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Health Policy and Mangemnet

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수록정보
수록범위 : 1권1호(1991)~32권1호(2022) |수록논문 수 : 989
보건행정학회지
32권1호(2022년 03월) 수록논문
최근 권호 논문
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KCI등재

1보건학 연구에서 연구윤리심의위원회 심의

저자 : 이선희 ( Sun-hee Lee )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 1호 발행 연도 : 2022 페이지 : pp. 1-2 (2 pages)

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With the rising attention dedicated to research ethics, the responsibility of researchers to comply with research ethics is also highlighted. Among a number of research ethics obligations that researchers should abide by, an institutional review board (IRB) review is the most essential step to be taken before launching research. As the health service research field grapples with human subjects, it closely aligns with IRB deliberation. However, it seems that researchers still do not fully understand their obligations of IRB reviews. Due to the nature of health services research, there are many cases that are exempt from IRB reviews, which often elicits confusion in the research field. On that note, we aim to explore the issues regarding IRB reviews that health service researchers need to know.

KCI등재

2지역보건의료기관의 진료현황 분석을 통한 보건소 기능개편 방향

저자 : 박선희 ( Sun Hee Park ) , 이미선 ( Mee Sun Lee ) , 오유미 ( Yumi Oh )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 1호 발행 연도 : 2022 페이지 : pp. 3-13 (11 pages)

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Health centers provided intensive health care services for local residents according to changes in the times and environment. Public health centers were given various roles such as medical treatment, administration, and service, and the demand for functional reorganization has emerged. We analyzed the literature on the functional restructuring of public health care institutions. In addition, the current status of medical services, which is the main function of institutions, will be analyzed through health insurance statistical data, and detailed contents will be analyzed according to regional types and income levels. As a result of the analysis of medical services at institutions, the total number of patients was 2,238,000, and the number of visits was 11,806 times. Total medical expenses were 169.6 billion won, of which 132 billion won was found to be benefit. When analyzing the number of patients per institution, public health centers had the largest number of 4,326, and the share of benefit was also the highest at public health centers. It should focus on the function of providing local health and medical services related to health promotion and disease prevention in the community. This functional reorganization of public health centers can contribute to forming cooperative relationships with private medical institutions in the local community. For this, first, to establish the role, essential functions for public health centers for preventive health management are established. Secondly, regular manpower expansion and flexible manpower management are required in the human resources sector. Finally, in the organizational sector, it is necessary to establish a step-by-step organizational system according to environmental changes.

KCI등재

3다년도 자료를 이용한 나주시의 지역 내 우울증 영향요인: 도시와 농촌 지역을 중심으로 비교

저자 : 조경희 ( Kyung-hee Jo ) , 류소연 ( So Yeon Ryu )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 1호 발행 연도 : 2022 페이지 : pp. 14-20 (7 pages)

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In this study, we distinguished urban and rural areas in Naju-si, Jeollanam-do, grasped the characteristics of those areas, and investigated the depression-related factors in Naju-si based on this. This study used Community Health Survey data from 2017 to 2019. To investigate the factors affecting the depression in Naju-si local residents, the odds ratio was calculated using a complex sample logistic regression model. As a result of confirming the factors affecting the prevalence of depression in Naju-si residents, the risk of depression was significantly higher at 1.59 (95% confidence interval [CI], 1.02-2.50) for women, 2.14 (95% CI, 1.20-3.83) for recipients of basic livelihoods, 2.35 (95% CI, 1.46-3.79) for those who did not practice walking, and 2.00 (95% CI, 1.23-3.26) for those who slept less than 5 hours. It is necessary to select high-risk groups as a regional-specific project to resolve the mental health disparities in Naju-si and to intervene in early depression prevention through support for mental health support services.

KCI등재

4Regular Physical Exercise and Falling in Middle-Aged and Elderly Population: Results from Korean Longitudinal Study of Ageing

저자 : Sueon Jeong , Hyeon Ji Lee , Jae-hyun Kim

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 1호 발행 연도 : 2022 페이지 : pp. 21-28 (8 pages)

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Background: To investigate the association between regular physical exercise and falling experience for 2 years and fear of falling (FOF) in Korean middle-aged and elderly population.
Methods: Data from the Korean Longitudinal Study on Aging was used and 3,871 participants who exercised regularly were included at 2006 and follow-up until 2018. An analysis was performed to investigate the association between exercise (exercise time per week and duration) and falls (experience over past 2 years and FOF) using the generalized estimating equation model.
Results: Compared to those who exercised more than 5 hours a week (reference group), those who exercised less than 3 hours were more likely to experience falls and FOF (odds ratio [OR], 1.334; 95% confidence interval [CI], 1.059-1.682; OR, 1.218; 95% CI, 1.119- 1.326, respectively). Compared to the group who exercised for more than 5 years, those who exercised for less than 1 year were more likely to experience FOF (OR, 1.310; 95% CI, 1.162-1.478).
Conclusion: This study showed that there was a negative relationship between physical exercise time and falling experience and FOF in Korean 45 years or more community-dwelling adults. Based on these results, physical activity can be expected to have a positive effect on fall prevention, which implies the need for policy and research on long-term physical activity programs.

