• 보건행정학회지
• /
• 제9권2호
• /
• pp.118-138
• /
• 1999

This study presents the variations on drug utilization for outpatients' URI, gastritis. and hypertension by the type of hospital- tertiary hospital. general hospital. hospital. clinic. It investigated drug expenses. daily drug expenses. days of medication. the highest price of the drugs used. and the number of the different drugs used for each disease and type of hospital. This study also performed analysis to see how much the variations of variables related to drug use affect the variations of drug expenses. The dependent variable was drug expenses and the independent variables were days of medication. the average price of the drugs used. and the number of the different drugs used. Analysis of the drug utilization was performed on NFMI(National Federation of Medical Insurance) 1994 medical expense claim data. Patients with secondary diseases were excluded. In this study. 379 patients with URI, 386 patients with gastritis. 1.257 patients with hypertension were included. It was founded that there were large variation on drug utilization between the types of hospital for same diseases. Days of medication were longest in tertiary hospitals and shortest in hospitals or clinics. Clinics showed the lowest daily drug expenses in all of the diseases investigated. Daily drug expenses were highest in general hospitals or hospitals. which also tended to use drugs of higher price than other types of hospital. General hospitals and hospitals had larger variations in daily drug expenses and the highest price of drugs. It suggested that drug might be utilized overly in general hospitals and hospitals and some other factors might influence on drug utilization in these hospitals. It was found that the variations of drug expenses were affected by the variations of drug price and days of medication rather than the number of the different drugs. Then the strategy to reduce the variations of drug utilization and to improve the quality of drug utilization should focus on the drug price and days of medication. Further study is needed to assess the quality as well as the variation of drug utilization and to show the factors which affect them.

• 보건행정학회지
• /
• 제19권4호
• /
• pp.66-77
• /
• 2009

This study aims to examine the effect of socioeconomic status (hereafter, SES) on healthcare utilization of the patients with rare and incurable diseases. Information of 2,973 patients who were self-employed insured and utilized healthcare service in 2007 was drawn from the National Health Insurance (hereafter, NHI) claim data. SES was set as four groups based on the monthly contribution. Outcome variable was the expense for outpatient and in-hospital services, which was log-transformed and square-rooted in oder to obtain normal distribution. Covariates included age, gender, residence and diagnosis. To examine the effects after controlling for covariates, we employed generalized estimating equation model, since patients with the same diagnosis are likely to have similar characteristics of demographics and healthcare utilization. Univariate statistics showed that lower SES was associated with less utilization of healthcare services. After controlling for covariates, a significantly smaller amount of money was expended for the lowest SES group compared to the highest one. Rural residence was associated with less utilization, except that residents in Seoul significantly more utilized outpatient services in tertiary hospitals. Considering that there is a subsidy program for the low income patients, such differences in healthcare utilization according to SES seems to result from the burden of out-of-pocket payments for uncovered services of the NHI.

• 보건행정학회지
• /
• 제24권1호
• /
• pp.85-91
• /
• 2014

Background: This study aims to analyze West African pregnancy experienced women's self-rated health and related factors in Democratic Republic (DR) of the Congo, and provide basic data which can be used in developing maternal and child heath projects and health promotion programs to enhance women's self-rated health in the DR Congo. Methods: A survey was conducted among 400 women, 300 of whom were from Kenge and 100 from Boko in Bandundu Province. Three hundred and fifty-two questionnaires were administered on factors expected to affect the self-rated health, categorized into basic information and economic status of respondents, healthcare service, and illness patterns. The hierarchical logistic regression analysis was performed taking each variable into account. Results: The results show that those who have had nutrition education, work in the office, have no health insurance, or have had no illness for the last one year perceive themselves to be in good health. Conclusion: To improve the self-rated health status and promote maternal and child health in DR Congo, the results suggest that the government or relevant agencies should develop programs to educate people regarding health and nutrition, and policies based on the right status of each country. Systems are also required for healthcare at all social levels along with aspects to avoid illness in daily life.

