• Journal of Preventive Medicine and Public Health
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• 제39권5호
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• pp.411-418
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• 2006

Objectives: The purpose of this study was to determine whether the disabled have worse access to primary care than the non-disabled. Methods: We used the National Disability Registry data and the National Health Insurance data for the calendar year 2003, and we analyzed 807,380 disabled persons who had been registered until December 2001 and we also analyzed 1,614,760 non-disabled persons for nine ambulatory care sensitive conditions (ACSCs). The rates of physician visits and hospitalizations for the patients with ACSCs were compared between the disabled and the nondisabled. Multiple logistic regression analysis was used to evaluate the association between medical care utilization and disability and to assess the association between hospitalization and the number of physician visits while controlling for potential confounders. Results: The numbers of physician visits per 100 patients were $0.78{\sim}0.97$ times lower for the disabled than that for the non-disabled with five of nine ACSCs. The numbers of hospitalizations per 100 patients were $1.16{\sim}1.77$ times higher for the disabled than that for the non-disabled with all the ACSCs. While the ORs of a physician visit for the disabled were significantly lower than that for the non-disabled with all the ACSCs (OR: $0.44{\sim}0.70$), and the ORs of hospitalization for the disabled were significantly higher (OR: $1.16{\sim}1.89$). The lower physician visit group (number of physician visits ${\leq}$1) was more likely to be hospitalized than the higher physician visit group (number of physician visits ${\geq}$2) (OR: $1.69{\sim}19.77$). The effect of the physician visit rate on hospitalization was larger than the effect of disability on hospitalization. Conclusions: The results suggest that the disabled were more likely to be hospitalized for ACSCs due to their lower access to primary care.

• 융합정보논문지
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• 제11권1호
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• pp.183-190
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• 2021

본 논문은 만성질환으로 응급실에 내원한 노인 환자의 응급의료 이용 변화 추이를 알아보고자 하였다. 2014년 1월 1일부터 2019년 12월 31일까지의 국가응급진료정보망 자료에서 응급실 퇴실 주 진단 상병코드가 8개 만성질환에 해당하는 환자를 선택하여 응급실 이용 현황 및 응급실 내원과 입원의 변화 추이를 살펴보았다. 2014년을 기준으로 만성질환으로 응급실을 내원한 노인 환자는 지속 증가하였고, 특히 85세 이상의 환자가 급격히 증가하였다. 만성질환별 응급실 내원 비율 변화추이에서는 대부분 질환에서 증가세를 보였고(P<0.001), 그 중 허혈성심장질환, 관절병증에서 높은 증가율을 보였으나 고지혈증은 전 연령에서 감소세를 보였다(P<0.001). 응급실 입원율 변화 추이에서는 고지혈증, 고혈압, 결핵을 제외한 만성질환에서 지속적으로 증가세를 보였다(P<0.001). 만성질환을 가진 노인 환자의 응급실 내원 및 입원율의 지속적인 증가는 응급의료자원의 점유 및 의료 소비량 증가 문제를 가속시킬 수 있는 원인으로 작용할 수 있으므로 적절한 만성질환 관리가 필요하다.

• 대한소아치과학회지
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• 제24권1호
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• pp.195-203
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• 1997

The purpose of this study is to provide framework for understanding women's preventive dental utilization. In this paper Andersen-Newman's model is applied to the use of dental visits. This model consists of predisposing, enabling, and need components that describe a person's decision to use preventive health services. The sample consisted of 1907 women living Iksan city. Models are operationalized using stepwise multiple regression analysis and path analysis. The number of independent variables used in the analysis was 27 in total, i.e. 20 predisposing components, 6 enabling components, and 1 need component. Preventive dental utilization was measured based on the number of visits. The data collected by means of a questionnaire survey. In this study, the amount of variance by the model was 11 percent. Number of restricted activity days caused by oral disease, perceived threat of dental disease, having a regular dental care, and income were found to have significant major effects on preventive dental utilization of women. Number of restricted activity days caused by oral disease was the most important variable affecting preventive dental utilization of women.

• 대한한방소아과학회지
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• 제36권2호
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• pp.1-12
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• 2022

Objectives We analyzed visiting patterns to medical institutions and cost per visit according to the common cold patients aged 0-19 years. We analyzed Korean medical treatment for common cold. Methods Using the Pediatric Patient Sample data of the Health Insurance Review and Assessment Service (HIRA-PPS), we analyzed the data on health insurance claims of approximately 1 million people from 2017 to 2019. The data included the number of patients who visited the hospital due to common cold for the first and second time, the ratio of second visits by type of medical institution, and the status of prescriptions in Korean medical institutions. Results The number of patients visiting healthcare providers for common cold was higher in Western medical institutions than in Korean medical institutions. However, the number of second visits was higher in Korean medical institutions. Acupuncture is the most commonly used medical treatment in Korean medical institutions for common cold. Herbal medicine for common cold was usually prescribed for 2-3 days for children and adolescents. Conclusions Although the average medical cost of Korean medical institutions was higher than that of Western medical institutions, the rate of second visits to Korean medical institutions was higher because of the demand for Korean medical treatment

