• 보건의료산업학회지
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• 제9권3호
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• pp.115-126
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• 2015

Objectives : This research was performed to investigate the characteristics and determination factors of health care policy satisfaction and welfare recognition for health insurance & health care financing. Methods : The utilized data were 4,174 cases who responded to a welfare recognition survey in the 8th wave of the Korea Welfare Panel Study (2013). The statistical methodology used in this study is the multiple regression model. Results : The significant affecting factors of health care policy satisfaction were age, education, household income, welfare attitudes, and health status. Medical utilization & private medical insurance were not related to health care policy satisfaction. The affecting factors of health insurance reinforcement were age, health status, welfare attitudes. The affecting factors of health care financing expansion were age, economic activity type, medical utilization, welfare attitudes. The affecting factors of welfare attitudes were age, economic activity type, household income, health insurance, and health status. Conclusions : Health care policy satisfaction, health insurance reinforcement, and health care financing expansion were all affected by age and welfare attitude; but this was not the case for private health insurance. This study recommended that the Korean government provide active planning for reinforcement of health insurance and publicity of the health care system in order to accord with the prospects of people.

• 보건행정학회지
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• 제33권3호
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• pp.253-263
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• 2023

Background: The purpose of this study was to explore the relationship between the local extinction index and total medical service utilization. Methods: A fixed effects model in panel analysis was performed for the 228 administrative districts in Korea. The statistical yearbook on the usage of medical services by region and Korean Statistical Information Service data were used from 2010 to 2019 for analysis. Medical service utilization was represented by the number of visits day, the number of inpatient days, and medical charges. Control variables were selected by using an Anderson model. The local extinction index was calculated using resident registration population data. Results: Descriptive statistics showed that the number of areas at risk of extinction increased from 61 to 95 for the study years. In addition, the number of visits, the number of inpatient days, and medical charges all increased during the study years. After controlling for variables affecting medical service utilization and doing a panel fixed effects model, the result suggested that a one-step increase in the local extinction index was significantly associated with a 12.29% decrease in medical charges of inpatients, a 7.33% decrease in medical charge of outpatient, a 5.21% decrease in the number of inpatient day, and a 5.54% decrease in the number of visits day. Conclusion: This study showed that the higher the region's extinction risks, the higher the region's total medical service utilization. The results of this study suggested that there was a disparity in medical service utilization between areas at risk of extinction and areas not at risk of extinction, so measures should be taken to address this disparity.

• Child Health Nursing Research
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• 제27권4호
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• pp.328-338
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• 2021

Purpose: This study aimed to identify the factors influencing positive subjective health awareness of middle school-age multicultural adolescents in Korea. Methods: This study used data from the fourth to sixth waves of the Multicultural Adolescents Panel Study conducted by the National Youth Policy Institute. In this study, a panel logit model analysis was performed using the Eviews 8.0 program (p<.050). Results: Socioeconomic status (r=.02, t=2.13, p=.033), body satisfaction (r=.71, t=1.97, p=.048), and depression (r=-.74, t=2.35, p=.018) influenced positive subjective health awareness in multicultural adolescents. When multicultural characteristics were entered into a statistical model with environmental and personal characteristics, multicultural characteristics did not have a significant influence on positive subjective health awareness. Conclusion: Environmental, personal, and multicultural characteristics were related to positive subjective health awareness in multicultural adolescents; thus, an integrated approach considering those variables is recommended. Nursing interventions and educational programs are needed to improve the psychological status of multicultural adolescents and reduce prejudice about them. In addition, nurses need to be sensitive to multicultural characteristics and the developmental characteristics of multicultural adolescents.

