• 한국응급구조학회지
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• 제27권3호
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• pp.7-16
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• 2023

Purpose: The objective of this study was to compare the outcome of out-of-hospital cardiac arrest (OHCA) between National Health Insurance(NHI) and Medical Aid(MA), before (2019) and during 2020 COVID-19 in Seoul. Methods: This is a retrospective cohort study that used nationwide OHCA registry collected in 2019 and 2020. The participants were patients with medical etiology who lived in Seoul and were transferred by 119 ambulance in Seoul. It was classified into NHI and MA according to health insurance status. Main outcomes included survival rate and good neurological recovery. Results: A total of 2,888 patients (2,543 NHI and 345 MA) in 2019 and 2,949 patients (2,638 NHI and 311 MA) in 2020 were included. In 2020, the bystander cardiopulmonary resuscitation (CPR), was significantly lower in MA (25.7%) than in NHI (38.1%). Survival rate in the MA decreased from 11.6% in 2019 to 10.6% in 2020, while increased from 10.1% to 13.3% in NHI. The odds ratio of good neurological recovery were 0.47 (95%CI, 0.25-0.86) for the MA group compared with NHI during 2020 COVID-19. Conclusion: There were disparities in bystander CPR and good neurological recovery by health insurance status during COVID-19 pandemic. Public health interventions should strive to reduce disparity of MA group in OHCA.

• 정신신체의학
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• 제25권1호
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• pp.56-62
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• 2017

Objectives : The objective of this study was to investigate the relationship between psychological distress and pain in cancer patients. Methods : 249 patients with cancer who visited National Health Insurance Service Ilsan Hospital between April 2013 and March 2014 were evaluated with National Cancer Center Psychological Symptom Inventory(NCC-PSI) which consisted of Modified Distress Thermometer(MDT) and Modified Impact Thermometer(MIT). Each scale was divided into 3 subscales targeting separate symptoms: insomnia, anxiety, and depression. Psychological distress was defined as positive for those who scored above the cutoff values in at least one of all six subscales. The Numeric Rating Scale for Pain(NRS-Pain) was used to assess the subjective severity of pain. Logistic regression was performed to investigate the association between psychological distress and pain. Results : Univariate logistic regression analysis showed that pain, gender, compliance, and two subscale scores of Hospital Anxiety and Depression Scale(HADS) were significantly associated with psychological distress. Multivariate logistic regression analysis showed that pain and HADS anxiety subscale score maintained a statistically significant association with psychological distress adjusted for variables including age, gender, years of education, Eastern Cooperative Oncology Group performance status, cancer stage, Charlson Comorbidity Index, compliance, and HADS depression subscale score. One point increase in pain was 1.31 times more likely to cause psychological distress. In secondary analysis, pain was significantly associated with all subscales of NCC-PSI, except MIT-anxiety subscale. Conclusions : This study suggests that NCC-PSI, a screening tool for psychological distress, reflects pain. We recommend that physicians who treat cancer patients consider the examination of psychological distress which provides comprehensive evaluation of various factors regarding quality of life.

• 치위생과학회지
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• 제18권3호
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• pp.182-187
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• 2018

As the elderly population increases, they are increasingly affected by oral health problems. Therefore, efforts are being made to improve the oral health of older people, alleviate mental discomfort, and reduce unmet dental needs. This study was conducted to confirm the relationship between the National Health Insurance Elderly Denture Coverage and the unmet dental need for the edentulous elderly, as part of the protection policy. We analyzed the 2011 and 2013 Community Health Survey data of the edentulous elderly, aged 75 years or older, before 2012. In order to more precisely confirm the effects of the denture donation policy on unmet dental care, basic life recipients who were subject to the free elderly prosthetic project were excluded from the analysis. The final analysis included 20,400 subjects. According to our investigation of the factors that affect the unmet dental needs of the elderly, the National Health Insurance Elderly Denture Coverage did not affect unmet dental needs. The statistically significant variables that affected the unmet dental needs of the elderly were education and income levels, which are representative socioeconomic status variables. The lower the level of education, the unhealthier the dental care experience, and income levels showed a similar tendency. The elderly who have a low socioeconomic status are more likely to experience unmet dental needs because they lack the knowledge and socioeconomic ability to pay for dental care. Therefore, the policy for health protection of the entire elderly population should be continuously expanded. In addition, the socioeconomically vulnerable groups may have health problems due to the restriction of medical use, which may lead to quality of life deterioration.

• Journal of the Korean Data and Information Science Society
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• 제21권2호
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• pp.201-209
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• 2010

최근 10년간 허혈성심질환 사망은 급격히 증가하였기에 이에 대한 효과적인 예방대책이 매우 중요한 실정이다. 이에 본 연구에서는 1996년 국민건강보험공단 건강검진 수검자 2,268,018명을 약 10년간 추적하여 허혈성심질환의 주요 위험요인별 상대위험도를 콕스비례위험모형을 통해 파악하고자 하였다. 그 결과 남자에서는 체질량지수, 혈압, 흡연, 여자에서는 고혈압, 주관적 건강감 및 감마-글루타밀전이효소가 허혈성심질환과 유의한 관련성이 있었다.

