• 제목/요약/키워드: Health Care Cost

검색결과 798건 처리시간 0.022초

서울시 지역최저생계비 계측에 관한 연구 (Estimation of the Minimum Cost of Living in Seoul)

  • 김경혜
    • 한국사회복지학
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    • 제38권
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    • pp.7-32
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    • 1999
  • 현재의 생활보호제도는 거택 및 시설보호대상자의 선정기준이 지나치게 낮아 생계 보조를 필요로 하는 많은 집단이 보호대상에 포함되지 못하고 있으며, 급여수준도 최저생계비를 충족시켜 주지 못하는 수준이다. 뿐만 아니라, 전국에 동일한 대상자 선정기준 및 급여수준을 일률적으로 적용하고 있어 지역간물가, 특히 주거비 편차에 따른 최저생계비 차이가 반영되지 못하고 있다. 이 연구는 현재의 생활보호사업이 지역간 편차 및 최저생계비를 충족시키지 못하고 있다는 점에 논의의 초점을 두고, 서울시를 연구대상으로 지역 최저생계비를 계측하였다. 계측된 서울시 최저생계비를 전국기준과 비교함으로써 지역간 편차를 규명하였으며, 현재의 생활보호사업으로부터 보호받지 못하는 실질적인 빈곤인구 규모를 파악하였다. 생활보호사업에서 이용하고 있는 전국기준과의 비교를 위하여 현재 대상자 선정기준 및 급여수준 결정의 근간이 된 1994년 한국보건사회연구원의 <최저생계비 계측조사연구>에서 사용한 데이터 및 계측방법을 이용하여 1994년 서울시 최저생계비를 계측하였다. 계측결과 1994년 서울시 4인 표준가구의 최저생계비는 88만 7,611원으로, 이는 보사연에서 계측한 전국평군 최저생계비보다 약 1.33배 높은 값이다. 이를 빈곤선으로 간주하고 1994년도 도시가계조사데이터 서울시 표본을 이용하여 빈곤인구를 추정한 결과, 서울시 인구의 약 5.9%인 63만 6천여명이 이 기준에 미치지 못하는 것으로 나타났다. 이는 1994년 서울시 생활보호대상자 12만 3천명의 약 5.2배에 이르는 수치이다.

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의원급 노인 외래 정률차등정책 효과분석 (The Effect of Changes in Medical Use by Changing Copayment of Elderly)

  • 나영균
    • 보건행정학회지
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    • 제30권2호
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    • pp.185-191
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    • 2020
  • Background: From January 2018, a policy was applied to differentially apply the co-payment for medical expenses of 15,000 won or more from 30% to 10%-30% for each medical fee. This policy lowers the burden on the medical use of the elderly, and it is necessary to analyze the effect of the policy by confirming changes in medical use and supply behavior after 2 years. Methods: The National Health Insurance Service's national medical use database was used. As for the analysis method, first, the medical use and medical supply behavior change over the age of 65 years were confirmed, and second, in order to check the net effect of the policy, the 66-year-old as the experimental group and the 63-year-old as the control group were selected as the control group. The propensity score matching was performed using the variables of age, living alone, income quartile, residence, disability, chronic disease, and co-morbid disease scores, and then it was analyzed using the difference in difference analysis method. Results: The share of the number of treatments under 15,000 won decreased from 37.0% in 2017 to 20.2% in 2018, while the share of the number of treatments under 15,001-20,000 won increased from 8.0% to 22.7%. It was confirmed that the reason for the increase in the cost of treatment per treatment was the result of the increase in the amount of physical therapy and examination. As a result of the policy effect, the burden of co-payment per person was reduced, and as a result, the number of hospital visits per person and the total medical cost per person increased. Conclusion: The self-pay rate differential policy reduced the burden of medical expenses for the elderly and confirmed the increase in medical use. However, the interpretation of the increase in medical use was not able to distinguish whether the unsatisfactory medical care was satisfied or the inducement demand. Efficient allocation of resources is a more important point in the future when the super-aged society is in front. It is necessary to prepare a plan to induce rational medical use within a range that does not impair the medical accessibility of the elderly.

