• 제목/요약/키워드: Health Services Research

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중.고령자의 민간의료보험 가입 여부의 결정 요인 (The determinants of purchasing private health insurance among middle-aged and elderly Korean adults)

  • 유기봉;조우현;이민지;권정아;박은철
    • 한국병원경영학회지
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    • 제17권3호
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    • pp.23-36
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    • 2012
  • Objectives : The coverage of Korean National Health Insurance is limited to basic level. Korean government encourages private health insurance for covering medical securities. So, many studies examined the determinants of purchasing private health insurance. However, 11% of Korean population is older than 65 in 2011. Considering the elderly is important to establish a health policy. The aim of this study is to examine factors determining the purchase of private health insurance among middle-aged and elderly Korean adults. Methods : We used the second Korean Longitudinal Study of Ageing (KLoSA), selected 8,688 sample of the aged 47 or older for the analysis. KLoSA collected information on demographic characteristics, income, health- related factors. KLoSA data include in the number of outpatient, inpatient, oriental hospital visit, dental clinic visit for two years. Logistic regression was used to examine the relationship between the determinants of purchasing private health insurance and the factors which include age, gender, education, residential district, marital status, smoking, drinking, physical exercise, economic activity status, national health insurance type, income, the number of chronic disease, and the number of outpatient, inpatient, oriental hospital visit, dental clinic visit for two years. Results : People who were older, did not live in a city, had higher IADL, currently drunk alcohol, did exercise regularly and had chronic diseases more than three were inclined not to purchase private health insurance. Females, the married, well-educated, past & currently smokers, the employed, high income earners, national health insurers, metropolitan citizens and someone who got high MMSE were more likely to purchase private health insurance. The more people experienced outpatients, inpatients, dental clinics and Chinese medicine clinics, the more private health insurance was purchased. The elderly people over 75 had more private health insurance than the aged 65-74. The strongest factors for private health insurance is gender, and economic status such as income. Conclusion : In this study, we found healthy-high income people were more likely to purchase private health insurance. In contrast, unhealthy-low income and older people did not. The economic factors were strongly related with private health insurance in aged over 75. These mean inequality exists in the using private health insurance. Therefore, the government should consider vulnerable social group before expanding private health insurance.

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일 지역 맞춤형 방문건강관리사업의 고혈압.당뇨병 사례관리 효과분석 (The Effect of Case Management for Clients with Hypertension.DM Registered in Customized Home Visiting Health Care Services)

  • 박정숙;오윤정
    • 한국보건간호학회지
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    • 제24권1호
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    • pp.135-150
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    • 2010
  • Purpose: To analyze the effects of customized home visiting health services on the health and health behaviors of clients with hypertension (n=107) and diabetes mellitus (DM: n=67). Methods: A one group pre and post-test research design was used. The subjects were registered in a customized 8-week, interventional, home visiting health services available in Daegu. Data was collected from November 17, 2008 to January 23, 2009. Analyses involved descriptive statistics, $x^2$ test and paired t-test. Result: Hypertension control rate was improved 25.2% and DM control rate was improved 3.0%. There were significantly beneficial hypertension-related differences in BP, health belief, health knowledge and health behaviors including performance of 10 min of moderate exercise, diet, BP monitoring and medication. Significantly beneficial DM-related changes included glucose, health belief, health knowledge and health behaviors including performance of 10 min of moderate exercise and glucose monitoring. But there were no significant hypertension-related differences in health belief (barrier) and health behavior including drinking and exercise length/frequency. Also, no significant DM-related differences were evident in health belief (barrier) and health behaviors including drinking, smoking, exercise length/frequency, diet and medication. Conclusion: Customized home visiting health service can provide effective, but not complete. Whether these benefits are maintained in the longer term is unknown.

환경보건정보 통합관리체계에 관한 연구 (Research on the Integrated Management System of Environmental Health Information)

  • 김대선;위성승;유승도;박충희;정영희
    • 한국환경보건학회지
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    • 제33권4호
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    • pp.235-241
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    • 2007
  • The National Institute of Environmental Research(NIER) launched a research about Framework of Environmental Health Information System for Industrial Complex in 2001, with the goal of finding out measures to establish an integrated management system(IMS) for environmental health information. Based on the research results, NIER started to build integrated information system. The process will continue from 2006 to 2008. As the first step, in 2006, NIER outsourced the job of setting up the specific plan. In 2007, based on the plan created in the previous year, computerization work began. During 2008, the $3^{rd}$ year of the process, the integrated system will be compatible to conventional GIS system and statistics analysis system to deliver funker efficient and useful services. In this vein, the objective of the study is to identify data collection procedure, data utilization, and overall goal of the system. In addition, It will illustrate digitalization process and recommendation about how to utilize the system.

