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Health Policy and Mangemnet

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수록정보
수록범위 : 1권1호(1991)~31권2호(2021) |수록논문 수 : 948
보건행정학회지
31권2호(2021년 06월) 수록논문
최근 권호 논문
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KCI등재

1연구윤리 환경 변화와 연구윤리 정책동향

저자 : 이선희 ( Sun-hee Lee )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 31권 2호 발행 연도 : 2021 페이지 : pp. 145-147 (3 pages)

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The ethical environment in academic research is rapidly changing at a global level. Further, social expectations and public interest toward research ethics are also escalating in Korea. Understanding and applying ethical issues in academic research has become increasingly important. To conform to such changes in the ethical environment, the official journal of the Korean Academy of Health Policy and Management has been consistently establishing and modifying rules and principles regarding research ethics. For instance, we amended the submission guidelines to further address the policies for gendered innovations. For this editorial of the current issue, we would like to organize and share several ethical concerns, which recently gained considerable attention. We hope this review provides scholars with practical guidelines to comprehend and incorporate critical ethical issues into academic research.

KCI등재

2합리적 기술 활용이 연구개발에 미치는 영향: 의료기기 개발 사례를 중심으로

저자 : 민혜숙 ( Hye Sook Min ) , 박지은 ( Ji Eun Park ) , 김창엽 ( Chang-yup Kim )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 31권 2호 발행 연도 : 2021 페이지 : pp. 148-157 (10 pages)

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Background: Based on that the key function of health technology is improving the quality of healthcare services, our study purports to explore the process of medical device development in detail and to discuss its policy implications.
Methods: A total of 12 in-depth interviews were conducted with four groups of industry, hospital, academia, and civil society. All of the interviewees except those from civil society were involved in the new medical device development between 2009 and 2018. We performed a text network analysis and content analysis of the interview data.
Results: The frequency and the degree centrality rankings suggested a close association between the utilization issue and the technology development. Similarly, the results of the content analysis showed that the appropriate intervention in the utilization of technology has a direct impact on the progress of development. Under the continuous industrial effort to boost profits by developing new technology, service providers and citizens should be knowledgeable of and make good use of the new technology for the provision of better services.
Conclusion: As the development itself would not guarantee the improvement of service quality and better health outcomes, health technology policies should take a more comprehensive view to serve the unmet needs and even to facilitate the technology development.

KCI등재

3우리나라 성인의 고감도 C-반응성 단백과 대사증후군의 관련성: 성별 분석

저자 : 신은영 ( Eunyoung Shin ) , 이용재 ( Yongjae Lee ) , 김태현 ( Taehyun Kim ) , 정금지 ( Keum Ji Jung ) , 정우진 ( Woojin Chung )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 31권 2호 발행 연도 : 2021 페이지 : pp. 158-172 (15 pages)

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Background: Metabolic syndrome has been known as a risk of cardiovascular disease. Meanwhile, high sensitivity C-reactive protein (hs-CRP) is used as a predictor of cardiovascular disease. In this paper, we aimed to investigate the association between hs-CRP and metabolic syndrome.
Method: A total of 7,633 were chosen as the study population from the 7th Korea National Health and Nutrition Examination Survey dataset (2016-2017). Our dependent variable was whether an individual had metabolic syndrome or not, and the independent variable of interest was hs-CRP which was categorized into three groups. The chi-square tests and hierarchical logistic regression analyses reflecting survey characteristics were conducted. All analyses were stratified by gender.
Results: According to the adjusted model with all covariates, compared to individuals having the low risk of hs-CRP, those having its average risk were more likely to have metabolic syndrome in men (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.12-1.76) and women (OR, 1.69; 95% CI, 1.33-2.16). Individuals having the high risk was not significantly different in men; however, they were more likely to have metabolic syndrome in women (OR, 2.03; 95% CI, 1.28-3.23).
Conclusion: In an upcoming aging society, it is important to reduce the risk of metabolic syndrome to improve population health. This study suggests that hs-CRP may be used as a marker of the risk of metabolic syndrome in a gender-specific way, thereby contributing to enhancing awareness of the risk of metabolic syndrome among the general public.