• 한국유통학회지:유통연구
• /
• 제9권2호
• /
• pp.45-73
• /
• 2004

이 연구는 영업사원 이직의도에 영향을 미치는 선행변수들의 영향력 과정에 대한 이해의 폭을 넓혀보고자 하는 것을 목표로 한다 이 연구에서 기존 연구들에서 제시하고 있는 영업사원 이직의도의 선행변수인 직무성과, 만족, 조직몰입 이외에 사회교환이론에서 제시하고 있는 대안의 매력도라는 개념을 추가한 연구모형을 제시한다. 생명보험업계에 종사하고 있는 178명의 영업사원들로부터 자료를 수집하여 실증분석 한 결과, 이직의도에는 대안의 매력도가 직접적으로 긍정적인 영향을 미치는 것으로 나타났으며, 직무성과와 만족은 부정적인 영향을 미치는 것으로 나타났다. 하지만 직무성과 및 만족과 이직의도의 사이에서 중요한 매개변수 역할을 한다고 밝혀져 왔던 조직몰입의 영향력은 본 연구에서는 지지되지 않았다. 대안의 매력도와 조직몰입에는 직무만족만이 유의한 영향을 미치는 것으로 드러났다. 이 연구는 이직의도의 직접적인 선행요소로서 대안의 매력도의 역할을 규명했음에 그 첫 번째 공헌점이 있다. 두 번째로, 대안매력도 평가에 직무만족이 부정적인 영향을 미친다는 사실을 확인하였다. 세 번째는, 영업사원관리의 관계론적 관점에 대한 국내 연구자들의 관심을 촉진하는 계기가 될 수 있을 것이다.

• 보건행정학회지
• /
• 제15권4호
• /
• pp.46-64
• /
• 2005

This study was conducted to verify the current criteria and classification system used to determine specialized general hospitals status. In this study, we proposed a new classification system which Is simpler and more convenient than the current one. In the new classification system clinical procedure was chosen as the unit of analysis in order to reflect all the resource consumption and the complexities and degree of medical technologies in determining specialized general hospitals. We developed a statistical model and applied this model to 117 general hospitals which claim their national insurance through electronic data interchange(EDI). Analysis based on 984 clinical procedures and medical facilities' characteristic variable discriminated specialized general hospital in present without misclassification. It means that we can determine specialized general hospital's permission In new way without using the current complicated criteria. This study discriminated specialized general hospital by the new proposed model based on clinical procedures provided by each hospital. For clustering the same types of medical facilities using 984 clinical procedures, we executed multidimensional scale analysis and divided 117 hospitals into 4 groups by two axises : a variety of procedure and the Proportion of high technology Procedure. Therefore, we divided 117 hospitals into 4 groups and one of them was considered as specialized general hospital. In discriminating analysis, we abstracted proportion of 16 clinical procedures which effect on discriminating the specialized general hospital in statistical system also we identify discriminating function which include these variables. As a result, we identify 2 discriminating functions, one is for current discriminating system and the other two is for new discriminating system of specialized general hospital.

• 한국시뮬레이션학회논문지
• /
• 제28권3호
• /
• pp.57-63
• /
• 2019

본 연구는 중소기업퇴직연금제도가 가입자들에게 보증이율(최소수익률)을 제공할 경우 사전에 적립해야 하는 보증준비금 수준을 산출하여 제시하였다. 보증준비금을 산출하기 위한 방법론으로 본 연구는 변액연금보험의 보증준비금 산출 방법론을 적용하였다. 보증준비금 산출을 위해 2010년부터 2018년까지의 3대 연기금의 자산운용 평균 수익률을 기금형 제도의 목표수익률로 설정하였으며, 보증이율은 0%, 1.0%, 1.5%, 2.0%를 각각 적용하여 시나리오 별로 요구되는 보증준비금을 산출하였다. 주요 결과로 첫째, 제도 도입기간이 길어질수록 초기 설정한 보증이율에 따른 보증준비금 간의 차이는 증가하는 것으로 나타났다. 둘째, 제도가 성숙함에 따라 적립금이 부족할 가능성은 체감하였다. 결론적으로 보증이율투자전략에 내제된 수익-위험의 관계는 장기적으로 보수적 균형을 이루어야 함을 의미한다.

