• 한국사회복지학
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• 제37권
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• pp.307-326
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• 1999

본 연구에서는 지난 1995년 실시된 도시지역의료보험조합과 농어촌지역의료보험의 통합 이후 나타난 조합재정 및 피보험자들의 의료서비스 이용강도에 있어서의 변화를 분석함으로써 지난 1998년 10월 실시된 지역의료보험과 공무원 교직원의료보험의 통합과, 더 나아가서는 오는 2000년 시행 예정에 있는 전체 의료보험통합으로 인해 나타날 수 있는 변화를 예측하는데 필요한 기초자료를 제공하고자 시도했다. 분석결과, 1995년 실시된 통합이 조합의 총지출 증가율 및 보험급여비 증가율에 변화를 가져왔다고 볼만한 결과는 발견할 수는 없었다. 또한 입원 및 외래진료 수진률과 건당진료비로 정의되는 의료서비스 이용강도에 있어서도 통합에서 비롯된 것이라 볼 수 있을 만한 뚜렷한 변화는 나타나지 않았다. 반면, 1995년의 통합이 조합의 평균관리운영비 증가율을 감소시키는 결과를 가져왔음을 발견할 수 있었다. 이러한 연구 결과가 갖는 정책적 함의에 대한 논의와 함께 앞으로의 의료보험통합을 위한 몇 가지 제언을 시도하였다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권14호
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• pp.5869-5873
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• 2015

Background: Breast and cervical cancers are among the most frequent and most fatal cancers in women. Life span of patients may be increased and quality of life improved through early diagnosis and treatment. This investigation was performed in order to determine knowledge and practices of female health personnel working at a university hospital regarding breast and cervical cancers. Materials and Methods: This descriptive investigation was performed in Erciyes University Hospitals in 2014. A total of 524 female health personnel were included in the study. Data were collected through a questionnaire of 36 questions prepared by the researchers. The Chi square test and logistic regression were used for statistical analyses. Results: The mean age of the study group was $32.8{\pm}6.9$ years, 18.3% being doctors and 81.7% nurses. Of the study group, 60.5% stated that they performed self breast-examination, 4.4% underwent HPV testing, 26.3% thought about taking an HPV test, 34.7% of those who are 40 years and over had mammography regularly and 19.5% of those who were married had a Pap smear conducted regularly. Most important causes of not performing the methods for early diagnosis of breast and cervical cancers are "forget and neglect". Conclusions: It was concluded that female doctors and nurses do not pay sufficient attention to screening programs for breast and cervical cancers. The importance of early diagnosis and treatment should be emphasized during the undergraduate education and in-service training programs. Health condition of personnel and their utilization of preventive health care should be followed by occupational physicians.

• 한국의료질향상학회지
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• 제24권2호
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• pp.62-75
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• 2018

Purpose: The objective of this study was to publicly report the hospital-level surgical volume for 7 types of surgery including gastrectomy. Also, to investigate the changes in patient behaviors after the public reporting among patients with gastrectomy. Methods: This study used data from the National Health Insurance Service Cohort. The data comprised of 2,214 patients who were diagnosed with gastric cancer and underwent gastrectomy during 2004-2012. An interrupted time series analysis was performed to investigate the association between patients' choice and public reporting. Results: 79.27% of the patients visited a hospital with high surgical volume. The time trend after introduction of public reporting was positively associated with visiting a high volume hospital (per 1 month, RR: 1.004, p=0.0329). However, after adjusting the health policies by reducing copayment, public reporting on surgical volume was not associated with visiting a high volume hospital. Sub-group analyses had also similar results. Conclusion: Patients were more affected by policies on economic support than on public reporting, and the changes in treatment options may have been affected by the increasing preference for large size hospitals. Thus, public reporting did not significantly improve the options available for patients and their decision making on health care utilization.

