• 한국병원경영학회지
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• 제28권3호
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• pp.47-57
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• 2023

Purpose: Health expenditure and utilization of Korean medicine are increasing every year. Since Chuna Manual Therapy was covered by National Health Insurance in 2019, it is predicted that the usage of Chuna Manual Therapy would be also increasing. However, there are few studies about Chuna Manual Therapy using Korean National Health Insurance claims database. Therefore, we will investigate the utilization trend of outpatient's Chuna Manual Therapy using Korean National Health Insurance database and suggest political implications. Methodology: The Korean National Health Insurance claims database was used to identify outpatient's Chuna Manual Therapy usage spanning 4 years from 2019-2023 and the number of Chuna Manual Therapy claims were approximately 18.61 million. Findings: The number of Chuna Manual Therapy claims and patients, health expenditure of Chuna Manual Therapy have been increasing spanning 4 years among over 65 aged. In the case of female patients, the number of Chuna Manual Therapy claims was more than male patients and health spending related to Chuna Manual Therapy was also higher than male patients. Most patients visited Korean medicine clinics due to musculoskeletal diseases, and most claims were from rural regions. Practical Implication: Since Chuna Manual Therapy was covered by National Health Insurance in 2019, Utilization of Chuna Manual Therapy has been increased overall. In particular, Chuna Manual Therapy is mostly implemented in the elderly, Korean medicine clinics, and local areas, thus policy managers will need to consider this.

• 한국임상약학회지
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• 제31권4호
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• pp.268-277
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• 2021

Background: Most antipsychotic drugs studies have been mainly conducted on side effects, randomized clinical trials, utilization rates, and trends. But there have been few studies on the influencing factors in elderly patients. The purpose of this study was to analyze the influencing factors on the outpatient prescription of antipsychotic drugs in the elderly patients. Methods: Active ingredients of antipsychotic drugs in Korea were selected according to the Korean Pharmaceutical Information Center (KPIC)'s classification. Data source was Korean Health Insurance Review and Assessment Service (HIRA) claims data in 2020 and target patient group was the elderly patient group. We extracted patients who have been prescribed one or more antipsychotic drugs and visited only one medical institution. Data were analyzed using descriptive statistics, chi-square, t-test, negative binomial regression. Results: A number of outpatients were 245,197 and prescriptions were 1,379,092. Most characteristics of patients were 75-85 year's old, female, health insurance type, no disease (dementia, schizophrenia), atypical drugs, cci score (>2) and characteristics of medical institution were neurology in specialty, rural region, general hospitals. Results of regression showed that patient's characteristics and medical center characteristics had significant effect on the outpatient prescription of antipsychotic drugs in the elderly patients. Conclusion: This study suggests that national policy of antipsychotic drugs in the elderly patients, with the consideration of the patients' and medical institutions' characteristics, is needed.

• 한국산학기술학회논문지
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• 제19권7호
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• pp.443-452
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• 2018

본 연구는 제6기 국민건강영양조사 자료를 이용하여 만 25세 이상 성인을 대상으로 사회경제적 특성 및 유병상태에 따른 의료서비스 이용행태를 파악하기 위한 연구이다. SPSS 23.0을 이용하여 빈도분석 및 기술적 통계분석, 일원배치분산분석, ${\chi}^2$-test, 회귀분석을 실시하였다. 연구결과는 남자보다 여자가, 65세 이상, 고졸이상, 무직이 많았고 소득분위는 모두 비슷한 수준으로 나타났다. 교육수준, 직능, 소득분위를 함께 고려한 사회경제적 상태(socioeconomic status; SES)에 대한 점수는 7-8점이 가장 많았고, 대부분 응답자의 주관적 건강상태는 보통으로 느끼고 있었다. 평균유병개수는 $1.07{\pm}1.497$개이며 외래서비스 평균이용횟수는 $0.50{\pm}.0745$회이며, 입원서비스 평균이용횟수는 $0.12{\pm}0.454$회로 외래서비스 이용횟수 보다 낮았다. 일반적 특성에 따른 유병 및 주관적 건강상태는 유의한 차이가 있었고, 연령이 높을수록, 교육수준과 직능, 소득분위 및 SES점수가 낮을수록 평균 유병개수는 많았으며 주관적 건강상태는 나쁘게 인식하였다. 현재 앓고 있는 질환에서 입원서비스는 중증일수록, 외래서비스는 만성일수록 많이 이용하는 것으로 나타났다. 즉, SES점수가 높을수록 전반적인 의료서비스의 이용이 낮았고, SES점수가 낮을수록 의료서비스의 이용은 높게 나타났다. 이와 같은 결과를 토대로 사회경제적 특성이 낮은 집단에게 질환을 예방할 수 있는 적절한 보건교육 프로그램을 개발하여 이들이 질환에 노출되었을 때 적정한 의료서비스를 이용할 수 있도록 지역사회기반의 적절한 보건서비스 체계의 구축 및 시행의 필요성을 시사 할 수 있겠다.

