• 한국노년학
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• 제40권4호
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• pp.747-760
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• 2020

본 연구는 한국의료패널을 통해 인천광역시 고령자의 보건의료이용 행태 예측요인을 확인하여 고령자의 보건의료접근성을 높이거나 보건의료이용의 효율성을 높일 수 있는 서비스 또는 제도를 개발하는데 필요한 기초자료를 마련하는 것을 목적으로 한다. 한국의료패널 중 인천광역시에 거주하는 60세 이상 대상자 총 305개의 자료를 SPSS와 AMOS를 이용하여 분석하였다. 분석 결과, 개인속성과 건강수준, 건강수준과 보건의료이용행태에서 유의미한 상관이 나타났다. 또한, 구축된 연구모형의 적합도 및 효과 분석을 통해 개인속성 요인, 생활습관, 건강수준이 모두 보건의료서비스 이용에 직·간접적으로 유의미한 영향을 미치고 있음을 확인하였다. 이를 통해 인천시가 다른 지역들에 비해 보건의료서비스 수요 및 공급에서 불균형이 심한 편이므로 고령화 사회에 맞춰 인천시의 보건의료체계 정립이 필요함을 알 수 있었으며, 인천시 거주 고령자에게 제공할 보건의료서비스의 방안과 관련 정책 제도 수립 시 본 연구 결과를 기초자료로 활용할 수 있을 것이다.

• Journal of Preventive Medicine and Public Health
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• 제42권3호
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• pp.151-159
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• 2009

Objectives : This study was to determine how the perception and the satisfaction of outpatients who utilized clinics and hospitals are structurally related with their willingness to utilize the same institution in the future. Methods : Three hundred and ten responses (via convenient sampling) were collected from 5 hospitals and 20 clinics located in Seoul listed in the "Korea National Hospital Directory 2005". Service quality was utilized as the satisfaction measurement tool. For analysis, we used a structural equation modeling method. Results : The determining factors for general satisfaction with medical services are as follows: medical staff, reasonability of payment, comfort and accessibility. Such results may involve increased competition in the medical market and increased demands for quality medical services, which drive the patients to visit hospitals on their own on the basis of changed determining factors for satisfaction. Conclusions : The structural equation model showed that the satisfaction of outpatients with the quality of medical services is influenced by a few sub-dimensional satisfaction factors. Among these sub-dimensional satisfaction factors, the satisfaction with medical staff and payment were determined to exert a significant effect on overall satisfaction with the quality of medical services. The structural relationship in which overall satisfaction perceived by patients significantly influences their willingness to use the same institution in the future was also verified.

• 한국병원경영학회지
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• 제28권4호
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• pp.62-72
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• 2023

Based on the basic ideology of health care, this study realized the seriousness of annual unmet medical need and conducted a study to confirm the relationship between the subjective perception of regional healthcare environment and unmet medical needs. The independent variable was classified into attitude 'satisfaction' and 'unsatisfaction' toward regional healthcare, and the dependent variable was classified as whether unmet medical needs occurred annually. Based on previous studies, the control variables were selected as demographic and socioeconomic characteristics that can affect the occurrence of unmet medical care annually and characteristics related to health behavior. Descriptive statistics were conducted for each variable on the extracted sample, and multivariate survey logistic regression analysis was conducted to confirm the association between variables. As a result, more unmet medical needs occurred annually than those who were satisfied with the medical services in the area where they lived. In addition, more unmet medical need occurred annually in "unsatisfied" households compared to households "satisfied" with local medical services. In residential areas, women live in "metropolis" and "rural areas" compared to "urban," women live in men, lower education levels, and poor subjective health levels, and less satisfied with local medical services. As such, the impact of environmental factors in the community on the use of health and medical services is one of the major areas of interest in the field of health science, such as health policy and social dynamics. Therefore, hospitals in each region need to make efforts in terms of hospital management to increase the overall satisfaction of medical services in the region by continuously monitoring the attitude of residents to achieve universal health security, and policymakers should also be interested and propose new policies.

