• Journal of Preventive Medicine and Public Health
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• 제42권4호
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• pp.243-250
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• 2009

Objectives : The purposes of this study is to estimate the cost of cancer care after its diagnosis and to identify factors that can influence the cost of cancer care. Methods : The study subjects were patients with an initial diagnosis one of four selected tumors and had their first two-years of cancer care at a national cancer center. The data were obtained from medical records and patient surveys. We classified cancer care costs into medical and nonmedical costs, and each cost was analyzed for burden type, medical service, and cancer stage according to cancer types. Factors affecting cancer care costs for the initial phase included demographic variables, socioeconomic status and clinical variables. Results : Cancer care costs for the initial year following diagnosis were higher than the costs for the following successive year after diagnosis. Lung cancer (25,648,000 won) had higher costs than the other three cancer types. Of the total costs, patent burden was more than 50% and medical costs accounted for more than 60%. Inpatient costs accounted for more than 60% of the medical costs for stomach and liver cancer in the initial phase. Care for latestage cancer was more expensive than care for early-stage cancer. Nonmedical costs were estimated to be between 4,500,000 to 6,000,000 won with expenses for the caregiver being the highest. The factors affecting cancer care costs were treatment type and cancer stage. Conclusions : The cancer care costs after diagnosis are substantial and vary by cancer site, cancer stage and treatment type. It is useful for policy makers and researchers to identify tumor-specific medical and nonmedical costs. The effort to reduce cancer costs and early detection for cancer can reduce the burden to society and improve quality of life for the cancer patients.

• 가정∙방문간호학회지
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• 제21권2호
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• pp.127-138
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• 2014

Purpose: The objectives of this study were to analyze the state of hospital-based home care (HC) services annually and to provide basic information for research and policy regarding home care. Methods: This study is a secondary analysis of the yearly state of HC services from the Health Insurance Review & Assessment Services from 2007 to 2012. Results: The decreased by 34.6%, from 214 agencies in 2007 to 140 in 2012. The annual average number of active home care nurses was 440, which included 6.7% of the licensed home care nurses until 2012. The annual average number of HC patients were 32,000, and this number decreased by 21% in 2012, compared to that of 2008. Of the HC patients, about 70% were over 60 years of age. The chronic diseases among HC patients have been decreasing steadily since 2007. Seventy to eighty percent of the home visits were made in general hospitals or higher level hospitals. The total medical cost for HC services was 21 billion won in 2007, which consisted of 0.06% of the national medical costs, and it was 22 billion won and 0.03% in 2012. Conclusion: Based on the results of this study, further research on HC services is necessary to frame policies for the expansion of HC agencies.

• 한국사회복지학
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• 제60권3호
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• pp.129-150
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• 2008

본 연구는 노인장기요양보험제도 2차 시범사업 결과를 바탕으로 우리나라 노인의 요양시설 서비스 이용에 영향을 미치는 요인을 탐색해 보고자 하였다. 이론적 모형으로는 앤더선과 뉴만(Andersen and Newman)의 행동주의 모델을 토대로 하여 영향요인을 구분하였으며, 연구방법은 의사결정분석을 이용하였다. 분석결과 서비스 이용에 가장 큰 영향을 미치는 것은 대상 노인의 서비스 이용의향이었으며, 이러한 선행요인 다음 중요한 요인으로 자원 요인(수발자 있음 및 동거가족 여부)으로 나타났다. 욕구요인으로는 인지장애가 있는 경우, 치매로 인한 문제행동이 있는 경우, 기본적 일상생활수행능력에 있어 완전도움을 받아야 하는 경우로 나타났다. 이러한 분석결과는 앤더슨과 뉴만의 행동주의 이론의 과정을 그대로 보여주고 있음을 알 수 있는데, 즉 선행요인과 자원요인에 의해 서비스 이용형태가 달라지며, 이러한 선행요인과 자원요인은 욕구요인과 결합하여 실제 서비스 이용에 영향을 주는 것으로 나타났다. 이를 통해 본 연구는 시설 서비스 이용 대상자의 욕구요인을 정확히 파악하여 이에 적절한 서비스 내용을 구축하고 지역사회 내 시설서비스 이용노인을 선별하는데 기초 자료를 제공하는데 기여하고자 한다.

