• 보건행정학회지
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• 제23권4호
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• pp.387-396
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• 2013

Background: The purpose of this study was to analyze the association between areas of Korea Train Express (KTX) region and external medical service use in Korean society using spatial statistical model. Methods: The data which was used in this study was extracted from 2011 regional health care utilization statistics and health insurance key statistics from National Health Insurance Corporation. A total spatial units of 229 districts (si-gun-gu) were included in this study and spatial area was all parts of the country excepted Jeju, Ulleungdo island. We conducted Kruskal-Wallis test, correlation, Moran's I and hot-spot analysis. And after, ordinary linear regression, spatial lag, spatial error analysis was performed in order to find factors which were associated with external medical service use. The data was processed by SAS ver. 9.1 and Geoda095i (windows). Results: Moran's I of health insurance patients' external medical service use was 0.644. Also, population density, Seoul region, doctor factors positively associated with health insurance patients' external medical service. In contrast, average age, health care organization per 100 thousand were negatively associated with health insurance patients' external medical service use. Conclusion: The finding of this study suggested that health insurance patient's external medical service use correlated for seoul region in korea. The study results imply the need for more attention medical needs in the region (si-gun-gu unit) for health insurance patients of seoul region. It is important to adapt strategy to activation of primary health care as well as enhancing public health institution for prevent leakage of patients to other areas.

• 보건행정학회지
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• 제34권1호
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• pp.48-58
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• 2024

연구배경: 이 연구는 충청남도 지역 및 환자의 특성과 관외 의료기관 이용과의 연관성을 분석한 연구이다. 충청남도 지역에 거주하는 입원 및 외래 환자들을 통해 도내 진료권을 분석하고, 수도권 및 대전권 의료기관에 대한 관외 의료이용 양상을 파악하여 도내 의료전달체계 개선 및 건강보험 재정 안정 도모를 위한 충청남도 의료정책 사업의 근거적 자료 제공을 목적으로 한다. 방법: 이 연구는 건강보험 코호트 DB 2.0 2016-2019년 자료를 활용하였다. 수집된 원시 자료 중 환자의 거주지가 충청남도 지역이면서, 이용한 요양기관이 상급종합, 종합병원, 병원, 의원인 환자로 한정하였고, 최종적으로 2,570,439건(입원=43,309, 외래=2,527,130)의 자료를 추출하였다. 먼저, 분석대상자의 일반적 특성을 파악하기 위해 각 변수별로 기술통계를 실시하였고, 충청남도 지역 및 환자의 특성과 관외 의료기관 이용과의 연관성을 파악하기 위해 다변량 로지스틱 회귀분석 및 다항 로지스틱 회귀분석을 실시하였다. 또한 관외 의료기관 이용에 따른 입원 및 외래 환자의 진료 1건당 의료비 차이를 파악하기 위해 심사결정 후 건강보험 총요양급여비용을 자연로그값으로 변환하여 분석하였다. 결과: 분석결과, 충청남도 지역 거주 환자들은 충남권, 대전권, 수도권 순으로 의료기관을 많이 이용하였고, 입원 및 외래 환자 모두 천안, 아산 거주 환자들에 비해 모든 권역에서 관외 의료기관을 더 많이 이용하였다. 특히 공주, 부여, 천안(odds ratio [OR], 72.931) 및 계룡, 논산, 금산(OR, 116.817) 거주 입원 환자는 대전권 의료기관 이용과 매우 높은 연관성을 나타냈다. 또한 충청남도 지역 거주 환자들은 충남권 의료기관에 비해 수도권(외래=17.01%, 입원=22.11%)과 대전권(외래=16.63%, 입원=15.41%) 의료기관에서 더 많은 의료비를 지불하였다. 결론: 이 연구는 충청남도 지역 거주 환자들의 관외 의료이용 양상을 분석하고 관련 시사점을 제공하였다. 향후 지역 의료기관과 서비스에 대한 신뢰도 및 만족도와 환자의 주진단과 같은 요인들을 고려한 연구가 추가적으로 진행되어야 하며, 연구결과를 바탕으로 합리적인 의료의 지역화와 의료공급 효율성 및 건강보험 재정 건정성 확보를 위한 정책사업의 기초 자료로 활용되기를 고대한다.