• 한국엔터테인먼트산업학회논문지
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• 제14권2호
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• pp.225-235
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• 2020

본 연구는 골다공증 환자의 라이프 케어 증진을 위한 미충족 의료실태와 위험요인 분석하기 위하여 패널 자료를 활용한 횡단적 2차 분석 조사연구이다. 연구대상자는 한국의료패널 2015년 자료(β-version 1.0)를 활용하여 골다공증 진단을 받은 941명을 대상으로 하였다. SPSS/win 22.0 Program을 이용하여 χ² test, logistic regression을 이용하여 자료를 분석하였다. 연구결과 골다공증 환자의 미충족 의료 발생률은 22.6%이었으며, 인구학적 특성 요인의 Model I에서는 나이, 교육수준으로 나타났으며, 신체적 요인을 추가한 Model II에서는 섭식문제, 기억력 장애, 활동제한, 장애 판정으로 나타났다. 심리·사회적 요인을 추가한 Model III에서는 섭식문제, 기억력 장애, 총 가구 소득, 통증/불편감으로 확인되었다. 본 연구 결과를 바탕으로 골다공증 환자의 라이프 케어를 증진시키기 위해 지속적으로 의료정책 기획 시 고려되어져야 하겠으며, 미충족 의료를 감소시키기 위한 의료서비스 접근성 개선과 현실적인 예방 및 중재가 필요하겠다.

• 보건의료산업학회지
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• 제10권4호
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• pp.97-107
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• 2016

Objectives : This study aims to : (i) characterize and differentiate between two different periods of baby boomers, (ii) study the utilization of their health care services, and (iii) establish effective ways of providing better health service utilization and preventive policy strategies for upcoming and older generations. Methods : A multiple regression analysis using descriptive statistics, frequency analysis, and dummy variables was utilized to access the presence of correlations between socio-demographic factors and health care service utilization. Results : Medical insurance type, marital status, and chronic disease were factors that influenced health care service utilization. Furthermore, the factors that influenced individual medical expenses were cohabitation, inpatient days, and chronic disease. Conclusions : Primary findings and exploratory statistics revealed that there were strong correlations and interaction among some of the predictor variables. Because of the chronologically limited nature of the sample data set gathered in 2012, it would be helpful to continue to develop or research related constructs that may capture relationships more effectively among extended populations.

• 보건행정학회지
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• 제22권3호
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• pp.451-465
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• 2012

In order to strengthen assurance of National Health Insurance, co-payment should be reduced. This can happen with collaborative efforts of patients, medical institutes, and government altogether at the same time. This research applied Dutton(1986)'s medical service research model with high R-square, and analyzed 2008 Korea Health Panel Data (Beta Version 1), that was examined by Korea Institute for Health and Social Affairs and National Health Insurance, in order to figure out influential variables on co-payment. In result of Multiple Linear Regression Analysis, R-square was 46.7%, the older the age, the patients who had surgery, the longer days of hospital treatment are, the higher gross income of a household is, the more hospitalized in upper grade general hospitals, and the more upper grade rooms and selecting a doctor are used. The results have statistical significance. When conducting research applying medical service research model, there is a need to apply Dutton(1986)'s medical service research model with high R-square. In order to strengthen assurance of National Health Insurance, first conditions should be that patients are hospitalized in upper grade general hospital, and at the same time, are patients who had surgery with long stay of hospitalization. In addition, if proven that patients used upper grade rooms and selecting a doctor due to lack of regular treatment and rooms, for certain number of days of such hospitalization, it is suggested to be provided with health care insurance in upper grade rooms and selecting a doctor in calculating co-payment limit.

• 대한한의학회지
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• 제37권1호
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• pp.41-52
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• 2016

Objectives: There are no studies which have investigated the health related quality of life(HRQOL) about stroke patients according to the medical care utilization behavior by longitudinal analysis. The purpose of this study is to analyze the quality of life(QOL) and quality adjusted life years(QALYs) of stroke patients of western and combined treatment group by longitudinal analysis. Methods: A retrospective cohort study was conducted among 37 new patients who initiated diagnosis with stroke in 2009 from Korea Health Panel Data. We analyzed the HRQOL of stroke patients and calculated the QALYs after medical use initiation for up to 3 years according to the medical care utilization behavior. Results: Overall, the quality of life of stroke patients was lowered somewhat from 0.8431 to 0.7864 in 2009~2012. Western treatment group was appeared slightly declined in from 0.8527 to 0.8231 and combined treatment group was shown to be falling from 0.8173 to 0.6875. The QALYs of total patients were calculated 2.3654 and western treatment group were 2.4436, combined treatment group were 2.1542 during the 4 year period. The difference of QALYs between two groups was 0.2894 QALYs. Conclusions: Although there was a small difference in QALYs of the two groups, it is not certain that the difference is come from medical care utilization behavior. Further studies should be needed to confirm the relation of the medical care utilization behavior and quality of life by considering severity of the stroke.

