• 대한의사협회지
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• 제61권11호
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• pp.687-698
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• 2018

Inappropriate antibiotic use significantly contributes to antibiotic resistance, resulting in reduced antibiotic efficacy and an increased burden of disease. The objective of this study was to investigate the characteristics of prescribers whose antibiotics use was high and to explore factors affecting the use of antibiotics by medical institutions. This study analyzed the National Health Insurance claims data from 2015. Antibiotic prescription data were analyzed in terms of the number of defined daily doses per 1,000 patients per day, according to the World Health Organization anatomical-therapeutic-chemical classification and methodologies for measuring the defined daily dose. We investigated the characteristics of prescribers and medical institutions with high antibiotic use. Multivariate regression analyses were performed on the basis of characteristics of the medical institution (number of patients, type of medical institution [hospital or clinic], age of the physician, etc.). The number of patients and number of beds were found to be significant factors affecting antibiotic use in hospitals, and the number of patients, region, and medical department were significant factors affecting antibiotic use at the level of medical institutions. These findings are expected to help policy-makers to better target future interventions to promote prudent antibiotic prescription.

• 한국화재소방학회논문지
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• 제28권3호
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• pp.80-86
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• 2014

본 연구에서는 한국보건사회연구원과 국민건강보험공단(2013)의 한국의료패널 2009년 데이터를 이용해 응급환자 이송 서비스의 이용과 관련된 사회경제적 임상적 특성을 조사하고, 예측 인자를 분석하였다. 분석 결과를 요약하면, 첫째, 119 구급차, 민간 구급차 등 응급환자 이송 수단을 이용한 경우가 자가용, 택시, 도보 등 응급환자 이송 수단을 이용하지 않은 경우보다 많았다. 둘째, 개인 및 가구 특성 변수 중 연령, 교육 수준, 세대 구성, 주거 형태, 월 평균 가구 소득, 가구주와의 관계 등에서, 응급 상황 특성 변수 중 의료 보장 형태, 장애 유무, 만성질환 유무, 응급실 방문 이유, 응급실 이용 후 조치 등에서 응급환자 이송 수단을 이용한 경우와 이용하지 않은 경우에 통계적으로 유의한 차이를 나타냈다. 셋째, 개인 및 가구 특성 변수 중에서는 연령과 월 평균 가구 소득, 응급 상황 특성 변수 중에서는 장애 유무, 응급실 방문 이유, 응급실 이용 후 조치 등이 응급환자 이송 서비스의 이용에 통계적으로 유의한 예측 인자로 나타났다. 따라서 병원 전 응급환자 이송 단계에서 응급 처치의 적절성 제고와 함께 응급환자 이송 서비스의 이용 특성과 예측 인자를 감안한 효과적 대응이 필요하다.

• 보건의료산업학회지
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• 제13권2호
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• pp.67-79
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• 2019

Objectives: The purpose of this study was to analyze the factors affecting the utilization of emergency medical services and characteristics of emergency medical services according to age group among elderly individuals. Methods: This study conducted t-test and linear regression analysis on data of 1,960,575 participants to achieve the objective. Results: Analysis of the factors affecting the use of emergency medical services showed statistically significant correlation in all age groups. As the age of elderly people increased, the use of emergency medical service increased. Conclusions: Emergency medical policies are needed, such as coordinators with expert knowledge of medical and health administration and specialist emergency room operations that can provide specialized medical service for older patients.

