• 기본간호학회지
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• 제19권4호
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• pp.483-492
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• 2012

Purpose: This study was done to identify the relationship of perceived health status, leisure satisfaction, loneliness and life satisfaction and to identify predictors of life satisfaction for elders. Method: The research design for this study was a descriptive survey design using a convenience sample. Data collection was done using self-report questionnaires with 297 elders from 6 community health practitioner posts. Data were analyzed using ANOVA, t-test, Pearson correlation coefficients and hierarchical multiple regression with the SPSS Win 18.0 Program. Results: Life satisfaction had significant negative correlations with age (r=-.31, p<.001) and loneliness (r=-.73, p<.001), and positive correlations with monthly spending money (r=.44, p<.001), health status (r=.63, p<.001), and leisure satisfaction (r=.62, p<.001). The explained variance for life satisfaction was 72%. Variables of monthly spending money, health status, leisure satisfaction, and loneliness significantly predicted the degree on life satisfaction of these elders. Conclusion: Findings of this study provide a comprehensive understanding of life satisfaction and related factors for elders in Korea. However, further studies with a larger random sample and more detailed research design are necessary.

• 국제지역연구
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• 제21권1호
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• pp.39-72
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• 2017

이 연구의 목적은 원조 범람이 수원국의 정부지출에 미친 영향을 패널데이터를 이용해 실증 분석하고, 이를 통해 향후 공적개발원조 사업의 운영 방향에 대한 함의를 얻는 데 있다. 이 연구에서는 아프리카 사하라 사막 이남 지역 국가들의 보건 부문에 대한 원조범람지수를 산정하고, 원조범람이 보건 부문에 대한 정부지출에 어떤 영향을 미치는지를 실증분석하였다. 이 연구에서 수행한 실증분석 결과, 원조범람은 보건 부문에 대한 정부지출 수준을 유의미하게 감소시키는 효과를 발생시키는 것을 확인하였다. 그리고 이와 같은 현상이 발생한 것은 신규 사업을 추구하는 공적개발원조 사업의 특징(공여국의 니즈)과 가능하면 더 많은 공적개발원조 자금을 수혜하고자 하는 수원국 정부 간 상호 이익추구에 따른 것으로 추론된다. 분석결과를 토대로, 이 연구에서는 경쟁적이고 과도한 공적개발원조 사업지원이 수원국 정부의 예산운영 과정에 대한 왜곡을 유도해 결과적으로 공적개발원조 사업의 비효율을 초래하므로, 사업지원 과정에서 수원국의 정책 능력에 관한 종합적인 고려가 필요하며, 개발원조위원회(Development Assistance Committee)의 종합조정 기능의 강화가 필요함을 제안하였다.

• Journal of Preventive Medicine and Public Health
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• 제38권4호
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• pp.408-414
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• 2005

Objectives : The purpose of this study was to determine the impact of the sociodemographic and health characteristics on the out-of-pocket health spending of the individuals aged 20 and older in Korea. Methods : We used the data from the 2001 National Public Health and Nutrition Survey. The final sample size was 26,154 persons. Multiple linear regression models were used according to the age groups, that is, one model was used for those people under the age of sixty-five and the other was used for those people aged sixty-five and older. In these analyses, the expenditures were transformed to a logarithmic scale to reduce the skewness of the results. Results : Out-of-pocket health expenditures for those people under the age of 65 averaged 14,800 won per month, whereas expenditures for those people aged 65 and older averaged 27,200 won per month. In the regression analysis, the insurance type, resident area, self-reported health status, acute or chronic condition and bed-disability days were the statistically significant determinants for both age groups. Gender and age were statistically significant determinants only for the non-elderly. Conclusions : The findings from this study show that the mean out-of-pocket health expenditures varied according to the age groups and also several diverse characteristics. Thus, policymakers should consider the out-of-pocket health expenditure differential between the elderly and non-elderly persons. Improvement of the insurance coverage for the economically vulnerable subgroups that were identified in this study should be carefully considered. In addition, it is necessary to assess the impact of out-of-pocket spending on the peoples' health care utilization.

