• 한국응용과학기술학회지
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• 제37권2호
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• pp.268-278
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• 2020

본 연구는 공공보건자원이 지역사회의 정신건강수준에 영향을 미치는 과정에서 공공보건서비스 이용률이 조절 역할을 하는 지를 확인하고자 수행되었다. 연구대상은 144개의 지역사회이며, 자료는 제6기 지역보건의료계획과 2015년 지역사회 건강조사에서 확보하였다. 연구변수 중 공공보건자원은 공공보건예산, 공공정신보건예산 및 공공정신보건인력으로 구성하였으며, 정신건강수준은 스트레스 인지율, 우울감 경험률 및 자살률로 하였다. 조절효과 분석에 사용된 방법은 위계적 회귀분석이었다. 연구결과는 첫째, 공공보건서비스 이용률은 공공정신보건예산이 우울감 경험률에 영향을 미치는 과정에서 조절변수로 작용하고 있었다. 둘째, 공공정신보건인력이 우울감 경험률에 영향을 미치는 과정에서 공공보건서비스 이용률은 조절효과를 나타냈다. 셋째, 공공정신보건인력이 자살률에 영향을 미치는 과정에서도 공공보건서비스 이용률은 조절효과를 나타냈다. 넷째, 공공보건자원의 정신건강수준에 대한 영향이 공공보건서비스 이용률이 높은 집단과 낮은 집단에 따라 다르게 나타났다. 결론적으로 공공보건자원 강화가 지역사회 정신건강수준의 향상으로 이어지도록 하기 위해 지역사회 정신건강증진 방안에 공공보건서비스 이용률 개선을 위한 내용을 포함시킬 필요가 있을 것이다.

• 농촌의학ㆍ지역보건
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• 제19권2호
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• pp.97-106
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• 1994

In order to estimate the utilization pattern of a rural health subcenter, and to identify the recognition for it among the inhabitants in Kogsung district, a questionnaire survey was carried out for objects of 708 population. The results observed were as follows; 1. The annual utilization rate of a rural health subcenter for a basic health service unit was 27.5 per 100 persons, and annual mean visiting times was 1.43 times. 2. The most frequent disease by, annual health subcenter utilization illness was respiratory disease(26.5%), and the next was musculoskeletal disease(23.9%), gastrointestinal disease(15.9%) by order. 3. Favorite reasons for community health subcenter utilization were lower medical cost(23.4%), near distance from living place(20.7%) and lower disease severity(19.5%) by order. But disfavorite reasons for it were non effective treatment(26.2%), insufficient equipment(25.4%) and absence of specialist(17.4%) by order. 4. Insufficient items about community health subcenter utilization were restriction of treatment limit(47.1%), lower reliance(22.4%) and not punctral(21.8%) by order. 5. The results of logistic regression analysis suggested that statistically significant factors in health subcenter utilization were age, educational level and the nearest medical facility class. 6. There was no difference between recognition for a community health subcenter's work and actual utilizing service, and desirable works for it were disease preventing service, disease control of elderly and sanitation control by order. These results suggested that to increase the utilization of rural health subcenter and to promote the accessibility of rural residents to primary health care, there must be considered public relation about health subcenter, expansion of health equipment and recognition about access time.

• 한국보건간호학회지
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• 제24권2호
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• pp.182-196
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• 2010

Purpose: This study examined potential determinants of gender differences in utilization of health care services among Korean adults. Methods: The study population was 21,647 adults ${\geq}$25-years-of-age who had responded to a health interview survey conducted as part of the 2005 National Health and Nutrition Surveys. Relative gender differences in the use of each health service were assessed using chi-square test and sex ratios. The contribution of potential factors of sex differences in the use of health services was evaluated by comparing the odds ratio and sex ratio before and after adjustment for such variables. Results & Conclusions: More females had visited a physician and been admitted to hospital, but hospitalization time was longer for males. Adjustment for poor self-rated health, number of chronic disease and limit of full term for ADL led to a reduction in the odds ratio of females compared to males for health service utilization. However, adjustment for socioeconomic factors (household income, education, occupation, and health insurance) magnified the gender difference concerning length of hospitalization. Factors that explain gender-related differences in utilization of health care services are concluded to be different health needs and socioeconomic status.