• 약학회지
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• 제57권5호
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• pp.369-375
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• 2013

Objective: Using the Korean Health Panel data (KHP) of 2008 and 2009, this paper analyzed the effect of antihypertension medication adherence on the changes in medical service utilization and medical expenditure in the next year. Method: Through a face-to-face interview survey, KHP has provided an extensive data on demographic characteristics, medical utilizations behavior, medical expenditure and health behaviors of the targeted households and their members since 2008. KHP is recognized as highly accurate regarding medical expenditure in that it makes the target households to record 'Health diary' whenever they use healthcare service, which could minimize their cognitive bias or memory distortion. The 2010 KHP data was based on the interview from 6,432 households and 19,697 household members. Two part model was used to explore the effects of medication adherence on medical use (logistic regression analysis) and medical expenditures (OLS). Result: Our study result demonstrated that the 74.7% of the patients who strictly adhere to their medication in both years, in 2008 and in 2009, were likely to use inpatient service in 2010. This shows the noncompliant patients were in fact use emergency service less than the compliant patients. Conclusion: Based on our analysis, this paper concludes that the high medication adherence of hypertensive patients could contribute to reduce the emergency service use. Therefore it is highly recommendable for the Korean government and the insurer, NHIS, to actively invest in developing education and promotion program to improve medication adherence among hypertensive patients.

• Korean Circulation Journal
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• 제53권10호
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• pp.693-707
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• 2023

Background and Objectives: Inherited arrhythmia (IA) is a more common cause of sudden cardiac death in Asian population, but little is known about the genetic background of Asian IA probands. We aimed to investigate the clinical characteristics and analyze the genetic underpinnings of IA in a Korean cohort. Methods: This study was conducted in a multicenter cohort of the Korean IA Registry from 2014 to 2017. Genetic testing was performed using a next-generation sequencing panel including 174 causative genes of cardiovascular disease. Results: Among the 265 IA probands, idiopathic ventricular fibrillation (IVF) and Brugada Syndrome (BrS) was the most prevalent diseases (96 and 95 cases respectively), followed by long QT syndrome (LQTS, n=54). Two-hundred-sixteen probands underwent genetic testing, and 69 probands (31.9%) were detected with genetic variant, with yield of pathogenic or likely pathogenic variant as 6.4%. Left ventricular ejection fraction was significantly lower in genotype positive probands (54.7±11.3 vs. 59.3±9.2%, p=0.005). IVF probands showed highest yield of positive genotype (54.0%), followed by LQTS (23.8%), and BrS (19.5%). Conclusions: There were significant differences in clinical characteristics and genetic yields among BrS, LQTS, and IVF. Genetic testing did not provide better yield for BrS and LQTS. On the other hand, in IVF, genetic testing using multiple gene panel might enable the molecular diagnosis of concealed genotype, which may alter future clinical diagnosis and management strategies.

• 보건행정학회지
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• 제11권2호
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• pp.29-57
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• 2001

Since the inauguration of the medical insurance system in 1977, the increasing medical expenses which can be menace to tile finance of the medical insurance system, have become major concern in the medical insurance field In Korea. This study focuses on the determinants of the medical expenses in the health insurance in Korea and analyzes the impact of these factors on the increase in the medical expenses. The empirical work is done using the pooled cross-section and time-series data of the medical insurance for the self-employeds and the industrial workers from the year 1995 to 1997. The result of this study shows that the main determinants of the medical expenses in the health insurance are the ratio of the population of the aged to the total population, the frequency of the utilization, number of doctors per capita and the regime changes. Although the increasing trend in the medical expenses seems to be unavoidable, we probably need to add some efficiency to the medical expenses by suppressing the supply and the utilization of the unnecessary medical services. The fee-for-service reimbursement system of today can't suppress the supply of the unnecessary medical services effectively. So we need to convert the present fee-for-service system into DRG's which is known to reduce the medical costs. The increase in the medical expenses comes from a lot of factors. Therefore, we should develop more systematic and comprehensive measures to control the soaring medical expenses in consideration of the various factors such as demand, supply, and the organizational side of the medical system.