• 간호행정학회지
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• 제8권1호
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• pp.151-167
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• 2002

Purpose : The purpose of this study is to present the direction of service marketing for improving customers' satisfaction by comparing the difference in medical and nursing service satisfaction between internal and external customers. Method : The subjects were outpatients and inpatients as the external customers and nurses, doctors, and staffs as the internal customers, in a university hospital. Data were collected from April 25 to May 2, 2001 through questionnaires. The 2 structured instruments were used for collecting the data: Customer Satisfaction Measurement 2000 developed by Korean Society of Quality Assurance in Health Care(1999) and nursing service satisfaction questionnaires by the researcher. Data were analyzed using SPSSWIN 9.0 with t-test, one-way ANOVA, scheffe test.Result : 1. In overall medical service satisfaction scores, external customers' satisfaction showed significantly higher than internal customers'(p=.000) and there was no significant difference between external customers(p>.05). But there was significant difference between internal customers(p<.05). 2. There was no significant difference in nursing service satisfaction between the external and internal customers (p>.05). In the external customers, inpatients' nursing service satisfaction showed significantly higher than outpatients' (p<.001). And there was significant difference in nursing service satisfaction between internal customers(p<.05). Conclusion : To increase external customers' satisfaction with medical and nursing service, hospital should carry out internal marketing strategies for improving internal customers' satisfaction. Also to increase outpatients' satisfaction, it should conveniently improve procedures of use and provide more information and education for outpatients.

• 보건행정학회지
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• 제31권3호
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• pp.261-271
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• 2021

Background: In 2018, the government increased the fee for the magnetic resonance imaging (MRI) image deciphering services of the external hospital to discourage the redundant MRI scan and to induce appropriate use of the MRI services. It is important to evaluate the effect of the policy to provide the basis for establishing other MRI-related policies. Methods: The healthcare data of the patients who had brain MRI scans were organized by episode and analyzed using the panel study in order to find out the effect of the MRI-related policy on the substitution effect and the medical expenses. Results: As a result of the increase in the fee of deciphering the MRI image, there has been an uplift in deciphering the MRI scan of the external hospital. It implies that more hospitals chose to use the MRI scan taken by other clinics or hospitals, rather than the MRI scan taken at their own facilities. Conclusion: The research results imply that a policy that facilitates the exchange of the medical image data between the hospitals is needed in order to establish an efficient management system of the healthcare resources. Such improvement is expected to reduce the social cost and contribute to the stability in the finance of national health insurance.

• 한국응급구조학회지
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• 제21권2호
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• pp.39-50
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• 2017

Purpose: This study measured awareness of automated external defibrillators (AED) among students majoring in health-related versus non-health-related fields. Methods: A total of 577 students filled out a questionnaire on awareness of AEDs between June 12 and June 28, 2017. Using SPSS 23.0, data were analyzed using descriptive statistics, chi-square tests, and t-tests. Results: In response to a question about awareness of AED, 25.0% of students majoring in a health-related and 38.6% of those majoring in a non-health-related field answered on "I have seen or heard" and "I have no idea". In response to a question on perception on AED use, 82.4% of students majoring in a health-related field and 88.1% of those in a non-health-related field reported that they thought perception of AED use was not universal. In terms of experience with education on the use of AED, 30.2% of health-related majors and 49.7% of non-health-related majors had not received any training on the use of AED. The average overall score regarding knowledge about AED was 8.69 for health-related majors, compared to 7.79 for non-health-related majors. Conclusion: In order to improve awareness regarding AED use, education on importance and necessity of AED should be emphasized and implemented consistently by the mass media.

• 한국응급구조학회지
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• 제21권3호
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• pp.73-84
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• 2017

Purpose: The purpose of this study was to investigate the installation, management, and usability of automated external defibrillators (AED) installed in the apartments with over 500 households in Chungnam. Methods: The survey included 52 apartments with over 500 households having AED in Chungnam from July 1 to August 20, 2017. The information of AED was taken from the Chungnam Provincial Office. Results: The access and use of AED was closely affected by AED installation location, locking devices, lack of publicity, and AED use education for the residents. Conclusion: Efficient education on the use and management of AED for residents of the apartments is necessary.