• 보건행정학회지
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• 제29권2호
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• pp.160-171
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• 2019

Background: This study purposed to compare the difference on medical utilization and health expenditure of baby boomer generation by depression between gender. Methods: Korea Welfare Panel Survey 2016, provided by the Korea Institute for Health and Social Affairs, was used for the analysis. For the research, we used the two-part model, yes or no of use (part 1), and frequency of use (part 2) for medical utilization. The dependent variables are the whether or not to use of hospitalization services, outpatient services, length of stay, outpatient service visits, and health expenditure. And the independent variables are used as the predisposing (education, spouse presence), enabling (insurance type, private insurance, economic activity, income), and need (chronic disease, self-rated health, disability) factors in the Andersen behavior model. Depression was used as intervening variables. Structural equation model and multiple group analysis by gender were used. Results: There were differences in the medical care usage and cost between men and women in baby boomer. For men, mediating effects of depression were present at the hospitalization (yes/no), length of stay, and health expenditure. On the other hand, for women, the mediating effect of depression was found only at the outpatient visits. Specially, depression was working at the medical services by the different way between gender. The size of effect (multiple group analysis) was affected by significant differences between men and women. Conclusion: This study found that the mediating effect of depression is increased medical usage and health expenditure and the effect factors are different by gender. Therefore, it is necessary to establish a medical care policy considering the socio-economic characteristics of baby boomers.

• 한국병원경영학회지
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• 제27권1호
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• pp.11-19
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• 2022

Purposes: This study was to investigate intention to exercise the patient's right of self-determination on adopting the non-benefit medical services and was to identify factors associated with intention to self-determined decision. Methodology: A total of 1,000 adult respondents aged 20 to 65 years were recruited using stratified random sampling and surveyed by online. Multivariate logistic regression analysis was performed to identify factors associated with intention to self-determined decision using SAS 9.4(SAS Institute Inc. Cary, NC, USA). Findings: 61.9% of total participants(n=592) had intention to exercise patient's right of self-determination on adopting the non-benefit medical services. Significant differences were observed in the exercise of self-determination in relation to prior explanation and opportunity for self-determination. Practical Implications: This study suggested that explanation duty of provider might influence on increasing intention to exercise the patient's right of self-determination. Considering appropriate use of non-benefit services, it is important to enhance explanation duty of provider.

• 스마트미디어저널
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• 제9권4호
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• pp.81-90
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• 2020

최근 중국의 경제발전과 소득수준의 향상으로 과거에 비해 질 좋은 의료서비스에 대한 욕구가 높아지고 있다. 이러한 욕구를 충족시키기 위한 대안으로 스마트 폰을 활용한 다양한 애플리케이션이 개발되고 있다. 특히, 2019년 12월 발생한 COVID-19의 전 세계적인 확산으로 인하여 그 관심은 비대면 원격의료 서비스로 확대되고 있다. 본 연구에서는 중국 내 상위 3개의 모바일 의료 애플리케이션을 대상으로 총 200명을 대상으로 설문조사를 실시하였으며, 그 중 의료 애플리케이션을 실제로 사용해 본 120명의 데이터를 벤카테시(Venkatesh)의 UTAUT2 이론을 기반으로 사용자의 사용의도와 사용행위에 영향을 미치는 요인에 대한 연구를 실시하였다. 본 연구의 연구 결과는 다음과 같다. 첫째, 인터렉티브화 특성, 노력기대, 가격가치, 프라이버시 관심도, 습관, 촉진 조건이 사용자의 사용의도에 긍정적인 영향을 미치는 것으로 밝혀졌다. 둘째, 사용자의 사용의도가 사용행위에 영향을 미치는 것으로 조사되었으며, 습관과 촉진 조건은 사용의도와 사용행위에 모두 영향을 미치는 것으로 밝혀졌다. 셋째, 성별, 연령, 학령, 연간 수입 등의 조절변수가 사용자의 모바일 의료 애플리케이션 사용의도에 영향을 미치지 못한다는 연구결과를 도출했다. 마지막으로 인터넷 등을 사용하는 모바일 기기의 특성상 여러 보안에 취약점들이 존재하며 이로 인해 개인 또는 사회적으로 큰 피해나 파장을 불러올 수 있다. 따라서 중국의 모바일 의료 서비스 발전을 위해 차후 이러한 문제점 등을 보완 총체적이고 심층적인 고찰을 통해 연구모형의 재수립이 필요할 것이다.