KCI등재

5상용치료원 보유가 중노년층의 건강행동에 미치는 영향

저자 : 윤성훈 ( Sunghun Yun ) , 송연재 ( Yeonjae Song ) , 권순만 ( Soonman Kwon )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 1호 발행 연도 : 2022 페이지 : pp. 29-44 (16 pages)

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Background: This study was conducted to analyze the impact of having a usual source of care on health behaviors of the middle aged and the elderly, in order to investigate the potential effect of enhancing primary health care in a Korean context.
Methods: This study constructed a balanced panel of middle-aged and elderly samples using the Korea Health Panel 2016-2018, and fixed-effect models were used to analyze the data.
Results: Among three sets of dependent variables (physical activity, smoking, drinking), statistically significant results were found only in physical activity. Subgroup analysis showed that this effect was not observed in the late elderly (aged 75 and older) and those without chronic diseases.
Conclusion: Results of the study implied that enhancing primary health care among middle age and the elderly may have an effect on improving health behaviors. Moving forward to person-centered primary health care from disease-focused primary health care should be considered in high-risk groups such as the middle aged and the elderly with chronic diseases.

KCI등재

6코로나19 발생의 지역사회 위험요인 분석

저자 : 심보람 ( Boram Sim ) , 박명배 ( Myung-bae Park )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 1호 발행 연도 : 2022 페이지 : pp. 45-52 (8 pages)

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Background: There are regional variations in the incidence of coronavirus disease 2019 (COVID-19), which means that some regions are more exposed to the risk of COVID-19 than others. Therefore, this study aims to investigate regional variations in the incidence of COVID-19 in Korea and identify risk factors associated with the incidence of COVID-19 using community-level data.
Methods: This study was conducted at the districts (si·gun ·gu) level in Korea. Data of COVID-19 incidence by districts were collected from the official website of each province. Data was also obtained from the Korean Statistical Information Service and the Community Health Survey; socio-demographic factor, transmission pathway, healthcare resource, and factor in response to COVID-19. Community risk factors that drive the incidence of COVID-19 were selected using a least absolute shrinkage and selection operator regression.
Results: As of June 2021, the incidence of COVID-19 differed by more than 80 times between districts. Among the candidate factors, sex ratio, population aged 20-29, local financial independence, population density, diabetes prevalence, and failure to comply with the quarantine rules were significantly associated with COVID-19 incidence.
Conclusion: This study suggests setting COVID-19 quarantine policy and allocating resources, considering the community risk factors. Protecting vulnerable groups should be a high priority for these policies.

KCI등재

7거동불편 사유로 인한 미충족 의료의 규모와 관련 요인 탐색 연구: 방문의료 대상자 추계를 위한 근거

저자 : 최재우 ( Jae Woo Choi ) , 김창오 ( Chang-o Kim )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 1호 발행 연도 : 2022 페이지 : pp. 53-62 (10 pages)

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Background: This study was designed to examine regional proportions for people who experienced unmet health care needs due to reduced mobility or unhealthiness and factors associated with experience of unmet health care needs by them.
Methods: A total of 11,620 people were retrieved from the Korea Health Panel data (2014-2018). Regional proportions for people who experienced unmet health care needs due to reduced mobility or unhealthiness were estimated using cross-sectional weights and the factors associated with them were analyzed using generalized estimating equation.
Results: The number of people who experienced unmet health care needs due to reduced mobility or unhealthiness was estimated as 278,083 in 2018. Women, the aged (65+), below elementary school, single as marital status, low income, bad self-rated health, people with disabilities, and long-term insurance beneficiaries were statistically significantly associated with experience of unmet health care needs due to reduced mobility or unhealthiness.
Conclusion: Given high and dispersed demand for visiting health care, government need to expand the infrastructure and finance to facilitate visiting health care.

KCI등재

8생활체육시설의 지역 간 격차에 따른 19세 이상 인구의 우울증상

저자 : 심형섭 ( Hyung-seop Sim ) , 김봄결 ( Bom-gyeol Kim ) , 김도희 ( Do-hee Kim ) , 김태현 ( Tae-hyun Kim )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 1호 발행 연도 : 2022 페이지 : pp. 63-72 (10 pages)

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Background: Depression is a common disease around the world. Many studies are showing that mental health can be improved through physical activity, and daily regular exercise can reduce the negative effects of depression or depressive symptoms. In order to promote individual physical activity, a physical activity-friendly environment must precede. Therefore, this study attempted to confirm whether the number of sports facilities for all affects individual depression.
Methods: Among the respondents to the 2018 Community Health Survey, data from 181,086 people excluding missing value were used. Descriptive and chi-square tests were performed to understanding the general characteristics of individual level variables. A multilevel logistic regression was conducted to confirm the effect of individual and regional level variables on depressive symptoms.
Results: As a result of confirming the effect of individual characteristics on depressive symptoms, it was confirmed that both socioeconomic and health behavior factors had an effect. Similar results were shown in a model that considered regional level variables, and in the case of the number of sports facilities per population, people who belongs to smaller areas were more likely to have depressive symptoms (odds ratio, 0.98; 95% confidence interval, 0.97-0.99).
Conclusion: As a result of the analysis, it was confirmed that both individual level and regional level variables had a significant effect on depressive symptoms. This suggests that not only individual level approaches but also regional level approaches are needed to improve individual depressive symptoms In particular, it may be possible to consider to increase the number of sports facilities in areas where the prevalence of depressive symptoms is high and the number of sports facilities is insufficient.