• 보건의료산업학회지
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• 제8권2호
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• pp.115-125
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• 2014

This study tries to investigate inequity in supplementary private health insurance insured in terms of the analysis of insurance insured general characteristics and to analyze the influence of supplementary private health insurance on their admission and their outpatient medical utilization behavior. As a result of the analysis of the general characteristics of supplementary private health insurances insured, it has turned out that men, persons at low ages, people with a spouse and chronic diseases, and persons with a high income have applied such insurances more. We can also tell that low-income classes have difficulty in applying private health insurances as people in the fifth income quintile have applied such insurances about 9 times as much as those in the first income quintile. The analysis of supplementary private health insurance insured health care utilization behavior has revealed that both male and female insured aged less than 55 and without chronic diseases have increases the number of their use of health care, their patient charge, and their medical cost per visit.

• 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.

• 지역사회간호학회지
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• 제26권1호
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• pp.11-17
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• 2015

Purpose: This study was to ascertain whether there are differences in health care utilization and expenditure for Type I Medical Aid Beneficiaries before and after applying Copayment. Methods: This study was one-group pretest posttest design study using secondary data analysis. Data for pretest group were collected from claims data of the Korea National Health Insurance Corporation and data for posttest group were collected through door to-door interviews using a structured questionnaire. A total of 1,364 subjects were sampled systematically from medical aid beneficiaries who had applied for copayment during the period from December 12, 2007 to September 25, 2008. Results: There was no negative effect of copayment on accessibility to medical services, medication adherence (p=.94), and quality of life (p=.25). Some of the subjects' health behaviors even increased preferably after applying for copayment including flu prevention (p<.001), health care examination (p=.035), and cancer screening (p=.002). However, significant suppressive effects of copayment were found on outpatient hospital visiting days (p<.001) and outpatient medical expenditure (p<.001). Conclusion: Copayment does not seem to be a great influencing factor on beneficiaries' accessibility to medical services and their health behavior even though it has suppressive effects on outpatients' use of health care.

• 한국직업건강간호학회지
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• 제19권2호
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• pp.170-179
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• 2010

Purpose: It was to identify the relationship with the health beliefs, self-efficacy and medical care utilization in nurses in order to provide basic data for program development to actively help nurses' health practice. Methods: The subjects were 360 hospital nurses in P city, K Province. Instruments were health belief developed by Walker, Sechrist & Pender (1987), self-efficacy by Sherer, Maddux & Mercandante(1982), and medical care utilization by Korean National Health & Nutrition Examination Survey(2006). The data were analyzed as descriptive statistics, Chi-square, t-test, and ANOVA using SPSS 11.5. Results: There were significant differences in medical care utilization depending on age(p=.008), marital status(p=.019), education level(p=.005), types of work(p=.017), nursing units(p=.018), and period of work(p=.001). Use of outpatient clinic was significantly different depending on perceived susceptibility(F=2.463, p=.045). Nurses who consulted to doctor in other hospital had higher perceived severity(F=2.759, p=.028). Nurses who used complementary medicine had higher perceived barrier(F=2.278, p=.047). The score of self-efficacy was significantly different in medical care service frequency (F=3.030, p=.018) and to whom their health problems consulted(F=3.092, p=.010). Conclusion: Medical service utilization was different depending on the demographic characteristics, perceived susceptibility, severity, and barrier, and self efficacy. It is needed to give health promotion program considering these factors for nurses.

