• 한국산학기술학회논문지
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• 제15권11호
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• pp.6746-6755
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• 2014

본 논문은 기초생활보장수급자를 대상으로 장기요양서비스 이용 여부가 의료 이용에 미치는 영향을 파악하기 위한 서술적 연구이다. 연구 대상은 장기요양 1등급 판정을 받은 기초생활보장수급자 5,834명을 대상으로 하였다. 기초생활보장수급자의 의료 이용에 미치는 영향을 다중회귀분석으로 분석한 결과 2007-2009년 총 진료비 변화량을 설명하는 $R^2$은 22.6%이었으며, 장기요양 서비스 이용자에 비해 미이용자는 8,297,329원 증가하였다(${\beta}=.29$, p< .001). 입원일 변화량의 $R^2$은 22.4%이었으며, 서비스 이용자에 비해 미이용자는 119.013일 증가하였다(${\beta}=.33$, p< .001). 총 진료비와 입원일 변화량에 영향을 미치는 요인은 장기요양서비스 이용 여부, 수발자 여부, 2009년 일상생활수행능력, 간호처치, 재활기능이 유의한 영향을 미치는 것으로 나타났다. 따라서 장기요양 서비스 미이용자의 의료 이용이 높게 나타남에 따라 미이용자에 대한 적정 의료와 요양서비스 이용을 지원할 수 있는 정책 마련이 필요로 된다.

• 한국치위생학회지
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• 제15권6호
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• pp.1107-1116
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• 2015

Objectives: The purpose of this study was to examine awareness and satisfaction toward health insurance coverage of scaling. Methods: A self-reported questionnaire was completed by 221 patients receiving scaling service from July to August, 2014. The informed consent was approved after the explanation of purpose of the study. The questionnaire consisted of general characteristics of the subjects, awareness toward health insurance coverage of scaling, scaling service covered by health insurance, and satisfaction with health insurance service. Results: Those recognizing the health insurance service extension accounted for 87.3 percent and 67.4 percent answered that the appropriate coverage age would be 20 years old. The recommendable frequency of scaling was once a year and this accounted for 49.3 percent. Fifty percent of the subjects thought health insurance coverage of scaling would be reasonable and 34.8 percent acquired the information from mass media. The most common service providers were dental hygienists and the length of service was from 20 to 30 minutes. The contents of service included scaling service, toothbrushing method, and oral care. The satisfaction was 4.39 points. Conclusions: The health insurance coverage of scaling will improve the oral health and quality of life in Korean adults. So the government should try to extend the scaling coverage by health insurance and the frequency of scaling.

• 대한간호학회지
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• 제47권6호
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• pp.806-816
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• 2017

Purpose: As comprehensive nursing care service has gradually expanded, it has become necessary to explore the various opinions about it. The purpose of this study is to explore the large amount of text data regarding comprehensive nursing care service extracted from online news and social media by applying a semantic network analysis. Methods: The web pages of the Korean Nurses Association (KNA) News, major daily newspapers, and Twitter were crawled by searching the keyword 'comprehensive nursing care service' using Python. A morphological analysis was performed using KoNLPy. Nodes on a 'comprehensive nursing care service' cluster were selected, and frequency, edge weight, and degree centrality were calculated and visualized with Gephi for the semantic network. Results: A total of 536 news pages and 464 tweets were analyzed. In the KNA News and major daily newspapers, 'nursing workforce' and 'nursing service' were highly rated in frequency, edge weight, and degree centrality. On Twitter, the most frequent nodes were 'National Health Insurance Service' and 'comprehensive nursing care service hospital.' The nodes with the highest edge weight were 'national health insurance,' 'wards without caregiver presence,' and 'caregiving costs.' 'National Health Insurance Service' was highest in degree centrality. Conclusion: This study provides an example of how to use atypical big data for a nursing issue through semantic network analysis to explore diverse perspectives surrounding the nursing community through various media sources. Applying semantic network analysis to online big data to gather information regarding various nursing issues would help to explore opinions for formulating and implementing nursing policies.