KCI등재

4장기입원 의료급여 환자의 재원일수에 미치는 영향요인: 요양병원 입원유형 중심으로

저자 : 윤은지 ( Eun Ji Yun ) , 이요셉 ( Yo Seb Lee ) , 홍미영 ( Mi Yeong Hong ) , 박미숙 ( Mi Sook Park )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 31권 2호 발행 연도 : 2021 페이지 : pp. 173-179 (7 pages)

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Background: In Korea, the length of stay and medical expenses incurred by medical aid patients are increasing at a rate faster than the national health insurance. Therefore, there is a need to create a management strategy for each type of hospitalization to manage the length of stay of medical aid patients.
Methods: The study used data from the 2019 National Health Insurance Claims. We analyzed the factors that affect the length of stay for 186,576 medical aid patients who were hospitalized for more than 31 days, with a focus on the type of hospitalization in long-term care hospitals.
Results: The study found a significant correlation between gender, age, medical aid type, chronic disease ratio, long-term care hospital patient classification, and hospitalization type variables as factors that affect the length of hospital stay. The analysis of the differences in the length of stay for each type of hospitalization showed that the average length of stay is 291.4 days for type 1, 192.9 days for type 2, and 157.0 days for type 3, and that the difference is significant (p<0.0001). When type 3 was 0, type 1 significantly increased by 99.4 days, and type 2 by 36.6 days (p<0.0001).
Conclusion: A model that can comprehensively view factors, such as provider factors and institutional factors, needs to be designed. In addition, to reduce long stays for medical aid patients, a mechanism to establish an early discharge plan should be prepared and concerns about underutilization should be simultaneously addressed.

KCI등재

5Diagnosis-Related Group 지불제도가 위험도 보정 제왕절개 분만율에 미치는 영향

저자 : 곽진미 ( Jin-mi Kwak ) , 이광수 ( Kwang-soo Lee )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 31권 2호 발행 연도 : 2021 페이지 : pp. 180-187 (8 pages)

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Background: This study analyzed the effect of applying the diagnosis-related group (DRG)-based payment system, which was implemented in July 2012 for hospitals and clinics nationwide, on the cesarean section rate.
Methods: The subjects of the study were divided into new groups that participated in the payment system after July 2012 and maintenance groups that participated in the payment system before July 2012. As an analysis method, a difference-in-difference analysis, which is a quasi-experimental design, was used. The risk-adjusted cesarean section rate was used as a dependent variable.
Results: Seven risk factors (malpresentation of fetus, eclampsia, multiple pregnancies, problems in the placenta, previous Cesarean section, cephalopelvic disproportion, problems in amniotic fluid) were included in the final risk-adjustment model, and found to have a statistically significant relationship with the cesarean section rate. Results showed that the risk-adjusted cesarean section rate increased significantly in new groups after the application of the DRG-based payment system.
Conclusion: Study results provided policy implications for the reorganization of the DRG-based system should that reflects the demands of obstetricians, such as organizing a consultative body with obstetricians and establishing a reasonable fee.

KCI등재

6소멸위험지역과 치료 가능 사망률 간의 관계

저자 : 설진주 ( Jin-ju Seol ) , 조형경 ( Hyung-kyung Cho ) , 이현지 ( Hyun-ji Lee ) , 이광수 ( Kwang-soo Lee )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 31권 2호 발행 연도 : 2021 페이지 : pp. 188-196 (9 pages)

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Background: This study purposed to analyze the relationship between extinction risk regions and amenable mortality.
Methods: This was a cross-sectional study based on the statistics of 2018 which was extracted from the 228 administrative districts in Korea. Cause of death statistics on each region in 2018 was used to produce the age-adjusted amenable mortality. Regional characteristics were measured by demographic factors, health behavior factors, socioeconomic factors, and medical resources factors. Multiple linear regression model was applied to test their relationship.
Results: Results showed that extinction risk regions, crude divorce rates, national cancer screening rates, and independent rate of finance were significantly related to the amenable mortality.
Conclusion: The study demonstrated differences in health status by the extinction risks of regions. This study suggests that the use of customized community care program can provide integrated services such as housing, health care or the use of information and communications technology which can make early diagnosis.

KCI등재

7거주지역에 따른 물리적 접근성으로 인한 미충족 의료경험

저자 : 김지은 ( Ji Eun Kim ) , 함명일 ( Myung-il Hahm )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 31권 2호 발행 연도 : 2021 페이지 : pp. 197-206 (10 pages)

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Background: The purpose of this study was to identify factors affecting unmet healthcare needs due to physical accessibility by residential area by utilizing the Korea Community Health Survey (KCHS).
Methods: Andersen's medical service behavioral model was applied to analyze the enabling factors, predisposing factors, and needs factors of unmet healthcare needs focusing on residential areas. This study used data from the KCHS (2017-2019, n=440,792). We used multivariate survey logistic regression analysis in order to identify affecting factors. Sub-group analysis was conducted in order to evaluate the effects of residential areas.
Results: Some participants (2,621, 0.59%) had experienced unmet healthcare needs due to physical accessibility and 2,047 subjects (78.1%) of them lived in rural areas. Multivariate survey logistic regressions revealed that experience of unmet healthcare needs due to physical accessibility increased when people lived in rural areas (odds ratio [OR], 3.95; 95% confidence interval, 3.46-4.51).
Conclusion: This study showed that despite the development of transportation and efforts to alleviate medical inequality, residents in rural areas may still have higher experience of unmet healthcare needs due to physical accessibility compared to the metropolitan city regardless of any other sub-group differences (OR range, 1.90-6.31). This study suggested that government and policymakers should identify the causes of the experience of unmet healthcare needs due to physical accessibility and should develop policies to alleviate those healthcare disparities.

