• 제목/요약/키워드: Health care Inequality

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회피가능한 사망에 미치는 지역 영향요인 분석: 2010~2019 (Regional Factors Affecting the Avoidable Mortality: 2010~2019)

  • 이현지;이광수
    • 한국병원경영학회지
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    • 제27권1호
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    • pp.43-57
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    • 2022
  • Background: Avoidable mortality rate has been widely used as an indicator of the quality of health care and the degree of inequality in health levels. The purpose of this study was to identify the factors affecting the avoidable mortality rate in the region. Methods: The data was MDIS(Microdata Integrated Service) Causes of Death Statistics, and the analysis period was from 2010 to 2019. Panel analysis was performed to identify the influencing factors on the avoidable mortality rate. Findings: Result showed that the current smoking rate had a significant positive effects on the avoidable mortality rate of both men and women. And the smoking cessation trial rate, low salt diet rate, weight control trial rate, annual vaccination rate had a significant negative effect. In the social environment, the divorce rate had a significant positive effect. In the economy environment, financial independence and social welfare budget rate had a significant negative effect. In the physical environment, the factory area rate had a significant positive effect. Practical Implication: Practical implication in order to lower the local avoidable mortality rate, various social determinants of health as well as health care resources should be considered together.

저소득 가정 아동의 건강불평등과 건강 복지 (Health Disparity and Health Welfare among Children from Low-Income Families)

  • 김희순
    • Child Health Nursing Research
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    • 제19권4호
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    • pp.247-251
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    • 2013
  • Children from low income families are vulnerable to physical problems including obesity, asthma, hypertension and psychological problems including depression, anxiety. This study was done to identify trends in welfare policy for children from low-income families and future direction for solving health disparity problems. Dream Start is a government-sponsored project that offers services for vulnerable children, ages 0 (include pregnant woman) to 12 years and their families. The Korean Government has made an effort to alleviate health disparity through the 'Health Plan' by establishing health objectives. However, in spite of these efforts by the Korean government, health disparity has worsened in Korea. In order to strengthen family function as well as promote growth and development for vulnerable children, experts in child care need to be significantly involved in identifying neglected children in the community.

사회서비스 이용자 정보가용성이 서비스 품질 및 만족에 미치는 영향: 재가노인복지서비스를 대상으로 (The Effects of Information Literacy of Social Service Users' on Service Quality and Satisfaction: Based on Elderly Home Care Services)

  • 조한라;여영훈
    • 예술인문사회 융합 멀티미디어 논문지
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    • 제7권11호
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    • pp.717-725
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    • 2017
  • 본 연구는 재가노인복지서비스 이용자들 사이에 정보가용성의 차이가 있는지 확인하고, 정보가용성이 품질 및 만족에 미치는 영향을 파악하는 것을 목표로 한다. 이를 위해 전라북도 지역 이용자의 응답자료 466부를 활용하여 차이검증과 회귀분석을 실시하였다. 분석결과는 다음과 같다. 첫째, 서비스 이용자의 성별, 가구 형태, 거주 지역, 학력, 주관적 건강상태에 따라 정보가용성의 차이가 있었다. 둘째, 정보가용성은 서비스 품질과 만족에 유의미하게 영향을 미쳤다. 정보가용성의 하위요소 중 특히 서비스 내용에 대한 정보와 요구 가능한 내용에 대한 정보는 기타 정보가용성 하위요소 보다 서비스 품질 및 만족에 더욱 큰 영향력을 나타내었으며, 이는 각 이용자의 욕구와 상황을 기반으로 한 맞춤형 서비스의 중요성을 보여준다. 본 연구는 재가노인복지서비스 이용자들 사이의 정보가용성이 서비스 만족과 품질에 미치는 영향력을 확인하였고, 이러한 결과는 재가노인복지서비스 이용자 중 정보취약계층에 대한 효율적이고 능동적인 정보제공 방안이 필요함을 시사한다.