• 한국응급구조학회지
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• 제20권2호
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• pp.21-35
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• 2016

Purpose: This study aims to investigate awareness and performance of infection control during ambulance attendant training, and to provide basic data for infection control. Methods: The subjects were 235 paramedic students who completed ambulance attendant training. There were 51 questions. The infection control dimension was divided into hand washing, personal protective equipment use, and environmental management, for each sub-dimension, awareness and performance were measured by a 4-point scale. The collected data were analyzed using SPSS statistics ver. 22.0. Results: A total of 95.3%, of the subjects completed an orientation for ambulance attendant training and 71.7% received education on infection. In all three sub-dimensions, hand- washing (p<.001), personal protective equipment use (p<.001), and environmental management (p<.001), awareness scored higher than performance. The awareness of infection control showed a significantly positive correlation (r=.394) with performance. Conclusion: In order to improve performance of infection control, education to improve awareness should be provided, and paramedics with higher performance levels in hand washing, and use of gloves and masks wearing should be assigned as training advisors.

• 지역사회간호학회지
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• 제25권3호
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• pp.159-169
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• 2014

Purpose: The purpose of this study was to evaluate the effectiveness of case management for patients with hypertension on their health status and medical service utilization. Methods: This study was a secondary analysis of data collected for a larger study of chronic disease management in 2008 using the National Health Insurance Corporation database. A total of 12,944 patients who received case management for hypertension were included in this analysis. The subjects of case management were classified into subgroups, namely, over-use, under-use, and non-use groups according to the amount of medical service utilization. To compare the medical service utilization, a control group was selected randomly. The data were analyzed through descriptive statistics, McNemar test, and ANOVA. Results: All the subgroups displayed significant differences in blood pressure, self-management, social support, and their characteristics of medical service utilization. The total medical expense of the under-use and non-use groups increased after case management. However, there was no decrease in the medical expense of the over-use group. Conclusion: This finding suggests that there is a need to re-examine why patients overuse medical services and to supplement specific strategies for encouraging appropriate medical service utilization, and enhancing case management efforts for the over-use group.

• 한국응급구조학회지
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• 제24권1호
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• pp.85-92
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• 2020

Purpose: The purpose of this study was to analyze the English abstract key words found within the Korea Society of Emergency Medical Services journal using text mining techniques to determine the adherence of these terms with Medical Subject Headings (MeSH) and identify key word trends. Methods: We analyzed 212 papers that were published from 2012 to 2019. R software, web scraping, and frequency analysis of key words were conducted using R's basic and text mining packages. Additionally, the Word Clouds package was used for visualization. Results: The average number of key words used per study was 3.9. Word cloud visualization revealed that CPR was most prominent in the first half and emergency medical technician was most frequently used during the second half. There were a total of 542 (64.9%) words that exactly matched the MeSH listed words. A total of 293 (35%) key words did not match MeSH listed words. Conclusion: Researchers should obey submission rules. Further, journals should update their respective submission rules. MeSH key words that are frequently cited should be suggested for use.

• 한국병원경영학회지
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• 제16권2호
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• pp.31-52
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• 2011

The cutthroat competition of the market for the medical services caused changes and developments of hospital management from the traditional provider-oriented management to a consumer-oriented management toward the customer. And the popularization of on-line community through the growth and spread of internet technology is developed into an important exploration activity to provide various medical information to patient(or customer) who wishes a high-quality medical services. This is an on-line Word-of-Mouth(WOM). It is a kind of information exploration that is performed by customers before choosing the hospital with off-line word-of-mouth. In this study, we develop our research model to verify the causal relationships among on/off-line WOM, key determinants of hospital choice and the customer's will to make use of the hospitals, and total effect of these variables. We adopt a component-based PSL method for an empirical analysis of the patients experienced dermatology or obstetrics gynecology. Finally, we understand the characteristics of the various medical services and draw new and significant strategic previews.