• KDI Journal of Economic Policy
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• 제29권1호
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• pp.41-78
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• 2007

의료자원량의 지역 간 격차 해소는 오랫동안 정책과제로 지적되어 왔으며, 이에 따라 공공의료 확충계획과 병상수급관리 정책 등 지역 간 자원균점을 목표로 하는 정책방향이 수립되어 왔다. 그러나 정책방향으로서의 형평의 성격이나 측정기준이 무엇인지에 대한 구체적인 방향이 정립되어 있지는 않았기에, 정책방향에 대한 폭넓은 동의가 이루어지지 못해왔다. 본 연구는 의료기관들의 불균등분포가 초래하는 문제는 결국 진료를 위해 환자들이 이동해야 하는 불편함이라는 것에 착안하여, 우선 환자이동상황을 관찰한 후 이를 통해 병상수급관리에 대한 시사점을 도출하는 것을 목표로 한다. 또한 불편함을 초래하는 환자의 이동은 단일하고 동질적인 현상이 아니라 다양한 성격과 수준을 가진 현상이라는 점을 고려하였다. 먼저 이동기준에 관해서는 거주 행정구역을 벗어나거나, 인접지역을 포함한 지역을 벗어나거나, 생활권기준의 지역을 벗어나는 경우 등 세가지의 이동기준을 이용했고, 다양한 이동 수준을 반영한 다항로짓모형을 분석하였다. 결과적으로, 생활권을 기준으로 이동현황을 측정하는 경우에는 거주행정구역을 기준으로 한 경우보다 지역 간 불균등 정도가 크게 감소하였고, 이동기준과 이동수준에 따라 이동형태나 이동요인에도 차이가 나타났기에, 지역의 자원보유현황을 평가함에 있어 이동기준 설정과 이동의 원인과 폭을 파악하는 과정이 중요시되어야 한다는 점을 확인하였다.

• 한국BIM학회 논문집
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• 제11권3호
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• pp.75-90
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• 2021

A smart home system improves the elderly's quality of life by monitoring and analyzing their movements and health conditions with better health-care and social support services. Therefore, there has been an effort to adopt a smart home system for the independently living elderly. However, to the best of our knowledge, no study has investigated the usability of a smart home system on actual independently living elderly housing in long-term settings. Thus, this study aims to demonstrate the usability of a smart home system on independently living elders in living lab conditions. The BLE smart band and the BLE receiver were chosen for the smart home system to monitor the movement of the participants in their homes as well as to monitor the heart rates, step counts, sleep index. Nine independent living elderly from the senior welfare center in Kimjae participated in this living lab demonstration experiment for ten months. This demonstration experiment confirmed the effectiveness of low-cost and easily adoptable IoT-based BLE sensor sets on independent living elders and discussed the troubles and limitations of the experiment. By grasping the pros and cons of IoT-based BLE sensor sets, this study seeks to improve the accessibility and usability of smart home systems for the elderly population in independent living arrangements.

• 대한간호학회지
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• 제16권2호
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• pp.44-52
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• 1986

Maternal and child health(MCH) status is considered as an important indicator of the level of health and civilization of a community and a country. MCH services for the rural population in the remote ar deserves priority by the government, since more than half(52.9%) of the delivery was occured at home and almost half (45.5%) of the delivery was assited by family members or neighbors. The purpose of the study was to analyse the health fare behavior related to pregnancy and delivery, which can be contributed maternal health care policy mating for the rural people. Specifically, it was intended to analyze the variables which affect the health care behavior in selecting birth places and birth attendants. This study utilized the data which had been already collected for an experimental study on primary health program model in Korean rural communities, funded by the USAID. 184 sample households with women who had delivered a baby during March 1982 to February 1983 were selected. Discriminant Analysis was employed for statistical analysis by utilizing SPSS computer package program. Birth places and birth attendants were considered as dependent variables. Among 12 independent variables in 5 groups considered, 7 independent variables were found statistically significant to affect the selection of birth place. Significant variables by the order of importance are mother's age, order of baby, number of prenatal care, accessibility of emergency medical care, coverage of medical insurance, mother's membership in community organization and husband's educational level. The degree of correct classification of the grouped cases by employing a discriminant . analysis was significantly improved to 78.2％ in comparison to Cmax（56%) and Cpro(51%). Policy implications for each significant variable were discussed to improve the maternal and child health. in Korean ruralarea.

