• 대한물리치료과학회지
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• 제13권3호
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• pp.55-64
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• 2006

Despite well-known benefits of physical activity for older adults, most older adults remain significantly underactive. The purpose of this study was to examine the effects of an inclusive, choice-based physical activity promotion program to increase lifetime physical activity levels of seniors on physical activity & health-related quality of life outcomes in older adults. The physical activity promotion program guided participants to choose activities that took into account their health, preferences, and abilities. It offered information on ways for them to exercise safely, motivate themselves, overcome barriers, and develop a balanced exercise regimen. A six-month comparison-group trial was conducted with older adults in community senior center. Changes in self-reported physical activity & health-related quality of life(SF-36) by group & within group were evaluated using t-test. Of 30 subjects, 22(73%) completed the trial. Subjects were aged 63 to 75 years(mean=$68.36{\pm}4.02$); 86% were female. The intervention group increased estimated caloric expenditure by 1975 calories/week in moderate intensity activities(MET${\geq}3.0$; p=.008), and by 2312 calories/week in physical activities of any intensity(p=.005). Between-group analyses showed that the changes were significantly different in both measures(p=0.17; p=032). The intervention group also significantly better scores on general health perception(p=.031) & vitality(p=.002). Individually tailored programs to encourage lifestyle changes in seniors may be effective and applicable to health care and community settings.

• 가정과삶의질연구
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• 제23권2호
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• pp.137-148
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• 2005

This study compared one-child households' economic structures between those who determined not to have more children and those who have a birth plan. This study examined the demographic characteristics and economic variables such as income, consumption expenditures, assets. debt, and a subjective evaluation of future economic status. Especially, it compared the effects of socioeconomic variables on expenditures on a child between low-fertility and birth-planned households. From a questionnaire completed by a husband or wife of one-child households, 154 low-fertility households and 201 birth-planned households were obtained. A t-test, chi-square test, multiple regression analysis and a dummy variable interaction technique were used. The findings of this study are as follows: First, low-fertility households were older, had higher income, and had more educated, employed wives. Their marital duration was longer, and their child was older than those of birth-planned households. Second, low-fertility households had higher consumption expenditures than did birth-planned households. Especially, expenditures of apparel and shoes, health care, education, and entertainment were significantly higher for low-fertility households. Also, low-fertility households spent more than did birth-planned households on a child. However, low-fertility households had significantly more debt than did their counterparts, and their expectation level of future economic status were lower than that of birth-planned households. Third, the effects of socioeconomic variables on expenditures on a child were different between low-fertility and birth-planned households. Age, education level, husband's occupation, wife's employment status, income, net asset, and subjective evaluation of future economic status showed significant differences. Income elasticity of expenditure on a child was significantly higher for low-fertility households than their counterparts.

• 한국지역사회생활과학회지
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• 제22권2호
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• pp.267-282
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• 2011

This study investigated Korean and Chinese female college students' retirement attitudes. Considering the fact that the two countries are experiencing dramatic increases in elderly population, retirement planning is a significant social issue. Even though Korea and China share similar cultural backgrounds, economic systems and governmental retirement policies have been developed in different ways. The purpose of this research was to compare retirement attitudes and related factors between Korean and Chinese female college students. Based on a survey with 214 female college students (130 Koreans and 84 Chinese), differences and similarities in retirement attitudes and related factors were identified. On average, Chinese female college students showed more positive attitudes towards retirement than Korean students. The levels of thinking about retirement and worrying about finances in retirement were greater for Korean students than Chinese students. More Korean students anticipated that their actual retirement age will be earlier than their desired retirement age. Korean students believed that they should start retirement planning at an earlier age than Chinese students' retirement planning age. Korean students anticipated that the cost for food and housing as the major expenditure category in retirement while Chinese students anticipated cost for health care as the major expenditure category. Korean students who worry about finances in retirement, and those who anticipated that they will retire earlier than their desired age showed negative retirement attitudes when controlling other factors. Implications for retirement planning and education were presented based on the research findings.

• 디지털융복합연구
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• 제13권10호
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• pp.425-436
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• 2015

본 연구는 우리나라의 고혈압 의료비의 지역별 변이와 지역의 사회학적, 의료공급, 건강행태 등의 변이 요인을 규명함으로써 이를 기반으로 지역별 고혈압 관리 사업 방안 마련에 기초자료를 제시하는 것이다. 이를 위해 전국 시 군 구 247개 지역을 대상으로, 2012년 지역별 의료이용 통계자료(국민건강보험공단), 지역사회건강조사(질병관리본부) 및 국토해양부 자료를 이용 분석하였다. 연구결과 전국 247개 시 군 구의 고혈압 건강보험진료비는 평균 6만2천원이었고 변동계수는 30.0으로 지역 간 높은 고혈압 의료비 변이를 보였다. 주요 변이 요인으로는 인구밀도, 유배우자율, 평균가구원수입, 인구십만명당병원수, 관외의료비비율, 월간음주율, 중증도이상신체활동실천율, 평생의사진단율 등으로 나타났다. 의사결정나무를 이용한 분석 결과 평생의사진단율, 평균가구원수입, 유배우자율, 인구십만명당병원수, 비만율, 월간음주율에서 유의한 차이가 있었다. 본 연구의 결과 고혈압 의료비의 지역 간 변이요인으로는 의료공급이나 인구사회학적 특성뿐만 아니라 건강행태에 있음을 확인하였고 이는 고혈압의료비 절감을 위한 지역보건사업 정책 결정에 참고가 될 수 있을 것이다.

