• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제18권4호
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• pp.39-51
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• 2012

Purpose: Hospitals for patients and their guardians can, from the concept of healing, be removed from just gaining profits, but suggest a future-oriented direction for the hospital. Accordingly, there have been studies related to the selection of hospitals, but most were related to preference and satisfaction, and only recently did research from the concept of tradeoffs of factors for selection began to grow rapidly. Methods: From this context, this study evaluates the level of importance for factors of selecting hospitals using the analytical hierarchy process, and identifies the correlation with users, gender, age group, and outpatient features in order to identify the difference of awareness among different groups for selecting hospitals. In the factors for selection 26 factors in six categories were set through studies of preceding research, and after surveying 144 people, the following results were attained. Results: 1) The overall analysis results were found in the order of medical level, medical service, and fame, and low for facilities, which is similar to the cases of preceding studies. 2) For user analysis, it was similar between patients and guardians, but there was a slight difference in awareness among nurses, who are also medical service providers. Nurses showed relatively high level of importance in direct factors such as medical technologies and medical services, while guardians of patients showed higher importance in indirect factors such as facility environments and convenience. 3) Women showed higher assessments of importance levels in environmental factors, while men in physical factors. 4) The older the age group, the lower level importance there was on medical level, while the importance on fame reduced the further the commute to the hospital was.

• 보건행정학회지
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• 제21권3호
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• pp.397-413
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• 2011

Purpose: The purpose of this study is to examine the relationship between the income level and the healthcare utilization by health insurance type in all cancer patients in year 2005. Methods: The target population was cancer patients with health insurance who used healthcare as a diagnosis code (C00-C97) from January 1 to December 31 of 2005. The Korea Central Cancer Registry Center's Cancer Patient Registry Data, the list of cancer patients of the National Health Insurance Corporation, and the claim data of the Health Insurance Review & Assessment Service were used. The I was the wealthiest, followed by II, III, IV. The V was the poorest in this study. For the analysis, the $x^2$-test, ANOVA (and Kruskal-Wallis test), and regression were used. Results: Outpatient and hospitalization medical expenses, and outpatient visit days of cancer patients with self-employed health insurance were highest in I (p<.001, respectively), and the hospitalization days were the highest in II (p<.001, respectively). Outpatient and hospitalization medical expenses, and outpatient visit and hospitalization days of cancer patients with occupational health insurance were the highest in I (p<.001, respectively). Outpatient and hospitalization medical expenses, and outpatient visit and hospitalization days in cancer patients were higher in I compared to V, and higher in II and III, IV compared to V (p<.001, respectively). Conclusion: Supporting plan for cancer patients' outpatient healthcare utilization are necessary. Moreover, we should make specialized strategy for low income cancer patients with self-employed health insurance when we develop quality improvement policy for inpatient service.

• 한국의료질향상학회지
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• 제5권2호
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• pp.176-189
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• 1998

This study was conducted to evaluate the subjective ideas about the determinants of quality in ambulatory care unit among outpatients and medical staff of a university hospital, and to compare the differences of the ideas, between patients themselves and hospital staff. A self-administered questionnaire survey was conducted covering 799 outpatients and 190 hospital staff in March, 1998. The questionnaire included general characteristics and 26 determinants of ambulatory care quality. The following are summaries of the findings: 1. Both of outpatients and hospital staff perceived, "Physician's knowledge" as the most important determinant of medical care quality. 2. In respect of 7 determinants related to physician's knowledge and skill, both outpatients and hospital staff perceived "physician's knowledge and skill" as important determinants. The scores of determinants such as, "Not doing unnecessary examinations", and "Assignment of adequate number of patients and duty schedule for the physician" were significantly different between outpatients and hospital staff. 3. In respect of 4 determinants related to doctor-patient relationship, both outpatients and hospital staff perceived "attention to patient's complaints" as the most important determinant. The scores related to the determinants such as "kindness of physician" and "explanation of treatment outcome" were significantly different between outpatients and hospital staff. 4. Among the amenities related determinants, "Modern facilities and equipments" were perceived as the most important determinant in both group. 5. In respect of 8 determinants related to non-financial accommodation, outpatients perceived, "Waiting hours for treatment" as the most important determinant, and hospital staff perceived, "Kindness of hospital staff". 6. In respect of 4 determinants related to financial accommodation, outpatients perceived, "Fare account of medical cost" as the most important determinant, and hospital staff perceived, "Increasing reimbursements". Further comprehensive research should be made on the evaluation of perceptions of medical care quality, both of outpatient and inpatient care, among patients and hospital staff. So good quality in medical care will be achieved based on clients' needs.

