• Journal of Preventive Medicine and Public Health
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• 제18권1호
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• pp.13-24
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• 1985

This study seeks to provide a framework for understanding differential access to medical care. The framework is provided by Anderson Model, a model of health services utilization which suggests a sequence of predisposing, enabling, illness-morbidity characteristics that determine the number of times people will visit a physician. The framework in this study is composed of two models, one is for Adults and the other is for Non-Adults. Models are operationalized using stepwise multiple regression analysis and path analysis. The data come from a national health survey conducted in 1983. The findings of the analysis can be summarized as follows : First, the causal models used in this study are able to explain only a small amount of the variance in medical care utilization(Adjusted $R^2$ is .144 in the Model for Adults and .243 in that for Non-Adults). This finding suggests that we reconsider the utility of such existing model using the predisposing, enabling, and illness-morbidity characteristics in light of their poor correspondence with these data. Second, while small amount of the valiance in medical care utilization is explained, most of the explained variance is due to the illness-morbidity characteristics. The path coefficients of study variables except illness-morbidity variables show these characteristics to be substantially unrelated to medical care utilization, and the indirect effects of the predisposing and edabling characteristics on medical care utilization are also negligible. This casts doubt on the importance of the predisposing and enabling characteristics in explaining medical care utilization. Third, among the predisposing and enabling characteristics, Medical Security variable is the only one having significant direct effect on medical care utilization in both models for Adults and for Non-Adults. Fourth, the amount of the variance explained in the Model for Non-Adults is more than in the Model for Adults. This suggests that medical care utilization of adults is more influenced by behavioral factors than that of children.

• 한국IT서비스학회지
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• 제23권3호
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• pp.39-54
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• 2024

This study explores the barriers to using health and medical data in research and development (R&D) within the healthcare industry and suggests ways to enhance data utilization. As artificial intelligence technology drives transformative changes across industries, there is an increased demand for robust health and medical data, highlighting its critical economic value and utility in fostering innovation. Using qualitative analysis through Grounded Theory, the study involves ten R&D professionals from healthcare industry, including both medical centers and corporations, using surveys and in-depth interviews to gather diverse experiences and perspectives on the challenges and opportunities in health and medical data use. Key findings point to legislative, regulatory, and data quality and integration issues, as well as complexities in patient data access and usage. Technological limitations and inadequate data governance frameworks also emerge as significant obstacles. Recommendations focus on improving regulatory frameworks, enhancing data standardization and quality, and fostering stronger partnerships between data custodians and users. The study concludes that overcoming these obstacles requires a comprehensive strategy involving legislative changes, improved technological infrastructure, and increased stakeholder collaboration. Implementing these recommendations could greatly enhance health and medical data utilization in R&D, significantly advancing medical science and patient care services.

• 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.

• Journal of Preventive Medicine and Public Health
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• 제32권3호
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• pp.355-360
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• 1999

1995년 1월과 7월에 전라남도 일부 농촌지역에 거주하는 20세 이상의 주민 3,085명을 대상으로 자가건강인지도를 측정하였다. 이후 3년간의 지역의료보험 지불자료에서 나타난 의료이용도 및 해당 지역 행정관청의 사망신고 자료를 이용하여 사망여부를 파악하여, 이들 변수들과 자가건강인지도와의 관련성을 조사해본 결과, 다음과 같은 결과를 얻었다. 1) 지역의료보험 대상자 1,090명에서 자가건강인지도에 대한 설문을 실시하기 이전인 1994년의 의료이용량에 비해 이후 3년간의 의료이용량이 자가건강인지도 불량군에서 더 많았으며, 수진일과 투약일은 더 크게 증가하였다. 2) 조사대상자 3,085명중 3년간의 사망자는 123명으로 연령과 성별을 보정한 생존분석 결과, 자가건강인지도 불량군이 양호군에 비해 더 높은 사망위험도를 나타냈다. 94년 지역의료보험에 가입되었던 1,376명중 사망자는 72명, 연령과 성별, 그리고 94년도 의료이용량을 보정 한 생존분석 결과 유의한 차이는 보이지 않았다. 이상의 결과를 요약해 볼 때, 비교적 단기간의 비교를 통해서도 의료이용도와 사망은 자가건강인지도에 따라 차이가 발생함을 알 수 있다. 특히 기존에 같은 정도의 의료이용을 하는 사람 중에서도 자신을 건강하지 않게 생각하는 사람이 향후 의료이용량이 더 크게 증가할 것으로 예측되었다. 따라서 자가건강인지도의 측정은 향후 개인 및 지역사회집단의 의료이용도와 사망 등 건강상의 문제를 예측하는데 유용한 도구로 사용할 수 있을 것으로 생각된다.