• 보건행정학회지
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• 제29권2호
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• pp.184-194
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• 2019

Background: The extent of coverage rate of the public health insurance is still insufficient to meet healthcare needs. Private health insurance (PHI) plays a role to supplement coverage level of national health insurance in Korea. It is expected that reduce unmet need healthcare. This study was aimed to identify relationship between PHI type and the unmet healthcare need and its associated factors. Methods: Data were obtained from the 2014 Korea Health Panel Survey using nationally representative sample was analyzed. Respondents were 8,667 who were adults over 20 years covered by PHI but have not changed their contract. According to the enrollment form, PHI was classified into three types: fixed-benefit, indemnity, and mixed-type. To identify factors associated with unmet needs, multiple logistic regression conducted using the Andersen model factors, which are predisposing factors, enabling factors, and need factors. Results: Our analysis found that subjects who had PHI with mixed-type were less likely to experience unmet health care needs compared than those who did not have it (odds ratio, 0.80; 95% confidence interval, 0.66-0.98). As a result of analyzing what affected their unmet healthcare needs, the significant factors associated with unmet medical need were gender, marital status, residence in a metropolitan area, low household income, economic activity participation, self-employed insured, physically disabled, low subjective health status, and health-risk factors such as current smoking and drinking. Conclusion: The results of this study suggest that having PHI may reduce experience of unmet healthcare needs. Findings unmet healthcare needs factors according to various subjects may be useful in consideration of setting policies for improving accessibility to healthcare in Korea.

• Journal of Preventive Medicine and Public Health
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• 제41권1호
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• pp.51-60
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• 2008

Objectives : We examined the effect of sociodemographic factors, cancer, and psychiatric disorders on suicide by gender and age-specific patterns in South Korea. Methods : The study is a case-control study. Claim data was obtained from the national health insurance database and national death registration database. The number of people who committed suicide was 11,523, which was matched with a control group consisting of ten times as many people at 115,230 selected from the national health insurance and medical aids beneficiaries. The medical utilization of the case group was one year before death and that of the control group was from July 1,2003 to June 30, 2004. Four variables-address, economic status, presence of a psychiatric disease, and cancer-were used in multiple logistic regression analyses. Results : Living in cities or in rural areas showed a greater risk for suicide than living in a metropolitan city. Low economic status, the presence of a psychiatric disorder, and cancer were also statistically meaningful risk factors for suicide. The three major psychiatric diseases, schizophrenia, alcohol abuse, and bipolar disorder, were meaningful in all age groups, but the scale of the odds ratio differed by the age group. Only the psychiatric disorder variable was meaningful in the adolescent group, whereas a psychiatric disorder and economic status were meaningful for the young adult group, and all variables were meaningful for the middle-aged group. A psychiatric disorder and cancer were meaningful in the elderly group, economic status was meaningful for male subjects, and address was meaningful for female subjects. Conclusions : Factors such as living in city or rural areas, low economic status, the presence of a psychiatric disorder, and cancer were statistically meaningful risk factors in suicide. These factors also differed by age group. Therefore, policymakers should establish policies for suicide prevention that are relevant for each age group.

• 한국산학기술학회논문지
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• 제19권1호
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• pp.497-505
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• 2018

이 연구의 목적은 중증질환자들을 대상으로 민간의료보험 가입자와 미가입자간의 특성을 파악하고, 가입 요인을 분석하기 위함이다. 연구도구는 2015년도 국민건강영양조사 자료를 이용하였으며, SPSS ver 23.0을 사용하였고, 연구 대상자는 19세 이상 중증질환자(암, 심장질환, 뇌혈관질환) 417명을 선정하였다. 분석방법은 민간의료보험 가입 현황과 차이를 파악하기 위해 교차분석을 실시하였고, 민간의료보험 가입에 미치는 요인을 분석하기 위해 이항 로지스틱 회귀분석을 실시하였다. 분석 결과 사회 인구학적 특성에서는 성별, 거주지, 혼인상태와 관계없이 나이가 젊을수록 높았다. 그리고, 사회 경제적 상태에서는 교육수준과 관계없이 가구소득이 높을수록, 의료급여대상자에 비하여 건강보험대상자의 가입률이 높았다. 건강행태에서는 주관적 건강 인식 및 걷기 실천과 무관하게 활동제한이 있는 집단의 민간의료보험 가입률이 낮았으며, 설명력은 51.7%이었다. 그러므로, 중증질환자 중 민간의료보험에 가입하지 못한 집단을 선별하여 생활환경 개선 및 지방자치단체의 지원을 촉구해야 할 것이다. 또한, 사회적 취약계층 및 건강행태에 제한 있는 집단을 대상으로 중증질환 예방을 위한 정부의 보건교육 또는 프로그램 제공 등 다양한 보건정책을 고려해야 할 것이다.