• 지역사회간호학회지
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• 제19권2호
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• pp.196-204
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• 2008

Purpose: To examine factors affecting long-term care hospital patients' intention of transfer to a nursing home. Method: A questionnaire survey was conducted in Aug. 2007 that included 655 patients from 49 long-term care hospitals. The survey aimed to assess the patients' health status, family status, cost and intention of transfer to a nursing home. Institutional characteristics were analyzed from the nationwide database of Health Insurance Review & Assessment Service. The affecting factors were examined by employing chi-square test and logistic regression using SAS 8.2. Result: Of the subjects, 32.4% had intention of transfer to a nursing home. The intention of transfer to a nursing home was affected by moderate or severe pain, living together with the primary carer, high cost uncovered by insurance, and recognition of nursing home. Conclusion; For appropriate service utilization. a higher level of care is needed to satisfy patients at nursing homes and a balanced fee schedule is needed between long term care hospitals and nursing homes. It is desirable to encourage transfer to a nursing home at which nurses support patients and their families by giving information, coordination, and to make efforts to establish a reference system.

• 응용통계연구
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• 제35권4호
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• pp.457-468
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• 2022

고령인구가 증가함에 따라 국가차원에서 노인의 건강노화 실현을 위한 장기요양 필요 발생의 예방 방안을 마련하는 것은 매우 중요하며, 정책적 효과를 극대화하기 위해서는 적절한 대상자의 선정이 선행되어야 한다. 이에 본 연구는 국민건강보험공단의 국민건강정보를 활용하여, 장기요양 필요를 야기하는 기능장애 발생 가능성이 높은 대상자를 발굴하기 위한 예측모형을 개발하고자 한다. 본 연구는 연구대상자의 과거 수집된 자료를 활용하는 후향적 연구로, 본 연구의 연구대상자는 만 65세 이상 의료보장등록인구이다(총 7,724,101명). 예측모형 개발을 위해 고유 방법인 로지스틱 회귀모형, 머신러닝 방법인 의사결정나무와 랜덤포레스트, 딥러닝 방법인 다층퍼셉트론 신경망을 분석하였다. 체계적 분석절차를 통해 각 분석방법별 모형을 적합하였고, 내적 타당성 및 외적 타당성 평가 결과를 기반으로 최종 예측모형을 랜덤포레스트로 선정하였다. 랜덤포레스트는 모집단에서의 4.50%밖에 되지 않는 장기요양 필요 대상자의 약 90%를 장기요양 필요 발생 고위험 대상자로 예측할 수 있다. 본 연구의 예측모형 및 고위험군 기준은 노인의 욕구 중심에서 예방 서비스가 필요한 대상자를 선제적으로 발굴하는데 기여할 것으로 기대된다.

• 보건행정학회지
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• 제32권3호
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• pp.258-271
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• 2022

The rapidly aging trend of Korea is a major factor that threatens the sustainability of the long-term care insurance system. Therefore, looking at how Japan and Germany mitigated the financial burden when they managed similar long-term care insurance systems will provide important implications for improving the Korean system in the future. The study was conducted using the literature review method, and the "country" was set as a unit for the case analysis. The three countries selected are Korea, Japan, and Germany. Recently in Korea, the insurance premium rates of all subjects have been rapidly rising, which can exacerbate the issue of intergenerational equity. On the other hand, Japan has responded to the aggravating finances for long-term care insurance due to aging by raising coinsurance for selected groups like the wealthy elderly. Germany is selectively raising the insurance premium rates by additionally increasing the premium rate for childless recipients. A more preventive and quality-oriented care service plan can be promoted by referring to the recent changes in Japan and Germany. In addition, a more effective and selective increase in payment burden in Japan and Germany could be considered in response to a recent equity issue in Korea.