• 한국치위생학회지
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• 제12권5호
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• pp.1017-1027
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• 2012

Objectives : The purpose of this study was to help form treatment relationship with patient through more effective communication by defining the relationship between dental hygienist's medical communication and outpatient's reliance satisfaction. Methods : The study researched 273 male and female patients who visited dental clinics and hospitals of Busan from March 12 to March 26, 2012 and its results are as follows. Results : 1. The linguistic communication of dental hygienist was $3.72{\pm}0.63$ and non-linguistic communication was $3.48{\pm}0.58$. 2. For the dental hygienist's reliance satisfaction, the reliance was $3.62{\pm}0.65$ and the satisfaction was $3.74{\pm}0.65$. 3. The dental hygienist's communication degree depending on general characteristic was statistically significant when the job of patient was housewife(p<0.001) and the number of dental clinic visits was more than 10 times (p<0.000). The dental hygienist's non-linguistic communication was statistically significant depending on patient's gender(p<0.000), age(p<0.002), job(p<0.001) and number of dental clinic visits (p<0.000). 4. The dental hygienist's reliance and satisfaction showed statistically significant difference depending on patient's gender(p<0.000), age(p<0.002), job(p<0.001) and number of dental clinic visits (p<0.000). 5. The dental hygienist's non-linguistic communication showed a positive correlation with reliance and satisfaction(p=0.000). Conclusions : When considering the result above, it is necessary to develop the teaching method and material to educate the communication ability of dental manpower. It is necessary to reinforce the curriculum of dental hygienics and the education of dental hygienist to perform effective, smooth communication between dental hygienists.

• Journal of Preventive Medicine and Public Health
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• 제52권2호
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• pp.82-91
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• 2019

Objectives: Many studies have explored the relationship between short-term weather and its health effects (including pneumonia) based on mortality, although both morbidity and mortality pose a substantial burden. In this study, the authors aimed to describe the influence of meteorological factors on the number of emergency room (ER) visits due to pneumonia in Seoul, Korea. Methods: Daily records of ER visits for pneumonia over a 6-year period (2009-2014) were collected from the National Emergency Department Information System. Corresponding meteorological data were obtained from the National Climate Data Service System. A generalized additive model was used to analyze the effects. The percent change in the relative risk of certain meteorological variables, including pneumonia temperature (defined as the change in average temperature from one day to the next), were estimated for specific age groups. Results: A total of 217 776 ER visits for pneumonia were identified. The additional risk associated with a $1^{\circ}C$ increase in pneumonia temperature above the threshold of $6^{\circ}C$ was 1.89 (95% confidence interval [CI], 1.37 to 2.61). Average temperature and diurnal temperature range, representing within-day temperature variance, showed protective effects of 0.07 (95% CI, 0.92 to 0.93) and 0.04 (95% CI, 0.94 to 0.98), respectively. However, in the elderly (65+ years), the effect of pneumonia temperature was inconclusive, and the directionality of the effects of average temperature and diurnal temperature range differed. Conclusions: The term 'pneumonia temperature' is valid. Pneumonia temperature was associated with an increased risk of ER visits for pneumonia, while warm average temperatures and large diurnal temperature ranges showed protective effects.

• 예술경영연구
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• 제58호
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• pp.89-119
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• 2021

국민의 문화예술향유가 확대됨에 따라, 문화예술 관람에 영향을 미치는 요인에 대한 연구가 지속적으로 진행되고 있다. 그러나 대부분의 실증연구는 인구통계학적 및 환경적 요인에 치중하여 분석을 수행하였으며, 주로 순수문화예술 영역 내 장르를 구분하지 않고 수행된 경우가 많은 실정이다. 따라서 본 연구는 국민의 순수문화예술 향유 중 특히 미술전시회 관람에 영향을 미치는 요인을 실증적으로 분석하는 것을 주요 목적으로 한다. 이에 6개년의 「국민문화예술활동조사」 결과를 통해 수집된 총 56,588개의 표본을 활용하여 다중회귀분석 및 다원 분산분석을 수행하였다. 분석 결과 문화예술행사, 문화예술교육, 문화예술동호회에 참여한 경험이 있는 집단의 미술전시회 평균 관람횟수가 더 많은 것으로 나타났다. 또한 변수 간 상호작용효과를 확인하였다. 즉 문화예술행사, 문화예술교육, 문화예술동호회에 모두 참여한 경험이 있는 집단의 미술전시회 평균 관람횟수가 더 많은 것으로 나타났다. 본 연구는 다년간 수집된 빅데이터를 취합 및 분석하여 개인의 문화예술경험이 미술전시회 관람에 영향을 미치는 것을 실증적으로 확인했다는 점에서 의의가 있으며, 미술전시회 관련 중기 정책의 수립에 정책적 함의를 제공할 수 있을 것으로 기대된다.

