• 보건행정학회지
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• 제13권1호
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• pp.98-115
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• 2003

Concerns about growing health insurance expenditures became a national Issue in 2001 when the National Health Insurance went into a deficit. Increases in spending for ambulatory care shared the largest portion of the problem. Methods and systems to control the spending should be developed and a system to measure case mix of providers is one of core components of the control system. The objectives of this article is to examine the feasibility of applying Korean Diagnosis Related Groups (KDRGs) to classify health insurance claims for ambulatory care and to identify problem areas of the classification. A database of 11,586,270 claims for ambulatory care delivered during January 2002 was obtained for the study, and the final number of claims analyzed was 8,319,494 after KDRG numbers were assigned to the data and records with an error KDRG were excluded from the study. The unit of analysis was a claim and resource use was measured by the sum of charges incurred during a month at a department of a hospital of at a clinic. Within group variance was assessed by th coefficient of variation (CV), and the classification accuracy was evaluated by the variance reduction achieved by the KDRG classification. The analyses were performed on both all and non-outlier data, and on a subset of the database to examine the validity of study results. Data were assigned to 787 KDRGs among 1,244 KDRGs defined in the classification system. For non-outlier data, 77.4％ of KDRGs had a CV of charges from tertiary care hospitals less than 100％ and 95.43％ of KDRGs for data from clinics. The variance reduction achieved by the KDRG classification was 40.80％ for non-outlier claims from tertiary care hospitals, 51.98％ for general hospitals, 40.89% for hospitals, and 54.99% for clinics. Similar results were obtained from the analyses performed on a subset of the study database. The study results indicated that KDRGs developed for a classification of inpatient care could be used for ambulatory care, although there were areas where the classification should be refined. Its power to predict tile resource utilization showed a potential for its application to measure case mix of providers for monitoring and managing delivery of ambulatory care. The issue concerning the quality of diagnostic information contained in insurance claims remains to be improved, and significance of future studies for other classification systems based on visits or episodes is guaranteed.

• 한국주거학회논문집
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• 제21권2호
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• pp.77-86
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• 2010

Korean population is now aging at an unprecedented rate. Fertility decline together with rapid improvements in life expectancy is the dominant demographic trend. As human life and housing environment are inseparably related to each other, the importance of conditions of housing environment for active aging among seniors has been received considerable attention as vital ones to expand the independency period of seniors. The purpose of this case study is to identify relationships between environmental affordance and perceived holistic health of the active elderly living in a retirement community located in Seoul. With spending time personally in the community to observe their lives, the researcher could be in close rapport with the residents. After the period of getting familiar with each other, in-depth individual interview and focus group interview were conducted and then, qualitative analysis was completed. As a result, general evidences showed that perceived seniors' health on the whole was improved physically, socially, and mentally by moving into the community providing appropriate environment affordance with the older adults. The study presents that retirement relocation into an improper environment may be a negative challenge, however, it may positively influence on the health and well-being of those who live there if the environment properly supports seniors‘ needs physically and socially

• 여성건강간호학회지
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• 제14권3호
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• pp.181-188
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• 2008

Purpose: The purpose of this study was to investigate perceived stress and dietary habits of female college students and define the relationships between them. Method: A convenient sampling method was used at a university based In Seoul. Finally, 412 students participated in the study from May 1 to June 10, 2008. The questionnaires administered consisted of a Stress Scale for college students and Dietary habit scale questionnaires. The students filled out the questionnaires by themselves. The collected data was analyzed with the SPSS Win 14.0 statistics program, which was used to calculate the frequencies, percentages, ANOVA, and Pearson's correlation of the variables. Result: The major findings of this study were as follows; In general, female students were mostly stressed by 'schooling.' Stress scores were significantly different in accordance with religion. Overall, dietary habits of study participants were normal. Significant differences were observed in the dietary habits between type of residence, major, and spending money per month. There was a significant relationship between perceived stress and dietary habits. Conclusion: Stress management for female college students should be developed and nutritional education programs should be reinforced.