• 보건행정학회지
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• 제22권2호
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• pp.275-296
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• 2012

Graduate School of Public Health, Seoul National University The national health insurance system in Korea is characterized as relatively high out-of-pocket payments, which are the principal source of catastrophic health expenditure (CHE). The objectives of this study are to estimate the incidence of household CHE and to clarify the characteristics that affect the occurrence and recurrence of household CHE using the Seoul Welfare Panel Survey database for 2008 and 2010. Thresholds to estimate CHE were 10% and 20% of the total household income (T/X), and 25% and 40% of the income excluding food share (T/Y). Determinants of the occurrence and recurrence of CHE at the threshold of T/X=10% were analysed using multiple logistic regression models. Out of the 3,665 households that responded in 2008 survey, households with CHE were 12.07% (T/X${\geq}$10%), 5.34% (T/X${\geq}$20%), 6.84% (T/Y${\geq}$25%), and 4.44% (T/Y${\geq}$40%). Risk factors associated with household CHE included living with a spouse, non-Medicaid beneficiary, householder unemployment, low household income, the number of disabled members, poor subjective health, and the number of chronic diseases. A total of 41.78% of households with CHE in 2008 repeatedly experienced CHE in 2010. Risk factors of CHE recurrence included decreased household income and an increase in chronic diseases over the two time periods, the number of members with disability or chronic diseases, and the presence of cancer patients in 2008. Households with lower socioeconomic and health status had a higher financial burden on health care than do their counterpart households. There is a need to enhance society-wide financial protection from health spending among vulnerable citizens in Seoul, particularly, households with low income, disabled members or cancer patients.

• 보건행정학회지
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• 제22권2호
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• pp.207-224
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• 2012

This study estimates the total health expenditure of ambulatory dental care and explores the factors related to disbursements. The study used two waves of a 2008 Korea Health Panel (KHP) survey, of which each wave is composed of 7866 households and 24,659 persons. The KHP includes missing expanses of reimbursement data of the National Health Insurance (NHI), such as out-of-pocket, drugs, and private health insurance. The study estimates total monthly ambulatory dental expenditure and the sub-special categories of dental care. For influential factors analyses, the study exploits log-linear model with age, gender, education, job, equivalence income, the status of chronic diseases, means-tested benefit recipients, private insurance, and the composite deprivation index as independent variables. The total monthly outpatient health spending is estimated to be 102,468 won per household, and for dental, each household spends 31,115 won per month. Older age, means-test recipients, non-regular workers are more likely to spend less money on dental care, whereas private insurers, high income, and those who live in less deprived areas are more likely to spend more money for dental services. From the study we found that the KHP data are more suitable to estimate the total amount of health care markets, especially when the NHI coverage is low, such as for dental care in Korea.

• 보건행정학회지
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• 제27권4호
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• pp.359-365
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• 2017

Background: Computed tomography (CT) is one of the most efficient diagnostic methods for stroke patients. The number of CT scanners in South Korea, however, is higher than in other countries, and may cause the overuse of this tool in healthcare. We aim to study the relationship between using CT and various patient and hospital characteristics among patients with cerebral infarction. Methods: We analyzed nationwide health insurance claims data for patients due to cerebral infarction during the second half of 2013 for up to 3 months. We performed multilevel analysis, including both inpatient and hospital-level variables, to determine how factors affect CT spending and utilization. Results: The data used in our study consisted of 17,046 hospitalizations at 583 hospitals. Inpatients who visited more than one hospital had higher CT utilization numbers and cost (number: ${\geq}3$: ${\beta}$ hospitals, 2.27; p < 0.05; 2 hospitals: ${\beta}$, 0.70; p < 0.05; cost: ${\geq}3$ hospitals: ${\beta}$, 251,108; p < 0.05; 2 hospitals: ${\beta}$, 77,299; p < 0.05). People who visited a general hospital had higher numbers and cost of CT utilization than people who visited a smaller hospital. Conclusion: Increased sharing of records and improved continuity of care between hospitals are needed to help curb the overuse of CT.