KCI등재

8외래 환자경험에 영향을 주는 요인

저자 : 김경훈 ( Kyoung-hoon Kim )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 31권 2호 발행 연도 : 2021 페이지 : pp. 207-216 (10 pages)

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Background: Good patient experience is positively associated with adherence to treatment recommendations, better clinical effectiveness, and health outcomes. This study aims to find out the key factors affecting positive patient experience to improve the quality of care using nationally representative survey data.
Methods: The data was collected from the 6th National Health Nutrition Survey in 2015. Four patient experience items were investigated for patients with visiting outpatient care over the past year. Positive patient experience was defined as a case of responding always or usually yes. The t-test, chi-square test, and multiple logistic regression were performed to determine the key factors affecting the outpatient experience.
Results: More than 80% of the respondents reported their care experience as positive excluding doctor spending enough time during the consultation. Male, poor health status, and single/divorced, and the longer time interval between outpatient care visit and survey were found to be significantly correlated with negative care experiences in the multiple logistic regression. Patients who received outpatient care at the oriental medicine clinic had a positive experience compared to those received outpatient care at the general hospital. However, patient factors including age, income, job, and insurance type had no significant association with patient experience.
Conclusion: Health care providers should prioritize patients who report negative patient experiences and implement management decisions to improve the patient experience.

KCI등재

92018년 한국 보건의료의 상대적 위치와 추이: 경제협력개발기구 국가와 비교

저자 : 윤흰뫼 ( Hin Moi Youn ) , 이현지 ( Hyeon Ji Lee ) , 박은철 ( Eun-cheol Park )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 31권 2호 발행 연도 : 2021 페이지 : pp. 217-224 (8 pages)

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The objective of this study is to investigate the healthcare status of South Korea and other member countries of the Organization for Economic Cooperation and Development (OECD) using OECD health statistics 2020. We employed the position value for relative comparison index to measure the healthcare status in five following components: demand, supply, accessibility, quality, and cost. The Mann-Kendall test was used to analyze for increasing or decreasing trend of the position value for relative comparison values from 2000 to the recent year. Results showed that Korea was positioned above than the OECD median values in most of components, but lower than the median values in certain indices including healthcare employment, primary care, and mental health care. This study sheds some light on healthcare issues to be improved and the policy-makes can take into account for prior setting process.

KCI등재

102019 미충족의료율과 추이

저자 : 장빛나 ( Bich Na Jang ) , 주재홍 ( Jae Hong Joo ) , 김휘준 ( Hwi Jun Kim ) , 박은철 ( Eun-cheol Park ) , 장성인 ( Sung In Jang )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 31권 2호 발행 연도 : 2021 페이지 : pp. 225-231 (7 pages)

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Unmet healthcare is an important indicator to measure accessibility of healthcare services. To examine the latest status of unmet healthcare needs in South Korea, the four different data which is composed of nationally representative sample of South Korean population were used; the Korea Health and Nutrition Examination Survey (KNAHANES, 2007-2019), the Community Health Survey (CHS, 2008-2019), the Korea Health Panel Survey (KHP, 2011-2017), and the Korean Welfare Panel Study (KOWEPS, 2006-2019). The proportion of individuals reporting unmet healthcare needs were 5.8% (KNHANES), 5.3% (CHS), and 11.6% (KHP). Annual percentage change (APC) which identifies trend for the follow-up period was -9.5%, -8.0%, and -6.5%, respectively. The proportion of individuals reporting unmet healthcare needs due to cost were 1.1% (KNAHANES), 0.7% (CHS), 2.4% (KHP), and 0.4% (KOWEPS). The APC was -10.5%, -14.2%, -12.2%, and -19.6%, respectively. Compared to last year, the rate of unmet healthcare needs has declined in general. However, the low-income and the elderly population were reporting the highest rate of unmet health care needs, and the disparity between lowest and highest groups were remained. These results suggest that adequate benefit coverage is needed for low-income and elderly population.

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