• 한국조경학회지
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• 제46권3호
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• pp.92-102
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• 2018

본 연구는 생활권 도시림의 방문이 시민들의 주관적 웰빙의 향상에 기여하는지를 검토하였다. 도시림 방문은 강한 경험이 아니기 때문에 강도 대신 빈도에 해당하는 방문회수와 체류시간을 독립변수로 사용하였으며, 종속변수는 긍정적 감정, 부정적 감정 및 삶의 만족도이었다. 서울시민을 대상으로 여론조사기관이 온라인 설문으로 수집한 600매의 자료를 분산분석한 결과, (a) 도시림의 방문회수와 체류시간 간에는 상호작용 효과가 없었으며, (b) 방문회수와 상관없이 최근 2주간 도시림을 방문한 사람들은 방문하지 않는 사람들보다 긍정적 감정이 높았으며 부정적 감정은 낮았고, 평소에 한 달에 1번 이상 도시림을 방문한 사람들은 미방문자들보다 삶의 만족도가 높았지만, (C) 방문자들의 체류시간은 긍정적 감정, 부정적 감정 및 삶의 만족도 모두에 영향을 주지 못하였다. 결과적으로, 도시림 방문이란 의도적 활동이 유전적으로 결정된 주관적 웰빙 수준을 변화시킨다는 기존 이론을 확인함으로써, 도시림의 확대와 유지관리는 시민들의 복지향상을 위한 정부의 의미 있는 투자라는 것이 밝혀졌다. 보다 신뢰성 높은 추후연구를 위해 응답자 집단의 선정과 영향변수들의 중요성을 고찰하였다.

• 한국병원경영학회지
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• 제25권4호
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• pp.94-102
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• 2020

Purposes: The purpose of this study was to analyze the trends of hospitalization and emergency room visits of asthma patients over the three years in 25 districts of Seoul. And analyzed the relationship between preventable hospital service uses and number of clinics for asthma patients. Methods: Data was collected from a customized database of the NHI(National Health Insurance) for 2016 to 2018. The number of clinics means Internal Medicine, Pediatrics, Ear-Nose-Throat, and Family Medicine clinics. The hospital service means the number of adults admission for asthma and the number of total asthma emergency visits. This study used kappa analysis to assess the agreements of indicators between years, and structural equation modeling analysis was applied to analyze the relationship. Findings: The kappa value of the number of adults admission for asthma was compared between 2016 and 2017(kappa score=0.68), and was lowered when compared between 2016 and 2018(kappa score=0.26). And the value of kappa in the number of total asthma emergency visits due to asthma between 2016 and 2017(kappa score=0.51) was lower than that of between 2016 and 2018(kappa score=0.60). And the results showed that the number of clinics significantly negatively related to the uses of hospital services in asthmatic patients(β=-0.5, p=0.005). Practical Implication: This research could provide policy implications for strengthening primary care services that can contribute to the reduction of preventable hospital services.

• 대한소아치과학회지
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• 제48권3호
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• pp.324-332
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• 2021

이 연구는 코로나 바이러스 감염증-19로 인한 소아청소년의 치과 방문에 대한 변화를 알아보기 위해 수행됐다. 한국 건강보험심사평가원에서 제공하는 자료를 기준으로 2019년 1월부터 2020년 8월까지 소아청소년의 치과 방문 횟수 및 치과주상병 변화를 월별, 지역별 분석하였다. 2020년 1월부터 8월까지의 소아청소년의 치과의원 및 치과병원 총 방문 횟수는 2019년 같은 기간과 비교시 0 - 9세 연령군에서는 642,202회(16.3%), 10 - 19세 연령군은 313,488회(9.2%) 감소하여 0 - 9세 연령군이 10 - 19세 연령군보다 더 큰 감소를 보였다. 같은 기간 상병별로는 Z29(기타 예방적 조치의 필요)로 인한 감소가 0 - 9세 연령군에서는 118,219회(34%), 10 - 19세 연령군에서는 83,944회(31%) 감소하여 가장 큰 변화를 보였다. 코로나 바이러스 감염증-19로 인한 전반적인 소아청소년의 치과 이용이 감소된 것으로 분석되며 이는 추후 소아청소년들의 구강 보건 악화로 이어질 가능성이 있으며, 이 연구는 이후 코로나 바이러스 감염증-19와 같은 전염병 발생 시 참고 자료가 될 수 있을 것이다.