• 한국융합학회논문지
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• 제9권10호
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• pp.433-439
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• 2018

본 연구는 20세 이상의 남녀를 대상으로 녹내장 환자의 5년간의 안과 외래이용을 분석하여 한국인에서 녹내장 발병에 대한 변화추이를 조사하고자 시행하였다. 연구 자료는 한국의료패널의 2008년부터 2012년도의 연간자료를 활용하여 의료이용에 대한 빈도와 교차분석을 실시하였다. 녹내장환자의 안과외래 이용은 2008년 0.43%, 2009년 0.47%, 2010년 0.49%, 2011년 0.61%, 2012년 0.75%로 매년 유의하게 증가하였다(p<0.001). 안과외래를 이용한 녹내장 환자는 20대에서 70대까지 고 연령층으로 갈수록 더 높은 이용률을 보였고(p<0.001), 각 연령대에서 매년 증가하는 경향을 보였다(p<0.001). 이와 같은 결과에서 한국인에서 녹내장으로 인한 최근 의료이용은 매년 증가추세를 보여 각 연령대에 맞는 조기발견과 관리가 중요한 과제임을 알 수 있다.

• 보건행정학회지
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• 제9권2호
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• pp.77-94
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• 1999

The purpose of this study is to establish strategy by subdividing consumer market according to the lifestyle which influences the use of medical facilities. The subject of this study were 700 adults who were over 20 years of age and residing in Suwon and its vicinity. To collect data trained staff conducted person-to-person interviews with the assistance of structured questionnaires. The questionnaires cover the areas of life style pattern study. the characteristics of demographic sociology, decision-making process related to the use of medical service. The influencing factors were analyzed and as a result total 18 factors were singled out. Cluster analysis was performed to differentiate similar responses. Each group was named as 'health-unconcern type' 'passive health-concern type' 'regular health-concern type' and 'active health-concern type' according to the characteristics. Each group showed statistically significant difference in the characteristics of demographic sociology. Decision-making process regarding the use of medical service according to lifestyle was analyzed. As a result following items showed significant difference:whether the information was utilized, what was the criteria in selecting medical facilities for serious illness or complicated examination. who was the decision maker in selection medical facilities, and with whom one discussed in selecting medical facilities. The result of this study has its limitation in that it can not be applied directly to market subdivision. However, this will help medical facilities understand customers' lifestyle. which will eventually provide medical facilities with marketing tools in establishing effective PR strategy. In order to apply the lifestyle as a marketing tool of medical facilities, following tasks are to be carried out: the development of the questionnaire which can better analyze consumers' lifestyle related to the use of medical service. the examination of precise characteristics of subdivided market according to lifestyle. and the continuing study on the relationship between lifestyle and the process in selecting medical facilities.

• 임상간호연구
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• 제19권2호
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• pp.233-244
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• 2013

Purpose: The purpose of this study was to develop the evaluation indicators of positive nursing organizational culture in a clinical setting. Methods: The evaluation indicators of positive nursing organizational culture were developed from a literature review and a focus group interview. The content validity testing was done using a clinical expert panel. The content utility testing was done using a survey questionnaire. Results: The evaluation indicators of positive nursing organizational culture consists of 88 indicators representing the eight domains with the 24 categories. The average scores in evaluation indicators of positive nursing culture included the importance (3.29 points in average), the potential for further utilization (3.14 points in average) and the current state of extension agency (2.80 points in average). Conclusion: The developed evaluation indicators can be applied to measure the nursing organizational culture, which would be the basic data to manage human resources effectively in a clinical setting.