• Journal of Preventive Medicine and Public Health
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• 제22권4호
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• pp.542-554
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• 1989

The skyrocketing inflation of medical costs has become a major health problem among most developed countries. Korea, which recently covered the entire population with National Health Insurance, is facing the same problem. The proportion of health expenditure to GNP has increased from 3% to 4.8% during the last decade. This was remarkable, if we consider the rapid economic growth during that time. A few policy analysts began to raise cost containment as an agenda, after recognizing the importance of medical cost inflation. In order to Prepare an appropriate alternative for the agenda, it is necessary to find out reasons for the cost inflation. Then, we should focus on the reasons which are controllable, and those whose control are socially desirable. This study is designed to articulate the theory of medical cost inflation through literature reviews, to find out reasons for cost inflation, by analyzing aggregated data with a deterministic model. Finally to identify determinants of changes in both medical demand and service intensity which are major reasons for cost inflation. The reasons for cost inflation are classified into cost push inflation and demand pull inflation, The former consists of increases in price and intensity of services, while the latter is made of consumer derived demand and supplier induced demand. We used a time series (1983-1987), and cross sectional (over regions) data of health insurance. The deterministic model reveals, that an increase in service intensity is a major cause of inflation in the case of inpatient care, while, more utilization, is a primary attribute in the case of physician visits. Multiple regression analysis shows that an increase in hospital beds is a leading explanatory variable for the increase in hospital care. It also reveals, that an introduction of a deductible clause, an increase in hospital beds and degree of urbanization, are statistically significant variables explaining physician visits. The results are consistent with the existing theory, The magnitude of service intensity is influenced by the level of co-payment, the proportion of old age and an increase in co-payment. In short, an increase in co-payment reduced the utilization, but it induced more intensities or services. We can conclude that the strict fee regulation or increase in the level of co-payment can not be an effective measure for cost containment under the fee for service system. Because the provider can react against the regulation by inducing more services.

• Journal of Preventive Medicine and Public Health
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• 제28권2호
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• pp.325-333
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• 1995

Laparoscopic cholecystectomy was introduced into Korea in 1990 and has been rapidly replacing open cholecystectomy when the indications were met. In this study a medical utilization and technology was assessed on the selected hospitalized patients with cholelithiasis who underwent open or laparoscopic cholecystectomy from April 1, 1991 to March 31, 1994. The results are as follows. Despite the low reimbursement rate by the health insurance, the number of laparoscopic cases have been steadily increased. The post-operative days before health insurance coverage were significantly shortened from 8.4 days to 4.6 days. The preoperative days before health insurance coverage were significantly shorted from 8.4 days to 4.0 days. The total length-of-stays in the hospital were also significantly shortened from 15.2 days to 10.7 and 9.8 days in laparoscopic cholecystectomy. The laparoscopic cholecystectomy showed low expenses in all aspects expect the average hospital charges per day. For the hospital to have cost containment, it is more effective if length-of-stay is shorter because of high daily inpatient hospital charge. The laparoscopic cholecystectomy also showed shortened anesthesia time and operation time compared with open cholecystectomy that were statistically significant. The mean anesthesia and operation time for open cholecystectomy were 113.2 and 90.2 minutes but those of laparoscopic cholecystectomy were 105.7 and 68.6 minutes. According to this study the laparoscopic cholecystectomy has reduced the medical expenditure and we recommend this procedure over open cholecystectomy. The further discussion on the different morbidity rate between two types of procedure is essential in providing quality medical care, and to educate specialist.

• 한국콘텐츠학회논문지
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• 제18권1호
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• pp.504-516
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• 2018

재정의 지속가능성 확보는 보편적 의료보장(UHC)을 달성하기 위해 필수적이며, 전 세계적으로 재정관리체계 구성요소 중 하나인 전략적 구매기능에 관심이 높아지고 있다. 본 연구에서는 전략적 구매의 개념과 기능을 고찰하고, 한국 건강보험제도에 있어서의 구매기능과 관련 기관을 Preker(2005)가 제시한 전략적 구매 모형에 근거하여 검토하였다. 이를 위하여 관련 문헌을 고찰하였다. 전략적 구매는 주어진 예산의 범위 내에서 국민이 필요로 하는 보건의료서비스를 제공하기 위한 전략적 활동으로 정의된다. 구매관리자는 정부 혹은 국민들을 대신하여 구매 활동을 수행하며, 정부, 구매자, 의료공급자의 관계는 주인-대리인 이론으로 설명될 수 있다. 우리나라에서의 '구매'는 '한정된 재정 내에서 국민이 필요로 하는 보건의료를 제공하기 위한 전략적 활동으로 급여 범위와 대상 설정, 상급종합병원 지정이나 정보 공개 등 양질의 의료서비스 공급자 선정 활동, 급여기준과 가격 설정, 진료비 지불방법의 설계와 운영, 심사와 평가, 모니터링 활동을 포함'하는 것으로 설명할 수 있다. 건강보험심사평가원과 국민건강보험공단이 정부의 위임을 받아 주된 구매활동을 수행하며, 의료기관평가인증원과 한국보건의료연구원 등이 일부 역할을 담당하고 있다.

