• 대한물리치료과학회지
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• 제13권4호
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• pp.43-62
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• 2006

The survey was conducted with participation of the 289 handicapped persons residing at the rural area OOeup-gun in Kyungbook for the period of March 2 - May 31, 2006, to study the nature in general of the handicapped and the boundaries of their need. For the nature in general of the handicapped, the study was done by gender iscrimination, age, marital status, religion, educational level, occupation, monthly income, disability cause, disabled duration, disability type, disability level. For the boundaries of their need, the study was done by demand of financial support, educational demand, demand of voluntary workers, need of rehabilitation and medical treatment, job training, improvement of living conditions, or so. Using the Win.SPSS program, we made a frequency analysis and conclusions on the nature in general of the handicapped and the boundaries of their need on a 2-test. Conclusions are : 1. Nature in general of the handicapped The existence of the handicapped shows high at the age over 51 (71.6%), male-handicapped (65.1%), primary school graduates (62.9%), farming engaging (65.2%), monthly income less than one million Won (80.5%), cause by disease (53.8%), duration more than 10 years (61.6%), disability at level 3 (39.8%), extremity disability (66.4%). 2. Correlation of nature in general with demand of the handicapped a. In demanding the financial support, support for helper’s compensation shows high (p<0.05). In demanding the necessity of voluntary workers, the male-handicapped appears high during the absence of family assistance and the female-handicapped appears differently per week and also appears high during the absence of family assistance (p<0.05). b. In educational demand of the handicapped by their age, the age below 30 demands technical-job training and the age over 31 demands medical education for health care (p<0.01). c. In demanding the financial support by educational level, support for living cost shows high (p<0.05). d. In demanding improvement of living conditions by postnatal cause of disability, improvement of house structure shows high (p<0.05). e. In demanding assistance of voluntary workers by disabled duration, "No Need" shows high in the disabled duration more than 4 years (p<0.05). f. In demanding rehabilitation and medical treatment by disability type, home-visiting treatment, oriental medical treatment and physical therapy show high (p<0.001). g. In educational demand by disability level, medical education for health care shows high (p<0.01).

• 한국의료질향상학회지
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• 제9권2호
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• pp.210-228
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• 2002

Background: The purpose of this research was to examine the fall incidence rate and its related factors of fall in inpatients. Methods: The data were collected from the 138 fall incident reports in one tertiary hospital in Seoul from April 1st 1999 to September 30th 2001. The Fall Incident Report Form was originally developed based on that of Massachusetts General Hospital revised in 1995. And this was modified for this survey by the collaborating work of QI team including researcher and department of nursing service of this particular hospital. The contents of Fall Incident Form were general characteristics of patient. factors related to fall. types and places of fall. circumstances, nursing interventions. and outcome. Results: 1) The incidence rate of fall was 0.08% of total discharged patients and 0.081 per 1000 patient-day. This incidence rate is much lower than that of several hospitals in USA. This finding might result from the different incidence report system of each hospital. 2) The characteristics of fall-prone patient were found as follows. They were mostly over 60 years old, in alert mental status, ambulatory with some assistance, and dependent on ambulatory device. The types of diseases related high incidence rate were cerebrovascular disease(3.2), hypertension(1.6), cardiovascular disease(1.4), diabetes(1.3) and liver disease(0.6). 3) The majority of fall events usually occurred m bed. bedside(walking or standing) and bathroom in patient room. Usually they were up on their own when they fell. And there were more falls of elderly occurred during night time than day or evening. 4) 63.8% of fall events resulted in physical injuries such as fracture and usually the patients had diagnostic procedures and some treatment(ex. suture) which caused additional cost to the patients and their families. 5) The found risk factors of fall were drugs(antihypertensive drug, diuretics) and environmental factors like too high bed height, long distance of bedside table and lamp switch, and slippery tile of bathroom floor. Conclusion: Considering these results, every medical and nursing staff should be aware of the risk factors of patients in hospital, and should intervene more actively the preventive managements, specially for the elderly patients during night. Therefore, it is recommended that the development of Fall Prevention Programs based on these results.