• 보건행정학회지
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• 제6권1호
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• pp.110-143
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• 1996

The purpose of this study is to assess the extent of inequality in health outcomes and the distribution of health services according to health need under National Health Insurance System in Korea. For the empirical analysis, data were collected through an interview survey during one month of October, 1994. Interview were conducted with a total of 10, 875 of the employees and the self-employed selected through cluster, systematic sampling. The major findings of this research are as follows: 1. The analysis of the differentials in morbidity rates by socio-economic group showed that health inequality in the pro-higher groups existed in all self-reported morbidity indicators. 2. The findings of the conventional use measures showed that the lower socio-economic groups had more ambulatory and inpatient services than the higher groups. In contrast to the level of the medical care utilization, however, the higher socio-economic groups were more likely to use the high-quality source of care in terms of their treatment place compared to the lower groups. 3. By using the need-based use measures, the results were different from each use-disability ration indicator. Using the use-disability ration measured by physician visits per 100 restricted-activity days in the population, it was found that there was no evidence favoring the higher socio-economic groups. In contrast, the use-disability ration based on physician visits per a chronic patient in one year displayed that there was remarkable relative difference by income group as well as the evidence of the pro-higher income groups. 4. The results of logistic regression analysis and two-stage estimation method indicated that although the utilization is significantly affected by type and duration of insurance coverage, the use or nonuse of service and the volume of physician care consumed is determined by health need and demographic characteristics rater than economic status. In sum, these findings suggest that physician service is equitably distributed according to health need under national health insurance system in Korea. As there were some evidences of inequality including the differential in physician visits of chronic patients by income group, however, the government should strengthen the activities to guarantee the equity of health services utilization.

• 한국산학기술학회논문지
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• 제16권4호
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• pp.2726-2736
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• 2015

본 연구는 한방병원 이용 환자들의 의료서비스 만족도와 재이용의사 결정요인을 파악하여 향후 한방병원 경쟁력 강화전략의 기초자료를 제공하고자 시행되었다. 의사, 간호사, 직원 등의 인적 서비스 요소와 진료과정, 진료비 청구, 병원내 환경, 병원내 시설, 입원생활 만족도 등의 인적 외 서비스 요소 등 총 8개의 요인별 만족도가 전반적 만족도와 재이용 의사에 직접적인 영향을 미치며 한편으로는 각 요인들이 전반적 만족도를 통하여 재이용의사에 간접적인 영향도 미친다는 하나의 경로모형을 분석의 기본틀로 설정하였다. 충남지역 한방 병원 3개소의 외래 및 입원환자 578명을 대상으로 2014년 10월부터 12월까지 구조화된 설문지로 자료를 조사하였다. 분석결과 유의한 변수는 외래의 경우 전반적 만족도, 의사의 진료, 진료과정에 대한 만족도이었으며, 입원의 경우에는 전반적 만족도, 병원시설, 진료비, 병동생활에 대한 만족도가 중요한 변수로 분석되었다.

• 한국병원경영학회지
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• 제25권3호
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• pp.29-37
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• 2020

Purposes: The purpose of this study was to identify the factors related to the long-stay hospitalization of dementia patients aged 65 years or older who had received inpatient care at geriatric hospitals according to the minute facility characteristics and patient features. Methodology: This study was conducted on 317,353 cases of 1,512 geriatric hospitals using the Health Insurance Review and Assessment Service dataset. The data collected were processed using the SAS Enterprise Guide 4.3 for descriptive statistics, the chi-square test, and the binary logistic regression analysis. Findings: As a result of the study, in the facility characteristics of geriatric hospitals, the long-stay hospitalization of the aged with dementia were found to be related to the type of facility establishment, the number of hospital beds, the number of medical specialists, the number of nursing personnel, and the number of geriatric hospitals by region and province. In the personal features of patients, the long-stay hospitalization was found to be associated with the gender, age, insurance, and the patient classification groups. Practical Implication: Considering the results of this study, it seems that securing the sufficient medical personnel in a geriatric facility, providing the good quality medical services, and preparing the appropriate discharge plan can reduce the unnecessary long-stay hospitalization and spend the medical expenses for the older patients.

• 한국산학기술학회논문지
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• 제12권11호
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• pp.4968-4979
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• 2011

본 연구는 의료소비자들이 의료기관을 선택할 때 이용하는 의료정보원에 성별, 연령, 직업, 소득수준, 의료보장의 형태, 주거지역 등 사회경제적 요인이 어떤 영향을 미치는지 알아보기 위한 면접조사이다. 2008년 지역사회 건강조사의 일환으로 충북 지역 거주자들을 대상으로 표준화된 설문지를 이용한 면접을 통하여 의료정보원과 관련된 자료를 수집하였고, SPSS version 12.0을 이용하여 분석하였다. 의료기관 선택 시 가장 많이 이용한 정보원은 입원, 외래 모두 개인적 정보원(41.9%, 33.5%)이었으며 가정 적게 이용한 정보원은 경험적 정보원(3.0%, 4.3%)이었다. 개인적 정보원에는 입원, 외래 모두 성별의 차이가 존재하였으며, 외래이용에서 교육수준과 거주지역의 차이가 존재하였다(p<0.001). 공공적 정보원은 입원 시는 연령, 교육수준, 월 가구 소득 간의 차이를 보였고 외래이용 시는 거주지역만 차이를 보였다(p<0.001). 경험적 정보원은 거주지역의 차이만 보였으며, 전문가 정보원은 입원 시는 남자가 외래이용 시는 여자가 더 많이 이용하는 결과를 보였다. 결론적으로 의료기관 선택 시 사용한 정보원은 의료이용자의 사회 경제적 요인과 관련성을 가지고 있으며 이는 의료기관 이용형태(입원, 외래)에 따라 서로 다른 양상을 보였다.