• 대한가정학회지
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• 제35권4호
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• pp.229-242
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• 1997

the purpose of this study is to investigate the effect of household type on human capital enhancement expenditures and to compare the difference in these expenditures between female-hemale-headed and married-couple households. Data for this study were from the 1990-91 Consumer Expenditure Survey(CES) and consisted of a sample of 7,225 married-couple and 1,391 female-headed households with children under age 18. The dependent variable to measure human capital expenditures was the sum of four sub-components-education reading leisure and health care expenditures. Tobit analysis with a dummy variable for household type was used to identify the effect of household type on the dollars spent on human capital expenditures. The effect of household type was significant in human capital expenditures indicating that female-headed households spent significantly less for this category than did married-couple household holding other factors constant. the findings of this study suggested that income from a public assistance program was associated with lesser expenditures on human capital while social security income source was associated with greater human capital expenditures, It was also found that the addition of family members between ages of 6 and 17 positively affected human capital expenditures. Understanding these factors is useful for family resource management professionals who work with female-headed households.

• Journal of Preventive Medicine and Public Health
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• 제7권2호
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• pp.319-325
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• 1974

A study on the status of sickness and medical care of insured and non-insured groups of employee and his family in Naju fertilizer company, in the year of 1973, was carried out. The results obtained are as follows: 1. 66.8% of all employee was subscribed in this medical insurance program. No woman employee was subscribed and the rate of subscription was increased from 16.1% to 92.0% by age increases. 2. Also, as of period of service, the rate of subscription was increased from 11.3% to 89.4% by the period gets longer. 3. Employee who reside within boundary of the company (76.2%) subscribed more than that whom reside outside boundary (63.9%). 4. Rate of subscription was also indreased by family size becomes larger. In case of single, it was only 19.6% but in the case of family size became more than 6, it increased to 87.4%, 5. As of amount of monthly income, although no one had subscribed those who get less than 30,000 won a month. Subscriber, increased by monthly income get greater. 6. Subscribed family reside within company boundary utilized hospital 35.5 times a year whereas non-subscribed family reside within these utilized 12.5 times. And, subscribed family reside outside boundary utilized hospital 32.2 times a year and non-subscribed family utilized 9.6 times. Regardless of resident area, family who subscribed to this program utilized hospital more often than non-subscribed family. 7. The utilization of the hospital became gradually frequent from 15.6 times to 36.5 times per family by family size became larger. but in non-subscribed group, although it was increased from 8.3 times to 16.5 times per family, it was droped to the least 6.9 times at 2 person family. 8. 17,496 hospital visits were made by all employee and his family in the year 1973. 86.9% of them was made by subscribed group and the rest (13.1%) was made by non-subscribed group. Observing of the type of these sickness by the classification of WHO, only three types of VII (26.7%), XVII (25.0%) and IX(19.3%) were made more often by non-subscribed group while the others were made more by subscribed group. 9. Anual average medical expenditure per family was 13,098.9 won for subscribed family while it was 3,076.1 won for non-subscribed family. 10. Anual average hospital visits per capita was 6.5 times for subscribed groups and 3.4 times for non-subscribed group. Anual average medical expenditure per capita was 2,580.8 won for subscribed group while it was 1,061.0 won for non-subscribed one.

• 디지털융복합연구
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• 제15권12호
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• pp.625-633
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• 2017

본 연구는 가구소득의 불평등에 민간보험수입과 의료비본인부담지출이 어떠한 영향을 미치는지를 확인하기 위하여 2015년 의료패널조사데이타에 대하여 소득계층별 집중지수와 집중곡선 분석을 실시하였다. 주요 분석결과는 다음과 같다. 첫째, 가구소득 집중지수가 0.3580으로 소득이 고소득층에 집중되어 있어서 불평등 정도가 상당히 큰 것으로 나타났다. 둘째, 민간보험수입이 고소득층에 집중하여 적지만 고소득층 가구의 소득집중현상을 강화시킨다. 셋째, 저소득층의 의료비 본인부담지출이 많은 것으로 나타났다. 끝으로 가구소득에서 전체 의료비본인부담지출을 제외한 소득에 대한 집중지수가 0.3676으로 나타나서 의료비본인부담지출 후에도 소득이 고소득층에 크게 집중되어 있었다. 따라서 민간보험수입과 의료비본인부담지출은 모두 가구소득불평등을 심화시키는 요인으로 작용하고 있어서 융 복합적 연구 및 정책방안 마련을 통한 개선이 요구된다.