• 한국노년학
• /
• v.31 no.1
• /
• pp.171-188
• /
• 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 Convergence for Information Technology
• /
• v.10 no.1
• /
• pp.235-242
• /
• 2020

This study aims to provide direction for improvement of the hospital's management environment for customer satisfaction management, which is ultimately consumer-oriented in practice. this study was analyzed the relationship between hospital use satisfaction relative to expected level and medical service provision process for inpatients. The study method collected data from September 10 to September 30, 2018 for patients with inpatient care at hospitals and general hospitals under 300 beds, and conducted a t-test, ANOVA, and logistic regression. According to the analysis, hospital brands were the most frequently chosen reason for hospitalization, followed by doctor brands. The satisfaction level of the inpatient medical service provision process showed no statistical differences depending on the general characteristics. It has been confirmed that the hospital's satisfaction level relative to the expected level of inpatients has a causal relationship that significantly affects the hospitalized procedure the course of the provision of medical services.

• Proceedings of the KAIS Fall Conference
• /
• 2009.12a
• /
• pp.310-313
• /
• 2009

본 연구의 목적은 환자가 거주지가 아닌 타 지역에서 입원의료를 이용하는 요인을 규명하여 주민들의 의료이용에 대한 지역적 접근성을 향상시킬 수 있는 방안을 제시하는데 있다. 2005년 환자조사 입원자료 523,782건을 연구대상으로 하였으며, 2004년 의료기관평가 자료, 2005년 인구센서스, 2006년 보건의료자원실태조사를 이용하였다. 자료분석은 기술통계, 카이제곱 검정, 로지스틱 회귀분석을 실시하였다. 타 지역 입원의료 이용의 가장 큰 요인은 의료기관 소재지의 의료서비스 수준으로, 인구 10만명당 의료기관평가 점수가 9.5점 이상인 지역이 9.5점 미만인 지역에 비해 타지역 입원의료 이용확률이 8.3배가 높았다. 반면 인구 10만명당 병상수가 910병상 이상인 지역이 910병상 미만인 지역에 비해 타 지역 입원의료 이용확률이 2.0배 높았다. 정부는 지역주민의 의료의 접근성을 높이기 위해 의료공급량의 확충과 분배보다는 지역의료의 질적 수준을 향상시키는 방향으로 정책을 펼쳐야 한다.

• Proceedings of the KAIS Fall Conference
• /
• 2010.11b
• /
• pp.755-758
• /
• 2010

본 연구의 목적은 지방 환자의 서울 지역 입원진료의 추이를 파악하고 그 요인을 규명하는 데 있다. 이를 위해 2005년 및 2008년 환자조사 입원자료를 이용하였으며, 서울지역 거주 환자를 제외하고 2005년 333,280명, 2008년 419,873명을 연구대상으로 하였다. 자료분석은 기술통계, 카이제곱 검정, 로지스틱 회귀분석을 실시하였다. 2005년 대비 2008년 성별, 연령별, 의료기관 유형 등 일반적 특성의 분포는 유사한 것으로 나타났다. 지방 환자의 서울지역 이용은 다소 증가한 것으로 나타났으며, 서울 지역 입원진료는 남자, 중장년층 건강보험환자가 타기관에서 의뢰되어 외래를 통해 입원하며, 주 거주지가 경기, 강원, 충북, 충남, 제주지역 순으로, 광역시는 상대적으로 낮았다. 질병군별로는 선천성 기형, 신생물, 종양이나 수술후 추후치료, 눈 질환, 혈액 조혈 면역기 질환, 근골격계 질환 순으로 지방환자의 서울지역 의료기관 입원 이용률이 높았다. 그러나 상대적으로 지방 입원진료 확률이 높은 노년층, 의료급여, 응급경유, 질병군별로 중증도가 높은 환자가 혼재되어 있어 있을 가능성이 있어 향후 중증도 보정에 대한 심층 연구가 필요한 것으로 판단된다.

• Journal of Digital Convergence
• /
• v.10 no.7
• /
• pp.193-200
• /
• 2012

This study aims to provide an important base resource for the effective medical supply system construction by figuring out the characteristics and changes of admission medical use of gastritis in 160 middle treatment areas classified by 2008 patient examination resources, and by figuring out factors affecting on changes. As a result, in terms of admission rate according to sex and age standardization per small area, there were differences as EQ was 15.1 and CV was 0.4. Top 10 variations were mainly in rural areas. It showed significant positive relations between admission and the number of bed, doctor and special medical equipment per 10,000 population. It is recommended that the government set a priority in the management of regional bed supply and the distribution of efficient medical resources.