• 대한지리학회지
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• 제44권6호
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• pp.813-832
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• 2009

농촌지역의 과소화에 따라 의료서비스에 대한 공간적 접근성이 제한되고, 노령화에 따른 의료서비스의 수요가 급격히 증가함에 따라, 최근 방문보건서비스와 같은 서비스 제공자가 수요자에게 직접 이동하는 새로운 형태의 의료서비스가 많은 주목을 받고 있다. 이러한 의료환경의 변화는 공공 의료기관의 한정된 의료자원을 효율적으로 배분하고 운영하기 위한 혁신적이고 과학적인 접근법개발에 대한 요구를 증대시키고 있다. 이러한 배경하에서 본 연구의 목적은 방문 의료서비스 제공을 위한 구역 설정 모델을 수립하고, GIS 환경에서 구역 설정 모델을 구현하는 자동구획절차(AZP) 알고리즘을 개발하는 것이다. 구역 설정 모델은 구역 내 이동성, 구역간 업무량 균형, 연속성 등의 조건을 고려한다. 이동성에 대한 세 개의 서로 다른 목적함수를 평가한다; 1) 구역 내 단위 지역간 네트워크 거리의 합 최소화, 2) 구역 내 단위 지역간 공간상호작용 최대화, 3) 구역 내 단위 지역을 순회하는 경로의 길이 최소화. 모델을 위한 AZP는 GIS 환경에서 개발되었고, 농촌의 방문보건 사례에 적용되었다. 결과는 개발된 AZP를 업무량 균형과 연속성 제약조건하에서 각 목적함수에 대하여 상이한 구획체계를 산출할 수 있음을 보여준다.

• 디지털융복합연구
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• 제16권10호
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• pp.59-67
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• 2018

고령자들에 국한된 M-Health 관련 서비스는 많지 않다. 치매발병 위험성이 있는 고령자의 다수가 스마트 기기에 익숙하지 않은 것이 현실이므로 직관적으로 사용하기 쉽고 터치버튼의 크기를 최대화한 사용자 맞춤형 앱설계가 요구된다. 따라서 본 연구에서는 고령자들의 접근성을 높이고자 음성입력이 가능한 모바일 음성알리미 통합앱을 설계, 구현하여 치매 등 인지기능 저하에 따른 질병을 예방하고자 한다. 경북 H지역의 평생교육원 수강생들에게 앱을 배포 후 개별 인터뷰와 설문검사를 실시 후 분석한 결과 만족도가 높게 나타났다. 음성 헬스케어 알리미 앱을 통해 치매예방을 할 수 있어서 고령자들의 M-Health 서비스를 위한 핵심적인 역할을 수행할 수 있을 것으로 기대된다. 향후 웹 DB에 저장된 자료를 딥러닝을 통해 학습하여 고령자들의 생활패턴과 치매가능성 여부를 예측하고자 한다.

• 대한장애인치과학회지
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• 제10권1호
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• pp.9-21
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• 2014

This study aims to help utilize the dental treatment institutions for the disabled and provide high quality of medical services in the future by identifying the satisfaction factors for the patients of the dental clinics for the disabled. As a study method, surveys were completed 200 patients who visited the dental hospital for the disabled. Among these, the surveys from 187 patients were statistically analyzed. The main findings of this study are as follow. Since the study showed that there were differences in the satisfaction factors between the disabled and non-disabled people, subsequent studies needs to be done to develop measuring tools to accurately accommodate the satisfaction factors of the disabled. In addition, as the low spatial accessibility in terms of distance and location was found in this study, more dental treatment institutions for the disabled are required. In the meantime, the survey results found that the most satisfactory aspect was the lower treatment cost compared to other clinics, and that the most important factor when choosing a clinic was also treatment. In addition, given the fact that the group that took a prosthetic treatment, which was non-insured treatment, showed higher satisfaction compared to the group that did not, it suggests that the economic burden plays an important role for the dental treatment of the disabled.

• 여성건강간호학회지
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• 제26권1호
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• pp.93-103
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• 2020

Purpose: This study was conducted to identify unmet healthcare needs among man and woman one-person households and to explore related factors by gender. Methods: Data were drawn from the 2017 Korea National Health and Nutrition Examination Survey. The final sample consisted of 820 one-person households. The statistical analysis, conducted in SPSS version 20.1, included complex sampling analysis; descriptive statistics, the chi-square test, and logistic regression. Results: The demographic and socioeconomic characteristics of women in one-person households were significantly different from those of men in one-person households. Women in single-person households were mainly in their 70s or older and married, and they tended to have a low education level, low income, and no formal occupation. Unmet healthcare needs were experienced by 17.3% of women in one-person households and 13.5% of men in one-person households, which was not a statistically significant difference (χ²=2.17, p=.139). Factors related to unmet healthcare needs were subjective health status and unmet dental care needs in single-person-household men. By contrast, having experienced impairment within the past year, stress, and unmet dental care needs were factors related to unmet healthcare needs in single-person-household women. Conclusion: As one-person households become increasingly common, more attention needs to be paid to them and our understanding of them needs to be improved. Women in one-person households, in particular, are especially vulnerable, as they experience more unmet healthcare needs.