우리나라 성인의 성별에 따른 주관적 인지 저하 관련 요인 (Factors Associated with Subjective Cognitive Decline according to Sex in Korean Adults)

  • 이은숙;서영미
    • 동서간호학연구지
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    • 제30권1호
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    • pp.31-41
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    • 2024
  • Purpose: This study aimed to identify factors affecting subjective cognitive decline (SCD) in men and women. Methods: This study was conducted based on data from the 2021 Korea Community Health Survey, and targeted a total of 80,026 men and 98,753 women aged 40 or older who responded to the SCD assessment. Multivariate logistic regression analysis using a complex sample was performed to identify factors influencing SCD. Results: Of the participants, 19,438 (22.7%) men and 30,826 (29.9%) women in the community reported SCD. Significant factors that influence SCD in both groups were age, education level, subjective health status, and depressive symptoms, and the strongest risk factor was depressive symptoms. Compared to women, men's monthly income, flexibility exercise, hypertension, and diabetes mellitus were found to be significant factors on SCD and Healthcare services affected SCD only in women. Medical services affected SCD only in women. Conclusions: When planning and providing intervention programs for cognitive function, it is necessary to reflect differences in factors associated with SCD according to sex.

Effects of Application of Social Marketing Theory and the Health Belief Model in Promoting Cervical Cancer Screening among Targeted Women in Sisaket Province, Thailand

  • Wichachai, Suparp;Songserm, Nopparat;Akakul, Theerawut;Kuasiri, Chanapong
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권7호
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    • pp.3505-3510
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    • 2016
  • Cervical cancer is a major public health problem in Thailand, being ranked second only to breast cancer. Thai women have been reported to have a low rate of cervical cancer screening (27.7% of the 80% goal of WHO). We therefore aimed to apply the social marketing theory and health belief model in promoting cervical cancer screening in Kanthararom District, Sisaket Province. A total of 92 from 974 targeted women aged 30-60 years were randomly divided into two groups. The experimental group underwent application of social marketing theory and a health belief model program promoting cervical cancer screening while the control group received normal services. Two research tools were used: (1) application of social marketing theory and health belief model program and (2) questionnaire used to evaluate perceptions of cervical cancer. Descriptive and inferential statistics including paired sample t-test and independent t-test were used to analyze the data. After the program had been used, the mean score of perception of cervical cancer of experimental group was at a higher level (${\bar{x}}=4.09$; S.D.=0.30), than in the control group (${\bar{x}}=3.82$; S.D.=0.20) with statistical significance (p<0.001). This research demonstrated an appropriate communication process in behavioral modification to prevent cervical cancer. It can be recommended that this program featuring social marketing and the health belief model be used to promote cervical cancer screening in targeted women and it can be promoted as a guideline for other health services, especially in health promotion and disease prevention.

크라우드소싱(crowdsourcing)을 이용한 환경보건 연구 방법의 고찰 (Review of Environmental Health Research through Crowdsourcing)

  • 이보람;이기영
    • 한국환경보건학회지
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    • 제40권3호
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    • pp.171-177
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    • 2014
  • Background: The development of technology can be beneficial for the life and health of human society. Crowdsourcing refers to drawing upon a large pool of individuals in order to seek services, ideas, or other contributions. With the development of information communication technology, crowdsourcing is able to provide powerful results in environmental health research. Methods: We searched 'crowdsourcing' and 'citizen science' for keywords related to the environmental health field and only selected journal articles and conference proceedings material, such as research reports and WHO reports. Results: This paper reviewed environmental health research using crowdsourcing. Examples of such research based on crowdsourcing included practices in environmental disasters, noise monitoring, global positioning system (GPS) technology, smart phones, attached portable devices and information delivery by web. Crowdsourcing methods can provide notably distinct approaches for future environmental health research. However, it is also important to protect personal information whenever crowdsourcing is applied to data generation and information dissemination. Conclusion: We expect that this review may provide useful information for the development of new environmental health research methods using crowdsourcing and citizen science.

