• Journal of Preventive Medicine and Public Health
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• 제46권5호
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• pp.237-248
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• 2013

Objectives: The purpose of this study is to examine and explain the extent of income-related inequity in health care utilization and expenditures to compare the extent in 2005 and 2010 in Korea. Methods: We employed the concentration indices and the horizontal inequity index proposed by Wagstaff and van Doorslaer based on one- and two-part models. This study was conducted using data from the 2005 and 2010 Korean National Health and Nutrition Examination Survey. We examined health care utilization and expenditures for different types of health care providers, including health centers, physician clinics, hospitals, general hospitals, dental care, and licensed traditional medical practitioners. Results: The results show the equitable distribution of overall health care utilization with pro-poor tendencies and modest pro-rich inequity in the amount of medical expenditures in 2010. For the decomposition analysis, non-need variables such as income, education, private insurance, and occupational status have contributed considerably to pro-rich inequality in health care over the period between 2005 and 2010. Conclusions: We found that health care utilization in Korea in 2010 was fairly equitable, but the poor still have some barriers to accessing primary care and continuing to receive medical care.

• Asian Pacific Journal of Cancer Prevention
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• 제13권12호
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• pp.6333-6336
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• 2012

The burden of cancer is growing globally and is one of the top leading causes of death. Information on cancer patterns are essential for effective planning of cancer control interventions. There is limited published information available on pattern of cancer for the state of Odisha, India. The present study was an attempt to explore the pattern and trend of cancer in Odisha. To fulfill the objectives retrospective data available from 2001-2011 at Acharya Harihar Regional Cancer Center (AHRCC), Cuttack, Odisha, were analyzed. Medical records of cancer patients were reviewed and relevant information on diagnosis, primary site and demographic data were retrieved. Data were entered and analyzed using SPSS 16.0 (SPSS Inc.). A total of 74,861 cancer inpatients were registered at AHRCC for the years 2001-2011. The proportion of females outnumbered males with female:male ratio 1.1:1. The number of female cases increased four folds and that of males three fold over the period studied. Malignancies such as oral cancer (16.93%), acute lymphocytic leukemia/non Hodgkins lymphoma (14.09%) and cancer of gastrointestinal tract (21.07%) are leading cancers among males and carcinomas of breast (28.94%), cervix (23.66%) and ovary (16.11%) were leading among females. Findings from this study indicate an overall increase in cancer reporting which could be regarded as proxy measure for overall cancer situation in Odisha. There is scope and need for integrating other government hospitals, existing private health service providers and research institutions across the state for better planning of cancer control program.

• 보건행정학회지
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• 제33권4호
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• pp.411-420
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• 2023

Background: The purpose of this study was to analyze the demand and supply status of patient beds by type of medical institution, categorized into 70 clinical privilege, in order to understand the regional bed supply situation. Methods: Utilizing the 70 clinical privilege defined by the Ministry of Health and Welfare, we calculated bed demand and supply quantities from 2019 to 2021 using data from Statistics Korea and the Health Insurance Statistical Yearbook. The bed demand calculation formula was based on the detailed guidelines for the medical sector by the Korea Development Institute and the 3rd edition of bed supply basic policies announced by the Ministry of Health and Welfare. Additionally, to mitigate distorted bed supply situations caused by factors such as regional levels and patient outflows, we classified bed supply types using the population decrease index indicator published by the Ministry of Public Administration and Security. Results: Among the 70 clinical privilege, it was analyzed that a relatively balanced bed supply situation exists overall, irrespective of the type of healthcare institution. However, in medical institutions at or above the level of hospitals, regions with bed supply ratios exceeding 20% compared to demand, particularly in institutions at or above the level of general hospitals, showed a relatively high rate of demand diversion. Conclusion: We have identified the bed supply types in the 70 clinical privilege in South Korea. Based on the results of this study, we emphasize the need for bed supply policies that consider regional characteristics. It is expected that this research can serve as fundamental data for future efforts aimed at managing or rectifying bed supply imbalances on a regional basis.

• Journal of Chest Surgery
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• 제49권sup1호
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• pp.1-13
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• 2016

Background: The purpose of this study was to investigate longitudinal changes of the utilization of operational and surgical medical care inside and outside a metropolitan area over 10 years, analyzing the residential areas of patients and the locations of medical facilities for major cardiovascular surgery. Methods: Data analysis was conducted by classifying the addresses of patients and the locations of medical care facilities of metropolitan cities and provinces, using data from the National Health Insurance Corporation from January 2003 to December 2013. Results: There is serious concentration of major heart surgery to medical facilities in Seoul; this problem has not improved over time. There were differences in percentages of surgical procedures performed in the metropolitan areas according to major diseases. In the case of Busan and Daegu provinces, at least 50% of the patients underwent surgery in medical facilities in the city, but there are other regions where the percentage is less than 50%. In the case of provinces, the percentage of surgical procedures performed in medical facilities in Seoul or nearby metropolitan cities is very high. Conclusion: Policies to strengthen the regional capabilities of heart surgery and to secure human resources are required to mitigate the concentration of patients in the capital area. Many regional multi-centers must be designated to minimize unnecessary competition among regional university hospitals and activate a win-win partnership model for medical services.