Gini 계수와 Lorenz 곡선에 의한 지역별 병상분포 양상 분석 (Geographic distribution analysis of hospital beds by Gini index and Lorenz curve)

  • 안병기;박재용;김기훈
    • 한국병원경영학회지
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    • 제16권3호
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    • pp.1-18
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    • 2011
  • In this study, population census(2005 & 2008) from Statistics Korea and the statistical data of the number of hospital beds by healthcare facilities classification from Ministry of Health and Welfare were used. For analyzing distribution of hospital beds, hospital beds were classified as acute care beds, long-term care beds and all hospital beds, which is including acute and long-term care beds. Regional areas, which are city(si), county(goon) for the study and district(gu) were reclassified as metropolitan city, city(si) and county(goon). Because there were 165 regional areas in 2005 and 2008, 84 and 81 areas were classified as metropolitan city and/or city and county, respectively. Gini index were calculated for hospital beds from each year, and Lorenz curves were drawn. The following summary presents the findings of this study. Compared to the year 2005 and 2008, the Gini index was 0.24472, and hospital bed numbers increased slightly by 0.80% than in 2005. In case of acute care beds, the Gini index was 0.23797(0.13%), and there was no big difference; however, the Gini index for long-term care beds was 0.41091, and there was a 30.25% decrease, which shows improvement to reduce disparities. It might result from an increase in long-term care beds up to 476.2%. For geographical equality of hospital beds, the Gini index and Lorenz curve, which can be compared the degree of inequality in the distribution of hospital beds reasonably and possibly show statistical data, should be used. Through this study, the distribution policy of hospital beds should be established.

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건강과 의학의 새로운 흐름 - 담론과 실천 방식에 관한 사회문화적 비평 - (Emerging Currents in Health and Medicine - A Socio-Cultural Critique of Their Discourses and Practices -)

  • 이종찬
    • 보건행정학회지
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    • 제10권4호
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    • pp.1-19
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    • 2000
  • We have witnessed several kinds of new discourses and practices in health and medicine since the 1970s, such as popular concerns with alternative or complementary medicine, inordinate attention to the promotion of 'healthy' living, rapid resurrection of traditional medicine and ecological management of health. Four structural and situational factors are discussed to underlie these new trends:(i) as 'crisis' in health care of the 1970s was translated into health care reform of the 1980s backed up by neo-liberal political philosophy, the state responsibility for nation's health is being transferred to the individual ;(ii) it resulted from the limits of biomedical paradigm in dealing with chronic diseases;(iii) medico-scientific knowledge of disease is transformed into the subjective discourses and technologies of health in postmodern society ; and (iv) it is deeply associated with the considerable increase in environmental risk perception of health and disease. There are some inherent countervailing forces in these new discourses and practices. First, while they derive from lifestyle-oriented behavioral change, medicalization of life and death is still consolidated in the new trends. Second, inasmuch as new tides are reliant upon science, they. are likely to be remote from techne that means not the practical application of theoretical knowing but a special form of practical knowing. Third, as new discourses and activities accomplished'in the name of health'increasingly occupy important strategies in forming the self-identity, they serve as moral apparatus which involves prescriptions about how we should live our lives and conduct our bodies, both individually and collectively. Therefore, two points are suggested to consider seriously whether these streams will succeed in improving the‘healthy’living of all the people. Instead of limiting tile perspective to medicine, healing and health care, a new matrix that interweave welfare, ecology and labor along with them is timely needed for enhancing the health for all. In addition, as the World Health Report fm strongly shows, inequality in health heavily depends upon socio-economic development of a society, and it is not the richest countries that have the best health status, but those that have the smallest income differences between rich and poor.

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사회경제적 수준과 구강건강과의 관련성 연구: 제6기 국민건강영양조사 자료를 이용하여 (A study on the relationship between socioeconomic level and oral health: analysis of data from the Sixth Korean National Health and Nutritional Examination Survey)

  • 송애희;윤혜정
    • 한국치위생학회지
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    • 제19권4호
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    • pp.565-575
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    • 2019
  • Objectives: In this study, both subjective and objective levels of oral health were used to identify the relationship between oral health inequalities. Methods: Korean National Health and Nutritional Examination Survey data from 2013 to 2015 were combined to create an analysis plan. Oral health questions categorized as subjective oral health conditions and oral health-related diseases used dental tissue disease status as data measured by the Community Periodical Index(CPI) and decayed, missing, filled teeth(DMFT) experience. Other data on oral health behaviors such as toothache experience, the frequency of toothbrush use, chewing problems, oral examination status, and unmet dental care needs were classified and analyzed according to the socioeconomic level. Data were analyzed using frequency and cross analyses, and the statistical significance level was set at 0.05. Results: It was found that higher the economic and educational level, better was the subjective oral health, lower the CPI, lower the experience of toothache, higher the frequency of toothbrush use, lower the number of people having chewing problems, and higher the frequency of oral checkups. Conclusions: Oral health inequality exists among social classes. It is suggested that continuous research and efforts be carried out to promote oral health while considering socioeconomic and educational levels. Further, active government efforts will be needed to address polarization by social class.

