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한국병원경영학회> 한국병원경영학회지> 건강보험빅데이터의 고혈압 입원율 분석을 통한 장애인의 의료접근성 실증 분석

KCI등재

건강보험빅데이터의 고혈압 입원율 분석을 통한 장애인의 의료접근성 실증 분석

Empirical Analysis of Medical Accessibility for People with Disabilities using Health Insurance Big Data

전희원 ( Huiwon Jeon ) , 홍민정 ( Minjung Hong ) , 정재연 ( Jaeyeon Jeong ) , 김예순 ( Yesoon Kim ) , 이창우 ( Changwoo Lee ) , 이해종 ( Haejong Lee ) , 신의철 ( Eulchul Shin )
  • : 한국병원경영학회
  • : 한국병원경영학회지 27권1호
  • : 연속간행물
  • : 2022년 03월
  • : 1-10(10pages)
한국병원경영학회지

DOI


목차

Ⅰ. 서 론
Ⅱ. 연구방법
Ⅲ. 분석결과
Ⅳ. 고찰 및 결론
Reference

키워드 보기


초록 보기

Background: This study aims to empirically compare and evaluate the current status of medical accessibility and health inequality between people with disabilities and without. We calculated the ACSC hospitalization rate, which is a medical accessibility index, for hypertension, a major risk factor for cardiovascular disease that accounts for more than 20% of deaths among people with disabilities using the 2016 National Health Insurance Big Data.
Methods: The subjects of the study were a total of 601,520, including 64,018 people with disabilities and 537,501 people without. Logistic regression was performed to analyze the differences in hypertension hospitalization rates adjusted for demographic and sociological characteristics and disease characteristics using SAS 9.4 program.
Results: Before adjusting for the characteristics, the hypertension hospitalization rate of people with disabilities was 1.55%, and the people without disabilities were 0.49%. After adjusting, it was found that people with disabilities were 2.11 times higher than people without disabilities, and it was statistically significant.
Conclusion: The preventable hospitalization rate of people with disabilities is higher than that of people without, suggesting that the disabled have problems with access to medical care and health inequality. Therefore, the government's policy improvement is required to close the medical gap for the disabled.

UCI(KEPA)

간행물정보

  • : 사회과학분야  > 경영학
  • : KCI등재
  • :
  • : 계간
  • : 1226-6299
  • :
  • : 학술지
  • : 연속간행물
  • : 1996-2022
  • : 651


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27권1호(2022년 03월) 수록논문
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KCI등재

1건강보험빅데이터의 고혈압 입원율 분석을 통한 장애인의 의료접근성 실증 분석

저자 : 전희원 ( Huiwon Jeon ) , 홍민정 ( Minjung Hong ) , 정재연 ( Jaeyeon Jeong ) , 김예순 ( Yesoon Kim ) , 이창우 ( Changwoo Lee ) , 이해종 ( Haejong Lee ) , 신의철 ( Eulchul Shin )

발행기관 : 한국병원경영학회 간행물 : 한국병원경영학회지 27권 1호 발행 연도 : 2022 페이지 : pp. 1-10 (10 pages)

다운로드

(기관인증 필요)

초록보기

Background: This study aims to empirically compare and evaluate the current status of medical accessibility and health inequality between people with disabilities and without. We calculated the ACSC hospitalization rate, which is a medical accessibility index, for hypertension, a major risk factor for cardiovascular disease that accounts for more than 20% of deaths among people with disabilities using the 2016 National Health Insurance Big Data.
Methods: The subjects of the study were a total of 601,520, including 64,018 people with disabilities and 537,501 people without. Logistic regression was performed to analyze the differences in hypertension hospitalization rates adjusted for demographic and sociological characteristics and disease characteristics using SAS 9.4 program.
Results: Before adjusting for the characteristics, the hypertension hospitalization rate of people with disabilities was 1.55%, and the people without disabilities were 0.49%. After adjusting, it was found that people with disabilities were 2.11 times higher than people without disabilities, and it was statistically significant.
Conclusion: The preventable hospitalization rate of people with disabilities is higher than that of people without, suggesting that the disabled have problems with access to medical care and health inequality. Therefore, the government's policy improvement is required to close the medical gap for the disabled.