Tobacco Control Law Enforcement and Compliance in Odisha, India - Implications for Tobacco Control Policy and Practice

  • Panda, Bhuputra;Rout, Anita;Pati, Sanghamitra;Chauhan, Abhimanyu Singh;Tripathy, Asima;Shrivastava, Radhika;Bassi, Abhinav
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권9호
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    • pp.4631-4637
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    • 2012
  • Introduction: Tobacco use is a leading cause of deaths and disabilities in India, killing about 1.2 lakh people in 2010. About 29% of adults use tobacco on a daily basis and an additional 5% use it occasionally. In Odisha, non-smoking forms are more prevalent than smoking forms. The habit has very high opportunity cost as it reduces the capacity to seek better nutrition, medical care and education. In line with the WHO Framework Convention on Tobacco Control (FCTC), the Cigarettes and Other Tobacco Products Act (COTPA) is a powerful Indian national law on tobacco control. The Government of Odisha has shown its commitment towards enforcement and compliance of COTPA provisions. In order to gauge the perceptions and practices related to tobacco control efforts and level of enforcement of COTPA in the State, this cross-sectional study was carried out in seven selected districts. Materials and methods: A semi-structured interview schedule was developed, translated into Odiya and field-tested for data collection. It mainly contained questions related to knowledge on provisions of section 4-7 of COTPA 2003, perception about smoking, chewing tobacco and practices with respect to compliance of selected provisions of the Act. 1414 samples were interviewed. Results: The highest percentage of respondents was from the government departments. 73% of the illiterates consumed tobacco as compared to 34% post graduates. 52.1% of the respondents were aware of Indian tobacco control laws, while 80.8% had knowledge about the provision of the law prohibiting smoking in public places. However, 36.6% of the respondents reported that they had 'very often' seen tobacco products being sold 'to a minor', while 31.2% had seen tobacco products being sold 'by a minor'. In addition, 24.8% had 'very often' seen tobacco products being sold within a radius of 100 yards of educational institutions.

Breast Cancer Awareness among Middle Class Urban Women - a Community-Based Study from Mumbai, India

  • Gadgil, Anita;Sauvaget, Catherine;Roy, Nobhojit;Frie, Kirstin Grosse;Chakraborty, Anuradha;Lucas, Eric;Bantwal, Kanchan;Haldar, Indrani;Sankaranarayanan, Rengaswamy
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권15호
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    • pp.6249-6254
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    • 2015
  • Targeting breast cancer awareness along with comprehensive cancer care is appropriate in low and middle income countries like India, where there are no organized and affordable screening services. It is essential to identify the existing awareness about breast cancer in the community prior to launching an organized effort. This study assessed the existing awareness about breast cancer amongst women and their health seeking practices in an urban community in Mumbai, India. A postal survey was undertaken with low or no cost options for returning the completed questionnaires. The majority of the women were aware about cancer but awareness about symptoms and signs was poor. Women were willing to accept more information about cancer and those with higher awareness scores were more likely to seek medical help. They were also more likely to have undergone breast examination in the past and less likely to use alternative medicines. High income was associated with better awareness but this did not translate into better health seeking behaviour. Organized programmes giving detailed information about breast cancer and its symptoms are needed and women from all income categories need to be encouraged for positive change towards health seeking. Further detailed studies regarding barriers to health seeking in India are necessary.

델파이 조사법을 이용한 의료 자원 사용의 효율성 평가지표 개발 (Development of efficiency indicators for medical resources use using Delphi technique)

  • 최윤정;권영대;김창수;김윤
    • 보건행정학회지
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    • 제22권1호
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    • pp.65-84
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    • 2012
  • Because of the rising healthcare costs, there is a growing need for developing efficiency indicators for medical resources use and measuring efficiency of healthcare providers and healthcare systems using them. In this study, we aimed to develop efficiency indicators for medical resources use by means of Delphi technique. We systematically reviewed the existing measures of medical resource use. Thirty nine indicators were selected as a candidates across the six domains: medical personnel, medical equipment, medical facilities, ethical management, resource efficiency, and drug use. To develop efficiency indicators with professional consensus, a 2-round Delphi survey was conducted among 29 professional experts. The following indicators were selected based on the Delphi survey results: adjusted number of the patient per day and level of the nurse number medical personnel in medical personnel domain; the number of the scan a professional physician and the quality of the scan in medical equipment domain; bed utilization rate in medical facility domain; drug price reported pharmaceutical price by medical institutions, medical fee billing transparency, and medical care appropriateness in ethical management domain; costliness index in resource efficiency domain; and utilization of high cost drug and items per prescription in drug use domain. The efficiency indicators could provide valid information about efficiency of healthcare providers and healthcare systems with respect to their resources use and facilitate policies to improve their efficiency.