• 디지털융복합연구
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• 제14권12호
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• pp.357-367
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• 2016

본 연구는 간호사의 치매케어 관련 지식, 치매에 대한 태도 및 치매간호 접근법에 대해 조사하고 관련 변수를 파악하기 위한 서술적 조사연구이다. P시에 소재한 G 병원의 남 녀 간호사 202명을 대상으로 구조화된 설문지를 이용하여 자료를 수집하였다. 연구결과 대상자의 치매케어 관련 지식은 11.02점, 치매에 대한 태도는 40.15점이었으며 치매간호 접근법은 7.90점이었다. 치매케어 관련 지식은 성별(t=-2.424, p<.05)과 교육수준(F=2.932, p<.05) 그리고 근무병동(F=2.268, p<.05)에서 통계적으로 유의한 차이가 있는 것으로 나타났다. 치매케어 관련 지식은 치매에 대한 태도와 유의한 양의 상관관계(r=.162, p<.05)가 있었으며, 치매케어 관련 지식에 영향을 미치는 변수는 응급실(${\beta}=-1.568$)과 중환자실(${\beta}=-1.682$)이었다. 본 연구결과 치매환자에게 질 높은 간호를 제공하기 위해서는 치매케어 지식의 향상과 치매에 대한 긍정적인 태도를 향상시키기 위한 융복합적인 교육프로그램의 개발이 필요하다.

• 지역사회간호학회지
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• 제32권3호
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• pp.356-367
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• 2021

Purpose: This study conducted an economic evaluation of hospital-based home care services for the patients who had undergone breast cancer surgery. Methods: A total of 12,483 patients over 18 years of age who had received breast cancer surgery in 26 tertiary hospitals in 2018 were analyzed with the claim data from the Health Insurance Review & Assessment Service using cost-minimization analysis and societal perspectives. Results: There were 156 patients who utilized hospital-based home care services within 30 days after breast cancer surgery, and they received 2.17 (SD=1.17) hospital-based home care service on average. The average total cost was 5,250,028 KRW (SD=1,905,428) for the group receiving continuous hospital-based home care and 6,113,402 KRW (SD=2,033,739) for the group not receiving continuous hospital-based home care (p<.001). The results of the economic evaluation of continuous hospital-based home care services in patients who had undergone breast cancer surgery indicated a total benefit of 953,691,000 KRW, a total cost of 819,004,000 KRW, and a benefit-cost ratio of 1.16 in 2018. Conclusion: Continuous hospital-based home care was considered economically feasible as the total costs for the group receiving continuous hospital-based home care were lower than those of the group not receiving continuous hospital-based home care. Therefore, policy modification and financial incentives are recommended to increase the utilization of hospital-based home care services for patients who had undergone breast cancer surgery.

• 한국사회정책
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• 제25권2호
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• pp.3-29
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• 2018

이 논문은 헌법에 투영된 규범적 관점에 견주어 돌봄을 살펴봄으로써, 정의의 입장에서 돌봄을 재고함과 동시에 우리의 삶과 가까운 불가분의 생활영역에서 다뤄지는 구체적인 정치적 가치로서 돌봄의 위상을 정립하고자 한다. 헌법에서 이 논문이 주목하는 지점은 '국민의 권리와 의무'를 규정하는 헌법 제2장의 시작인 제10조 제1문의 '인간으로서의 존엄과 가치' 및 '행복추구권' 조항이다. 헌법 제10조의 '인간으로서의 존엄과 가치' 및 '행복추구권' 조항은 헌법질서의 최고 가치로 해석된다. 이 논문은 돌봄의 관점에서 인간존엄 및 행복추구조항을 살펴보고, 헌법의 최고이념이자 구성원리인 인간존엄으로서 돌봄의 가치를 강조함과 동시에 행복추구권에 함축된 자유주의적 자유의 개념 틀로 돌볼 자유를 설명하는 것의 한계를 지적하고자 한다. 이를 통해 궁극적으로 돌봄을 헌법에 명시해야 함을 주장하고자 한다. 결론적으로 이 논문을 통해서 우리의 삶과 사회를 지탱하고 견인하는 가치이자, 국가운영의 주축이 되는 원리이자, 부정의를 시정하고 정의로운 국가의 제작방향을 알려주는 길잡이로서 돌봄의 의의를 재고할 수 있기를 기대한다.

