• 지역사회간호학회지
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• 제23권4호
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• pp.438-445
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• 2012

Purpose: Medical Aid Beneficiaries were surveyed to identify differences in health behaviors, adherence to drug regimen, and quality of life between those people in the Designated Doctor System and those who are not. Methods: A total of 1,327 study subjects were separated into three groups: those in the Designated Doctor System for 2 years, those in for 1 year, and those not in the system. Results: After the introduction of the Designated Doctor System, 55.8% and 67.9%, respectively, of the subjects in the Designated Doctor System complained of inconvenience in relation to hospital use and the patient referral process. Also, the rate of emergency room use or hospitalization guided by the Designated Doctor System was only 8.7% and 6.5%, respectively. There were no significant differences in health behaviors and adherence to drug regimens between those in the Designated Doctor System and those who are not. Conclusion: This study was carried out early in the introduction of the system. Therefore, it is necessary to monitor the positive and negative effects of the Designated Doctor System for a full reflection of its impact.

• 한국사회복지학
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• 제42권
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• pp.107-138
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• 2000

Today, the public assistance program in Korea is provided mainly for the livelihood protection beneficiary in urban area. The fact that the urban community-centered program is also applied to the livelihood protection beneficiary in rural area brings about some problems in fitness and effectiveness of resource distribution. The purpose of my study is to present my opinion that the public assistance program for the rural community should be put in practice after being fully distinguished from the urban program for the effective distribution of limited social welfare resources to insure the minimum standard of living and seek the self-support contribution which is the purpose of the public assistance program. The subject for this study were livelihood protection beneficiaries living in both rural and urban area. And the study was carried out in this parts: first, the way of life in them, second, the contents of 6 main public assistance programs being carried out. Total number of the livelihood protection beneficiaries are 279 case: 143 case from 15 Dong in 5 cities, and 136 case from 15 Myun in 5 counties. And the social worker who are performing the public assistance programare consisted of 50 case: 25 case from 5 Dong in 5 cities, and 25 case from 5 Myun in 5 counties. This research reach the result that the differentiate performance of the public assistance program in rural community would be an effective device for self-support to be freed from the vicious circle of poverty.

• 지능정보연구
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• 제6권1호
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• pp.73-82
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• 2000

This study examined the characteristicso f the knowledge discovery and data mining algorithms to demonstrate how they can be used to predict health outcomes and provide policy information for hypertension management using the Korea Medical Insurance Corporation database. Specifically this study validated the predictive power of data mining algorithms by comparing the performance of logistic regression and two decision tree algorithms CHAID (Chi-squared Automatic Interaction Detection) and C5.0 (a variant of C4.5) since logistic regression has assumed a major position in the healthcare field as a method for predicting or classifying health outcomes based on the specific characteristics of each individual case. This comparison was performed using the test set of 4,588 beneficiaries and the training set of 13,689 beneficiaries that were used to develop the models. On the contrary to the previous study CHAID algorithm performed better than logistic regression in predicting hypertension but C5.0 had the lowest predictive power. In addition CHAID algorithm and association rule also provided the segment characteristics for the risk factors that may be used in developing hypertension management programs. This showed that data mining approach can be a useful analytic tool for predicting and classifying health outcomes data.

• The Journal of Asian Finance, Economics and Business
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• 제8권1호
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• pp.637-646
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• 2021

The main objective of this study was to investigate the impact of access to finance on the different dimensions of poverty. To achieve the objectives of the study, the participants/beneficiaries of the Mudra scheme were included and sample of target respondents was extracted through multistage random sampling technique. The sample for the study was taken from the Union Territory of Jammu and Kashmir of India. The study further utilized secondary data from the government official websites and lead banks. A paired t-test was applied to test the impact of access to finance across the various dimensions of poverty by constructing the Multidimensional Poverty Index(MPI), after checking the normality of the data. MPI incorporates dimensions such as education, health, and standard of living.The finding of the study revealed that dimensions of poverty responded positively to access to finance. The study shows that larger access to finance has helped in reducing the multidimensional poverty by having moderate, but positive impact on the standard of living, health, and education, thereby improving the lives of the poor. The present study identified that the level of impact of access to finance is moderate and further explains its importance for policy implications.

