance was ranked as KF80 < KF94 < N95 < KF99 and dead space inside a mask was ranked as KF80 = KF94 < N95 < KF99. The surface area covered by a mask was on average 1.1% of the total body surface area. The results showed no significant differences in body core temperature, oxygen consumption (VO2), carbon dioxide production (VCO2), heart rate or subjective perception among the five experimental conditions; however, cheek temperature, respiratory ventilation and blood pressure were greater for KF80 or KF94 conditions when compared to KF99 or N95 conditions (p<0.05). The differences among mask conditions are attributed to the dead space or specific designs (cup type vs pleats type) rather than the filtration level. In addition, the results suggest that improving mask design can help mitigate respiratory resistance from increased filtration.

포스트 코로나 시대 보건의료기술 접근성 제고를 위한 탐색 연구: 세계백신연합(Gavi) 글로벌펀드(Global Fund), 국제의약품구매기구(Unitaid) 및 Access to COVID-19 Tools Accelerator 사업 사례 (Promoting Access to Health Technologies in the Post-pandemic Era: Gavi, Global Fund, Unitaid, and Access to COVID-19 Tools Accelerator (ACT-A) Programs)

  • 송수연;허종호
    • 적정기술학회지
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    • 제7권2호
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    • pp.216-224
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    • 2021
  • 코로나19 확산은 전 세계 인구, 보건체계, 경제, 사회문화에 전례 없는 영향을 미치고 있으며, 국제사회는 코로나19를 극복하고자 보건의료기술 개발 및 접근성 제고를 위해 연대하고 있다. 본 고는 보건의료기술 접근성을 저해하는 장애물에 대한 이론적 틀을 기반으로 감염병 다자기구 및 코로나19 보건의료기술 접근성 제고를 위한 ACT-A 사업을 검토한다. 연구 결과, 첫째, 국제사회는 필요한 기술의 부재를 극복하기 위해 선시장공약, 백신채권, Covax Facility 등을 시행하고 있으며, 둘째, 존재하는 기술이 접근가능하지 않는 장애물을 극복하기 위해 공동조달메커니즘, 의약품특허풀 등을 시행하고 있으며, 셋째, 기술이 수용되지 않는 장애물을 극복하기 위해 인력역량 강화 등을 포함하는 보건체계 강화를 지원하고 있음을 발견하였다. 이를 바탕으로 실무적·학술적 향후 과제로써 기추진중인 한국 공적개발원조 사업과 감염병 다자기구 및 ACT-A 사업과의 연계 가능성을 검토하여 더욱 활발하게 협력할 필요가 있다.

보건의료 경제성 평가 방법론 고찰 -연구 설계와 비용 추정을 중심으로- (Critical Review of health care economic evaluation methodology : With a special reference to study design and cost estimation)

  • 이건세;;이상일;구혜원
    • 보건행정학회지
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    • 제14권2호
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    • pp.58-77
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    • 2004
  • Cost containment has become high political issues since financial crisis of the Korean Health Insurance fund in 2000. Korean Government has developed and implemented several measures to reduce the pharmaceutical expenditures. Pharmaceutical economic evaluation can be a tool in decision to allocate scare resource efficiently. In order to increase the quality of economic evaluation for pharmaceuticals, the Korean Health Insurance Review Agency(HIRA) is considering the development of a guideline for economic evaluation. It mandates that pharmaceutical companies could submit the result of an economic evaluation when demanding reimbursement of new pharmaceutical drugs. The purpose of this study is to provide a critical review of the economic evaluations of health care technologies published in the Korean context whether they have been performed according to current guidelines and therefore whether their results are directly useful for decision making. We found there exist important problems and deviation from, good practice' both in the general features of the studies, like the study design and perspective, and in terms of cost measurement and valuation. There are needs to develop clear guidelines and to educate and train researchers in performing economic evaluations.

2014 한국의 보건의료의 상대적 위치와 추이: 경제협력개발기구 국가와 비교 (Position Value for Relative Comparison of Healthcare Status of Korea in 2014)

  • 이상아;박은철
    • 보건행정학회지
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    • 제27권1호
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    • pp.88-94
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    • 2017
  • The aim of this study was to investigate the current and trend of healthcare status of South Korea compared to Organization for Economic Cooperation and Development (OECD) countries. We used the position value for relative comparison (PARC) method for measuring the healthcare status of South Korea by five parts of healthcare policy (demand, supply, accessibility, quality, and cost). Additionally, we conducted Mann-Kendall test for analyzing the trend of PARC from 2000 to the present. Demand, supply, accessibility, and quality of healthcare of Korea were located upon the average of OECD countries, and showed an increasing trend from 2000 to the present. However, primary care and screening for cervical cancer were placed at a lower level compared the OECD average. In conclusion, the current state of healthcare in Korea seems to be generally beyond the average among OECD countries. However, some parts, including primary care, need to be improved.