• Journal of Korean Academy of Oral Health
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• 제42권4호
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• pp.167-174
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• 2018

Objectives: The aim of this study was to analyze the accessibility of dental care services among individuals with precarious employment in South Korea. Methods: We used the $9^{th}$ wave of the Korean Health Panel data (2015) and included 7,736 wage and non-wage earners in our study. We determined precariousness in the labor market as a combination of employment relationship and job income, and categorized individuals based on this into the following four groups: Group A comprising those who report job and income security, Group B comprising those who experience job insecurity alone, Group C comprising those who report a stable job but low income, and Group D comprising those who experience both job and income insecurity. Accessibility to dental care services was determined by experience of unmet dental care needs and unmet dental care needs caused primarily by financial burden. Logistic regression analyses were used to assess the effect of precarious work on access to dental care services. Results: Individuals with job insecurity (Group B; OR=1.445; 95% CI=1.22-1.70) and both job and income insecurity (Group D; OR=1.899; 95% CI=1.61-2.24) were more likely to have unmet needs than the comparison group. Both groups B and D were also 2.048 (95% CI=1.57-2.66) times and 4.435 (95% CI =3.46-5.68) times more likely, respectively, to have unmet dental care needs caused by financial burden. Education status, health insurance, and health status were all also effective factors influencing unmet dental care needs. Conclusions: Unstable employment and low income resulted in diminished access to dental care services. Therefore, governments should consider health policy solutions to reduce barriers preventing individuals with employment and income instability from accessing adequate dental care.

• 도시과학
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• 제8권1호
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• pp.51-58
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• 2019

본 연구의 목적은 노인들의 응급의료이용에 영향을 주는 요인들을 알아보고 의료접근의 형평성을 조사하는 데 있다. 2014년 한국의료패널조사 자료를 사용하여 기술분석과 로지스틱회귀분석이 행하여졌으며 인터뷰에 참여했던 1,313명의 노인들이 표본으로 선정되었다. 연령, 성별, 교육수준 등의 인구변수들이 응급의료이용의 중요한 결정요인이었다. 의료요구는 노인 계층 간 응급의료이용의 차이를 충분히 설명하지 못한 걸로 나타났으나 건강상태는 응급의료서비스를 사용하는 노인들의 중요한 결정요인이었다. 의료비지출은 응급의료서비스이용의 계층 간 차이를 개선하지 못했으나 응급의료이용의 중요한 예측요인으로 남았다. 한국에서 의료개혁은 의료요구를 가진 노인들이 효과적인 진료혜택을 받을 수 있도록 전국민 응급의료 보장을 확대하는 방향으로 계속 이루어져야 한다. 앞으로 연구도 75세 이상의 교령노인과 여성 및 교육수준이 낮은 노인, 그리고 높은 의료비 지출을 하는 노인과 같은 인구계층들에게 혹시 있으지 모르는 의료접근의 장애들을 허무는 방향으로 이루어질 필요가 있다.

• International Journal of Contents
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• 제14권1호
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• pp.7-11
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• 2018

Digital technology has been changing everyday life of ordinary people let alone the structure of world industry. The elderly care service is also going through changes influenced by the unavoidable impact from torrents of digital technologies. There are numerous reports and news about the digital technologies increasing the efficiency and effectiveness of care service yet lacking systematic understanding of the sources of such improvement. This study aims to present a new classification framework for digital elderly care service innovation to fully utilize the power of digital technologies drawing on insights from innovation studies and service studies. First, 4 features of digital technologies are identified as sources of new value in service innovation. The co-creation of value by users and producers in service and technology development is discussed to illuminate users' contributions to service innovation. Communication of needs and ideas with producers and application of new technologies into everyday practice of life are identified as the source of new value which can be attributed to the elderly. Customization along with efficiency gains is the key to digital elderly care service innovation. The classification framework, thus, incorporates the needs of the elderly as one axis of criteria in the conventional technology-centered framework. The new classification framework would help give due weight to user-driven or demand-driven innovation in the elderly care service R&D activities.

• 가정과삶의질연구
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• 제33권6호
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• pp.51-63
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• 2015

This study explored the effects of after-school services on whether they reduced the possibility of self-care of children. In terms of characteristics of the use of after-school services, it focused on the 1) types, 2) diversity, and 3) use patterns of the after-school services. For the analysis, it used data of the cohort of elementary-school children from the Korean Children and Youth Panel Survey. The main findings are as follows. First, private mentoring and after-school services provided by welfare centers reduced the possibility of self-care. Second, when the total amount of educational time was controlled, the diversity of participating after-school services did not explain the possibility of self-care. Third, when the total amount of educational time was controlled, the use patterns of after-school services did not explain the possibility of self-care. Based on these findings, it suggested policy implications and future research.