• Asian Pacific Journal of Cancer Prevention
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• 제15권24호
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• pp.10683-10690
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• 2015

The big gap between efficacy of population level prevention and expectations due to heterogeneity and complexity of cancer etiologic factors calls for selective yet personalized interventions based on effective risk assessment. This paper documents our research protocol aimed at refining and validating a two-stage and web-based cancer risk assessment tool, from a tentative one in use by an ongoing project, capable of identifying individuals at elevated risk for one or more types of the 80% leading cancers in rural China with adequate sensitivity and specificity and featuring low cost, easy application and cultural and technical sensitivity for farmers and village doctors. The protocol adopted a modified population-based case control design using 72, 000 non-patients as controls, 2, 200 cancer patients as cases, and another 600 patients as cases for external validation. Factors taken into account comprised 8 domains including diet and nutrition, risk behaviors, family history, precancerous diseases, related medical procedures, exposure to environment hazards, mood and feelings, physical activities and anthropologic and biologic factors. Modeling stresses explored various methodologies like empirical analysis, logistic regression, neuro-network analysis, decision theory and both internal and external validation using concordance statistics, predictive values, etc..

• 정보보호학회논문지
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• 제20권6호
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• pp.251-260
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• 2010

의료서비스와 IT 기술간의 융합으로 환자 개인의 건강정보가 전자의무기록(EHR)의 보급과 함께 빠르게 전자화되고 있다. 이와 함께 유헬스사회에 접어들면서 전자화 된 환자의 건강기록들을 진료 이외의 공중보건 및 의학 분야의 연구, 의료서비스 향상을 위해 사용하고자 하는 2차이용의 요구가 증가하고 있다. 개인건강정보의 2차이용으로 의학 분야의 발전의 매우 유익한 일이지만 부주의하게 개인의 건강정보를 이용하는 경우 환자 개인의 프라이버시 손상이 발생, 더불어 2차이용융 통한 연구나 서비스 발전에도 제한이 발생할 수 있다. 하지만 아직 개인건강정보를 이용한 2차적 이용에 대해 체계적인 연구나 논의가 없는 것이 현실이다. 따라서 본 논문에서는 개인건강정보의 2차이용과 관련하여 국내외의 법안들을 살펴보고 이를 비교 분석하여 앞으로 개인의 프라이버시를 존중하고 더불어 의료분야 서비스 있는 방향을 제시하고자 한다.

• The Journal of Korean Physical Therapy
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• 제34권5호
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• pp.224-233
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• 2022

Purpose: In Japan, the Long-Term Care Insurance Act has stipulated visiting rehabilitation since 2000. This study aimed to identify the actual conditions of visiting rehabilitation in Japan through a literature review of reports published by the Japanese government. Methods: This literature review was conducted on eight articles among various government reports on the topic of the actual conditions of visiting rehabilitation. These reports were published by the Ministry of Health, Labor and Welfare of Japan based on their own investigations or reports from an external agency entrusted with the task, and were issued between 2000 and 2021. Results: The characteristics of the visiting rehabilitation offices, their number, manpower allocation, the number of users, and their visits to each office were identified. Also, the characteristics of the users, number of users, age and required degree of long-term care, causative disease, and required medical care were identified. To evaluate the actual status of the visiting rehabilitation service, the service use time, frequency, period of use, intervention by doctors and the degree of such intervention, therapist's service content, visitors' address before the use of the service, reason, and timing of the service introduction, evaluation of the service effectiveness, combination of services and transfer destination after termination, and status after service termination were checked. Conclusion: Based on the Japanese experience where visiting rehabilitation was introduced and applied to long-term care insurance, it would be meaningful to review the factors that required benchmarking among the Japanese service models while designing a similar model in Korea.

• International Journal of Contents
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• 제7권3호
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• pp.65-70
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• 2011

This research, by analyzing the current first aid education status in K district, Seoul and comparing first aid education systems in other developed countries, introduces the need of first aid/Cardio Pulmonary Resuscitation(CPR) education with Automated External Defibrillator(AED) usage to high school students, who are on the verge of becoming adults. The thorough research shows that schoolsshould be appointed as mandatory facilities for AEDs by laws and execute first aid education to their students. Only through organized and consistent first aid education would the students develop into true volunteers who not only have altruistic minds, but the ability to fluently adapt to medical emergency and properly use AED. In addition, the research also outlines various laws that could be legislated such as having to master the basic degrees of first aid education before getting driver's license and graduating high school so that more people become aware of first aid.