Journal of Preventive Medicine and Public Health
- 제21권2호
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- Pages.390-403
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- 1988
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- 1975-8375(pISSN)
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- 2233-4521(eISSN)
입원환자 질병유형의 구성에 의한 지역별 진료기능에 관한 연구
A Study on the Regional Function of Health Care by the Disease Pattern of the Inpatients
- 최현림 (서울대학교 의과대학 예방의학교실) ;
- 이상일 (서울대학교 의과대학 예방의학교실) ;
-
신영수
(서울대학교 의과대학 의료관리학교실) ;
- 김용익 (서울대학교 의과대학 의료관리학교실)
- Choi, Huyn-Rim (Department of Preventive Medicine, College of Medicine, Seoul National University) ;
- Lee, Sang-Il (Department of Preventive Medicine, College of Medicine, Seoul National University) ;
-
Shin, Young-Soo
(Department of Health Policy and Management, College of Medicine, Seoul National University) ;
- Kim, Yong-Ik (Department of Health Policy and Management, College of Medicine, Seoul National University)
- 발행 : 1988.11.01
초록
The objectives of the study were to provide the basic informations needed in the development of balanced medical services throughout the nation. As the national health care system was expanding rapidly along with the economic growth, quantitative re-evaluation of the system is of great need. For that reason, characteristics of the admitted patients were analyzed for the case-mix and patients' flow within and through regions. Materials were 421,530 cases of inpatients, who were reported through Korea Medical Insurance Corporation(KMIC) for insurance claim, during the period of March 1, 1985 through February 28, 1987. Korean Diagnosis Related Groups(K-DRGs) classification system was adopted for the study of case-mix and 189 cities and counties were classified into 5 district groups by factor analysis results of K-DRGS. The major findings of this study were as follows ; 1) Factor analysis of case-mix, employing K-DRG system, revealed 5 distinct funtional district groups. Group A(18 districts) was prominent for tertiary medical care. In group B(36 districts), rather simple procedures were prevalent. Group C(26 districts) was distinctive for the medical care of well organized internal medicine practices with qualified clinical laboratories. Group D(17 districts) was characterized by relatively high balanced medical care. Group E (92 districts) was with very low level of medical care. 2) Analysis of the case-flow through the districts showed 3 types of flow patterns : inflow, outflow, and balanced types. Inflow type of case-flow was found in Group A, C and D while Group B and E showed outflow type. Inflow was most prominent in Group A and Group E was of typical outflow type. Group B was consistently the outflow type except for Major Diagnostic Category XX regardless of the disease treaters, but Group C and D were inflow or outflow types according to the disease tracers.
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