산업보건사업의 경제성 분석 (A Cost-Benefit Analysis of Industrial Health Promotion Program in Korea)

  • 김진현;양봉민;이석연
    • 한국환경보건학회지
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    • 제19권2호
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    • pp.88-99
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    • 1993
  • There has been investments by firms to protect workers' health and to improve their health status. Most of the investments are made on the ground of legal requirement. However many argue that the amount of investments made falls short of the legally required level. One of the reasons why firms are not active in undertaking required investments is that they are not certain whether such investment is economically beneficial to them or not. Using CBA (Cost-Benefit Analysis), this study investigates whether firms' investments on workers' health are economically justifiable or not. All kinds of expected costs and benefits are itemized and calculated, and costs are compared with benefits. The result shows that if firms fully undertake the legally required investments, total expected costs amount to W453.2 billion and expected benefits accruing to reductions from medical care costs, workers compensation costs, litigation costs in case of legal suit, work days lost, and etc. comes up to W2,086.8 billion. In other words, economic benefits from firms' investment on industrial health far outweighs their costs. As the economy grows, the probability of having various occupational disease increases. It is well conceivable from this study outcome that, the higher the probability, the greater the social loss would be, and the greater the benefits from proper investments on workers' health.

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2017년 한국 보건의료의 상대적 위치와 추이: 경제협력개발기구 국가와 비교 (Position Value for Relative Comparison of Healthcare Status of Korea in 2017)

  • 이현지;오소연;박은철
    • 보건행정학회지
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    • 제30권1호
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    • pp.131-138
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    • 2020
  • The purpose of this study was to compare the health status of South Korea with those of Organization for Economic Cooperation and Development (OECD) countries and examine the trends. Position vAlue for Relative Comparison (PARC) was used as a gauge for comparison, and five sectors of the health care system were measured: demand, supply, accessibility, quality, and cost. The Mann-Kendall test was used as a statistical analysis method to examine trend of PARC values obtained from 2000 to recent years. According to the results, the demand, supply, accessibility, and quality sectors were higher than the OECD average, while the cost was lower than the average. However, there is a recent trend of sharp increases in health care costs. Some indicators: health employment, quality of primary care and mental health care were lower than the OECD average, and health determinants showed a worsening trend. Therefore, policy-makers need to take this into account and make efforts for sustainable health care.

2015년 한국 보건의료의 상대적 위치와 추이: 경제협력개발기구 국가와 비교 (Position Value for Relative Comparison of Healthcare Status of Korea among Organization for Economic Cooperation and Development Countries, 2015)

  • 채원정;이상아;박은철
    • 보건행정학회지
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    • 제28권1호
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    • pp.98-103
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    • 2018
  • This study aims to evaluate the status of Korean healthcare among Organization for Economic Cooperation and Development countries and to monitor the trend of health care status since 2000. The position value for relative comparison (PARC) index was selected to gauge the level of healthcare status in demand, supply, accessibility, quality, and cost as per healthcare policy aspects. The Mann-Kendall test was conducted to allocate healthcare status of Korea since 2000. The PARC values indicate strength and weakness of Korean healthcare system by the mathematical comparisons. Korea positioned higher in demand, supply, accessibility, and quality. Yet, there are shortages in human resources and primary care. In conclusion, we suggest utilizing this study provides evidence to prioritize health care problems that can lead to establishing healthcare policy.

근로자의 고용상태가 미충족 의료에 미치는 영향 (The Effect of Employment Status on the Unmet Needs of Medical Utilization in Workers)

  • 최재우
    • 보건의료산업학회지
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    • 제12권4호
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    • pp.31-41
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    • 2018
  • Objectives: This study was designed to evaluate whether employment status is associated with the experience of unmet care needs. Methods: This study utilized the Korea Health Panel data from 2012 to 2016. A total of 4,083 workers were selected as baseline subjects in 2012 and were followed for four years. This study used the GLIMMIX procedure under the marginal model while adjusting for covariates. Results: A total of 12.4% of 4,083 people said they had failed at least once to have a treatment or checkup despite the needs. Those more likely to experience unmet care needs were women and people of lower income level, with worse health conditions and chronic disease. Precarious workers, the self-employed, and the unemployed were more likely to experience unmet care needs caused by economic burden than permanent workers (Odds Ratio: 2.14, 2.07, 2.74, respectively). Conclusions: This disparity means that precarious workers and the unemployed are more likely to face barriers in obtaining needed health services. Given their insecure employment status, meeting their needs for health care is an important consideration.