• 한국산학기술학회논문지
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• 제16권11호
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• pp.7463-7473
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• 2015

본 연구는 장기요양 1등급 건강보험가입자를 대상으로 장기요양서비스 이용자와 미이용자의 의료비 지출 차이를 비교하고, 의료비 지출에 미치는 영향 요인을 규명해 보고자 시도하였다. 연구 대상은 건강보험가입자로 2009년 1월 1일부터 12월 31일까지 1등급 판정을 받은 21,213명 전수를 대상으로 국민건강보험공단의 장기요양급여, 건강보험급여 자료를 활용하였다. 연구결과 2007년부터 2009년의 연간 총 진료비 변화량의 경우 서비스 이용자에 비해 미이용자는 5,337천원 증가하였으며, 연간 요양병원 진료비 변화량은 5,449천원 증가하였다. 연간 총 입원일 변화량의 경우 서비스 이용자에 비해 미이용자는 87.31일 증가하였으며, 요양병원 입원일 변화량은 79.47일 증가한 것으로 나타났다. 이 같은 결과는 장기요양 서비스 미이용자의 의료이용, 특히 요양병원의 의료이용이 높게 나타남에 따라 미이용자에 대한 적정의료와 요양서비스 지원 정책을 통해 장기요양과 의료서비스의 효율적 연계가 필요로 된다.

• 대한예방한의학회지
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• 제14권2호
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• pp.67-75
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• 2010

Objectives : Recently, the number of elderly people has been rapidly increasing in Korea, and it led to increase demands of Korean traditional medical services. However, there is a lack of information on Korean traditional service utilization. Thus, this study was intended to identify Korean traditional service utilization patterns such as acupuncture, moxibustion and cupping, since Korean traditional services were specially used in treating chronic diseases for elderly people. It is important to understand health services utilization for quality improvement of healthcare systems. Methods:We used data of 'Survey in Daegu' in 2008 and analyzed characteristics of disease structure and utilization patterns of health care service of 1,097 cases of participated citizens. Results : The proportion of the elderly people (>50 age) in total participators is 52.4%. Male to female ratio is 1:1.65 and most common age group was between 50 and 59 years old. 84.2% of participators were admitted at oriental health care facilities. In addition, the results showed that female were more used the service than man. The most common treated disease is musculoskeletal disorders in both male and female. Conclusions : Acupuncture, moxa and cupping are widely used to treat chronic degenerative diseases such as musculoskeletal disorders at oriental health care facilities. Elders and female prefer to be admitted at oriental health care facilities.

• 보건행정학회지
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• 제5권2호
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• pp.104-126
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• 1995

This study was carried out to assess the utilization of urban health center and its related factors among the urban residents. The survey was carried out for 2,394 households in Taegu and Kyongju by the structured questionnaire from 28 March to 4 April and from 2 July to 9 July, 1994. Well trained interviewers visited 2,630 households in Taegu and Kyongju, and interviewed with housewives. Of the target households, 91.0%(2,394 households) were responded through three-time visiting. The major results were summarized as follows : The fourth and fifth decad utilized the health center more frequently than any other age groups.. The lower income group showed higher rate of health center utilization than those in higher income group in Taegu City. The mean length of residence among residents of Kyongju City is longer than those of Taegu City, and the longer length of residence, the higher rate of the health center utilization. Those who are living together with neonate and infant or elderly people showed higher rate of health center utilization than those who are living without neonate and infant or elderly people in both Taegu and Kyongju. The most common reason for visiting the health center was 'low cost'. The major reasons for not visiting the health center were 'not regular customer', 'poor health center facility', and 'low quality of care'. Vaccination, communicable disease control, outpatient care, public hygiene, maternal and child health program were well recognized as health center activities. In logistic regression for the utilization of health center, the significant independent variables were length of residence and recognize the site of health center in both Taegu and Kyongju. The improvement of quality of health service, physical environment of health center and public relations on health center's activities shoulod be considered for reactivation and reingorcement of health center functions.

• 보건행정학회지
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• 제31권4호
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• pp.508-517
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• 2021

Background: After the first case of coronavirus disease 2019 (COVID-19) in January 2020, Korea has experienced three waves in 2020. This study aimed to analyze changes in health care utilization according to the period of the 1st to 3rd waves of the COVID-19 pandemic. Methods: We analyzed 3,354,469,401 national health insurance claims from 59,104 medical facilities between 2017 and 2020. Observed-to-expected ratios (O:E ratio) with data from 2017 to 2019 as expected values and data from 2020 as observed values were obtained to analyze changes in medical utilization. T-test was used to test whether the difference of observed and expected values was statistically significant. Results: In 2020, the O:E ratio was 0.894, indicating a decrease in health care utilization overall during the pandemic. The O:E ratio of the 1st wave was 0.832, which was lower than those of the second (0.886) and third (0.873) waves. Health care utilization decreased relatively more among outpatient, women, children and adolescents, and health insurance patients. And health care utilization decreased more in small medical facilities and in Daegu and Gyeongbuk during the first wave. During the pandemic, the O:E ratios of respiratory diseases were 0.486-0.694, while chronic diseases and mental diseases were more than 1.0. Conclusion: Health care utilization decreased during the COVID-19 pandemic overall, and there were differences by COVID-19 waves, and by the characteristics of patients and medical facilities. It is necessary to understand the cause of changes in health care utilization in order to cope with the prolonged COVID-19 pandemic.

