DOI QR코드

DOI QR Code

A Comparative Study on the Satisfaction of Korean and Canadian Primary Care Based on the Survey of Overseas Korean in Canada

캐나다 재외국민 설문조사에 기초한 한국과 캐나다 1차 의료기관 만족도 비교 연구

  • O, Dongil (Department of Global Finance and Management, SangMyung University)
  • 오동일 (상명대학교 글로벌금융경영학과)
  • Received : 2020.01.02
  • Accepted : 2020.05.08
  • Published : 2020.05.31

Abstract

This study compares and analyzes satisfaction with Korean and Canadian primary medical care based on a survey of Koreans living in Canada. Based on data collected from Koreans who live in Canada, a paired sample t-test, analysis of variance (ANOVA), and GLM were used. The main conclusions of this study are as follows. First, overall satisfaction with Korean primary care was high. Second, the results of the analysis were stable, regardless of gender, age, education, and residential area. Third, overall satisfaction with Korean medical care was higher than for medical care in Canada. Fourth, satisfaction was high in terms of treatment skill and technology, and promptness in appointments, but was low in terms of medical expense. Fifth, there was a high level of confidence in physician skills and practices, but there was no significant difference in terms of sufficient counseling and explanations. Finally, the survey found that the tendency to increase medical treatment volume in order to increase a physician's own income was large. As a result of detailed analysis, it was concluded that Korea's primary care is more competitive than in Canada, but the primary medical doctors' patient interview and explanation obligations, and incentives to control income and medical expenses, need to be improved.

본 연구에서는 캐나다에 거주하는 재외국민을 대상으로 한국과 캐나다에서의 1차 의료기관 이용 경험을 토대로 한국과 캐나다 의료기관 만족도를 비교·분석하기 위한 목적으로 수행되었다. 설문조사를 기초로 대응표본 T 검정, ANOVA분석, 일반선형분석모형을 이용해 자료를 분석하였다. 본 연구의 주요 분석 결과는 다음과 같다. 첫째, 한국의료에 대한 종합적인 만족도는 캐나다 보다 높았다. 둘째, 한국의료만족도는 성, 연령, 교육수준, 거주 지역에 무관하게 안정적이었다. 셋째, 한국의료에 대한 항목별 만족도가 캐나다의료에 대한 만족도 보다 높았다. 넷째, 특히 치료기술 및 수준, 진료예약 신속성 등에서 만족도가 높았으나 진료비용 측면에서는 만족도가 낮았다. 다섯째, 의사기술 및 실력에 대한 신뢰는 높았으나 충분한 상담 및 설명 측면에서는 유의한 차이가 없었다. 여섯째, 한국의사는 캐나다 의사에 비해 진료수입을 늘리기 위해 진료회수를 늘리는 경향이 있다고 인식하고 있었다. 세부적인 분석결과 우리나라 1차 의료가 캐나다에 비해 충분히 경쟁력을 가지고 있으나 1차 의료 의사의 환자면담 및 설명의무, 수입조절을 위한 유인행위, 진료비용 등은 개선될 필요가 있다는 결론에 도달하였다.