• 보건행정학회지
• /
• 제29권3호
• /
• pp.303-311
• /
• 2019

Background: Cerebrovascular disease is included in four major diseases and is a disease that has high rates of prevalence and mortality around the world. Moreover, it is a disease that requires a high cost for long-term hospitalization and treatment. This study aims to figure out the correlation between grip strength, which was presented as a simple, cost-effective, and relevant predictor of cerebrovascular disease, and cerebrovascular disease based on the results of a prior study. And furthermore, our study compared model suitability of the model to measuring grip strength and relative grip strength as a predictor of cerebrovascular disease to improve the quality of cerebrovascular disease's predictor. Methods: This study conducted an analysis based on the generalized linear mixed model using the data from the Korea Longitudinal Study of Ageing from 2006 to 2016. The research subjects consisted of 9,132 middle old age people aged 45 years or older at baseline with no missing information of education level, gender, marital status, residential region, type of national health insurance, self-related health, smoking status, alcohol use, and economic activity. The grip strength was calculated the average which measured 4 times (both hands twice), and the relative grip force was divided by the body mass index as a variable considering the anthropometric figure that affects the cerebrovascular disease and the grip strength. Cerebrovascular diseases, a dependent variable, were investigated based on experiences diagnosed by doctors. Results: An analysis of the association between grip strength and found that about 0.972 (odds ratio [OR], 0.972; 95% confidence interval [CI], 0.963-0.981) was the incidence of cerebral vascular disease as grip strength increased by one unit increase and the association between relative grip strength and cerebrovascular disease found that about 0.418 (OR, 0.418; 95% CI, 0.342-0.511) was the incidence of cerebral vascular disease as relative grip strength increased by unit. In addition, the model suitability of the model for each grip strength and relative grip strength was 11,193 and 11,156, which means relative grip strength is the better application to the predictor of cerebrovascular diseases, irrespective of other variables. Conclusion: The results of this study need to be carefully examined and validated in applying relative grip strength to improve the quality of predictors of cerebrovascular diseases affecting high mortality and prevalence.

• 보건행정학회지
• /
• 제34권2호
• /
• pp.178-184
• /
• 2024

연구배경: 본 연구는 의료질평가지원금 drug utilization review (DUR) 평가지표 도입 전·후의 DUR 점검률 및 의약품 중복처방 예방률 변화 차이를 비교하여 DUR 평가지표의 도입과 안전한 의약품 사용 간의 효과성을 파악하고자 한다. 방법: 본 연구는 2018년 건강보험심사평가원(Health Insurance Review and Assessment Service) DUR 자료(DUR 평가지표 도입 전)와 2023년 의료질평가지원금 평가 결과 산출 자료(DUR 평가지표 도입 후)를 활용하였다. 종속변수는 DUR 평가지표로, DUR 점검률과 의약품 중복처방 예방률 지표를 활용하였다. 독립변수는 DUR 평가지표 도입 여부이며, 통제변수는 의료기관 단위변수로, 종별 구분, 설립 구분, 소재지, DUR 청구 software 업체, 병상 수를 선정하였다. 결과: DUR 평가지표 도입 전·후의 의약품 중복처방 예방률 변화 차이를 분석한 결과, DUR 평가지표 도입 전·후의 의약품 중복처방 예방률은 통계적으로 유의미한 차이가 있었으며, DUR 평가지표 도입 후 의약품 중복처방 예방률이 유의미하게 증가하였다. 결론: 본 연구의 정책적 시사점은 다음과 같다. 첫째, DUR 시스템의 지속적인 평가 진행이 필요하다. 본 연구를 통해 DUR 평가지표 도입 후 의약품 중복처방 예방률이 유의하게 증가한 것을 확인하였다. 따라서 DUR 시스템의 효과를 계속해서 검토하고 의약품 사용의 안전성을 확대하기 위해 DUR 시스템의 지속적인 평가 진행이 필요할 것으로 판단된다. 둘째, DUR 시스템 정보를 활용하는 의료기관과 이를 관리하는 기관과의 협력 파트너십 구축이 필요하다. 의료기관의 적극적인 DUR 점검 참여와 관리기관의 다각적인 지원을 바탕으로 공동의 노력과 협력이 이루어진다면, DUR 시스템의 활성화를 통해 안전한 의약품 사용을 보장하고 국민건강을 보호하며, 의료의 질적 수준 향상을 불러올 것으로 판단된다.