여성건강을 위한 개념적 모형 (Conceptual Model for Women s Health)

  • 이경혜
    • 대한간호학회지
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    • 제27권4호
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    • pp.933-942
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    • 1997
  • There has recently been an increased interest in women's health from, various disciplines, with different perspectives presented according to each profession's academic background. This has led to many instances of incorrectly defining, or misinterpretation, of the issues even among professionals. Nurse scholars as well as practitioners who work in women's health care need to have a clear conceptual understanding of women's health in order to build a body of knowledge, delineate curricular activities, and set directions for professional nursing interventions. In addition, a conceptual model that may be directly utilized in practice is needed to maintain and promote women's health issues. The purpose of this study was to apply a Hybrid model, analyzing conceptual definitions and discussions related to women's health gathered from review of the literature. Further to compare analyticals the concepts and properties observed from field work, so as to present a final definition of women's health and, build a conceptual framework for a united comprehensive perspective on the concept as well as on nursing practice. Data collection and analysis consisted of a theoretical stage, field work stage, and final analysis. A heterogeneous group of professionals and lay persons, 39 in all, participated in the field work. Study findings Include several subconcepts under the concept of women's health : a woman's whole life, holistic health, quality of life, awareness of being a woman, individual nursing, self care ability, reproductive health, and family health. Thus, a comprehensive definition was built, 1. e., "Women's health care be defined as improvement in the quality of life of women through attainment of holistic health throughout the life span. With reproductive health at the core, the concept is directly related to family and national health, and includes taking care of one's own health based on awareness of being a woman and utilizing self care activities. Women's health care issues are unique and allow various responses, therefore women's health professionals need to apply individual approaches to reach solutions in attaining holistic health and improving quality of life." The constructual factors of women's health were found to be reproductive functions, diseases more common in woman, self actualization, mental health, women's health policies, sexuality, midlife changes, and marital relations, with each factor having more than three properties. Positive factors affecting women's health were found to be a normal childbearing process, a healthy lifestyle, active health management, health information, support, and resources, and interpersonal relationships. Negative factors were found to be overwhelming role stress, cultural oppression, gender inequality, distorted sexual identity, economic difficulties, misuse and/or abuse of substances, and stress. The model of women's health may be visualized as a balance scale set upon a woman's life, supporting 4 concentric circles. The innermost circle and second circle incorporate conceptual definitions of women's health, and the outer two circles represent the constructional factors and properties of women's health. Each circle has its own color that symbolizes the conceptual meaning. Positive and negative factors are represented as weights at either end of the scale, and are affected by nursing intervention, i. e., health and wellness increase when positive factors are stronger, whereas disease and illness increase when negative factors are stronger. This model is only a preliminary effort and requires much discussion and testing to be further developed. Continuous research is also required.

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종사상 지위와 가구 균등화 소득이 치과 의료 미충족에 미치는 영향 : 2018 한국의료패널 자료를 활용한 분석 (The effect of employment status and household equalization income on unmet dental and medical care needs : a study on the application of Korea Medical Panel Data 2018)

  • 이진하;오경재
    • 한국치위생학회지
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    • 제23권2호
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    • pp.125-132
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    • 2023
  • Objectives: This study used the 2018 Korea Health Panel Survey data to analyze factors affecting employment status and income relating to unmet dental and medical care needs. Additionally it investigated measures to reduce oral health inequality among various socioeconomic classes. Methods: Descriptive statistics for the subjects' unmet dental and medical care needs were calculated through chi-square test analysis, and multivariate logistic regression analysis was applied to identify factors affecting the unmet dental and medical care needs. The odds ratio and 95% confidence interval were calculated for each level. These data were analyzed using STATA 17.0 SE (64-bit) version, and the statistical significance level was set to p<0.05. Results: As a result of unmet dental and medical care needs according to general characteristics, the lower the education level (p<0.001), the higher the age (p<0.001) and the lower the household equalization income (p<0.024) and the smoker status (p<0.003) were, respectively. Factors that have a statistically significant impact on unmet dental and medical care needs were divorce, separation and bereavement (p<0.001) in individuals than in married persons, and being smokers than non-smokers (p<0.009). The frequency of unmet dental and medical care needs were found to be lower in the cases of a high school graduate than an elementary school graduate (p<0.018), and of higher household equalization income (p<0.001) than the lowest household equalization income, respectively. Conclusions: It was found that various factors such as age, education level, household equalization income, employment status, type of working hours type, and smoking status affect unmet dental and medical care needs.