• Quality Improvement in Health Care
• /
• v.2 no.1
• /
• pp.58-67
• /
• 1995

Background: This paper describes an effort to provide baseline informations for appropriate utilization of emergency room in a tertiary hospital. Methods: Authors have evaluated that the admissions in the emergency room were medically necessary by objective criteria, Appropriateness Evaluation Protocol(AEP), for one month in a tertiary hospital. Data were analysed by chi-square test and multiple logistic regression to exmaine statistical significances at the level of 0.05. Results: The prevalence of inappropriate decisions for admission was found to be 47.8%(154/322). Whether the physician decided the patient to admit or not was affected by type of services, number of departments involved, patients' medical condition, route of visit, and a day of the week visited. Level of appropriateness of admission is significantly related to patients' age, type of services, and a day of the week visited. Conclusion: We found that substantial proportion of admissions through emergency room are medically unnecessary and that non-medical factors are related to physician's for admission decisions and level of appropriateness of admission. This suggests that policy measures be required to relieve the overcrowding problem and to reduce non-emergent utilization of emergency room in a tertiary hospital.

• Journal of the Health Care and Life Science
• /
• v.9 no.1
• /
• pp.95-102
• /
• 2021

This study analyzed all medical institutions located in the Yeongbuk area of Gangwon Province by dividing the use of medical institutions by "including nursing hospitals" and "excluding nursing hospitals" from 2003 to 2017. As a result, high blood pressure, dementia, musculoskeletal diseases, small-scale mechanical diseases, and other diseases were accounted for in the use of hospitalization for the elderly (including nursing hospitals) in the Yeongbuk region. In the case of hospitalization use of the elderly population (excluding nursing hospitals), blood and circulation machine diseases, digestive and urinary system diseases, mental diseases, and other diseases, including high blood pressure, were shown in the order. Therefore, the treatment and health care of the elderly are very important, and the expansion of public health organizations is necessary to establish governance with local medical institutions, organizations, universities, etc. Based on this, health projects should be carried out at a preventive level to maintain a healthy life for senior citizens in Yeongbuk, Gangwon-do.

• The Journal of the Korea Contents Association
• /
• v.17 no.4
• /
• pp.585-595
• /
• 2017

The purpose of this study is to analyze the difference of medical care between medical assistance and health insurance patients to evaluate the increase of medical care costs due to the moral hazard of medical care patients and to provide a basis for rational medical care policy decision. For this purpose, we compared health insurance benefit data for Seoul citizens by gender, age, and type of medical institutions. The results of the analysis are as follows. First, all of the hospitalized and outpatient use of the advanced general Hospitals, medical assistance patients were less than those of the health insurance patients, so that the medical assistance patients could not use the high cost medical services. Second, in general hospitals, patients with health insurance are often hospitalized. On the other hand, medical assistance patients use a lot of outpatient services because they are less burdened. Third, in hospitals and clinics, medical benefits patients often use inpatient and outpatient services. Therefore, medical assistance patients are likely to use unnecessary medical care of outpatient and hospitalization clinics and hospitals, outpatient of general hospitals. But, in hospitalization and outpatient use in advanced general hospitals and medical assistance patients can not use due to excessive medical burden. Therefore, the policy to reduce the burden of medical expenses for patients with severe illness will continue, and the medical care patients using clinics and hospitals should be careful not to use unnecessary medical services.

• Journal of Digital Convergence
• /
• v.18 no.6
• /
• pp.401-409
• /
• 2020

The purpose of this study is to develop a convergence inpatient medical service patient experience management model(IMSPEMM) that can help in the management strategy of a medical institution to create a patient-centered medical culture. Using the original data from the 2018 Medical Service Experience Survey, 593 people with medical services inpatient(MSI) over the age of 15 were analyzed. By using the decision tree model, we developed a prediction model for overall satisfaction(OS) with the inpatient medical service experience(IMSE) and the intention to recommend patient experience(RI), and were classified into 4 and 7 types. The accuracy of the model was 68.9% and 78.3%. The OS level of IMSE was the nurse area and the hospital room noise management area, and the RI decision factor was the nurse area. It is significant that the IMSPEMM for MSI was presented and confirmed that the nurse area and the noise management area of the hospital room are important factors for the inpatient experience. It is considered that further research is needed to generalize the IMSPEMM.

• Journal of the Korea Convergence Society
• /
• v.11 no.6
• /
• pp.311-318
• /
• 2020

This was a basic study to ascertain the changes in sleep patterns and the factors disrupting sleep in hospitalized children. The participants were children aged 6 years or younger who had been hospitalized in an advanced general hospital in a particular region. A total of 81 participants were included, and for data analysis using SPSS/WIN 21.0. The results showed that children's sleep duration decreased significantly after hospitalization compared to before (p<.001), and there were significant differences in sleep onset latency (p<.001) and frequency of sleep deprivation (p<.001). Factors perceived by the children's mothers to disrupt sleep included the child's health state, noise in the ward, nurses' treatments, and lighting in the ward. This study verified that children's sleep quality and duration decreases during hospitalization, demonstrating the need to prepare measures to improve sleep in hospitalized children based on an understanding of changes in sleep patterns and disrupting factors.