• 대한물리의학회지
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• 제18권3호
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• pp.121-133
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• 2023

PURPOSE: Computerization using ICF as a protocol can enhance the assessment, communication, and decision-making of various disciplines and cultures, individual functions, disabilities and health to promote communication and understanding among various professionals, organizations, and countries. The empirical foundation for these propositions was provided by delineating of six distinct computerization components. METHODS: This study analyzed 14 papers that combined the medical field and information technology to activate the ICF through computerization. From each of these papers, distinctive advantages were extracted to propose six computerization elements. The validity of these computerization elements was examined. These papers encompass various computerization elements, among which core elements were identified. In particular, six common core elements were extracted from these papers and assumed to be strategic computerization components for ICF activation. A heuristic methodology was employed to validate these components, representing IT technology maturity using four determining indices, which were then presented graphically for validation attempts. RESULTS: Four quantified indices were defined: reliability, cost-effectiveness, support and updates, and collaboration. Using these indices, this study identified elements that leverage existing IT technologies and require new development. The possibility of increasing utility was identified by applying computerization to ICF. CONCLUSION: This study examined the strategic elements of utilizing ICF by computerizing it using a protocol concept and discussed its potential for utilization. The potential to enhance the value of information in social, physical, and cultural contexts was presented by integrating various domains and data within the ICF framework.

• Journal of Preventive Medicine and Public Health
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• 제25권2호
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• pp.115-126
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• 1992

우리나라 일부지역의 암사망률을 추정하기 위하여 경상남도지역을 대상으로 조사연구를 시행하였다. 조사대상연구는 공무원및교직원의료보험공단 경상남도지부 피보험자 및 피부양자들이며, 이들중 1989년 1월부터 1990년 12월까지의 사망자 3,867명에 대하여 사망원인을 조사하였다. 사망원인의 확정은 사망진단서 및 의료보험공단의 전산화된 의료기관 이용자료를 기본자료로 3단계에 걸쳐 시행하였다. 사망진단서를 이용한 1차조사, 의료기관 이용자료를 이용한 2차조사, 가족설문조사인 3차조사를 시행한 결과 암질환으로 인한 사망자는 990명이었다. 사망원인이 암질환인 사망자 990례를 분석하여 우리나라 경상남도지역의 암사망률 및 부위별 암사망률을 추정하였다. 우리나라 경상남도지역 암질환의 조사망률은 10만 인 년당 남자 138.7, 여자 65.7으로 추정되었다. 또한 부위별 암사망률의 순위는 남자의 경우 위암, 간암, 폐암, 식도암, 조혈기계 암의 순이었으며, 여자는 위암, 폐암, 간암, 유방암, 자궁경부암의 순으로 나타났다.

• 대한간호학회지
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• 제38권6호
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• pp.813-821
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• 2008

Purpose: This study was conducted to develop an instrument measuring awareness of osteoporosis. Methods: The process included construction of a conceptual framework, generation of 86 preliminary items, verification of content validity, selection of secondary items, verification of construct validity and extraction of final items. The 86 items were reviewed for content validity by two groups of experts and were tested to evaluate inter item correlation coefficient by two groups of adult women. From June to August 2007, data were collected from 383 adult women who lived in Seoul and provinces in Korea. Data were analyzed by performing item analysis, Varimax factor analysis and Cronbach's alpha. Results: There were 31 items in the final instrument categorized into 5 factors. The factors were labeled as "preventive behaviors (10 items)", "risk factors (5 items)", "characteristics of osteoporosis (6 items)", "improving bone health (5 items)", and "bone physiology (5 items)". Cumulative percent of variance was 60.92% and eigen values ranged from 1.20 to 12.44. Cronbach's alpha was .948 and ranged from .804 to .917. Conclusion: Validity and reliability of the scale are confirmed in this study showing its utility for measuring awareness of osteoporosis for women. Utilization of the scale will also contribute to designing an appropriate prevention program for osteoporosis.