• 한국병원경영학회지
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• 제14권1호
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• pp.36-61
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• 2009

This study focused on finding the variation of medical service utilization, paths of medical service utilization and medical payments of the patients died by cerebrovascular diseases. For this study, data of the one-year episodes of the health insurance subscribers died in 2004 were selected. The frequency of medical visits, the lengths of stays, the days of outpatient visits, the total period of medical services and the total medical payments were compared by the characteristics of the suppliers and utilizers. This study is useful in reviewing the equity of medical service utilization because it analyzed variance in utilization by episodes. In oder to collect accurate data of the patients died by cerebrovascular diseases in 2004 the 2004 reimbursement data of all medical institutions were matched to the data of funeral fee payment by the National Health Insurance Corporation from January 2004 to May 2005. The major results of the study are as follows. The variation of medical service utilization of cerebrovascular diseases was influenced by supplier factors suppliers, such as types and locations of medical institutions and user factors such as sex and age. It was suspected that the reimbursement by fee-for-service contributed to the variation quite a lot, but we could not compare the variation between the different reimbursement systems in Korea. On the basis of analyzing results this study suggests that the factors of suppliers and utilizers should be reviewed to reduce the under use and over use expressed by variations of medical service. The processes of care, effective communication and management system should be investigated for the equity of medical service utilization and also. alternative medical services would be recommended to reduce the high medical payment. Additionally to find other causes of variation further in depth study controling the severity of diseases, socio-economic status of the users and the system factors is required.

• International Journal of Advanced Culture Technology
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• 제12권1호
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• pp.100-107
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• 2024

Addressing challenges posed by an aging society, this study explores inclusive design orientations for digital medical interfaces catering to the elderly. The aim is to enhance inclusiveness and optimize interactive experiences within the medical system for senior users. Employing inclusive design concepts, the study analyzes characteristics through literature, focusing on functional purpose, interactive behavior, and emotional expression in digital medical interface design for the elderly. User research methods, including in-depth interviews and field research, generate user personas and behavioral analysis diagrams, organizing and categorizing pain points for elderly patients with chronic diseases. The study proposes principles for improving service touchpoints based on inclusiveness, optimizing pain point types and design processes in age-friendly services. These enhancements aim to help the elderly adapt to and integrate into a digital lifestyle.Incorporating inclusive design principles enhances the inclusiveness of service design, improving the service experience for the elderly. Age-friendly service design with inclusiveness serves as a valuable entry point for research targeting elderly populations and provides practical strategies for age-friendly medical service process design.

• 보건행정학회지
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• 제6권2호
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• pp.131-148
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• 1996

This study was carried out by using questionnaires with 200 general doctors serving as the director of health subcenter in Kyongsangbuk-do Province as of January 1995. The results are summarized as follows. It was shown that the general characteristics consisted of 53 directors in the lst year(26.5%), 85 in the 2nd year(42.5%) and 62 in the 3rd year(31.0%). The percentage spent on their medical service showed that 73.0% of those directors spent more than 90% on their medical service. Based on their general service attitiude, 0% answered that the director of the health subcenter completes the given duties as the director, and 24.5% did that the director has the sense of responsibility and duty. Multiple answers concerning inconvenience and difficulties of the health subcenter director showed that less monthly salary accounted for 75.5%, no administrative power for 50.0%, insufficient medical instruments for 35.5%, insufficient budget for 30.0%, respect. In conclusion, in order for the health subcenter to meet the function as the primary medical clinic, it is required to arange the plans to inspire the public health doctors' service desire to that they can give the medical service as good as the private primary medical clinics, to convert existing concept of the public health doctors' placement in Myon administrative district into new concept in Gun by breaking from a uniform placement, and to consider an intensive placement according to the relevant projects so that preventive health activities can be planned and carried out.

• 한국병원경영학회지
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• 제12권3호
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• pp.1-19
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• 2007