• Communications for Statistical Applications and Methods
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• 제28권4호
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• pp.393-410
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• 2021

The Korean Long-Term Care Insurance (K-LTCI) provides financial support for long-term care service to people who need various types of assistance with daily activities. As the number of elderly people in Korea is expected to increase in the future, the demand for long-term care insurance would also increase over time. Projection of future expenditure on K-LTCI depends on the number of beneficiaries within the grading system of K-LTCI based on the test scores of applicants. This study investigated the suitability of mixture distributions to the model K-LTCI score distribution using recent empirical data on K-LTCI, provided by the National Health Insurance Service (NHIS). Based on the developed mixture models, the number of beneficiaries in each grade and its variability under the current grading system were estimated by simulation. It was observed that a mixture model is suitable for K-LTCI score distribution and may prove useful in devising a funding plan for K-LTCI benefit payment and investigating the effects of any possible revision in the K-LTCI grading system.

• Journal of Preventive Medicine and Public Health
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• 제17권1호
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• pp.37-45
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• 1984

의료보호사업의 의료이용 현황을 파악하고 그동안 시행과정에서 나타난 문제점을 발견하여 이에 대한 합리적인 개선책을 마련하는데 도움을 주고자 경산군의 전 의료보호대상자 17,527명이 1981년 10월 1일부터 1982년 9월말까지 1년동안에 진료증을 사용하여 진료를 받은 의료이용과 상병상태를 일차진료기관의 진료기록부와 매달 각 의료기관에서 군에 제출한 진료비청구서 및 내역서 기타 군과 읍, 면의 각종 행정통제자료에서 조사분석하였다. 경산군의 의료보호대상자는 전인구의 12.7%로서 전국의 9.5%보다 높았다. 대상자들의 의료이용율은 1차진료의 경우 대상자 100명당 월간 환자수는 9.3명, 방문회수는 14.0회, 투약일수는 42.9일이었다. 2,3차 진료의 경우는 연간 대상자 100명 당 입원이 1.7건, 외래이용이 9.3건이었다. 1종대상자가 2종대상자에 비해 1차진료 및 2,3차 진료 모두에서 의료이용이 월등히 높았다. 성별이용율은 1차진료는 여자가, 2,3차 진료는 남자가 많았다. 월별이용율은 7월이 가장 높고 1월이 가장 낮았다. 1월이 가장 낮은 것은 진료증의 갱신때문인 것으로 생각된다. 2,3차 진료기관의 연간 이용자수는 1,931명이고 이중 84.4%가 외래진료이었고 15.6%가 입원이었다. 전문과목별로는 정신과 환자가 66명중 55명이 입원으로 가장 높은 입원율을 나타내었으며, 이비인후과, 안과, 피부과, 비뇨기과 등은 연 입원환자가 $1{\sim}4$명으로 아주 낮은 입원율을 나타내었다. 2,3차 진료기관의 평균입원일수는 21.2일, 외래평균치료기관은 4.7일, 입원과 외래전체의 평균치료기간은 8.6일이었다. 정신과 환자의 평균 입원일수가 74.4일이나 되어 정신과를 제외할 경우 평균 입원일수는 9.3일이었다. 질환군으로 분류한 환자분포는 1차진료는 호흡기질환(35.4%)이 가장 많고, 2,3차 진료는 신경감각기질환(20.1%)이 가장 많았다. 연간 의료보호대상자 1인당 평균 진료비는 9,821원(1종: 24,240원, 2종: 7,464원)이고, 가구당 평균진료비는 40,531원(1종: 66,605원, 2종: 33,559원)이었다. 일차진료기관의 건당진료비는 3,901원, 일당진료비는 840원이고, 2,3차 진료기관의 건당진료비는 49,875원, 일당진료비는 5,822원이었다. 본 조사결과 다음과 같은 의료보호제도의 개선책을 제시하고자 한다. 첫째, 의료보호증의 연초에 일제갱신시 재발급절차를 신속히 할 수 있는 방안이 마련되었으면 한다. 둘째, 전문과목별로 1차지정의료기관을 지정함으로(관내에 전문의료기관이 없을 경우 인근 진료권에 지정) 2,3차 진료기관으로 이송되는 환자를 줄여서 예산의 절감과 이용자의 불편을 덜어주어야 한다고 생각된다. 셋째, 1차지정의료기관과 2,3차 지정의료기관의 진료비 산출방법이 좀더 합리적으로 개선되어야 한다고 생각된다.