• 가정∙방문간호학회지
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• 제26권2호
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• pp.155-165
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• 2019

Purpose: This study aimed to understand the meaning and nature of the early experiences of retired nurses. Methods: This qualitative study adopted Colaizzi's phenomenological method. Study participants were 10 nurses who had retired within the previous two years. Data were collected through in-depth individual interviews with the participants from September to December 2017, which were conducted until recurring themes emerged. Results: Early experiences of retired nurses in 14 sub-themes and 5 themes from the total of 256 initial codes. The five themes were 'vaguely initiated retirement preparation,' 'decreased income and increased spending,' 'mixture of longing and unfamiliarity,' 'the comforts left regret,' and 'go to another start another beginning.' Conclusion: Based on the results of this study, we suggest pre-retirement education that considers economic, interpersonal, and psychological changes to help nurses adapt to their new lives after retirement. We propose the development of education programs based on an understanding of lifestyle changes experienced by retired nurses, and further study to measure the effectiveness of these programs.

• 한국콘텐츠학회논문지
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• 제14권1호
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• pp.200-208
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• 2014

본 연구는 민간의료보험이 국민보건의료에 미친 영향과 관련된 오랜 논쟁에 관한 기존연구들을 분석하고, 논의가 부족했던 의료서비스 이용만족에 대한 영향을 확인하여 민간의료보험의 발전적 역할설정에 기여하는 데 목적이 있다. 선행연구 고찰을 통해 민간의료보험이 국민보건의료에 미친 영향을 확인한 결과 민간의 료보험 활성화가 저소득층과 건강상태가 좋지 않은 국민을 배제시키는 국민양극화를 초래할 가능성이 있고, 민간의료보험에 가입한 가입자의 의료이용량이 많아서 건강보험 추가재정지출을 유발할 가능성이 있었다. 그러나 민간의료보험이 의료서비스 질 개선과 의료소비자 만족에 기여하는지는 더 많은 연구가 필요한 상황이었다. 문헌고찰에서 연구가 미진한 것으로 확인된 민간의료보험이 소비자의 의료서비스 만족에 미치는 영향을 국민건강영양조사 자료를 통하여 확인한 결과 민간의료보험가입여부에 따라서 외래의료이용과 입원의료이용에 대한 의료서비스 만족도의 차이가 없었으며, 통계적으로 유의미한 영향관계도 없었다. 즉, 민간의료보험가입이 의료서비스 만족에 영향을 미치지 않는 것이다. 이러한 분석결과에 따라 향후 우리나라의 민간의료보험은 비급여 보충형으로 운영하는 것이 바람직할 것이다.

• 디지털융복합연구
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• 제13권6호
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• pp.341-350
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• 2015

본 논문은 호주의 국가정신보건전략에 대한 주요 내용과 국가정신보건전략을 통한 정신보건개혁 이후의 변화들, 그리고 정신보건개혁에 대한 논의를 통해서 우리나라의 정신보건정책의 문제점들을 개선하기 위한 현실적인 시사점과 융복합 정책적 함의를 찾는데 그 목적이 있다. 1992년에 발표되어 2008년에 개정된 국가정신보건정책, 1993년부터 2014년까지 네 차례에 걸쳐 수립된 국가정신보건 5개년 계획, 2006년 호주정부협의회에 의해 수립된 정신보건실행계획, 그리고 2012년 호주정부협의회에서 채택한 국가정신보건개혁을 위한 로드맵(2012-2022)을 포함한 국가정신보건전략은 지난 20년 동안 호주의 정신보건개혁의 광범위한 과정을 선도하는 대단히 중요한 정책 준거를 제공하였다. 1992년 시작된 국가정신보건전략을 통해서 정신보건재정 확충, 지역사회 중심의 치료 및 보호시스템 구축, 정신병상의 변화, NGO의 참여와 역할의 증대, 정신장애인과 가족(보호제공자)의 참여 확대 등과 같은 변화를 이루었다.

• 보건교육건강증진학회지
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• 제19권2호
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• pp.1-13
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• 2002

The purpose of this study was to investigate the factors influencing health promoting lifestyles in undergraduate students thus providing the basic data necessary to establish a health promoting program. The subjects of this study were 392 undergraduate students, living in Seoul, Chung-Buk, and Kangwon, during the period from May 10 to July 15, 2000. The instruments for this study were the health promoting lifestyles scale developed by Bak, Insuk(l995), the hardiness scale by Suh, Yeonok(1995), the social support scale by Su, Moonja(l988), and the perceived health status scale by Lawton et al.(l982). The results of this study are as follows; 1. The average score for health promoting lifestyles was 2.47 on 4 point scale. The health promoting lifestyles categories ‘harmony relationships’(3.08) and ‘sanitary life’(2.97) revealed higher scores, whereas scores for ‘healthy diet’(2.31), ‘exercise ＆ activity’(2.20) and ‘professional health management’(1.48) were lower. 2. The mean score for hardiness, social support and perceived health status was 4.43(on 6 point scale), 2.91(on 4 point scale) and 3.11(on 5 point scale) respectively. 3. There was a statistically significant difference in degree of health promoting lifestyle according to religion(t=2.05, p=0.04) and spending money per month(F=2.98, p=0.03). 4. Health promoting lifestyles showed significant positive correlation with hardiness, social support, and perceived health status. 5. Stepwise multiple regression analysis revealed that the most powerful predictor of health promoting lifestyle was hardiness. Social support and perceived health status have significant effects on health promoting lifestyles. These predictive variables of health promoting lifestyles explained 24% of variance. Finally, the result of this study will provide important factors for the development of a nursing intervention program for the promotion of healthy lifestyles in Korean undergraduate students.