This study focused on finding the variation of medical service utilization and medical payments of the patients died by three, cancers, stomach, breast, and colon cancer. For this study, data of the one-year episodes of the health insurance subscribers died in 2004 were selected. The frequency of medical visits, the lengths of slays, the days of outpatient visits, the total period of medical services and the total medical payments were compared by the characteristics of the suppliers and utilizers. The data of the patients died by cerebrovascular diseases and cancer in 2004 were selected. To select the dead by cerebrovascular diseases and cancer in 2004, were matched the 2004 reimbursement data of all medical institutions to the data of funeral fee payment by the National Health Insurance Corporation from January 2004 to May 2005 for the death in 2004. The results of the analysis were as follow. The variation of medical service utilization of the dead by cancers were not small in Korea. The current study found that the variation of medical care utilization was influenced by the factors of suppliers, such as types and locations of medical institutions and the factors of users, such as sex and age. It was suspected that the reimbursement by fee-for-service contributed to the variation quite a lot, but we could not compare the variation between the different reimbursement systems in Korea. The results of the study suggested that tile factors of suppliers and utilizers should he reviewed to reduce the under use and over use expressed by variations of medical service utilization. The processes of care, effective communication and management system should be investigated for the equity of medical service utilization. Additionally, prospective payment could he recommended to reduce the high variation of medical service Use. To find the variation caused by under use and over use, further study need to control the severity of diseases, socio-economic status of the users and the system factors.

• 보건의료산업학회지
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• 제7권1호
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• pp.1-9
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• 2013

This study intends to identify the characteristics of cancer in-patients and those of cancer patients who defected to other medical institutions based on the summary of hospital discharge information of a university hospital for the purpose of improving work efficiency and maximizing the number of patients. The study used data on cancer patients registered in the database of C University Hospital in Gyeonggi Province for a period of one year between January 1 and December 31. The analysis results suggest that the commonalities of the cancer patients who defected to other medical institutions include no specific job, old age, and hospitalization through emergency room. In conclusion, hospitals need to identify the characteristics of cancer patients classified as patients who are prone to defect and the defection factors through this prediction model.

• 보건행정학회지
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• 제26권4호
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• pp.343-351
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• 2016

Background: This study aims to analyze the effects of insurance types on the medical service uses for heart failure inpatients using propensity score matching (PSM). Methods: 2014 National inpatient sample based on health insurance claims data was used in the analysis. PSM was applied to control factors influencing the service uses except insurance types. Negative binomial regression was used after PSM to analyze factors that had influences on the service uses among inpatients. Subjects were divided by health insurance type, national health insurance (NHI) and medical aid (MA). Total charges and length of stay were used to represent the medical service uses. Covariance variables in PSM consist of sociodemographic characteristics (gender, age, Elixhauser comorbidity index) and hospital characteristics (hospital types, number of beds, location, number of doctors per 50 beds). These variables were also used as independent variables in negative binomial regression. Results: After the PSM, length of stay showed statistically significant difference on medical uses between insurance types. Negative binomial regression provided that insurance types, Elixhauser comorbidity index, and number of doctors per 50 beds were significant on the length of stay. Conclusion: This study provided that the service uses, especially length of stay, were differed by insurance types. Health policy makers will be required to prepare interventions to narrow the gap of the service uses between NHI and MA.

• 한방재활의학과학회지
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• 제29권1호
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• pp.31-39
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• 2019

Objectives To obtain future research basis of Korean Medicine for total knee arthroplasty patient by analyzing medical and Korean Medical service utilization and treatment duration. Methods Data sampling was performed on Health Insurance Review and Assessment Service patient data of 2015 (Confidence level of 97%) to analyze patients' medical and Korean Medical service tendency. Sampling groups were divided into two groups; i) Patients who completed their treatment within 5 months of total knee arthroplasty, ii) Patients who continued their treatment after 5 months of total knee arthroplasty, to investigate patients' medical and Korean Medical service tendency and individual characteristics were carefully monitored. Results It was confirmed that total of 1,655 patients had gone through total knee arthroplasty out of 1,453,486 patients who were gathered for sampling. First sampling group (Patients who completed their treatment within 5 months of total knee arthroplasty) was 287 patients and second sampling group (Patients who continued their treatment after 5 months of total knee arthroplasty) was 385 patients. The proportion of patients who visited Korean Medical service in first sampling group was lower than that of second sampling group. Conclusions It was confirmed that medical and Korean Medical service and cost consumed by second group (Patients who continued their treatment after 5 months of total knee arthroplasty) was higher than that of first group (Patients who continued their treatment after 5 months of total knee arthroplasty). It is highly recommended to continue with further study for efficient medical and Korean Medical service and reduced cost.