• 보건행정학회지
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• 제3권1호
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• pp.53-83
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• 1993

A small number of high cost patients usually spend a larger proportion of scarce health resources. Korea is no exception. Under the national health insurance, 12% of the insured persons have consumed approximately half of the national health insurance expenditures. Therefore, it is necessary to identify the characteristics of the high cost patient group, if we would like to reduce them. This study has defined high cost patients as those who have spent one and half million won and over per 6 months. The study reveals that high cost users are those who have a longer length of stays(LOS), 40days of LOS in the 6 months, have multiple admissions, 2 to 3 admissions per 6 months and are the elderly patients. They have spent 814.126won per on the average, and commonly suffered from malignant neoplasms, circulatory diseases, fracture, diabetes mellitus, etc. Unlike the case of western developed countries, early readmissions are not the major causes of high cost spending in Korea. Undoubtedly, a lengthy admission is the main cause of large spending. Health policies should vigorously be explored to respond appropriately. There are evidences that hospital beds are often misused. As the Korean health care system is lacking in a mechanism of patient evaluation under the fee-for-service remuneration system, an idea of progressive patient care needs to be tested. The Goverment should set up health policy to diversify the role of long-term care facilities and encourage people to establish them. Further studies are needed to identify factors influencing large medical bills necessary for formulating the health policy on cost containment.

• 대한영양사협회학술지
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• 제26권2호
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• pp.101-115
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• 2020

The purpose of this study was to increase the utilization of traditional snacks in the Daejeon, Chungnam and Sejong regions by investigating the awareness of traditional snacks by parents and teachers of Children's foodservice facilities. The survey method was a self-monitored survey, and 576 people (298 parents, 278 teachers) were used for statistical analyses. 66.4% of parents believed that the snacks provided at facilities are nutritious, and that traditional snacks are rich in nutrition but difficult to cook (66.1%). Further, 77% of parents preferred traditional snacks, and 92% thought that traditional snacks should be passed on to future generations and continuously developed. Increasing the number of stores selling traditional snacks (41%) and a generalized awareness of traditional snacks (34%) are needed to expand the use consumption of traditional snacks. For teachers of Children's foodservice facilities, 92.8% said that the number of snacks provided per day was twice, and snacks were made and served more than twice a week (77.7%). The reasons for not making these traditional snacksit more often were the long cooking time (47.1%) and lack of labor (20.5%). There were no differences in the perceptions of traditional snacks among the types of children's foodservice facilities, but the private and public facilities showed a higher usage demand than the family type foodservice facilities for of traditional snack-focused food education programs. In order to increase the utilization of traditional snacks, it is necessary to create programs according to the facility types and to develop traditional snacks to meet the needs of consumers. The results of this study are expected to be used as basic data for the development of instructions and programs for increasing the consumption of traditional snacks at children's foodservice facilities.

• 한국가정과교육학회지
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• 제20권3호
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• pp.17-30
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• 2008

본 연구는 학교급식 영양사들의 한국의 전통음식과 절식에 대한 인식을 파악하여 전통음식과 절식을 학교급식에 적극적으로 활용하기 위한 기초자료를 제공하고자 하였다. 조사 대상자는 전남지역 초등학교 영양사 239명이었고, 수집된 자료는 SAS program을 이용하여 빈도, 백분율, 평균, 표준편차를 산출하였다. 주요 연구 결과는 다음과 같다. 전통음식과 절식에 대한 선호도는 영양사의 경력이 많을수록 높았다. 학생들에게 실시하는 전통음식과 절식에 대한 교육은 매월 또는 6개월마다 실시하였고, 교육방법은 학교 홈페이지 활용, 학교급식 게시판을 활용하였으며, 교육 장소는 학교와 가정에서 우선되어져야 한다고 하였다. 영양사의 대부분이 전통음식과 절식을 학교급식에 활용하여 계승발전 시켜야 한다고 긍정적인 반응을 보였으며, 전통음식과 절식의 전통을 계승발전 시켜야 하는 이유는 "우리의 미풍양속이므로'에서만 학교급식 유형에 따라 유의한 차이를 나타내었다.