• Pediatric Infection and Vaccine
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• 제22권3호
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• pp.136-142
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• 2015

대한소아감염학회는 2015년 우리나라에서 처음으로 중동호흡기증후군(Middle East Respiratory Syndrome, MERS, 메르스) 환자가 발생하여 보건의료 응급 상황 발생의 긴박했던 시기에 이에 대한 대처에 참여하였다. 우리 학회는 메르스 발생 시 학회 홈페이지에 관련 공고문을 즉시 게시하였고 소아청소년에서의 메르스 환자의 발생시 의심 환자의 검사와 진단 및 국민안심병원 운영을 위해 소아청소년 MERS (중동호흡기) 검사 지침, 국민안심병원 소아청소년과 운영지침을 발빠르게 배포하였다. 이는 메르스 의심환자에 대한 접근에서 소아청소년에서 흔한 호흡기 질환 환자들이 메르스로 오인되어 불필요한 공포, 검사 및 격리를 당하지 않도록 하기 위함이었다. 이를 통해 소아청소년 환자를 진료하는 의사들과 이들의 보호자들을 안심시켰고 결국 많은 심리적 공포와 의료 비용을 감소시켰으며 메르스 종식 시 돌이켜보니 이는 결국 적절한 조치와 가이드라인이었음이 증명되었다. 앞으로 대한소아감염학회와 회원이 유관기관과 긴밀한 협조와 소통을 할 수 있는 체계 시스템을 구축해야 하며 상급의료기관의 소아청소년 감염전문의 필수 상주 및 이에 의한 감염관리료 제도 장착과 수가 신설 및 개선을 유도하는 등의 추진이 필요하다.

• Journal of Preventive Medicine and Public Health
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• 제14권1호
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• pp.65-74
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• 1981

This survey was made to determine the overall health situation on (1) the status of sickness; (2) the medical care utilization; (3) the medical cost in Mi-Kum Myun, Nam Yang Ju Gun, Kyung-Gi Do. The survey with questionnaire was carried out with 2,840 peoples in 560 households from August 9th to 16th, 1979. The findings from the survey were as follows; 1. Annual morbidity rate of the prolonged ill cases was 97.2 per 1,000 population (male 94.7, female 99.6), The highest age specific morbidity rate was 274.5 of the 45-to 64-year group and the lowest was 21.9 of the 5-to 14-year group. 2. Annual morbidity rate of the new patients was 777.5 per 1,000 population(male 644.5, female 909.5). 3. The chief complaints distribution of the prolonged ill cases was: local pain 36.6%, indigestion 22.4%, and coughing 7.3%, respectively, In terms of age and sex distribution, a large number of female of the 45-to 64-year group complained of local pain or general pain and a large number of both sexes of the 25-to 44-year group complaned of indigestion. 4. The major diseases of the new patients which classified with International Classfication of Diseases (I.C.D.) were disease of the respiratory system, disease of the digestive system, and disease of the musculo-skeletal system and connective tissue for male, disease of the respiratory system, disease of the digestive system, and accident, poisoning, violence for female. 5. Total ill days of the 92 new patients were 536 days and average ill days per case were $6{\pm}38.3$ days. 6. The rate of receiving treatment in the prolonged ill cases was 82.2%(medical facilities 46.4%, drug stores 27.5%, herb medicine 8.3%). 7. The rate of receiving treatment by first choice of the new patients was 88.0% (drug stores 57.%, medical facilities 28.2%, and herb medicine 2.2%), and the rate of receiving treatment by second choice was 30.9% of first treatment cases (medical facilities 44.0%, drug store 44.0% and herb meicine 12.0%). 8. Annual hospitalization rate per 1,000 population was 12.0 (male 12.0, female 11.9). 9. The locations of medical facilities utilized by out-patients were: in the prolonged ill cases Seoul or other places 66.4%, Nam Yang Ju Gun 33.6%, in cases of the new patients Seoul or other places 35.1% and Nam Yang Ju Gun 64.9% respectively. 10. The satisfaction rate of the new patients by mode of receiving treatment was: in cases of primary utilization by first choice herb medicine 100.0%, medical facilities 88.5%, and drug stores 69.8%, in cases of secondary utilization medical facilities 100.0%, herb medicine 100.0%, and drug stores 72.7% respectively. 11. The medical cost per utilized facilities was as follows; in average medical fee per case out-patient 8.947 won, in-patient 266,000 won, drug stores 1,532 won, and herb medicine 15,607 won, in average medical fee per day out-patient 4,829 won, in patient 14,178 won, drug stores 891 won, and herb medicine 4,906 won respectively. 12. The sources of the hospital charges paid out were: there own expense 50.0%, debt 35.3%, and security of medical care 14.7% respectively.