• 한국실내디자인학회논문집
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• 제16권4호
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• pp.62-71
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• 2007

Due to the shortage of elderly care services in urban areas, multi-functional welfare facilities are proven to be very effective for delivering various service needs of elderly in Japan. Introduction of new longterm care policy for elderly in Korea would change many aspects of elderly care service facilities. Especially elderly home care services like adult daycare centers will expand drastically after beginning of elderly longterm care insurance. The purpose of this research is to study and analyze multi-functional welfare facilities in Japan focusing on the types of day service in those facilities. Planning of daycare centers in multi-functional welfare facilities for the elderly can be classified to 8 types. Those types are daycare centers with senior housing, longterm care insurance facilities, senior centers, small multi-function facility, medical facilities, educational facilities, community facilities and general housing projects. Each type has different benefits for the networking of services for the elderly. Design of daycare centers in multi-functional welfare facilities have distinctive features in entrance and user approach, space allocation and circulation planning. The study of daycare centers and multi-function planning should be followed to make better home care environments for the elderly in Korea.

• 한국치위생학회지
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• 제20권5호
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• pp.611-621
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• 2020

Objectives: This study aimed to verify the impact of dental health care insurance coverage policy by analyzing the changes in dental care utilization and expenditures over 5 years from 2012 to 2016, when the dental health insurance coverage expansion policy was implemented. From the national cohort data collected by the Korea Health Panel Survey, a retrospective study was conducted for all household members using dental services. Methods: This study statistically verified the difference in the dependent variables by frequency analysis, chi-square test, t-test, and one-way analysis of variance (SPSS version 22, IBM Co. USA, p<0.05). Results: The annual utilization rate steadily increased from 23.4% to 26.1% between 2012 and 2016. Although there were differences in utilization rates by gender, age, and income level, patients kept using the dental services in 2016 regardless of the type of health insurance. The average annual copayment for patient expenditures (out-of-pocket amount) increased from ￦463,844 to ￦537,401 in 2012 and 2016, respectively. Of the dental care expenditures over 5 years, the ratio of uninsured expenses by the elderly decreased from 38.5% to 25.9%, and the national health insurance service coverage increased from 40.3% to 49.1%. Conclusions: Although this policy did not reduce overall patient expenditures, it has been found that there was a positive effect on the elderly and low-income groups; it increased the utilization and access to dental services.

• 보건행정학회지
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• 제19권3호
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• pp.109-124
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• 2009

Background: This study aimed to examine whether cases of punishing false claimants threat general physicians to check their medical cost claims with care to avoid being suspected, and identify empirically general deterrence effects of the on-site investigation system in the Korean National Health Insurance. Methods: 800 clinics were selected among a total of 15,443 clinics that had no experience of on-site investigation until June 2007 using a stratified proportional systematic sampling method. We conducted logistic multiple regression to examine the association between factors related to provider's perception of on-site investigation and high level of perceived deterrence referring to fear of punishment after adjusting provider's service experiences and general characteristics. Results: The probability of high perceived deterrence was higher 1.7 times (CI: 1.13-2.56), 2.73 times (CI: 1.68-4.45) each among clinics exchanging the information once or more per year or once or more for 2-3 months than among clinics no exchanging the information about on-site investigation. Also, the probability of high perceived deterrence was higher 2.27 times (CI: 1.28-4.45) among clinics that knows more than 3 health care institutions having experienced an on-site investigation than among clinics knowing no case. Conclusion: A clinic knowing more punishment cases by onsite investigation and exchanging more frequently information about on-site investigation is likely to present high perceived deterrence. This result will provide important information to enlarge preventive effects of on-site investigation on fraud and abuse claims.

• 한국보건간호학회지
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• 제31권1호
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• pp.19-33
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• 2017

Purpose: This study was conducted to explore the meaning and contents of high-quality aged care facilities and provide basic data for evaluation of service quality in such facilities. Methods: The focus group interviews and participants consisted of two user groups, for a total of 16 family caregivers of the elderly living in facilities and four service provider groups, for a total of 26 chief managers and caregivers working in aged care facilities. All interviews were recorded and transcribed as they occurred. Content analysis was used and debriefing notes were referred to in order to analyze the data. Results: Four themes of a high-quality aged care facility emerged from the analysis; 1) a place to rest for comfortable later years; 2) systematic value-based management; 3) providing professional care; 4) comprehensive service provision in response to diverse needs. Conclusion: The findings of the study showed the importance of client centered care and ethical mindset of providers, which had not been included in the existing quality evaluation programs. Based on these results, medical treatments, end-of-life care and more comprehensive and extended services including family care need to be provided in facilities to ensure good quality aged care.