• 농촌계획
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• 제29권1호
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• pp.29-35
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• 2023

Although Due to industrial development and urbanization, the number of schools closing due to a decrease in the school-age population is increasing due to the phenomenon of relocation from farming and fishing villages. Closing schools are used as social and cultural facilities, or they are used to generate income by providing education and experiences. Agro-healing is an activity that promotes psychological, social, and physical health by using rural resources. By reflecting the Agro-healing in the services operated by the closed school, the perception of the provision of the Agro-healing service was investigated as a way to provide a therapeutic service to visitors and to increase the utilization of the closed school. The questionnaire consisted of 10 questions, a total of 5 questions related to demographic information, a total of 5 questions related to the perception of agro-healing activities in closed school facilities. As a result, 347 people participated in the survey. The higher the awareness of agro-healing, the need for a agro-healing expert, the satisfaction with the use of rural closed school facilities, and the willingness to participate in agro-healing activities, the higher the awareness that the provision of agro-healing services was necessary by the state. Theses results are expected to be useful as basic to data to solve the diverse limitation in rural closed school and agro-healing activities.

• 한방재활의학과학회지
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• 제29권4호
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• pp.89-100
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• 2019

Objectives We are going to analyze patient's medical and Korean medicine use trends after lumbar surgery, and examine the percentage of use of Korean medicine after surgery and its relevance to the medical care outcome after lumbar surgery. Methods Using 3% patients' sample data of the Health Insurance Review and Assessment Service, two groups were compared the treatment progress of the Korean Medicine treatment group and the untreated group after lumbar surgery by hierarchical logistic regression analysis. After hierarchical logistic regression analysis(including propensity scores), two groups were compared after lumbar surgery, the Korean Medicine treatment group within 50days and untreated group within 50days. Results Lumbar surgery was performed in 2750 patients in 2015. It was 3.72 that the risk(odds ratio) of finished treatment of patients treated without Korean Medicine, compared to patients with Korean Medicine. It was 0.12 that the risk of continuing treatment(odds ratio) of patients treated with Korean Medicine within 50 days, compared to patients treatment more than 50 days. Conclusions The ratio of Korean Medicine treatment after lumbar surgery was 14.8%. The group that did not have Korean Medicine showed a higher possibility of treatment termination than the group who did not. Among the groups treated with Korean Medicine, the early treatment group was more likely to end treatment than the late treatment group. Considering various situations in the medical environment, further studies such as prospective studies and long-term data analysis are considered to be necessary.

• 대한예방한의학회지
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• 제15권3호
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• pp.51-65
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• 2011

Purpose : To figure out the degree of leisure satisfaction of elderly's life. Method : A total of 1,015 persons were randomly selected from cities. This survey was performed by college students from July 1 through October 31, 2008. Results : 1. The level of health status of the subjects was $8.58{\pm}0.24$ of 15 points(57.2points of 100 points). 2. The average satisfaction degree of leisure was $2.92{\pm}39$(58.8points of 100). Of the study subjects, females, a group over 65-69, singles, the persons spending petty cash over 1.1 million won a month, the persons living with 3-4 family members and the subjects living with children had higher degree of satisfaction than other groups. 3. The factors affecting the degree of leisure satisfaction by regression analysis were age, gender, marital status, amount of petty cash, education level, the number of family members, utilization of social service agency, current health status. The influence level of those variables was 36.1%. Conclusion : It is very important to develop special activity program for their pleasant leisure time. The recreation and leisure program for the elderly should be implemented to provide by the authorities concerned. Children should be encouraged to live with their parents. All elderly welfare related agencies such as government, NGOs and professionals have to work together to improve the health of the elderly.

• 보건행정학회지
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• 제31권4호
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• pp.491-507
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• 2021

Background: This study aims to measure regional healthcare differences in Korea, and define relatively underserved areas. Methods: We employed position value for relative comparison index (PARC) to measure the healthcare status of 250 areas using 137 indicators in five following domains: healthcare demand, supply, accessibility, service utilization, and outcome. We performed a sensitivity analysis using t-SNE (t-distributed stochastic neighboring embedding). Results: Based on PARC values, 83 areas were defined as relatively underserved areas, 49 of which were categorized as moderate and 34 as severe. The provincial regions with the most underserved areas were Gyeongbuk (16 areas), Gangwon (13), Jeonnam (13), and Gyeongnam (12). Conclusion: This study suggests a relative comparison approach to define relatively underserved areas in healthcare. Further studies incorporating various perspectives and methods are required for policy implications.