• Journal of Preventive Medicine and Public Health
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• 제49권5호
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• pp.308-322
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• 2016

Objectives: The objective of this study is to investigate associations between contextual characteristics and unmet healthcare needs in South Korea after accounting for individual factors. Methods: The present study used data from the 2012 Korean Community Health Survey (KCHS) of 228 902 adults residing within 253 municipal districts in South Korea. A multilevel analysis was conducted to investigate how contextual characteristics, defined by variables that describe the regional deprivation, degree of urbanity, and healthcare supply, are associated with unmet needs after controlling for individual-level variables. Results: Of the surveyed Korean adults, 12.1% reported experiencing unmet healthcare needs in the past. This figure varied with the 253 districts surveyed, ranging from 2.6% to 26.2%. A multilevel analysis found that the association between contextual characteristics and unmet needs varied according to the factors that caused the unmet needs. The degree of urbanity was associated with unmet need due to "financial burden" (odds ratio [OR], 0.53; 95% confidence interval [CI], 0.42 to 0.66 for rural vs. metropolitan), but not unmet need due to "service not available when needed." There were no significant associations between these unmet need measures and regional deprivation. Among individual-level variables, income level showed the highest association with unmet need due to "financial burden" (OR, 5.63; 95% CI, 4.76 to 6.66), while employment status showed a strong association with unmet need due to "service not available when needed." Conclusions: Our finding suggests that different policy interventions should be considered for each at-risk population group to address the root cause of unmet healthcare needs.

• Asian Pacific Journal of Cancer Prevention
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• 제16권3호
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• pp.1259-1275
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• 2015

Background: This study reviewed the published evidence as to how prostate cancer outcomes vary across geographical remoteness and area level disadvantage. Materials and Methods: A review of the literature published from January 1998 to January 2014 was undertaken: Medline and CINAHL databases were searched in February to May 2014. The search terms included terms of 'Prostate cancer' and 'prostatic neoplasms' coupled with 'rural health', 'urban health', 'geographic inequalities', 'spatial', 'socioeconomic', 'disadvantage', 'health literacy' or 'health service accessibility'. Outcome specific terms were 'incidence', 'mortality', 'prevalence', 'survival', 'disease progression', 'PSA testing' or 'PSA screening', 'treatment', 'treatment complications' and 'recurrence'. A further search through internet search engines was conducted to identify any additional relevant published reports. Results: 91 papers were included in the review. While patterns were sometimes contrasting, the predominate patterns were for PSA testing to be more common in urban (5 studies out of 6) and affluent areas (2 of 2), higher prostate cancer incidence in urban (12 of 22) and affluent (18 of 20), greater risk of advanced stage prostate cancer in rural (7 of 11) and disadvantaged (8 of 9), higher survival in urban (8 of 13) and affluent (16 of 18), greater access or use of definitive treatment services in urban (6 of 9) and affluent (7 of 7), and higher prostate mortality in rural (10 of 20) and disadvantaged (8 of 16) areas. Conclusions: Future studies may need to utilise a mixed methods approach, in which the quantifiable attributes of the individuals living within areas are measured along with the characteristics of the areas themselves, but importantly include a qualitative examination of the lived experience of people within those areas. These studies should be conducted across a range of international countries using consistent measures and incorporate dialogue between clinicians, epidemiologists, policy advocates and disease control specialists.

• 한국병원경영학회지
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• 제23권4호
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• pp.1-14
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• 2018

Purpose : Customers with loyalty are very important to hospitals for sustainable growth in their medical market. Individuals with loyalty are likely to visit same hospital repeatedly when they need medical services. This study was to identify factors associated with selection of specialty hospitals among customers with loyalty. Methods : The subjects of this study were 735 inpatients in 22 specialty hospitals in 6 designated fields(joints, spine, colorectal-anal, obstetrics and gynecology, ophthalmology, otolaryngology). Customer types classified as customers with high loyalty, neutral customers, and customers with low loyalty according to net promoter score(NPS). Factor analysis was conducted to classify 22 hospital selection factors into some similar properties. Logistic regression analysis was conducted to confirm the selection factors related to loyal customers. Findings : Most of specialty hospitals received high NPS of 8 points or higher in all the designated fields. Five factors associated with selection of specialty hospital are (1) hospital facilities and convenience, (2) trust in doctor and hospital, (3) rapidness of treatment, (4) hospital awareness, and (5) accessibility. As a result of logistic regression analysis, selection factors related to loyal customers were 'hospital facilities and convenience', 'trust in doctor and hospital' and 'rapidness of treatment'. Differences in the degree of importance of three selection factors by customer types appeared for each designated field. Practical Implications : This study confirms the high level of patient experience among inpatients of specialty hospitals. Factors associated with selection of hospital among inpatients with loyalty are 'facilities and convenience of hospitals', 'trust of doctor and hospital' and 'rapidness of treatment'. This study will be meaningful as basic data to systematically enhance the roles and functions of the health care system and to provide securing competitiveness according to designated fields in the management aspect of specialty hospitals.