• 지역연구
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• 제37권1호
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• pp.3-14
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• 2021

코로나19 이후 공공의료시설, 특히 감염병전문병원의 중요성이 높아졌다. 그러나 메르스 사태 이후 정부의 강력한 정책의지에도 불구하고 공공의료시설과 감염병전문병원의 공급은 충분히 이뤄지지 않았다. 여러 가지 이유가 있겠지만 가장 큰 문제로 대두된 것이 바로 사회·경제적 변화와 시대의 흐름을 충분히 반영하지 못한 예비타당성조사이다. 본 연구의 목적은 공공의료시설과 관련된 현행 예비타당성조사제도의 문제점을 도출하고 그 대안을 제시하는 것이다. 본 연구는 그 대안으로 '선택가치'를 제안한다. 선택가치는 불확실한 상황에 대한 지불의 사이므로 감염병에 대비한 공공의료시설의 편익항목으로 반영하는 것이 학술적으로 가능하다. 선택가치는 비시장 재화이므로 조건부가치추정법과 선택모형을 통해 추정가능하다. 본 연구에서는 두 가지 방법론의 장단점과 활용대안을 제시하였다. 일상에서는 그 존재가치가 보이지 않지만 위기 상황에서 나타나는 것이 바로 의료와 보건시스템이다. 따라서 의료·보건분야의 예비타당성평가에서도 보이지 않는 편익을 찾고, 후생변화를 반영할 수 있는 방법론 개발이 지속적으로 이뤄져야 할 것이다. 본 연구가 그 촉매제가 될 것으로 기대한다.

• 한국실내디자인학회논문집
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• 제26권6호
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• pp.71-80
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• 2017

The purpose of this study is identify the status of the ward of public hospital for integrated nursing care service. Integrated nursing care service has been expanding on a national scale from 2016 but most of public hospitals are currently unable to operate due to nursing shortage. In this study 8 wards of public hospital have been chosen and analyzed. The measure of space program and area distribution(patient area percentage, staff area percentage, circulation area percentage), nurses's walking distance(distance from ns to patient room, distance from ns to core) were calculated by depthmapX and autocad programs. The result of this study is as follows. Nurse's walking distance is more than 24m so the efficiency of nurse's patient care is reduced. The percentage of patient area in double-corridor is higher and the patient feels more comfortable but the Nurse's walking distance is longer and the accessibility is lowered. NS should be located in the center of the ward and close to the core but some wards are not composed of proper space-separation and flow of human trrafic is overlapped. This study may serve as basic research for the architectural plan for future integrated nursing care ward.

• Journal of Chest Surgery
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• 제49권sup1호
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• pp.28-36
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• 2016

Background: This study aimed to develop the models for regional cardiac surgery centers, which take regional characteristics into consideration, as a policy measure that could alleviate the concentration of cardiac surgery in the metropolitan area and enhance the accessibility for patients who reside in the regions. Methods: To develop the models and set standards for the necessary personnel and facilities for the initial management plan, we held workshops, debates, and conference meetings with various experts. Results: After partitioning the plan into two parts (the operational autonomy and the functional comprehensiveness), three models were developed: the 'independent regional cardiac surgery center' model, the 'satellite cardiac surgery center within hospitals' model, and the 'extended cardiac surgery department within hospitals' model. Proposals on personnel and facility management for each of the models were also presented. A regional cardiac surgery center model that could be applied to each treatment area was proposed, which was developed based on the anticipated demand for cardiac surgery. The independent model or the satellite model was proposed for Chungcheong, Jeolla, North Gyeongsang, and South Gyeongsang area, where more than 500 cardiac surgeries are performed annually. The extended model was proposed as most effective for the Gangwon and Jeju area, where more than 200 cardiac surgeries are performed annually. Conclusion: The operation of regional cardiac surgery centers with high caliber professionals and quality resources such as optimal equipment and facility size, should enhance regional healthcare accessibility and the quality of cardiac surgery in South Korea.