• 보건행정학회지
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• 제20권3호
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• pp.36-57
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• 2010

The degree of income inequality deepened by health care expenditure was useful in assessing the health security level. This exploratory study was conducted to provide a basic evidence to prove the necessity of reinforcement the benefit coverage of South Korea's health security systems. Data from the Household Income and Expenditure Survey of Korea and Luxembourg Income Study were used. Income inequality indices before and after deduction of health care expenditure were computed, and the degree of the increase in the indices was compared among 13 countries. The degree of decrease against the effect of income inequality reduction policies by health care expenditure was determined. The relationships between the national characteristics and the increase in income inequality were examined. In South Korea, all income inequality indices increased after deducting health care expenditure, but the difference was not high compared to the mean of 13 countries. However, the degree of decrease against the effect of income inequality reduction policies by health care expenditure was high, compared to the mean of 13 countries. The proportion of public sector spending on health care proved to be statistically significant with the increase of income inequality indices (p<0.05). In the context of the continuous increase in health care expenditure, if benefit coverage of health security systems is not reinforced, income inequality will all the more increase due to health care expenditure. In the establishment of the policies for reinforcement of the benefit coverage, income inequality after deduction of health care expenditure should be continuously monitored.

• 보건행정학회지
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• 제18권4호
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• pp.23-48
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• 2008

Although the universal health insurance, National Health Insurance (NHI), have improved access to health care and financial burden of health care costs for Koreans, limited coverage of the NHI leads to high out-of-pocket payment for health care. This study examines financial burden of household health expenditures by income level. Data from the Urban Household Expenditure Survey from 1985 through 2005 is analyzed and household expenditure is used as a proxy measure for income. Health expenditures include spending for inpatient care, ambulatory care and pharmaceuticals. If a household spends health expenditure above 40% of household consumption except for foods, that is defined as catastrophic health expenditure. Access to health care for the lowest income group had been improved for two decades relative to other income groups as well as in absolute term. However, both financial burden of health expenditures and the proportion of households that experienced catastrophic health expenditure had been increased in the lowest income group. Study findings have several policy implications. First, in terms of financial burden of health expenditures. the differences among income groups decreased until 2000 but it was worsen in 2005. This suggests that recent policies for extending NHI coverage are not enough to improve the disparity by income level. Second, a differential catastrophic coverage by income level would be an effective strategy that relieves financial burden for low income group. Third, since the catastrophic coverage is applied to only covered services by the NHI, additional strategy for uncovered services should be considered.

• 한국병원경영학회지
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• 제14권4호
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• pp.52-70
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• 2009

This study is to analyse the reimbursement prices of drugs in Japan. Japan has the world's second-largest pharmaceutical market, and the world's largest price-controlled pharmaceutical market. The reimbursement prices of new drugs in Japan are determined by confidential negotiations between the manufacturer and the Japanese Ministry of Health, Labor, and Welfare. Pharmaceuticals account for a larger share of total healthcare expenditures in Japan than in most other major pharmaceutical markets such as France, Germany, United Kingdom and United States. Prescription drugs' share of total healthcare spending has slightly increased in recent years, from 20.2% in 2000 to 21.5% in 2004, the most recent year for which data are currently available. This trend is attributable to the effect of the Japanese rapidly aging population that stimulates demand for healthcare services. There are several method of price setting for drugs as below. First, on the initial pricing of branded drugs, is the similar-efficacy pricing method and cost calculation method. Second is postmarketing price changes which are biennial price revisions under the rule of National Health Insurance. Third is the rule of the generics price. Recently, the generics market is expanded because there are increasing numbers of hospitals by DPCs(Diagnosis-procedure Combinations).