산업보건에의 한의학적 참여방안에 관한 연구 (Research on the Plan of Oriental Medical Participation in the Industrial Health)

  • 이은경;정명수;천은주;김삼태;강성호;이수경;한종민;김성천;유택수;정재열;송용선;이기남
    • 대한예방한의학회지
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    • 제3권2호
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    • pp.55-77
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    • 1999
  • Oriental Medical Service established foundation that Oriental medical clinic can take part in industrial health service by being specified industrial calamity medical treatment organ, but research which develope program that Oriental Medical Service approach on the occupational disease and industrial health only dealt in the Western Medical System was insufficient. So we studied on theoretical foundation and basic bearing about .program of oriental medical health examination in the workplace, it is based on explanation and assessment reformed by western medicine. We reached the conclusion as follows, 1. We must reconsider the concept that mind of Oriental medicine is preventive medicine, and assess positively result of social medicine. 2. Importance of industrial health is being enlarged in the category of health care. 3. Western medical health in including industrial health have faced much problems at this time, we can search by alternative proposal grafting on Oriental Medicine. 4. Oriental medical participation in the industrial health have various benefits at side satisfaction of workers, effect of prevention, efficiency of cost, and increasing rate of medical treatment and return to workplace of workers with industrial calamity. 5. We must consider Oriental Medical Health Examination as one way of health management program of workers, not as formality. 6. The advantage of Oriental Medical Health Examination can increase ability of individual health management in preventive medicine and the production in workers' health management.

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노동형태에 따른 근로자의 만성질환 유병, 건강행태 및 의료이용 수준 - 여성육체근로자를 중심으로 - (The Prevalence of Chronic Diseases, Status of Health Behaviors and Medical Service Utilization - Focused on Female Blue-Collar Workers -)

  • 김상아;송인한;왕정희;김윤경;박웅섭
    • 농촌의학ㆍ지역보건
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    • 제35권3호
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    • pp.239-248
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    • 2010
  • 우리나라 20세 이상 성인 37,108명을 대상으로 노동형태와 성별에 따른 이중적 문제를 동시에 가지고 있는 여성육체근로자의 건강수준과 의료 이용을 분석한 결과, 여성의 만성질환의 유병률이 남성보다 높고, 특히 여성 육체근로자의 만성질환 유병률, 미치료율, 건강행태가 남성보다 좋지 않게 분석되었다. 그리고 만성질환 유병률과 미치료율, 건강행태의 육체근로 여부별 차이는 남성에서보다 여성에서 더 큰 것으로 분석되었다. 의료이용에 대해서도 외래방문횟수에서는 유의한 차이가 없었으나 여성 육체근로자의 외래진료비가 여성 중에서 가장 적은 것으로 분석되었다. 따라서 여성 육체근로자의 건강수준이 낮음에도 불구하고 적절한 의료이용을 하지 못하는 건강불평등상태에 있을 가능성을 보여주었다. 그러므로 건강불평등을 해소시키기 위해서는 육체근로자에 대한 정책적 배려 이외에도 여성 육체근로자에 대한 배려가 추가로 고려되어야 할 것으로 보인다. 그러나 이 연구는 노동형태별, 성별 차이를 분석함에 있어 연령이외에 건강수준과 의료이용에 영향을 미치는 다양한 환경적, 경제적, 사회적 요인들이 통제하지 못하였으며, 자료수의 한계로 만성질환의 의료이용과 일부 행태만을 분석하고 있고, 연구 자료의 수집연도가 오래되어, 연구 결과의 해석에 주의가 필요하다.

New Directions in Communicating Better Nutrition to Older Adults

  • Guldan, Georgia-Sue;Wendy Wai-Hing Hui
    • Journal of Community Nutrition
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    • 제2권1호
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    • pp.62-70
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    • 2000
  • Nutrition education should be an important component of ongoing health promotion for older adults and their caregivers. This is because prevention through sound nutrition and food hygiene practices and regular excercise is the most cost-effective way to reduce risks for and deal with their major health problems. nutritions education services should effectively promote optimum intake and successful self-care. Unfortunately, however relative to other vulnerable groups, nutrition education for older adults has not been systematically developed or evaluated. Usually oder adults care a lot about their health, so this should be a relatively easy group to teach - but their increasing numbers, longevity and great diversity with respect to health, physical, and economic status and educational level present challenges. Some older adults may not perceive they would benefit from nutrition education, so interesting and motivating them is a challenge. The food and nutrition knowledge of older people has been acquired through a lifetime of experience. For most older adults in the Asian region, their sources are restricted by their restricted education, so that their major sources of information have been informal sources, such as television, radio, friends, family, and perhaps newspapers and magazines if they are literature. Nonetheless, dietary advice for older people should build on their existing knowledge and ingrained values. It should provide information useful in daily food selection, and focus on food, not nutrients - the same foods and groups considered appropriate for younger people, with consistent messages as given throughout the population. Attention must also be paid to discovering learning styles in older people. When we teach in schools, the young students are a captive audience resigned to their learning role. Learning by an older adult, however, reflects an effort to meet his or her perceived needs. Therefore, nutrition education should be a positive experience in a non-threatening environment, relaxed and non-competitive, and perhaps even social environment. The messages also need to be practical and achievable. A needs assessment is essential, because our ability to provide the most effective nutrition education will depend on our success in matching the needs, both perceived and unperceived. of this vulnerable group. Therefore, go to the potential older learners to assess their interest and preferences. Nutrition education activities for older adults are widespread, but few have been evaluated. Evaluation is therefore also recommended, particularly when new methods are used. Tips from other countries for giving successful nutrition education will be given, including some examples of applications as attempted in Hong Kong. Research needs will also be described. In conclusion, successful nutrition education for older adults depends on positive needs-based messages. This is may be hard to do, as few good examples are available to illustrate these principles.

