• 한국병원경영학회지
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• 제28권1호
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• pp.24-36
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• 2023

Purposes: The purpose of this study was to analyze the factors associated with current smoking status in Wonju-si and Chuncheon-si, and to study the cause of difference in smoking rates between these two regions. Methodology: Data was from the National Health Insurance Service database from 2019 to 2020. Current smoking status was based on the response to the health examination questionnaire. Logistic regression analysis was conducted to identify factors associated with current smoking status. The study included 207,307 individuals from Wonju-si and 173,698 individuals from Chuncheon-si. Findings: The smoking rate of Wonju-si was 19.83%, and Chuncheon-si was 18.20%, showing a difference in the smoking rates between the two regions. Logistic regression analysis found that men, those aged 40-49, being a self-employed insured, a medical-aid beneficiary, having a lower income, working in construction, transport, storage, communication, or manufacturing industries, having a high-risk drinking level and being underweight were significantly associated with a higher likelihood of smoking(p<0.05). Additionally, having a chronic disease was associated with a lower likelihood of smoking in the case of Chuncheon-si(p<0.05). Practical Implication: This study found the differences of factors associated with smoking rates between the two regions and could provide implications for establishing intervention programs or policies that could contribute to lowering the smoking rate in areas with high smoking rates.

• 보건행정학회지
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• 제24권1호
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• pp.71-84
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• 2014

Background: Informal care is increasingly recognized as placing a significant burden on the lives of family caregivers. The purpose of this study is to investigate factors related to family caregivers' burden with the community-dwelling disabled elderly under the long-term care insurance system, using the Stress Process Model developed by Pearlin (1990). Methods: Total 1,233 family caregivers with the disabled elderly, using the long-term care services in their home from May to June 2009, completed questionnaires finally. The questionnaire of this study consists of a total of 32 questions, including 11 questions related to background and context, 17 questions related to objective stressors, and 4 questions related to coping resourses. Family caregivers' burden is measured by the Korean Revised Caregiving Appraisal Scale (K-RCAS, Cronbach's alpha=0.86). To investigate factors related to family caregivers' burden, multiple regression analysis was conducted. Results: The average score of caregivers' burden was 22.0 (${\pm}6.12$). In multiple regression analysis, there were statistically significant factors affecting on the family caregivers' burden, that are related to background and context (region, living status, education level, relationship with beneficiary), objective stressors (duration of caregiving), coping resourses (caregiver's health status). Conclusion: This study found that family caregivers experience a considerable burden. The findings suggest that policies must be taken to relieve family caregivers of their duties temporarily, and to support them with counselling and education.

• Journal of Preventive Medicine and Public Health
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• 제52권4호
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• pp.234-241
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• 2019

Objectives: To identify simultaneous behavioral changes in alcohol consumption, smoking, and weight using a fixed-effect model and to characterize their associations with disease status. Methods: This study included 7 000 529 individuals who participated in the national biennial health-screening program every 2 years from 2009 to 2016 and were aged 40 or more. We reconstructed the data into an individual-level panel dataset with 4 waves. We used a fixed-effect model for smoking, heavy alcohol drinking, and overweight. The independent variables were sex, age, lifestyle factors, insurance contribution, employment status, and disease status. Results: Becoming a high-risk drinker and losing weight were associated with initiation or resumption of smoking. Initiation or resumption of smoking and weight gain were associated with non-high-risk drinkers becoming high-risk drinkers. Smoking cessation and becoming a high-risk drinker were associated with normal-weight participants becoming overweight. Participants with newly acquired diabetes mellitus, ischemic heart disease, stroke, and cancer tended to stop smoking, discontinue high-risk drinking, and return to a normal weight. Conclusions: These results obtained using a large-scale population-based database documented interactions among lifestyle factors over time.

• 지역사회간호학회지
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• 제26권2호
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• pp.89-99
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• 2015

Purpose: The purpose of this study was to demonstrate the effects of visiting nursing services in long-term care (LTC) insurance on changes in health status and physical functions among the elderly. Methods: We analyzed survey data on the living status and welfare needs of the elderly from 2008 and 2011 using the difference-in-difference method with propensity score matching. Results: The subjects were 76 elders including 38 visiting nursing service users(intervention group) and 38 home-based LTC service users (control group). Results from DID analysis confirmed that the subjective health status level of the intervention group was 2.2 points higher (p=.044) and the depression level was 0.3 point lower (p=.039) than the control group. In addition, the intervention group's ADL score was 1.9 (p=.027) and IADL 3.9 (p=.030), showing that their health was deteriorated less. Conclusion: Visiting nursing service in LTC insurance was associated with delayed deterioration of subjective health status, depression, ADL and IADL. These findings suggest the need of rebuilding visiting nursing service programs focusing on prevention services, which will be more contributive to elderly health care and the reduction of social costs.

• 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.

• 대한영양사협회학술지
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• 제28권2호
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• pp.67-84
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• 2022

This study aimed to explore the status of food service outsourcing behavior of long-term care institutions (LTCIs) through a cross-sectional survey using a questionnaire administered between July 16th and August 7th, 2020. The survey respondents were either dietitians or facility managers, who worked at 731 nursing homes, 477 group homes, and 673 day-care centers. Approximately 25.9% of nursing homes, 11.7% of group homes, and 33.1% of day-care centers used a managed-services company to operate their food service units. The main reason for outsourcing food service by nursing homes was related to the staffing of dietitians and cooks, whereas group homes and day-care centers outsourced food services due to factors relating to meal costs and the cooking process. Almost all the LTCIs entered into private contracts for outsourced food services. Only a few food service contracts included the types of meals, nutrition standards such as protein and calories per meal, and the parameter or ratio of food cost. Of the respondents, 84.5% from nursing homes, 87.5% from group homes, and 87.1% from day-care centers agreed that the quality of outsourced food services of the LTCIs should be regulated. Meals are essential for maintaining the health and functional status of LTCI users. As more LTCIs outsource their food services, we suggest the following: (1) Increasing the minimum dietitian staffing standards for LTCIs as per the Welfare of Senior Citizens Act and requiring at least one dietitian for every nursing home, (2) Making it mandatory to use a standard food service contract template when drafting food service contract, and (3) Developing realistic standards for food service operations considering the size and operation type of the LTCIs.