• 보건행정학회지
• /
• 제31권1호
• /
• pp.74-90
• /
• 2021

Background: It is getting important to improve the oral health status of the elderly because oral health status may affect their health status of the whole body. In this respect, we aimed to explore the association of oral health status and behavior factors with self-rated health status by sex. Methods: Using the data from the 7th Korea National Health and Nutrition Examination Survey for health surveys and oral examinations (2016-2018), we analyzed a total of 3,070 people aged 65 or older (men: 1,329; women: 1,741). Our dependent variable, self-rated health status, was divided into two groups: not good (bad and very bad) and good (very good, good, and fair), whereas our independent variables of interest were oral health status and behavior factors. In addition to descriptive analysis and the Rao-Scott chi-square test, reflecting survey characteristics, we conducted hierarchical multivariable logistic regression analyses adjusted for socio-demographics and health status and behavior factors. All analyses were stratified by sex. Results: The proportion of people having 'not good' self-rated health was 36.5% in women but 24.5% in men. In a model adjusted for all covariates, the self-rated health status showed significant association with the self-rated oral health status. For example, in men, the risk of having 'not good' self-rated health was high in people having 'poor' (odds ratio [OR], 5.31; 95% confidence interval [CI], 2.34-12.03) self-rated oral health status and in those having 'fair' (OR, 4.03; 95% CI, 1.68-9.70) in comparison with those having 'good' self-rated oral health status. Dental status regarding speaking difficulty seemed to be very important in influencing self-rated health status. For instance, in women, compared to people having 'no discomfort' speaking difficulty, the risk of having 'not good' self-rated health was high in people having 'not bad' (OR, 1.60; 95% CI, 1.14-2.24) and 'discomfort' (OR, 1.79; 95% CI, 1.30-2.47) speaking difficulty. The covariates significantly associated with the risk of having 'not good' self-rated health were: physical activity, chronic disease, stress, and body mass index in both sexes; health insurance type and drinking only in men; and economic activity only in women. Conclusion: Oral health status and behavioral factors were associated with self-rated health status among the elderly, differently by sex. This suggests that public health policies toward better health in the elderly should take their oral health status and oral health behaviors into account in a sex-specific way.

• 한국건축시공학회지
• /
• 제20권2호
• /
• pp.137-145
• /
• 2020

최근 교량은 장대화, 신공법의 도입에 따른 위험요인의 증가로 교량공사에서의 철저한 안전 및 리스크 관리 체계가 필요하다. 공사 현장 주변에 있는 발주자 건설공사 관련자 및 공사와 관련이 없는 제 3자의 기존 재산에 손해를 발생시킬 수 있어 제3자 피해 손실로 인한 리스크가 명확히 분석되어야 함에도 불구하고 연구가 미비한 실정이다. 본 연구는 교량건설 사업에 대한 국내 주요 보험사의 과거 보험료 지급 실적을 토대로 실제 교량 건설에서 제3자 피해 손실로 인한 손실에 대한 교량건설 특성에 따른 리스크 요인을 분석하고, 정량화된 예측 손실 모델을 개발하고자 하였다. 정량적 교량건설 손실모형 개발을 위해 사고 건당 보험지급액을 총공사비로 나눈 손실비율을 종속변수로 선정하였고, 상부구조, 하부구조, 홍수 및 도급순위가 교량건설 중 제3자 피해에 의한 손실비율에 영향을 미치는 지표로 나타났다. 도출된 결과는 건설프로젝트에 대한 손실 평가 모델 개발에 기존의 프로젝트 내부에서 발생한 손실과 더불어 제3자 피해손실을 고려함으로써 더불어 균형 있는 리스크 평가에 필수적인 지침으로 활용할 수 있다.