• 한국병원경영학회지
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• 제14권1호
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• pp.36-61
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• 2009

This study focused on finding the variation of medical service utilization, paths of medical service utilization and medical payments of the patients died by cerebrovascular diseases. For this study, data of the one-year episodes of the health insurance subscribers died in 2004 were selected. The frequency of medical visits, the lengths of stays, the days of outpatient visits, the total period of medical services and the total medical payments were compared by the characteristics of the suppliers and utilizers. This study is useful in reviewing the equity of medical service utilization because it analyzed variance in utilization by episodes. In oder to collect accurate data of the patients died by cerebrovascular diseases in 2004 the 2004 reimbursement data of all medical institutions were matched to the data of funeral fee payment by the National Health Insurance Corporation from January 2004 to May 2005. The major results of the study are as follows. The variation of medical service utilization of cerebrovascular diseases was influenced by supplier factors suppliers, such as types and locations of medical institutions and user factors such as sex and age. It was suspected that the reimbursement by fee-for-service contributed to the variation quite a lot, but we could not compare the variation between the different reimbursement systems in Korea. On the basis of analyzing results this study suggests that the factors of suppliers and utilizers should be reviewed to reduce the under use and over use expressed by variations of medical service. The processes of care, effective communication and management system should be investigated for the equity of medical service utilization and also. alternative medical services would be recommended to reduce the high medical payment. Additionally to find other causes of variation further in depth study controling the severity of diseases, socio-economic status of the users and the system factors is required.

• 보건행정학회지
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• 제33권3호
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• pp.253-263
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• 2023

Background: The purpose of this study was to explore the relationship between the local extinction index and total medical service utilization. Methods: A fixed effects model in panel analysis was performed for the 228 administrative districts in Korea. The statistical yearbook on the usage of medical services by region and Korean Statistical Information Service data were used from 2010 to 2019 for analysis. Medical service utilization was represented by the number of visits day, the number of inpatient days, and medical charges. Control variables were selected by using an Anderson model. The local extinction index was calculated using resident registration population data. Results: Descriptive statistics showed that the number of areas at risk of extinction increased from 61 to 95 for the study years. In addition, the number of visits, the number of inpatient days, and medical charges all increased during the study years. After controlling for variables affecting medical service utilization and doing a panel fixed effects model, the result suggested that a one-step increase in the local extinction index was significantly associated with a 12.29% decrease in medical charges of inpatients, a 7.33% decrease in medical charge of outpatient, a 5.21% decrease in the number of inpatient day, and a 5.54% decrease in the number of visits day. Conclusion: This study showed that the higher the region's extinction risks, the higher the region's total medical service utilization. The results of this study suggested that there was a disparity in medical service utilization between areas at risk of extinction and areas not at risk of extinction, so measures should be taken to address this disparity.

• 간호행정학회지
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• 제11권4호
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• pp.401-414
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• 2005

Purpose: This study was to evaluate the utilization of health care service and to provide supportive data for health care policy making in one urban area in Korea. Method: This study tested the significance of public health service using the database of an university hospital and public health center from Feb. 2000 to Dec. 2004. Data were analyzed by multidimensional analysis and data mining technique and produced the information on the classification of utilization characteristics by main disease and the total cost of use and disease association with the users of the public health center. Results: The Results were as follows: 1) Top 10 diseases in the area accounted for 22.4% of total frequency for the most recent 5 years in university hospital, while 59.0% in public health center. 2) There were significant correlations between university hospital and public health center user's insurance type and place of residence: It showed higher use of public health center for free service beneficiaries residing in Seoul than residents in nearby or local area. The medical insurance types for hospital users were more various than those for public health center users. 3) The use of hospital for patients of hypertension, diabetes mellitus and hyperlipidemia was tended to concentrate in mostly autumn and winter since August 2000, while the cost of using public health center for those patients has been steadily reduced since July 2000. 4) As a result of cluster analysis, there were classified into three homogeneous groups according to the total cost of using public health service, age, and the frequency of use. 5) The association analysis on patients with chronic disease in public health center produced a detailed information on accompanying diseases related to the incidence rate of disease of high frequency due to aging, information on drug abuse and immune disease. Conclusion: The health care policy for local community should be evaluated continuously. And the policy to build an integrated data warehousing by public health indicator system and to enhance the faithfulness of data is required.