대만 의료보장개혁과 교훈 (Tawian's Health Care Reform and Its Lessons)

  • 이규식
    • 보건행정학회지
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    • 제8권1호
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    • pp.232-265
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    • 1998
  • Taiwan has experienced rapid economic growth during the past two decades. As a result, the demand for health care in Taiwan has increased rapidly. To meet the rising demand, Taiwan implemented a National Health Insurance (NHI) program on March 1, 1995. This program now covers more than 96 percent of Taiwan's citizens. Implementation of the NHI in 1995 represents fulfillment of a primary social and health policy goals of Taiwan. The goals of the NHI program is to eliminate financial barriers of health care for the citizens, to improve the quality of care. To achieve these goals, the NHI was designed on the following principles: 1. All Taiwan citizens are compul내교 joined the NHI program by law; 2. The NHI program provides comprehensive services; 3. The NHI is run by one single govt' subsidy; 5. The NHI adopt fee-for-services scheme to pay medical expenses and copayment to avoid abouse of medical services. However, the scheme did not bring in the efficient use of health care C. National Health Council, 1986 NARC, Aging in Japan, International Publication Series 1991;2 Kahana EF. Kiyak HA. Attitude and behavior of staff in facilities for the aged, 1984 Naoki I, John CC. Health polic report japan's medical care system, New England Joumal of Medicine 1995; 333(19) National Economic Research Associates, The Health CAre System in Japan, NERA, 1993. National Federation of health Insurance Societies (KEMPOREM), Health Insurance and Health Insurance Societies in Japan, 1995. Owe Ahlund, Aging and housing in sweden, Paper presented at the International Symposium, Long term Care Facility, 1993. Statisitics Jahrbuch, Statistisches Bundesamt, 1992. Stein S. Linn, MIW. and Stein EM. Patient's anticipation of stress in nursing home care, 1985. U. S. Senate Special Committee on Aging, A Report of the special Committee on Aging, Washing D. C, 1992. U.S. Bureau of the Census, 1994.

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실손형 민간의료보험의 도입이 국민건강보험 재정에 미치는 영향 (Impact of Complementary Private Health Insurance on Public Health Spending in Korea)

  • 허순임;이상이
    • 보건행정학회지
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    • 제17권2호
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    • pp.1-17
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    • 2007
  • Limited coverage for health care services of National Health Insurance(NHI) in Korea has been ongoing policy issue but additional NHI financing through raising contribution or taxes in order to improve coverage faces substantial obstacles. Private health insurance(PHI) is often considered as an alternative financing source to improve coverage. Recent reform that attempted to stretch the role of PHI allowed life insurance companies to provide complementary PHI, indemnity plan which will pay for uncovered services by NHI and out-of-pocket spending for covered services. Although complementary PHI may relieve financial burden of patients, it may significantly raise NHI spending as well as total health expenditure since little out-of-pocket spending may increase utilization of health care. So far, there has not been enough discussion about concerns of potential adverse effect resulting from extended role of PHI. This study investigated potential increase of NHI spending followed by extension of complementary PHI through sensitivity analysis. The amount of NHI spending for services that would be covered by complementary PHI was calculated using 2005 NHI statistics and expected complementary PHI enrollment rate by age and sex. Expected utilization increases were obtained based on price elasticities$(-0.2{\sim}-0.5)$ from previous studies and expected coverage rate$(50{\sim}80%)$ of complementary PHI and then converted to monetary figures. Because coverage rate of complementary PHI has not been determined yet, we employed the sensitivity analysis using coverage rate of $50{\sim}80%$. Findings demonstrate that additional spending for health care services is expected to be $426{\sim}1,702$ billion won, corresponding amount payed by NHI $298{\sim}1,192$ billion won. In conclusion, since complementary PHI may raise NHI spending significantly, there should be an agreement whether this additional cost would be accountable and acceptable in our society. Potential inefficiency resulting from extended role of complementary PHI should be considered since public and private financing do not operate in isolation and there should be more discussion on proper role of PHI in Korea.

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.

MRI 외부병원 판독 수가 인상의 효과 분석: 뇌 관련 자기공명영상을 중심으로 (An Analysis on the Effect of the Increase in the Fee of Magnetic Resonance Imaging Deciphering of the External Hospital: Focusing on the Brain Magnetic Resonance Imaging)

  • 김록영;사공진;조민호;위세아;이진용;김용규
    • 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.