농촌지역 여성의 건강수준과 의료이용에 대한 연구 (Health Status and Medical Utilization of Women in Rural Area)

  • 신형철;강지영;박웅섭;김상아
    • 농촌의학ㆍ지역보건
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    • 제34권1호
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    • pp.67-75
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    • 2009
  • 우리나라 20세 이상 성인 37,108명을 대상으로 농촌여성들의 건강수준과 의료이용을 중심으로 분석한 결과, 여성의 만성질환의 유병률과 미치료율이 남성보다 높고, 농촌지역의 유병율과 미치료율이 대도시지역보다 높게 분석되었다. 그리고 만성질환 유병률과 미치료율의 지역별 차이는 남성에서보다 여성에서 더 큰 것으로 분석되었다. 의료이용에 대해서도 비슷한 경향을 관찰하였으나 통계적으로 유의한 수준에는 미치지 않았다. 따라서 농촌지역 여성의 건강수준이 낮음에도 불구하고 적절한 의료이용을 하지 못하는 건강불평등 상태에 있을 가능성을 보여주었다. 그러므로 건강불평등을 해소시키기 위해서는 농촌지역에 대한 정책적 배려 이외에도 농촌여성에 대한 배려가 추가로 고려되어야 할 것으로 보인다. 그러나 이 연구는 성별, 지역별 차이를 분석함에 있어 연령이 외에 건강수준과 의료이용에 영향을 미치는 다양한 환경적, 경제적, 사회적 요인을 통제한 것이 아니기 때문에 해석에 주의가 필요하다. 또한 진료비용 자체가 의료서비스의 질을 대표한다고는 볼 수 없다. 따라서 후속연구에서는 이러한 다양한 변수들이 통제된 성별, 지역간 건강수준과 의료이용의 차이에 대한 분석과 농촌지역의 의료서비스의 질에 대한 연구가 수행되어야 할 것이다.

보건의료 서비스의 공간적 불균등 분포 변이에 대한 연구: 1995년부터 2021년까지 초기진료기관을 대상으로 (Evolution of Healthcare Service Disparities: A Case Study of Primary Care Services in Korea, 1995-2021)

  • 김현;송예나
    • 한국경제지리학회지
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    • 제26권3호
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    • pp.289-309
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    • 2023
  • 우리나라의 국민건강보험은 빠른 시간에 보편적 의료시스템을 정착시키는데 큰 기여를 했다. 하지만 연령대에 따른 의료서비스의 차이는 지속되고 있으며, 내과, 가정의학과, 소아청소년과와 같은 핵심의료 서비스에서 이러한 불평등이 존재하는 것은 큰 우려를 불러일으킬 수 밖에 없다. 진료기관 접근에 대한 불평등은 연령대만이 아니라 지역, 특히 도시와 농촌 사이에도 크게 나타나고 있다. 본 연구는 1995년부터 2021년까지 초기진료기관의 분포를 이용하여 변화하는 경제환경 속에서 의료서비스의 공간적 불평등이 어떻게 변화되어 왔는지를 살핀다. 다양한 불평등 지수와 공간통계분석의 결과를 토대로 볼 때, 1997년 IMF 경제위기, 2008년 금융위기, 그리고 2020년의 COVID-19 공중보건 위기를 겪으며 불평등이 심화 확대된 것을 확인할 수 있었다. 또한 초기의료기관의 불균등 분포에 큰 변화가 온 시기도 밝혀낼 수 있었는데, 이러한 변화에는 유소년이나 전체 인구 분포보다는 고령인구의 분포가 큰 역할을 하고 있었다. 본 연구결과는 인구와 의료서비스의 공간적 분포를 통합적으로 고려하여 핵심적인 의료자원의 불평등을 해소하기 위한 노력이 절실히 필요하다는 것을 강조한다. 특히 이러한 노력은 미래의 경제적 충격에도 적절한 수준의 의료 서비스를 지속할 수 있는 기반이 될 수 있을 것이다.