• 한국콘텐츠학회논문지
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• 제16권10호
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• pp.411-419
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• 2016

본 연구는 가구소득 수준과 가구소득 대비 의료비 지출 비중의 관련성을 규명하고자 한다. 자료 분석을 위해 한국보건사회연구원과 국민건강보험공단이 공동 주관하는 한국의료패널 2010-2011년 연간 데이터를 이용하였다. 독립변수의 효과가 2010년과 2011년에 따라 변화하는지 확인하기 위해 연도와 독립변수 간의 상호작용 효과를 확인하였으며, 연도에 따라 상호작용 효과가 나타난 요인은 연도별로 분리하여 일반화 추정 방정식 방법을 이용한 선형회귀분석을 수행하였다. 의료 이용을 한 사람들을 대상으로 가구소득 대비의료비 지출 비중과 관련성을 가진 요인들을 살펴본 결과, 가구소득 수준이 높을수록 의료비 지출 비중이 낮음을 확인할 수 있었다. 저소득층의 의료비 부담을 줄여주는 정책을 마련해야 할 것이다.

• 보건행정학회지
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• 제3권1호
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• pp.53-83
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• 1993

A small number of high cost patients usually spend a larger proportion of scarce health resources. Korea is no exception. Under the national health insurance, 12% of the insured persons have consumed approximately half of the national health insurance expenditures. Therefore, it is necessary to identify the characteristics of the high cost patient group, if we would like to reduce them. This study has defined high cost patients as those who have spent one and half million won and over per 6 months. The study reveals that high cost users are those who have a longer length of stays(LOS), 40days of LOS in the 6 months, have multiple admissions, 2 to 3 admissions per 6 months and are the elderly patients. They have spent 814.126won per on the average, and commonly suffered from malignant neoplasms, circulatory diseases, fracture, diabetes mellitus, etc. Unlike the case of western developed countries, early readmissions are not the major causes of high cost spending in Korea. Undoubtedly, a lengthy admission is the main cause of large spending. Health policies should vigorously be explored to respond appropriately. There are evidences that hospital beds are often misused. As the Korean health care system is lacking in a mechanism of patient evaluation under the fee-for-service remuneration system, an idea of progressive patient care needs to be tested. The Goverment should set up health policy to diversify the role of long-term care facilities and encourage people to establish them. Further studies are needed to identify factors influencing large medical bills necessary for formulating the health policy on cost containment.

• 지능정보연구
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• 제19권2호
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• pp.141-156
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• 2013