• 한국산학기술학회논문지
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• 제19권2호
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• pp.247-260
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• 2018

본 연구는 우리나라 장기요양보험 인정자들의 연령대(70대군, 80대군 및 90세 이상 군)별 정신적 건강상태(우울, 인지기능장애 및 치매)를 알아보고, 정신적 건강상태에 관련된 요인을 규명해 보고자 시도하였다. 조사대상은 2011~2014년도에 국민건강보험공단에서 장기요양 인정자로 판정받았던 70세 이상 노인 1,488명(남성 740명, 여성 748명)으로 하였다. 자료 수집은 국민건강보험공단으로부터 생활습관 등이 기재된 문진표, 검사항목별 건강검진 및 장기요양자료를 연구목적으로 제공받아 수집하였다. 연구결과, 조사대상자들의 연령대별 정신적 건강상태를 나타내는 우울, 인지기능장애 및 치매 수준은 연령대가 증가할수록 유의하게 높아지는 경향을 보였다. 다중 로지스틱 회귀분석 결과, 정신적 건강상태를 나타내는 우울, 인지기능장애 및 치매가 나타날 위험비는 각 연령대별로 큰 차이 없이 남성보다 여성에서, 과체중군보다 저체중군에서, 비흡연군보다 흡연군에서, 비음주군보다 음주군에서 유의하게 증가하였다. 이상과 같은 연구결과는 조사대상자들의 정신적 건강상태(우울, 인지기능장애 및 치매)는 연령이 증가할수록 저하됨을 시사하며, 특히 흡연, 음주 및 규칙적인 운동 등과 같은 건강관련행위특성이 좋지 않은 군이 좋은 군보다 정신적 건강상태가 저하되고 있음을 시사하고 있다.

• 보건행정학회지
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• 제19권2호
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• pp.127-134
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• 2009

It is known that socioeconomic status(SES) of the cancer patient is associated with survival in recent studies, performed in other countries. The purpose of this study was to determine whether the association between status of national health insurance and survival is also present in a community in Jeonnam province, South Korea. The Gwangju-Jeonnam Cancer Registry, a population-based cancer registry, provided information to identify the cancer cases of study community diagnosed from 1998 to 2007. Total of 2,046 cases were identified during the period. There were significant associations between the status of national health insurance and survival for total cancer after adjusted by age, geographic accessibility to health care, and stage at diagnosis. However, this differences were not found in the analysis using only stomach and colorectal cancer cases. Despite of some limitations, this results suggest that the policy for reducing the difference according to the SES is required in national cancer management program.

• 한국치위생학회지
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• 제19권5호
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• pp.765-776
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• 2019

Objectives: The purpose of this study was to compare the oral health statuses pre- and post-insurance using the $5^{th}$ and $6^{th}$ National Health and Nutrition Examination Survey data to confirm the effect of scaling insurance after a year. Methods: Data were analyzed using IBM SPSS ver. 21.0 (IBM Co., Armonk, NY, USA). The four years were integrated, and a composite sample analysis was performed. A total of 26,990 people were included in the study before applying for scaling insurance (14,343 persons) or after receiving scaling insurance (12,647 persons). A chi-squared test was performed to compare the demographic characteristics and oral health status of the subjects. The significance level of the statistical test was 0.05. Results: The proportion of patients without implants was high before the provision of scaling insurance once a year, however, the proportion of patients with one or more implants was high (p<0.05) after the provision of scaling insurance once a year. Hemorrhagic periodontal tissues and tartar formation in periodontal tissues were highly prevalent before the provision of scaling insurance once a year, however, healthy periodontal tissues and formation of periodontal pockets were highly prevalent (p<0.05) after the provision of scaling insurance once a year. The decay, missing, and filled teeth index scores were higher before the provision of scaling insurance once a year (p<0.05). Conclusions: The aforementioned results showed that scaling once a year helps prevent or treat periodontal disease. In addition, we confirmed the effect of prevention on periodontal disease and dental caries, therefore, we expect it to develop into a stable policy.

• 대한예방한의학회지
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• 제26권1호
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• pp.25-41
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• 2022

Background & Objectives : As the government of South Korea implemented policies to strengthen health insurance coverage, the health insurance benefit for raw herbal medicines has been promoted. This study investigated the current status of the herbal medicines coverage in the Japanese national health insurance to secure reference data for the design of herbal medicines coverage in South Korea. Methods : Literature review was conducted to collect and analyze the history and current situation on herbal medicines coverage in the Japanese health insurance system. To supplement the contents not presented in the documents, on-site interviews were conducted at the medical institutions and pharmacies that prescribed or prepared herbal medicines in Tokyo, Japan. The contents of the survey included the background and progress of the herbal medicines coverage, the status of herbal medicines use, the payment system, and the safety management of herbal medicines. Results : Since the introduction of health insurance in the 1960s, Japanese insurance system has covered herbal medicines, and so far, it has been maintained without any additional restrictions. When the raw herbal medicines are prescribed to outpatients, the preparation fee is set higher than that of other medicines, but overall payment regulations and systems for herbal medicine are generally the same as other medicines. Conclusions : The case of Japan can be a useful references and implications for national health insurance policy on herbal medicines in south Korea.