• 경영과정보연구
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• 제38권4호
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• pp.25-39
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• 2019

본 연구는 의료기관의 회계정보공시 자료 즉, 재무상태표와 손익계산서를 활용하여 의료기관의 재무비율을 통한 안정성비율, 수익성비율, 성장성비율, 활동성비율을 분석함으로서 병원의 수익성지표에 영향을 미치는 요인과 재무비율 특성을 분석하고자 하였다. 주요 목표는 의료기관의 회계정보공시 자료의 2016년과 2017년도 재무제표를 분석하며 의료기관의 설립형태 및 종별, 규모별의 일반적 특성 및 재무비율의 평균 차이 분석을 실시, 재무지표에 대한 평균값을 통해 의료기관의 재무적 특성을 파악하였다. 재무비율을 통한 안정성비율, 수익성비율, 성장성비율, 활동성비율의 평균 비교 분석 및 재무적 특성을 파악하였다. 또한 개정된 의료회계기준규칙에 의한 의료기관의 회계정보공시 자료를 활용하여 의료기관의 의료수익의료이익률, 총자산의료이익률, 의료수익순이익률, 총자산순이익률에 대해 회귀분석을 하였다. 주요결과를 보면 회계정보공시 자료에는 첫째, 재무상태표 통한 총자산, 총부채, 자본총계의 변화를 통한 병원의 규모 및 부채의 규모는 증가 추세이며 자본총계의 규모가 상대적으로 감소되었으며 또한 경영성과가 악화되는 경향을 보이고 있다. 둘째, 손익계산서에서 평균 의료수익의 증가는 미비한 편이며, 평균 당기순이익은 감소하는 편이다. 이에 의료기관은 의료 활동을 통한 이익 창출의 어려움을 확인할 수 있었다. 또한 의료기관의 종별에 따라 상급종합병원과 종합병원의 부채비율, 안정성비율, 수익성 비율의 차이가 컸으며, 설립형태에 따라서 국공립병원, 학교법인병원, 의료법인·재단법인병원의 평균 재무비율의 차이를 확인할 수 있었다. 병원경영의 수익성지표에 미치는 영향을 파악하여 병원의 의료수익순이익률과 총자산순이익률의 경영 성과 개선을 위한 노력이 필요하다.

• KDI Journal of Economic Policy
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• 제34권3호
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• pp.31-65
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• 2012

본 연구에서는 세대 간 회계를 이용하여 현행 재정정책의 유지 가능성과 최근 논의되고 있는 복지확대정책이 재정건전성과 세대 간 형평성에 미치는 영향에 대해 분석하였다. 분석 결과, 현행 재정정책은 유지 가능하지 못하며, 재정수지 불균형도 매우 큰 것으로 나타났다. 재정지출 수준을 통제하지 않는 한 납세자의 재정부담이 감내할 수 없을 정도로 높아질 수 있을 것으로 예상된다. 또한 최근 논의되고 있는 무상의료와 같은 복지지출 확대정책은 납세자의 재정부담을 대폭적으로 높이게 된다. 무상급식, 무상보육, 반값등록금 지급과 관련된 복지확대정책은 현시점에서의 금액이 비교적 크지 않으며 낮은 출산율로 인해 향후 보육인구와 학령인구가 줄어듦에 따라 지출액이 줄어들 것으로 예상되어 이들 정책으로 인한 재정부담의 증대규모가 비교적 크지 않은 반면, 무상의료의 경우는 현시점에서의 금액도 매우 클 뿐만 아니라 인구의 노령화로 인해 수급자 수가 증가할 것으로 예상되므로 이로 인한 재정부담이 더욱 증가할 것으로 예상된다.