그 동안 한국 사회에서 지방자치단체(이하 지자체) 복지사업과 재정지출에 대한 연구는 장애인, 노인, 보육 등 복지사업 대상 등을 중심으로 부문별 복지지출에 대한 영향요인 연구가 대부분 이루어져 왔다. 최근 지자체의 자체적인 복지노력도 측면에서 자체 사업에 대한 연구가 특정 지역의 사례를 중심으로 이루어지기는 하고 있지만, 자료에 대한 접근과 조사의 한계로 여러 요인이 실증적으로 고려되지 못하여 정책적 함의를 도출해 내기 어려웠다. 현재 우리사회의 복지예산과 그 지출규모는 국가 예산의 30%에 이를 만큼 높은 비중을 차지하고 있다. 이에 따라 국가적 차원에서 공공복지 전달체계의 효율적 운영과 관리를 위해 사회보장 정보시스템을 구축, 운영하고 있다. 본 연구에서는 기존 연구에서 사용하는 지방재정시스템이 아닌 사회보장 정보시스템을 통하여 지자체 복지재정 지출과 관련, 기존 연구에서 한계점으로 지적되었던 전수데이터에 대한 접근과 조사를 실시하여 학문적이고 정책적인 함의를 도출해 내고자 한다. 사회보장정보시스템은 복지전달체계의 효율화를 위해 구축되었으며, 이를 통해 17개 부처 292개 복지사업이 집행되며, 230개 지자체 4만여 개 복지사업의 정보가 관리되고 있다. 이에 따라 본 연구는 사회보장정보시스템을 통해 관리되는 지자체 복지사업을 중심으로 지자체 복지지출에 미치는 영향요인을 탐색하고자 한다. 이를 위해 지자체 복지노력도로 대변되는 순수 시 군 구 복지예산액을 종속변수로 설정하였으며, 기존문헌 검토를 바탕으로 인구사회학적, 지역 경제적 그리고 지자체 재정적 요인을 독립변수로 설정하였다. 또한 독립변수 요인간 다중공선성 문제를 점검하였고, 다중공선성의 문제가 없는 것으로 확인된 수급자 비율, 영유아 비율, 아동청소년 비율, 복지비 비율, 구인배율, 재정자립도, 재정자주도의 총 7개 독립변수와, 소속 정당을 통제변수로 사용하여 결정요인의 변화를 분석하였다. 연구결과를 살펴보면 기본모델에서는 복지비 비율, 영유아 비율, 재정자립도, 재정자주도, 구인배율이 유의한 영향을 미치는 것으로 분석되었다. 그리고 기존 문헌에서 분석되지 못했던 시 군 구별 복지지출 영향요인의 차이점을 분석하였다. 또한 복지예산 총량 데이터에 근거한 기존 연구들이 논의하지 못했던 자체 복지사업 예산에 미치는 영향요인을 구체적으로 밝혀내는데 의의가 있다.

• 보건교육건강증진학회지
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• 제17권2호
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• pp.17-33
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• 2000

The aim of this study is having the status, knowledge and attitude of the high school attendees toward smoking be analyzed, helping to make effective health education methods to diminish adolescent smoking habits. The field self-questionnaire investigation has been performed from Oct 10th through 23rd in 1999. The whole 427 cases were distributed to 1st and 2nd grade students of randomly selected men's high school in Seoul. And 414 cases (97%) were finally selected for analysis after exclusion of cases with insufficient information. The main contents of questionnaire are composed of several sectors; the general characteristics of the interviewees, the relationship with parents, the life style and the peer relationship in school. And smoking-related characteristics are taken into consideration, too. The major findings of the study are as follows: The smoking/non-smoking related factors are, in socio-demographical terms, the grade, average spending per month of the interviewees. And the degree of satisfactory relationship with parents is significant on smoking behavior. The higher, the degree of satisfaction on school life and relationship with designated teacher, the more chances of non-smoking habit. Poor academic grades and peer group dependability of interviewees cause higher smoking habit rate in other way. The self-interviewees grade and cohabitation with parents are also significant on both the attitude toward smoking habit and the knowledge on smoking statistically. The academic history and vocations of the parents and the academic grades of interviewees are also effective variables, but don't make any gap between groups knowledge on smoking. Smoking groups used to have positive attitude toward smoking habit. Both the attitude and knowledge on smoking by the consideration of Quit-smoking have statistically significance. The groups which have negative attitude and high knowledge on smoking quit-smoking into consideration. And the primary cause of quit-smoking is on health by smoking. Depression, stress, adult smoking in the house, peer group pressure, cigarettes advertisements on papers and magazines and smoking scenes on TV have positive correlation on forming smoking habit (p〈0.001) But the knowledge on diseases triggered by smoking has negative correlation on forming smoking habit. (p〈0.05, p〈0.001). Social factors as monthly spending, relationship and communication with parents, the degree of satisfaction in school life, academic grades and student-teacher relationship have crucial negative correlation on smoking habit. That is to say, the higher, the monthly spending is, the worse, the relationship with parents and teachers is, the lower, the academic grades of the student is, the percentage of the interviewees who have smoking habit seems to get higher.