노인의 사망 전 1년간 의료이용 수준과 추이분석

Medical Service Utilization and Trends among Korean Elderly in the Last One Year of Life

  • 이지전 (연세대학교 보건대학원) ;
  • 박기순 (국민건강보험공단) ;
  • 유승흠 (연세대학교 보건대학원) ;
  • 김정인 (연세대학교 보건대학원) ;
  • 박재용 (경북대학교 보건대학원) ;
  • 유왕근 (대구한의대학교 보건대학원) ;
  • 이상욱 (관동대학교 의과대학 예방의학교실)
  • Yi, Jee-Jeon (Graduate School of Public Health, Yonsei University) ;
  • Park, Ki-Soon (National Health Insurance Cooperation) ;
  • Yu, Seung-Hum (Graduate School of Public Health, Yonsei University) ;
  • Kim, Jeoug-In (Graduate School of Public Health, Yonsei University) ;
  • Park, Jae-Yong (Graduate School of Public Health, Kyungpook National University) ;
  • Yoo, Wang-Kun (Graduate School of Public Health, Daegu Haany University) ;
  • Yi, Sang-Wook (Department of Preventive Medicine and Public Health, Kwandong University College of Medicine)
  • 발행 : 2003.12.01

초록

Objectives : To analyze medical service utilization and trends among the elderly in the last year of life. Method : The subjects of this study were People that had died at the age sixty-five and above between January $1^{st}$ and June $30^{th}$ 2000 The names of the deceased and their dates of death were collected from the data of the funeral-expenses-receivers of the National Health Insurance Corporation (NHIC). This data was merged with that of the individual medical expenses of the NHIC. Results : In the first half of 2000, 84.2% of the funeral-expenses-receivers (53,063) utilized medical services during the year prior to their death; 51.0% (27,042) were female and 49.0% (26,021) male. In the last twelve months of life, the medical fees, the number of days receiving medical services and the number of days receiving medicine were 3,107,935 Won, 47.88 and 153.21, respectively, for each person. As the age of the groups increased, the level of medical service utilization decreased; the change was more obvious in female group. The level of medical service utilization during the twelve months prior to death drastically increased around the time of death. Conclusions : This study, from an analysis of the level of medical service utilization prior to death, shows a concentrated volume of medical services during a certain time period prior to death.

키워드

참고문헌

  1. Scitovsky AA. The High Cost of Dying: What Do the Show?Milbank Mem Fund Q Health Soc 1984; 62(4): 591-608
  2. Lubitz JD, Riley GF. Trends in Medicare Payments in the Last Year of Life. New Engl J Med 1993; 328(15): 1092-1096 https://doi.org/10.1056/NEJM199304153281506
  3. Emanuel EJ. Cost Savings at the End of Life, What Do the Data Show? JAMA 1996; 275(24): 1907-14
  4. Yu W, Ash AS, Levinsky NG, Moskowitz MA.J GenInternMed2000;15(2):97-102
  5. Lubitz J, Prihoda R. The use and costs of Medicare services in the last 2 years of life. Health Care Finane Rev 1984; 5(3) :117-131
  6. McCall N. Utilization and costs of medicare services by beneficiary in their last year of life.Med Care1984; 22:329-342 https://doi.org/10.1097/00005650-198404000-00004
  7. Gaumer GL, Stavins J.Medicare Use in the Last Ninety Days of Life. Health Serv Res 1992; 26(6): 725-742
  8. Sutton GF. Hospitalization in the last year of life. United States - 1961 Vital and Health Statistics, series 22, no. 1, September. Hyattsville, Md : U.S. Department of Health,Eudcation, and Welfare, 1965
  9. Timmer EJ, Kovar MG. Expenses for hospital and institutional care during the last year of life for adult who died in 1964-1965 - Vital and Health Statistics, series22, no 11, March. Hyattsville, Md: U.S. Department of Health, Education, and Welfare, 1971
  10. 박노례. 암 환자의 사망전 l 년간 의료이용행태 및 진료비 변동양상 인제대학교 대학원 보건학과 박사학위 논문, 2000
  11. 김정인. 노인의 사망전 1년의 의료이용수준에 관한 연구-뇌혈관질환을 중심으로 연세 대학교 대학원 보건학과 석사학위 논문,2001
  12. 이상욱, 이지전, 박종연. 종말기 노인환자의 보건의료 비용과 삶의 질. 관동대예방의학교실. 2002
  13. 이지전. 노인의 의료전탈 체계의 현실 및 미래의 효율적인 의료체계 모형. 대한노인병학 회 추계학술대회 주제강연 . 2002
  14. Brockmann H. Why is less money spenton health care for the elderly than for the rest of the population? Health care rationing in German hospitals. Soc Sci Med 2002; 55: 593-608 https://doi.org/10.1016/S0277-9536(01)00190-3