• 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.

• Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology
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• v.6 no.7
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• pp.9-16
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• 2016

As life in a rapidly changing Internet age at home and abroad, large amounts of information are being used medical, financial, services, etc. Accordingly, especially hospitals, is an invasion of privacy caused by leakage and intrusion of personal information in the system in medical institutions, including clinics institutions. To protect the privacy & information protection of personal health medical information in medical institutions at home and abroad presented by national policies and de-identification processing technology standards in accordance with the legislation. By comparative analysis in existing domestic and foreign institutional privacy and de-identification technique, derive a advanced one of pseudonymization and anonymization techniques for destination data items that fell short in comparison to the domestic laws and regulations, etc. De-identification processing technology for personal health information is compared to a foreign country pharmaceutical situations. We propose a new de-identification techniques by reducing the risk of re-identification processing to enable the secondary use of domestic medical privacy.

• Proceedings of the KAIS Fall Conference
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• 2010.05b
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• pp.859-862
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• 2010

본 연구는 대전광역시의 응급의료서비스 취약지를 도출하고 취약지역의 보건학적 특성 및 응급의료서비스 취약여부와의 관련성을 분석하여 응급의료 관련 정책의 의사결정에 유용한 기초자료로 제공하기 위한 연구이다. 응급의료서비스 취약지 도출은 Arc GIS의 공간분석 방법 중 가중분석(Cost Weighted distance) 방법으로 응급의료센터로부터의 접근성 분석을 하였으며, 응급의료서비스 취약지의 보건학적 특성 및 응급의료서비스 취약여부와의 관련성은 SPSS 17.0을 이용하여 비모수 t-검정 및 다중회귀분석을 시행하였다. 본 연구의 주요 결과는 다음과 같다. 연구지역의 응급의료기관 분포는 동구와 유성구, 대덕구는 지정된 응급의료센터가 없으나 서구와 중구는 응급의료센터가 2개소 이상 위치하고 있어 응급의료기관 분포가 편중되어 있으며, GIS를 활용하여 응급의료센터와의 접근성 분석을 수행한 결과, 대전광역시 자치구별 전체 면적 대비 응급의료서비스 취약지의 비율이 높은 자치구는 동구가 41.2%로 가장 높았다. GIS를 활용하여 행정동별 응급의료서비스 취약지를 분석한 결과, 대덕구 신탄진동, 동구 대청동과 산내동, 유성구 구즉동과 노은2동, 서구 기성동, 중구 산성동으로 나타났으며, 응급의료서비스 취약지 중 기성동, 대청동이 노인 인구밀도가 높게 나타났다. 응급의료서비스 취약여부에 따른 보건학적 특성별 차이를 분석한 결과, 국민기초생활수급권자, 장애인등록자, 농업인구 비율의 평균은 취약지가 비취약지에 비해 높았으며 통계적으로 유의한 차이를 보였다(p<0.01). 응급의료서비스 취약여부를 종속변수로 하고 지역별 보건학적 특성을 독립변수로 하여 로지스틱 회귀분석을 시행한 결과, 농업인구 비율과 국민기초생활수급권자 비율이 높았으며 이는 통계적으로 유의하여 응급의료서비스 취약여부를 설명할 수 있는 변수인 것으로 나타났다(p<0.01, p<0.05). 이상의 결과를 종합하면 대전광역시 5개 자치구의 행정동 중 응급의료서비스 접근 불평등지역이 도출되었고 이러한 지역은 보건학적 특성 중 농업인구 비율과 국민기초생활수급권자의 비율이 높았으며 이는 통계적으로 유의하여 응급의료서비스 취약여부와 관련성이 있는 것으로 나타났다. 향후 효율적인 응급의료 자원 분배를 위해서는 GIS를 활용한 의사결정이 필요하며, 응급의료서비스 이용의 형평성을 증진시키기 위해서 응급의료서비스의 사각지대에 놓여있는 지역의 보건학적 특성을 고려한 정책이 시행되어야 할 것으로 사료된다.

• 한국노년학
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• v.31 no.1
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• pp.171-188
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• 2011

The purpose of this study is to examine the factors associated with the probability and levels of the health service utilization among the disabled elderly in Korea. The sample includes 2,111 people older than 65 who are extracted from the 2008 National Survey on People with Disabilities. More than half (54.3%) of the sample experienced at least 1 outpatient physician visit within two weeks and 26.7% were hospitalized within a year. The key factors associated with the outpatient visits were health insurance status, the existence of chronic disease, self-rated health, the Activities of Daily Living (ADLs), as well as renal impairment. Similarly, the utilization of inpatient care was related to health insurance status along with the existence of the internal organ disabilities such as cardiac or respiratory disorders. The study implies the need for the health care policies regarding the prevention of chronic diseases, dependency for daily activities of the elderly, and a management system that specifically targets those with internal organ disabilities. Moreover, the study suggests that financial supports for the low-income group would be helpful to increase their access to health service utilization.

• Journal of Digital Contents Society
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• v.17 no.3
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• pp.197-202
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• 2016

This paper suggested that medical image database construction technique that generated and recognized from variable medical device and professional medical experts for the formalization and pattern extraction from informal medical images. And then we transformed informal image characteristics to digital data, and generated the meaningful pattern matching informations. Through this experienced works, so many related researchers can easily access the medical images database and use this formalized image informations on the variable fields.