KCI등재

9시스템 다이내믹스를 활용한 지역별 국내 의사인력 수요에 대한 추계모델 개발

저자 : 이경민 ( Gyeong Min Lee ) , 유기봉 ( Ki-bong Yoo )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 1호 발행 연도 : 2022 페이지 : pp. 73-93 (21 pages)

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Background: Appropriate physician workforce projection through reasonable discussions and decisions with a broad view on supply and demand of the workforce, thus, is very important for high-quality healthcare services. The study expects to provide preliminary research data on the workforce diagnosis standard model for Korean physician workforce policy decision through more flexible and objective physician workforce projection in reflection of diverse changes in healthcare policy and sociodemographic environments.
Methods: A low flow rate through the causal map was developed, and an objective workforce demand projection from 2019 to 2040 was conducted. In addition, projections by scenarios under various situations were conducted with the low flow rate developed in the study. Lastly, the demand projection of the physician workforce by region of 17 cities and provinces was conducted.
Results: First, demand of physicians in 2019 was 110,665, 113,450 in 2020, 129,496 in 2025, 146,837 in 2030, 163,719 in 2035, and 179,288 in 2040. Second, the scenario for the retirement of baby boomers led to a decrease in the growth rate due to time delay. Third, Seoul and Gyeonggi-do account for a high percentage of demand, a very high upward trend was identified in Gyeonggi-do, and as a result, the projection showed that the demand of the physician workforce in Gyeonggi-do would worsen over time.
Conclusion: This study is meaningful in that rational and collective physician workforce supply and demand and its imbalance in workforce distribution were verified through various projections by scenarios and regions of Korea with System Dynamics.

KCI등재

10의료서비스경험조사의 신뢰도 및 타당도 검토: 의료기관 특성별 차이를 중심으로

저자 : 김희년 ( Heenyun Kim ) , 최용석 ( Yongseok Choi ) , 문석준 ( Seokjun Moon ) , 신정우 ( Jeongwoo Shin )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 1호 발행 연도 : 2022 페이지 : pp. 94-106 (13 pages)

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Background: The efforts to build more “people centered,” “patient centered” health system has been emerging all over the world. Aligning with it, the Korean government is conducing the survey called “Medical Service Experience Survey (MSES).” There are critics, however, that MSES is not scrutinizing the medical experiences of patients in various healthcare settings. For this reason, this study aims to perform an empirical analysis of the differences in answers of patients responding to various healthcare settings.
Methods: There are two steps in this study. First, explanatory analysis is conducted to compare the tendency of statistical concentration on questionnaires by divided healthcare settings. Second, confirmative analysis is carried out to evaluate the construct validity, reliability, and discriminant validity of the questionnaire in each healthcare setting. The raw data of MSES, which was conducted in 2020 by the Ministry of Health and Welfare in Korea and the Korean Institute for Health and Social Affairs is used.
Results: As a result of exploratory factor analysis for all outpatients, the items were classified into four factors statistically: “doctor experience,” “nurse experience,” “outpatient service experience,” and “patient satisfaction.” It was confirmed that the reliability of all factors extracted was secured. However, for patients who visited hospitals, questionnaires related to personal privacy, such as “experiences on medical staffs considering physical exposure” or “experiences related to personal information exposure,” were answered in conjunction with items of “nurse experience.” Besides, patients responded that administrative elements of medical services, such as “experiences of comfort in medical institutions” and “experiences of satisfactory administrative services,” were related to the items of “nurse experience.” The answers of patients who visited traditional medical hospitals and clinics about “doctor experience” and “nurse experience” were not discerned statistically, and the answers to “doctor experience,” “nurse experience,” and “medical institution experience” were entangled with the responses of patients who visited dental hospitals and clinics. On the other hand, as a result of the confirmatory factor analysis, it was found that the inquiries of MSES generally had intensive validity.
Conclusion: The collection of objective and scientific data is the prominent component to enlighten the patient-centered healthcare system alongside with change of the worldwide paradigm of measuring the healthcare system performance as follows the transition of perspective of health care from provider-centered to patient-centered. This study empirically shows that the patient experience can vary as the healthcare settings. Furthermore, to make an advance in measuring the experience of patients with medical services, this article proposes the deliberate consideration of the different kinds of healthcare settings and articulate design of the survey.

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