Keywords

References

  1. Lee JH, Choi YJ, Volk RJ, Kim SY, Kim YS, Park HK, Jeon TH, Hong SK, Spann SJ. "Defining the concept of primary care in South Korea using a delphi method", Inter Fam Med Vol.39, pp.425-431, 2007. DOI: http://doi.org/10.4332/KJHPA.2014.24.1.100
  2. Starfield B, "The future of primary care: refocusing the system", N Engl J Med. Vol.359, No.20, pp.2087-2091, 2008. DOI: http://doi.org/10.1056/NEJMp0805763
  3. Danica R. Pavlic, Maja Sever, Zalika Klemenc-Ketis, Igor Svab, "Strength of primary care service delivery: a comparative study of European countries, Australia, New Zealand, and Canada", Primary Health Care Research & Development Vol.19, Issue 3, pp.277-287, 2018. DOI: https://doi.org/10.1017/S1463423617000792
  4. Ji, Eun Hee, Kang, Sung Hong and Kim, Yoo Mi, "Healthcare Optimization of Customer Satisfaction Evaluation for Outpatient", Health and Social Welfare Review Vol. 37(1), pp.463-494, 2017. DOI: http://doi.org/10.15709/hswr.2017.37.1.463
  5. Berry LL, Seiders K, Wilder SS. Innovations in access to care: a patient-centered approach, Annals of Internal Medicine, Vol.139(7), pp.568-74, 2003. DOI: http://doi.org/10.7326/0003-4819-139-7-2003
  6. Boquiren VM, Hack TF, Beaver K et al. "What do measures of patient satisfaction with the doctor tell us?", Patient Educ Couns., Vol.98, pp.1465-73, 2015. DOI: http://dx.doi.org/10.1016/j.pec.2015.05.020
  7. Kyu Sik Lee, "Ideology of Social Health Insurance and Health Policy", Health Policy and Management, V.28, No.3, pp.202-209, 2018. DOI: http://doi.org/10.4332/KJHPA.2018.28.3.202
  8. Wang MC, Mosen D, Shuster E et al. "Association of patient-reported care coordination with patient satisfaction", J Ambul Care Manage, Vol.38, pp.69-76, 2015. https://doi.org/10.1097/JAC.0000000000000021
  9. Hye Ran Paik, Kwang Jum Kim, How to Improve Patients' "Satisfaction in Healthcare Organization-Healthcare Service Quality Classification using Kano Model", Journal of Korea Hospital management, Vol.19(2), pp.72-87, 2014.
  10. Anna Maria Murante, Chiara Seghieri, Milena Vainieri, Willemijn L.A.Schafer, "Patient-perceived responsiveness of primary care systems across Europe and the relationship with the health expenditure and remuneration systems of primary care doctors", Social Science & Medicine Vol.186, pp.139-147, August 2017 DOI: https://doi.org/10.1016/j.socscimed.2017.06.005
  11. Kringos DS, Boerma WGW, Hutchinson A, Saltman RB (ed), Building primary care in a changing Europe, WHO, 2015.
  12. Dionne Kringos, Wienke Boerma, Toni Dedeuetc., "The strength of primary care in Europe: an international comparative study", British Journal of General Practice Vol. 63, pp.742-750, 2013. DOI: https://doi.org/10.3399/bjgp13X674422
  13. Silvana Robone, Nigel Rice, and Peter C Smith, "Health Systems' Responsiveness and Its Characteristics: A Cross-Country Comparative Analysis", Health Serv Res. Vol.46(6 Pt 2): pp.2079-2100, 2011. DOI: http://doi.org/10.1111/j.1475-6773.2011.01291.x
  14. G. Anderson, P.S. Hussey, "Comparing health system performance in OECD countries", Health Aff., 20 (3) (2001), pp. 219-232, 2019. DOI: http://doi.org/10.1377/hlthaff.20.3.219
  15. Ridic, Goran et al. "Comparisons of health care systems in the United States, Germany and Canada." Materia socio-medica Vol.24, No.2 pp.112-20, 2012. DOI: http://doi.org/10.5455/msm.2012.24.112-120.
  16. Blewett LA, Johnson PJ, Lee B, Scal PB. "When a usual source of care and usual provider matter: adult prevention and screening services", J Gen Intern Med 2008; 23: 1354-60. DOI: http://doi.org/10.1007/s11606-008-0659-0
  17. Chung Kang, Jae-Ho Lee, Dae-Kyun Kim, Clara Lee, Jee-Hye Oh, "Current Status of Having a Usual Source of Care and Its Associated Factors in Korean Adults with Hypertension", Korean J Fam Pract. Vol.8, No.4, pp.607-615, 2018. DOI: https://doi.org/10.21215/kjfp.2018.8.4.607
  18. Lee J. H., Lim H. S., Sung N. J., Kim S. L, Kim K.U., "Effect of a Usual source of care on hospital admission", presentation paper, 11th Korea medical panel conference, pp.141-157, 2019.
  19. Youngho Oh, "Establishment of Healthcare Delivery System through Improvement of Health Insurance System", Health Policy and Management, Vol.29, No.3, pp. 248-261, 2019. DOI: http://doi.org/10.4332/KJHPA.2019.29.3.248.
  20. Kutzin J. "Health financing for universal coverage and health system performance: concepts and implications for policy", Bull World Health Organ, Vol.91, No.8, pp.602-611, 2013. DOI: http://doi.org/10.2471/BLT.12.113985.
  21. Donabedian A. "The quality of care. How can it be assessed?", JAMA, Vol.260, No.1, pp.1743-1748,1988. DOI: http://doi.org/10.1001/jama.260.12.1743
  22. Rima Kavalniene, Ausra Deksnyte, and Lukas Aranauskas, "Patient satisfaction with primary healthcare services: are there any links with patients' symptoms of anxiety and depression?", MC Family Practice, Vol.19, No.90, 1-9, 2018. DOI: https://doi.org/10.1186/s12875-018-0780-z
  23. Crow R, Gage H, Hampson S, Hart J, Kimber A, Storey L, Thomas H. "The measurement of satisfaction with healthcare: implications for practice from a systematic review of the literature", Health Technol. Assess, Vol.6, No.32, pp.1-244, 2002. DOI: https://doi.org/10.3310/hta6320
  24. Van Uden CJ, Ament AJ, Hobma SO, Zwietering PJ, Crebolder HF. "Patient satisfaction with out-of-hours primary care in the Netherlands", BMC Health Serv Res. Vol.5, 2005. DOI: https://doi.org/10.1186/1472-6963-5-6
  25. Yoon HJ, Choi JW, Lee SA, Park EC., "Influence of usual source of care on outpatients visit and expense of hypertension patient". Korean Journal of Hospital Management Vol.22, pp.1-9, 2017 DOI: https://doi.org/10.21215/kjfp.2018.8.4.607
  26. Dongil O, "Policy for establishing Korea healthcare delivery system to boost patients satisfaction and Korean primary healthcare", Vol.18, No.1, pp. 175-196, 2016. DOI: http://doi.org/10.5762/KAIS.2016.17.4.340
  27. Kim, Keum Soon, Ahn Jung Won, Kim Jin A, Kim Hee Jung, "A Comparison Study using Mixed Methods on Foreign Residents' Satisfaction with Korean Health Care Services", J Korean Acad Nurs Vol.44 No.1, pp.86-96, 2014, DOI: http://doi.org/10.4040/jkan.2014.44.1.86.
  28. NHIS and KIHASA, 11th Conference on Korea Healthcare Panel Study, 2019.
  29. Lee J. H., Byung-Su Ko, Jong-Han Leem, and Sang-Il Lee, "Standard model and quality appraisal framework for the organization of primary care", J Korean Med Assoc., Vol.56, No.10, pp.866-880, 2013. DOI: https://doi.org/10.5124/jkma.2013.56.10.866
  30. Marcinowicz L, Chlabicz S, Grebowski R. "Understanding patient satisfaction with family doctor ", J Eval Clin Pract, Vol.16, pp.712-15, 2010. DOI: https://doi.org/10.1111/j.1365-2753.2009.01180.x.
  31. Kim Yun, Quality Assurance in Health Care, SNU Health Policy Management, 2019. http://www.snu-dhpm.ac.kr/pds/files.