• Journal of Convergence for Information Technology
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• v.11 no.8
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• pp.185-193
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• 2021

The purpose of this study is to prevent risk of emotional labor and health through verifying the mediating effects of depression on the relationship between emotional labor and somatic symptoms and insomnia in non-medical hospital workers. For this study, a sample of 533 tertiary hospital's non-medical workers completed the questionnaires of the Korean Emotional Labor Scale, PHQ-15, ISI, PHQ-9. The data was analyzed using the SPSS 25.0 program. The results can be summarized as follows. 1. Among the emotional labor sub-factors, emotional dissonance had a significant effect on depression, somatic symptoms and insomnia. Other sub-factors had a relatively small effect or had no effect. 2. The results showed the partial mediating effects of depression on the relationship between emotional labor and somatic symptoms. 3. The results showed the full mediating effects of depression on the relationship between emotional labor and insomnia. On the basis of the results, we suggest the necessity of dealing with emotional dissonance and depression in non-medical hospital workers' emotional labor and health issues.

• The Journal of the Korea Contents Association
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• v.13 no.2
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• pp.378-389
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• 2013

Health care expenditure might be understood as a core source of social welfare. It is mainly due to the fact that the health care expenditure is closely related to the level of social welfare. And, therefore, the paper is basically designed to investigate the effect of social welfare improvement resulted from an increasing in per capita, private, public, and total health care expenditures during 1995-2009 periods. Empirical evidence reveals that the improvement of social welfare in middle income group reveals the highest improvement in social welfare, and the other income groups maintain a quite similar pattern in improvement of social welfare. As far as category of health care expenditure concerns, the effect of social welfare improvement by per capita health care expenditure is in general lower in all case. And, private sector achieves the highest improvement of social welfare in comparing with public and total health care expenditures. To this end, it could be tentatively concluded that the private health care expenditure has to be substituted for the public sector to induce market-oriented operational system. Accordingly, it would be better to build an institutional basis more elaborately in setting up the market system.

• Korea Journal of Hospital Management
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• v.22 no.3
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• pp.1-17
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• 2017

Purposes: Diabetes is a metabolic disorder that requires continuous care in order to prevent complications, as it can impose a critical burden on families and society due to various complications, including terminal renal failure, non-traumatic lower extremity amputation, and adult blindness. The usual sources of care are "specified private clinics, public health centers, or other facilities to visit when ill or when health-related advice is needed". These usual sources of care offer preventative services, have a high overall satisfaction rate in terms of public health care, and decrease the inpatient rates and medical costs of medical aid recipients. This study analyzed the current status of diabetic patients over 20 years of age based on their possession of a usual source of care, and the effects of this possession on the frequency of their medical service usage and its costs. Methodology: Based on data from the 7th Korea Health Panel, a Tobit analysis was used to analyze the different factors that can affect the frequency of medical service usage and its costs for diabetic patients with and without a usual source of care. Findings: The medical costs of diabetic patients with a usual source of care decreased in terms of inpatient, and the outpatient visits and inpatient costs of the group with a usual source of care in the form of a mainly-visiting doctor decreased more than those of the group with a mainly-visiting medical institution only. Practical Implications: Having a usual source of care can increase the treatment continuity, leading to reduced inpatient, and having a mainly-visiting doctor as the usual source of care further increases the treatment continuity. Based on these results, a new policy is needed to increase and strengthen diabetic patients? possession of a usual source of care.

• Journal of Urban Science
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• v.8 no.1
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• pp.51-58
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• 2019

This study examines the determinants of emergency care utilization and equity of access to care in elderly Koreans. Based on the data from the 2014 Korea Health Panel Survey, descriptive and logistic regression analysis was performed. The sample for this study was 1,313 individuals who participated in interviews. Predisposing factors such as age, sex, and education were significant determinants of emergency care utilization. Differences in need do not fully account for the original differences observed between subgroups of older Koreans. Health status was important determinant of older Koreans using emergency care services. Spending medical expense did not ameliorate the subgroup differences in the use of emergency care services. Nonetheless, spending medical expense remains a particularly important predictor of emergency care utilization. Health care reforms in Korea should continue to concentrate on insuring effective universal emergency care, implying that all older Koreans with need receive effective coverage. Future study is also needed to understand the access barriers that may exist for the selected demographic subgroups, i.e., those over 75, women, less educated persons, and those with higher medical expense.

• 한국사회정책
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• v.25 no.1
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• pp.99-123
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• 2018

Purpose: This study empirically investigates the utilization and expenditure of health care and long-term care at the last year of life for long-term care beneficiaries in Korea. Methods: This study used National Health Insurance and Long-term Care Insurance claims data of 271,474 LTCI beneficiaries, who died from July 2008 to December 2012. Their cause of death, place of death, health care costs, and the provision of aggressive care were analyzed. Results: Cardio-vascular disease(29.8%) and cancer(15.3%) were reported as their major cause of death, and hospital(64.4%), home(22.0%), social care facility(9.2%) were analyzed as the place of death. 99.3% of subjects used both health care and long-term care during the last 1 year of life. The average survival period were 516.2 days after they were LTCI beneficiaries. The health care expenditure gradually increased near the death, and the last month were three times more rather than the first month. Furthermore, 31.8% experienced some aggressive cares(CPR, blood transfusion, hemo-dialysis, etc.) at the last month of life. Conclusion: The results of this study suggest that it is important to develop the end of life care policies(for example, hospice, advanced care directives) for the LTCI beneficiaries. They might contribute to the improvement of quality of life and the reduction of health care expenditure of the elderly at the end-of-life.