• 한방안이비인후피부과학회지
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• 제34권2호
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• pp.21-37
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• 2021

Objectives : Allergic rhinitis(AR) is a common chronic disease that accounts for 10-40% of the world's population. This study aims to analyze the status of claims, prevalence, and medical utilization of allergic rhinitis patients using representative patients sample data. Methods : This study used the National Patients Sample(HIRA-NPS) of the Health Insurance Review and Assessment Service for 7 years(2010-2016). And we defined AR patients as all statements including J30 or a subcategory of J30 as the main disease, using the Korean Standard Classification of Diseases(KCD-7). The trend of AR patients by year was divided into Western medicine(WM) and Korean medicine(KM), and analyzed by subgroup analysis such as inpatient/outpatient, gender, age, insurance type, and care institution. Results : Patients with AR were mainly claimed for first sub diagnosis in WM and major diagnosis in KM, and the number of claims increased about 1.3 times and 1.4 times compared to 2010 in WM and KM, respectively. In addition, the total annual medical expenses in 2016 increased 1.3 times and 1.7 times compared to 2010, respectively. Conclusions : Both WM and KM are showing a steadily increasing trend in medical use due to allergic rhinitis. Further research is needed by considering genetic and environmental factors and individual characteristics, and linking with additional data.

• 보건행정학회지
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• 제34권1호
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• pp.94-102
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• 2024

연구배경: 현행 간호인력정책이 간호사의 불균형 분포를 심화시킨다는 논란이 지속되고 있으나, 이를 확인한 연구는 매우 드물다. 이에 본 연구는 간호정책과 관련된 변수를 포함하여 지역수준에서 임상간호사 분포에 영향을 미치는 요인을 규명하고자 하였다. 방법: 2020년 기준 250개 시군구의 총 225,462명의 임상간호사 분포를 대상으로 분석하였다. 2020년 시군구별 국가통계자료를 수집하여 회귀분석을 실시하였다. 결과: 임상간호사 분포에 영향을 미치는 요인은 연간 입원일수, 간호간병통합서비스 병상 수, 공공보건의료기관 수, 상급종합병원 수, 종합병원 수 등으로 나타났다. 비수도권 지역에서는 간호학과 졸업생 수와 간호1, 2등급 기관 수도 임상간호사 분포에 영향을 미쳤다. 결론: 간호사 불균형 분포가 심화되지 않도록 간호간병통합서비스 병상의 확대 지역을 신중하게 결정해야 한다. 또한 간호사가 부족한 비수도권 지역을 중심으로 간호학과 학생을 늘리고, 비수도권 간호사의 임금과 근무환경을 우선적으로 개선해야 한다.

• Journal of the Korean Data and Information Science Society
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• 제25권1호
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• pp.37-52
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• 2014

본 연구는 가정 호스피스완화의료 제도도입방안 연구의 일부로 가정호스피스 기관들의 실태를 파악하여 가정 호스피스완화의료 표준지침 개발을 위한 기초자료로서 활용하기 위해 시행되었다. 별도의 인력을 배정하고 지속적으로 가정호스피스를 운영하고 있는 7개 기관의 실무자들을 대상으로 개방식 서면조사와 포커스그룹 인터뷰를 실시하였다. 인터뷰에 참여한 기관들은 24시간 on call 서비스, 의사와 간호사, 사회복지사, 사목자를 포함한 호스피스팀 구성, 정기적 팀회의, 사별가족관리 등을 가정 호스피스완화의료의 필수사항으로 여기고 있었고, 필수 시설은 방문간호사 사무실 및 물품준비 공간, 필수 장비는 방문용 가방으로 파악되었다. 방문을 가장 많이 하는 인력은 간호사였고, 가정방문서비스를 위한 전담인력을 두어야 한다는 데에 합의하였다. 가정호스피스 활성화의 장애요인으로 가정 호스피스에 대한 보험수가보상이 없어 팀원의 방문이 제한적이고, 집에서 처방변경이 어려우며, 24시간 주 7일 입원연계가 어려운 점, 가정 내 돌봄제공자가 없는 경우가 늘어나고 있는 점 등이 제시되었다. 가정호스피스 제도화를 위해 가정호스피스 서비스의 표준 개발은 매우 시급하고도 중요하며, 이에 본 연구의 결과는 서비스 표준안의 초안 마련에 근거자료로 활용될 것이다.