• KDI Journal of Economic Policy
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• 제30권2호
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• pp.129-155
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• 2008

급성상기도감염증에 대한 항생제 처방률은 의료기관의 유형, 표시과목, 의료기관이 위치한 지역 등 여러 요인에 따라 차이를 보인다. 본 연구는 1차 의료기관인 의원들 중 내과, 소아과, 이비인후과 의원의 급성상기도감염증에 대한 항생제 처방률에 환자의 특성과 같은 의학적 요인이 아닌 의원의 수입과 밀접한 관계가 있는 의원 수의 변화(경쟁 정도의 변화)와 같은 경제적 요인이 미치는 영향을 실증 분석하였다. 2006년 건강보험심사평가원에서 발표한 전국 각 의료기관의 급성상기도감염증에 대한 항생제 처방률을 주 자료원으로 하여, 경쟁지수를 두 가지 형태로 정의하고 수요 측면을 나타내는 변수와 공급 측면을 나타내는 변수를 통제변수로 선정하여 회귀분석을 실시한 결과 경쟁지수를 어떤 형태로 정의하든, 의원이 위치한 지역의 경쟁정도는 의사들의 항생제 처방률에 통계적으로 유의한 영향을 미친 것으로 분석되었다. 이러한 결과는 시장지역 내 경쟁 정도의 변화와 같은 경제적 요인이 의사들의 처방행태에 영향을 미치는 요인 중 하나라고 해석할 수 있다. 아울러 인과관계의 방향과 관련하여, 의사가 진료하는 지역의 경쟁 정도가 높아질수록 항생제 처방률이 통계적으로 유의하게 높아지는 것으로 나타났다. 이러한 결과는 의사의 진료수입 감소를 초래할 것으로 예상되는 시장환경의 변화에 대해 자신의 진료수입을 예전상태로 보전하기 위해 불필요한 의료서비스 소비를 유도해서 얻는 편익(소득효과)이 이를 위해 자신이 지불해야 할 비용(대체효과)보다 크기 때문에 항생제 처방률을 증가시킨 것으로 해석할 수 있으며, 또한 경제적 유인체계의 변화에 대하여 의사의 진료행태가 영향을 받을 수 있음을 실증적으로 뒷받침하는 것으로 이해할 수 있을 것이다.

• 디지털융복합연구
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• 제13권8호
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• pp.375-385
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• 2015

본 연구의 목적은 흡연율의 지역간 변이 정도와 흡연율에 영향을 미치는 요인을 살펴보는 데 있다. 분석을 위해 2009-2011년 질병관리본부의 지역사회건강조사 자료와 국민건강보험공단의 자료를 사용하였다. 흡연율에 영향을 미치는 요인을 파악하기 위해 상관분석, 다중회귀분석을 이용하였으며, 지역간 변이 분석을 위해 의사결정나무 모형을 이용하였다. 연구결과, 지역간 흡연율의 변이요인은 고위험음주율, 고혈압관리교육 이수율, 금연캠페인 경험율, 스트레스 인지율, 고혈압 유병률, 건강보험료, 당뇨병 유병률, 비만율, 근력운동 실천율로 나타났다. 융복합 기반으로 지역별 흡연율의 변이를 파악하는 것은 흡연율을 감소시키기 위한 지역별 맞춤형 보건프로그램을 수행하는데 매우 중요하다. 향후 흡연율이 높은 지역의 원인과 대상에 맞는 구체적인 관리방안을 모색하는 노력이 필요할 것이다. 본 연구의 결과는 효과적인 흡연관리사업 방안을 도출하는 데 필요한 기초자료로 의미있게 활용될 수 있으리라 여겨진다.