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한 병원이 지역사회에 미치는 경제적 영향 분석 (The Economic Impact of a Rural Hospital to Local Economy)

  • 강임옥;이선희;김한중
    • Journal of Preventive Medicine and Public Health
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    • 제29권4호
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    • pp.831-842
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    • 1996
  • Demand for high quality medical care has recently been increasing in step with high level of income and education. Patients prefer the use of large general hospitals to small community hospitals. Large hospitals, usually located at urban area, expand their capacities to cope with the increasing demand, therefore, they easily secure revenue necessary for growth and development of hospitals. However, small community hospitals are facing with serious financial difficulties caused from the reduction of patients in one hand and the inflation of cost in another. If small rural hospitals were closed, the closure would have negative impacts on local economies in addition to the decrease in access to medical care. Community leaders should have an insight on the contribution of community hospitals to local economies. They could make a rational decision on the hospital closure only with the understanding of hospital's contribution to the community. This study is designed to develop an economic model to estimate the contribution of rural hospital to local economies, and also to apply this model with a specific hospital. The contribution of a hospital to local economies consists of two elements, direct effect and multiplier effects. The direct impacts include hospital's local purchasing power, employee's local purchasing power, and the consumption of patients coming from outside the community. The direct impact induces multiplication effect in the local economy. The seed money invested to other industries grows through economic activities in the region. This study estimated the direct effect with the data of expenditure of the case hospital. The total effect was calculated by multiplied the direct effect with a multiplier. The multiplier was drown from the ratio of marginal propensity of income and expenditure. Beside the estimation of the total impacts, the economic effect from the external resources was also analyzed by the use of the ratio of patients coming outside the region. The results are as follows. 1. The direct economic contribution of the hospital to the local economy is 1,104 million won. 2. The value of multiplier in the region is 2.976. 3. The total economic effect is 3,286 million won, and the multiplication effect is 2,182 million won. 4. The economic contribution from the external resources is 245 million won which is 7.5% of the total economic effect.

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핀란드의 농업보건서비스 사례와 시사점 (Research on Farmers' Occupational Health Services in Finland)

  • 이경숙;;김효철;채혜선
    • 농촌지도와개발
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    • 제21권4호
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    • pp.1007-1028
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    • 2014
  • 핀란드는 한국과 유사하게, 자영농 및 소규모 기업농 위주로 농업구조가 구성되어 있으며, 일반 산업과는 별도의 농업안전보건 체계를 운영하고 있다. 본 연구에서는 핀란드의 농업보건서비스(Farmers' Occupational Health Services, FOHS) 제도를 검토하여 한국 농업 안전보건 체계의 발전 방향을 도출하고자 하였다. 분석결과, 핀란드 농업안전보건체계는 자영농을 대상으로 국립 농업보건센터의 조율 하에 각 지자체의 산업보건 및 농업 전문기관이 농업인에게 농업보건서비스를 제공하고, 비용에 대해서는 사회보장제도에서 지원하는 형태로 운영되고 있다. 이에 따른 시사점은 첫째, 예방방안에 대한 국가 표준을 제시하고 재해통계, 원인연구 등을 수행할 수 있는 국립농업보건센터가 필요하다. 둘째, 저비용, 저난이도의 농작업 환경 평가 및 개선 기술의 개발이 필요하다. 셋째, 보험할인 및 사회보장제도를 활용한 서비스를 통해 농업인의 참여를 유도해야 한다. 넷째, 안전보건 기관 및 전문가의 육성, 지역 및 작목별 맞춤 서비스 등 지역특성에 맞는 안전보건 서비스의 제공이 확보되어야 한다.