• Journal of Preventive Medicine and Public Health
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• 제53권6호
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• pp.455-464
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• 2020

Objectives: The distribution of hospitals in Korea is unbalanced in terms of accessibility. Many local public health centers (PHCs) exempt out-of-pocket payments (OOPs) based on local government laws to increase coverage. However, this varies across administrative regions, as many make this exemption for the elderly, while others do not. This study aimed to evaluate the effects of the OOP exemption at local PHCs among elderly individuals. Methods: This study used online data on Korean national law to gather information on individual local governments' regulations regarding OOP exemptions. Individual-level data were gathered from the 2018 Community Health Survey and regional-level data from public online sources. Results: The study analyzed 132 regions and 44 918 elderly people. A statistical analysis of rate differences and 2-level multiple logistic regression were carried out. The rate difference according to whether elderly individuals resided in areas with the OOP exemption was 1.97%p (95% confidence interval [CI], 1.07 to 2.88) for PHC utilization, 1.37%p (95% CI, 0.67 to 2.08) for hypertension treatment, and 2.19%p (95% CI, 0.63 to 3.74) for diabetes treatment. The regression analysis showed that OOP exemption had an effect on hypertension treatment, with a fixed-effect odds ratio of 1.25 (95% CI, 1.05 to 1.48). Conclusions: The OOP exemption at PHCs can affect medical utilization in Korea, especially for hypertension treatment. The OOP exemption should be expanded to improve healthcare utilization in Korea.

• 보건행정학회지
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• 제34권1호
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• pp.94-102
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• 2024

연구배경: 현행 간호인력정책이 간호사의 불균형 분포를 심화시킨다는 논란이 지속되고 있으나, 이를 확인한 연구는 매우 드물다. 이에 본 연구는 간호정책과 관련된 변수를 포함하여 지역수준에서 임상간호사 분포에 영향을 미치는 요인을 규명하고자 하였다. 방법: 2020년 기준 250개 시군구의 총 225,462명의 임상간호사 분포를 대상으로 분석하였다. 2020년 시군구별 국가통계자료를 수집하여 회귀분석을 실시하였다. 결과: 임상간호사 분포에 영향을 미치는 요인은 연간 입원일수, 간호간병통합서비스 병상 수, 공공보건의료기관 수, 상급종합병원 수, 종합병원 수 등으로 나타났다. 비수도권 지역에서는 간호학과 졸업생 수와 간호1, 2등급 기관 수도 임상간호사 분포에 영향을 미쳤다. 결론: 간호사 불균형 분포가 심화되지 않도록 간호간병통합서비스 병상의 확대 지역을 신중하게 결정해야 한다. 또한 간호사가 부족한 비수도권 지역을 중심으로 간호학과 학생을 늘리고, 비수도권 간호사의 임금과 근무환경을 우선적으로 개선해야 한다.

• 대한예방한의학회지
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• 제17권2호
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• pp.29-46
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• 2013

A survey conducted on 1,103 patients or caretakers visited Korean medical clinics and hospitals between August 25, 2011 to September 30, 2011 by the Ministry of Health and Welfares and Korea Institute for Health and Social Affairs was analyzed and obtained following results: 1. For sociodemographic distribution, female(813) outnumbered male(290) patients with majority of patients ranging from 30s to 60s. Married patients(793) outnumbered unwed(150) patients and 65.0% with higher than high school education. Statistical significance was seen in gender, age, marital status, and education level but no significant difference for status of employment, income level, and types of insurance between the clinics and hospitals. (P<0.05). 45.1% had less than \2,000,000 in monthly salary and most of coverage was provided by either regional or work insurance. 2. 67.9% of the patients rated health conditions to be better than average and 32.1% listed as poor. People in good health showed tendency to visit Korean medical facilities. Musculo-skeletal conditions such as arthritis, ankle sprain, lumbago, muscular injury, and frozen shoulder were common conditions, followed by gastric disorders, common cold and herbal tonics. No significant difference was observed between the clinics and hospitals for above conditions, but significance was seen in atopic dermatitis, stroke, and sequela from traffic accidents (P<0.05). 3. Ten most common conditions addressed at Korean medical facilities were lumbago, arthritis, muscular injury, back sprain, gastric disorders, ankle sprain, common cold, herbal tonics, frozen shoulder and stroke. Major treatment modalities rendered were herbal medicine, herbal supplements, acupuncture and moxibustion, cupping, tuina, and Korean midical physical therapy. No significant difference existed between the clinics and hospitals. 4. All modalities showed at least 85% effectiveness. No statistical significant difference between the clinics and hospitals except for herbal decoction. (P=0.0452) 5. 88.3% of responses showed treatment satisfaction with significant difference between the clinics and hospitals (P=0.002). The occurrence of side effects was at 2%, mostly corning from treating digestive, skin, kidney disorders and neurological issues. No significant difference was observed between the clinics and hospitals. From the above results, the typical population visiting Korean medical facilities can be summarized as being middle aged female with relatively higher education and moderately low income. The health condition is generally good and the purpose of visit is to receive traditional treatments of acupuncture, herbal medicine, and physical therapy. Treatment efficacy and satisfaction were high with no significant differences between the clinics and hospitals.