• Journal of Preventive Medicine and Public Health
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• 제10권1호
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• pp.3-15
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• 1977

In order to find out health problems among inhabitants in slum areas in Kwanak-Ku, Seoul, a series of health survey was conducted upon 510 households by interview from March to December, 1976. The results obtained were as follows: 1. Employments of householders were unstable; Out of 508 householders, 164(32.3%) were unemployed and 184 (36.2%) were daily or temporary employees. 2. Average number of households per house was 2.0 and average area of residential room per person was $4.0m^2$. 3. 476(93.3%) out of 510 households were supplied with tap water and rest of them made use of ground water as a source of drinking water. 4. Only 279(18.3%) out of 1527 live births were delivered at medical facilities, 496(32.7%) were at home attended by doctors or midwives and 358(25.1%) took prenatal care. The above findings were worse in urban slum area than in other urban area of relatively high economic level, but were better than in rural area of less medical facilities. 5. Initiation of treatment were delayed until their illnesses were advanced in most of the households, 472(92.5%) out 510. In the early stage of the illness, 131(25.6%) of the house-holds sought physicians in their clinics or general hospitals and 250 (40.9%) visited chemists, to toy drugs at first hand. Frequency of visits to physician increased to 52.8% as the disease aggravated in later stages. 6. Cost of medical expenditure per household amounted to 815 won, and was paid to, in the order of chemists, physicians, chinese herb stores, chinese herb doctors. 7. Concerning the health knowledge of the inhabitants, 273(53.9%) out of 506 respondents were aware of the infectivity of pulmonary tuberculosis, and 68(13.4%) of them checked regularly their chest findings by X-ray at least once every two years. 8. As for the family planning, although 448(87.3%) out of 510 respondents were in favor of it, 215 (41.8%) of them were actually practicing contraception. 9. About 40.6% (125 respondents) of them obtained information and knowledge concerning contraception through personal contact with family planning workers. 10. Nutritional status of housewives was generally poor: 49(38.3%) out of 128 housewives were found to be anemic and average serum protein level was $7.5{\pm}0.82g/dl$.

• Journal of Preventive Medicine and Public Health
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• 제37권3호
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• pp.260-266
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• 2004

Objectives : To assess the impacts of implementing case payment system (CPS) to Medical Aid (MA) hemodialysis patients on the frequencies and expenditure of dialysis. Methods : Fifty-eight clinics and 35 tertiary care hospitals were identified as having a minimum of 10 hemodialysis patients for each of the MA and Medical Insurance (MI) programs, who received hemodialysis from the same dialysis facilities for both periods of July 2001 and July 2002. From these facilities, a total of 2,167 MA and 2,928 MI patients were identified as the study subjects. Using electronic claims data, the changes in the total number of monthly treatments and charges for outpatient hemodialysis treatments for each patient after the introduction of the CPS were compared between the MA and MI patients. Multiple regression analyses were performed to examine the independent impact of the CPS on the utilization and expenditure of dialysis treatments among the MA patients. Results : There was a significant decrease in the total charges for the hemodialysis treatments of the MA patients, 3.4% (p<0.05), whereas a significant increase was observed for the MI patients, 2.5% (p<0.05). For both the MA and MI patients, the frequency of the monthly hemodialysis treatments were significantly increased, 5.5 (from 12.1 to 12.7) and 7.8% (from 11.6 to 12.5), for the MA and MI patients, respectively. However, a multivariate regression analysis showed no significant difference in the changes in the total number of monthly hemodialysis treatments between the MA and MI patients after implementation of the CPS. Another regression model, regressing on the changes in the monthly claims of dialysis treatments, showed a significant negative coefficient for the MA ((=-70725, p<0.05). Conclusion : The significant decrease in the total charges for hemodialysis treatments among MA as compared to MI patients suggests that there was a cost reduction in the MA program following the introduction of the CPS.