• 응용통계연구
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• 제27권5호
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• pp.667-679
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• 2014

우리나라 노인장기요양보험에서는 수급자가 월 한도액 범위 내에서 필요한 서비스를 비용-효율적으로 이용할 수 있도록 지원하고자 표준장기요양이용계획서를 작성하여 제공하고 있다. 본 연구는 표준장기요양이용계획서의 객관성 확보와 업무 효율성 제고를 위하여 의사결정나무기법을 이용해 수급자의 건강 및 기능 상태에 맞는 최적의 급여계획을 도출하는 표준급여모형을 개발하였다. 타당도 높은 모형 개발을 위하여 국민건강보험공단의 전국 220개 장기요양운영센터로부터 장기요양인정조사와 표준장기요양이용계획서 작성 경험이 풍부한 직원(본 연구에서는 '훈련된 조사자'라고 함)을 추천받아 자료수집의 내용과 방법에 대해 교육을 실시하였고, 이들이 수급자의 건강 및 기능 상태를 평가하고 작성한 수급자 개인별 맞춤형 급여계획을 자료 분석에 활용하였다. 표준급여모형은 1단계로 시설 또는 재가 급여 권고 여부를 결정하는 모형을, 2단계로 재가급여를 권고했을 경우의 재가급여 세부 종류별 권고 여부를 결정하는 모형을 개발하였다. 본 연구에서 개발된 표준급여모형은 전산프로그램화 되어 국민건강보험공단 직원이 수급자에게 제공할 표준장기요양이용계획을 수립하는 과정에 실제로 활용되고 있어 표준장기요양이용계획서의 객관성 확보와 업무 효율화가 기대된다.

• 한국치위생학회지
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• 제8권3호
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• pp.1-11
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• 2008

Oral health projects that cater to the disabled should be more prevailing in order to ensure the maintenance and successful promotion of the oral health of disabled people. 70 public dental clinics that conducted oral health projects geared toward the disabled were examined to get a precise grip on their oral health projects. The findings of the study were as follows: 1. 31 out of 70 public dental clinics investigated(44.3%) were equipped with two or more dental hygienists who were professional human resources in charge of the oral health projects for the disabled. As for the age and disability type of the beneficiaries of the oral health projects, adolescents(74.3%) and people with mental retardation(87.1%) benefited most from the oral health projects. Concerning the most common implementation frequency of the projects, the projects were carried out once to three times a week(62.9%). 2. The most dominant oral disease treatment provided to disabled people was amalgam treatment and resin treatment(68.6%), which were the early dental caries treatment. The most common preventive treatment that was offered to improve their oral health was oral prophylaxis(82.9%). As for reform measures for the oral health projects, education of personnels in charge of the projects and their specialization(58.6%) were most emphasized. 3. Regarding factors related to the preventive oral health projects for the disabled, the implementation of oral prophylaxis and toothbrushing education was linked to the age of the beneficiaries. More oral prophylaxis was offered to teens, and more toothbrushing education was provided to preschoolers and adolescents. The age of the beneficiaries and the number of dental hygienists responsible for the projects had something to do with the application of fluorides. 4. Concerning the relationship of the preventive oral health projects for the disabled to the number of dental hygienists, one of the personnels in charge of the projects, the application of fluorides( 54.4%) and pit & fissure sealing(56.8%) were more prevalent when there were two or more dental hygienists. There was a statistically significant disparity in that regard(p<0.05). The above-mentioned findings illustrated that in order to boost the oral health of the disabled, dental hygienists who are responsible for the oral health projects for the disabled should put ceaseless efforts into fostering their professional knowledge and ability and offering quality service to disabled patients. Every public dental clinic should be equipped with plenty of professional personnels to enlarge the scope of treatment and ensure the efficiency of treatment and the preventive projects.