• 디지털융복합연구
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• 제12권8호
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• pp.377-387
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• 2014

본 연구는 시뮬레이션을 이용하여 외래프로세스를 개선하여 기관 운영의 효율성을 높이고자 수행되었다. 3가지의 시나리오를 설정하여 시뮬레이션 분석을 수행하였으며 외래환자 전체 체류시간, 대기시간, 이동시간, 진료시간, 직원 활용도 지표를 비교하여 시나리오에 따른 외래프로세스의 효율성을 평가하였다. 병원의 진료자료를 수집하여 통계도구와 프로세스 마이닝 도구를 이용하여 분석하였다. 그리고 시뮬레이션 툴인 PIOS를 이용하여 모형의 타당성은 t-test로 검증하였다. 시뮬레이션 분석 결과, 센터제로 운영하는 경우의 외래프로세스가 가장 효율성이 높은 것으로 나타났다. 이를 볼 때 외래환자에 대해서는 센터제 형태로 운영되는 것이 기관의 효율성을 높이는 방안이라는 것을 확인할 수 있었다. 본 연구를 통하여 시뮬레이션이 최적의 외래프로세스를 선정하는데 활용될 수 있는 방법이라는 것을 확인할 수 있었다. 시뮬레이션을 이용하면 과거 경험, 감정, 직관에 의존하는 기존의 보건의료 관리 기법에 비해 효율적인 의사 결정을 지원하는 방법이라는 것을 알 수 있다. 따라서 본 연구에서 제시한 연구 모델은 보건 의료 시스템 상에 다양한 활용이 가능할 것으로 보인다.

• Journal of Preventive Medicine and Public Health
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• 제39권5호
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• pp.397-403
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• 2006

Objectives: We estimated the asthma-related health care utilization and costs in Korea from the insurer's and societal perspective. Methods: We extracted the insurance claims records from the Korea National Health Insurance claims database for determining the health care services provided to patients with asthma in 2003. Patients were defined as having asthma if they had ${\geq}$2 medical claims with diagnosis of asthma and they had been prescribed anti-asthma medicines, Annual claims records were aggeregated for each patient to produce patient-specific information on the total utilization and costs. The total asthma-related cost was the sum of the direct healthcare costs, the transportation costs for visits to health care providers and the patient's or caregivers' costs for the time spent on hospital or outpatient visits. Results: A total of 699,603people were identified as asthma patients, yielding an asthma prevalence of 1.47%. Each asthma patient had 7.56 outpatient visits, 0.01 ED visits and 0.02 admissions per year to treat asthma. The per-capita insurance-covered costs increased with age, from 128,276 Won for children aged 1 to 14 years to 270,729 Won for those aged 75 or older. The total cost in the nation varied from 121,865 million to 174,949 million Won depending on the perspectives. From a societal perspective, direct health care costs accounted for 84.9%, transportation costs for 15.1 % and time costs for 9.2% of the total costs. Conclusions: Hospitalizations and ED visits represented only a small portion of the asthma-related costs. Most of the societal burden was attributed to direct medical expenditures, with outpatient visits and medications emerging as the single largest cost components.

• 한국병원경영학회지
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• 제25권4호
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• pp.13-28
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• 2020

Purposes: The purpose of this study is to analyze the institutional and personal factors that affect the medical utilization of patients transferred to tertiary medical institutions. Methodology: We retrospectively analyzed the 2 weeks electronic medical records of 1,556 patients, who were referred to the tertiary hospital, from June 15 to 26, 2015. The patient's personal characteristics, referral hospital, referral path, medical experiences and expenses were analyzed for 6 months after the patient's first visit. Findings: The largest proportion (848; 54.5%) of referrals was referred from primary clinic but the referrals of the same tertiary hospital level were one in seven (228; 14.7%) of the patients. Most patients (1,401; 90%) were referred from the clinics and hospitals directly and only one in ten (155; 10%) of the patients utilized the medical referral center. Patients who had been referred from tertiary care institutions had significantly higher medical costs than those referred to primary care (7,560,000 vs 2,333,000 won). The institutional factors including the numbers of visits to outpatient clinic, previous history of hospitalization and operation, consultation to other medical departments and hospitalization fee significantly influenced on medical utility pattern. Personal factors including patient's medical diagnosis and department of disease have a highly correlation with patient's referrals. Practical implications: The medical utilization of medical expenses and experiences is influenced by institutional and individual factors, and it is important to establish a referral system considering the institutional factors of the type of referral hospital.