• 보건행정학회지
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• 제26권4호
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• pp.305-314
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• 2016

Background: The purpose of this study is to examine the characteristics of and factors associated with long-term care (LTC) utilization under public long-term care insurance (LTCI) among end-of-life older adults in Korea. Methods: Using a 5% sample of older people aged 65 or older and their health and LTC insurance data, two-part model analyses were conducted. We compared LTC uses and their determinants during the last year of life among decedents in the year 2010 with those of survivors. We also compared the medical uses of the same sample with their LTC uses. Results: The end-of-life elderly were more likely to use LTC, and their expenditure on LTC was higher than their counterparts. Whether or not older people used LTC during their last year of life was significantly affected by age, sex, health insurance, household income, and living alone; however, LTC costs of the decedents were only affected by functional status, which may have been due to the reimbursement scheme of the current LTCI, which is mainly based on functional dependency level. For the survivors, having chronic diseases significantly increased the likelihood of LTC use, which was not the case for the decedents. End-of-life elderly with relatively low social economic status were more likely to use the LTC other than medical services, while the health conditions affected their medical uses most significantly. Conclusion: The study findings provide key information for predicting demand related to the increasing LTC needs of Korean older people at the end of life.

• 한국학교ㆍ지역보건교육학회지
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• 제24권4호
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• pp.51-60
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• 2023

Objectives: This study attempted to examine the factors that affect the national health checkup rate of the elderly, analyze the impact of these factors, and discuss countermeasures to problems that may arise based on this. Methods: This study used the '8th National Health and Nutrition Examination Survey (2019-2021)', a nationwide survey, as the main data. The subjects of the study are seniors aged 65 years or older, the dependent variable is whether or not they underwent a national health checkup, and the independent variables are gender, marital status, residence, education level, income level, economic activity, type of medical coverage, private insurance subscription, subjective health, High blood pressure, diabetes, depression, stress, and weight change were selected. The statistical analysis package for data analysis is SPSS ver. 27.0 was used, and a p value of less than 0.05 was considered significant. Results: Of the 2,806 seniors aged 65 years or older, 2,074 (73.9%) took the national health screening over the past two years. In terms of marital status, married was 1.451 times higher than single (p<0.001), and in terms of residence, myeon was 1.240 times higher than dong (p<0.01). In terms of education level, college graduates were 2.053 times higher than elementary school graduates (p<0.001), and in terms of economic activity, the employed were 1.325 times higher than the unemployed (p<0.01). Private insurance was 1.883 times higher than non-subscription (p<0.001), weight change was 1.234 times higher for change than no change (p<0.05), and current smoking rate was 2.003 times higher for non-smokers than for former smokers. It was high (p<0.001). Conclusion: In conclusion, if differentiated promotion and health education are strengthened for the elderly who cannot participate in the national health screening, the participation rate of the elderly in the national health screening is expected to increase.

• 한국콘텐츠학회논문지
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• 제10권12호
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• pp.190-204
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• 2010

본 연구는 우리나라의 민간의료보험 가입자의 인구 사회 경제학적 특성과 가입자와 미가입자간의 질병 유형, 예방 및 건강행태, 의료이용 양상 등을 비교하였다. 그리고 민간보험 가입의 영향을 파악하여 향후 국민건강보험 및 민간의료보험 관련제도의 바람직한 발전방향을 제시하기 위한 기초자료 활용에 그 목적이 있다. 연구의 결과는 민간의료보험 가입 요인은 인구 사회 경제적 요인이 유의하게 나타났으며, 국민건강 영양조사에서 이루어진 인플루엔자 예방접종율과 건강보험 건강검진은 민간의료보험 가입자에게서 더 낮았고, 지난 2년간 본인부담 건강검진비율과 지난 2년간 암검진비율은 민간의료보험 가입자의 검진율이 더 높았다. 그리고 건강행위 평균을 민간의료보험 가입여부별로 보면, 격렬한 신체활동을 실천하는 비율은 민간의료보험 가입자가 더 높았고, 평균 수면시간, 1주일간 격렬한 신체활동을 하는 일수, 1주일간 중등도 신체활동을 하는 일수, 1주일간 유연성 운동일수 및 1주일간 근력운동일수에서도 민간의료보험 가입자가 미가입자 보다 많았다. 걷기를 실천하는 비율과 1주일간 걷기일수는 민간의료보험 가입자가 미가입자보다 적었다. 의료이용에 민간의료보험이 어떤 영향을 미치고 있는가를 살펴본 결과에서는 외래이용이 있는 경우와 입원이용횟수에서 민간의료보험가입자가 미가입자보다 외래를 이용할 확률이 높았고, 더 많은 횟수의 입원이 관련 요인으로 나타났다.