• 가정과삶의질연구
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• 제32권4호
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• pp.23-39
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• 2014

The purpose of this study is to examine if there is any difference due to the general characteristics of middle school students who are beneficiaries of educational welfare services and a special quality of use about educational welfare services. Additionally, the examination has been performed to understand the relationship that exists between the satisfaction about educational welfare services, and adaptation to school life and self-respect of middle school students who are beneficiaries of educational welfare services. The results of the study showed meaningful higher scores by male students than female students only in the environmental adaptation area among lower areas in school life adaptation due to sex. Due to school year, third-year students showed meaningful high scores in school life adaptation. The satisfaction about programs in each area of educational welfare services of middle school students who are beneficiaries of educational welfare services showed a meaningful static relationship with school life adaptation. The inspection of the relationship between satisfaction about educational welfare services and 5 lower areas of school life adaptation showed statistically meaningful results in the order of adaptation to the teacher, adaptation to the environment and adaptation to the class, which are lower areas. The examination on the relationship between self-respect and adaptation to school life showed that self-respect has a static relationship with all lower areas of school life and overall school life adaptation. However, no meaningful relationship was shown between the satisfaction about educational welfare services and self-respect. Also, it was found that the factors of grade, self-respect, the number of service utilization have an effect on school life adaptation. This study has some limitations. But in this study, which is different from other studies which dealt with students who had used partial areas of educational welfare services, students who were using all 4 areas of educational welfare services were selected as subjects. In addition, this study is significant in that basic data has been offered for establishment of a policy on educational welfare services in middle schools in the future.

• 한국사회복지학
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• 제56권3호
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• pp.113-133
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• 2004

본인부담과 관련한 이전의 연구들을 살펴보았을 때 외래와 입원 또는 상병별로 환자개인의 본인부담이 진료비에서 차지하는 비율을 파악하여 우리나라 건강보험이 안고 있는 보장기능의 취약성을 거론하거나 이와는 반대로 의료수요의 가격탄력성을 측정, 소비자의 도덕적 해이의 가능성을 지적하는데 초점을 맞추고 있음을 알 수 있다. 그러나 현재 환자본인이 부담하여야 하는 진료비규모를 파악하여 평균 본인부담액의 실제규모와 본인부담률을 밝히는 동시에 만성질환 보유여부, 의료보장의 종류, 또는 의료서비스 기관에 따른 본인부담의 비형평성 문제에 대하여 직접적으로 논의하는 작업은 극히 미미한 실정이다. 높은 본인부담의 결과로 경제적으로 취약하거나 만성질환에 시달리는 계층이 가장 큰 피해를 입게 된다는 점에서 이에 대한 심도 있는 임상적 및 정책적 논의는 절실하다. 이러한 맥락에서 본 연구는 의료서비스에 대한 계층간 본인부담의 차이가 형평성에 미치는 영향을 분석하고 이에 관련된 정책적 함의를 도출하는데 그 목적이 있다. 본 연구의 결과에서 소득 5분위 대비 최하위 계층의 경우 월등히 높은 만성질환 유병률을 보이고 있음에도 불구하고 최상위층의 6배가 넘는 과중한 본인부담을 안고 있음이 밝혀졌다. 또한 최종적인 회귀분석모형 분석결과는 의료이용 빈도 이외에 환자본인의 인구학적 특성, 가구소득, 만성질환 수, 보험의 종류, 상용치료기관의 종류가 본인부담의 규모를 결정짓는데 있어 영향을 미치는 결정적 요인들로 드러났다.