KCI등재

2의료소비자의 비급여 진료에 대한 자기결정권 행사와 관련 요인

저자 : 김지은 ( Ji Eun Kim ) , 함명일 ( Myung-il Hahm ) , 이혜원 ( Hyewon Lee ) , 김선정 ( Sun Jung Kim )

발행기관 : 한국병원경영학회 간행물 : 한국병원경영학회지 27권 1호 발행 연도 : 2022 페이지 : pp. 11-19 (9 pages)

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(기관인증 필요)

초록보기

Purposes: This study was to investigate intention to exercise the patient's right of self-determination on adopting the non-benefit medical services and was to identify factors associated with intention to self-determined decision.
Methodology: A total of 1,000 adult respondents aged 20 to 65 years were recruited using stratified random sampling and surveyed by online. Multivariate logistic regression analysis was performed to identify factors associated with intention to self-determined decision using SAS 9.4(SAS Institute Inc. Cary, NC, USA).
Findings: 61.9% of total participants(n=592) had intention to exercise patient's right of self-determination on adopting the non-benefit medical services. Significant differences were observed in the exercise of self-determination in relation to prior explanation and opportunity for self-determination.
Practical Implications: This study suggested that explanation duty of provider might influence on increasing intention to exercise the patient's right of self-determination. Considering appropriate use of non-benefit services, it is important to enhance explanation duty of provider.

KCI등재

3가감지급사업 실행 후 급성기 출혈성 뇌졸중의 원내 사망률 변화 분석

저자 : 설진주 ( Jin-ju Seol ) , 유기봉 ( Ki-bong Yoo ) , 이광수 ( Kwang-soo Lee )

발행기관 : 한국병원경영학회 간행물 : 한국병원경영학회지 27권 1호 발행 연도 : 2022 페이지 : pp. 20-30 (11 pages)

다운로드

(기관인증 필요)

초록보기

Purposes: This study purposed to evaluate the effect of a value incentive program(VIP) on the in-hospital mortality of acute stroke.
Methodology: Study period was from January 2010 to December 2018. This study included 63 hospitals for acute hemorrhagic stroke that the mortality rate per month was more than one during study period. Independent variables were time variables and hospital characteristics such as hospital type, district and bed number. Interrupted time series analysis was applied to analyze the data.
Findings: In case of general hospitals, the in-hospital mortality rate per month for acute hemorrhagic stroke tends to be increased by 0.03% in overall study periods but decreased by 0.32% after the implementation of the policy. On the other hand, tertiary hospital changes are not statistically meaningful.
Conclusion: This study provides evidences how the VIP was effective in improving quality of acute hemorrhagic stroke care. General hospitals showed higher policy effect compare to that of tertiary hospitals.

KCI등재

4노인 환자 및 보호자에 의한 입원서비스 결정 여부가 재원일수와 진료비에 미치는 영향

저자 : 손예리 ( Yehrhee Son ) , 김규나 ( Kyuna Kim ) , 서영준 ( Youngjoon Seo )

발행기관 : 한국병원경영학회 간행물 : 한국병원경영학회지 27권 1호 발행 연도 : 2022 페이지 : pp. 31-42 (12 pages)

다운로드

(기관인증 필요)

초록보기

Purposes: This study aims to investigate the changes in the length of stay and medical expenses by the impact of the admission decided by patients or their family.
Methodology: The analysis was conducted using data from elder patients aged 65 or older who have used admission services more than once from year 6(2012) to year 12(2017) of the Korean Medical Panel Data(KOWEPS). The statistical analysis was performed through the Chi-square test, mean difference analysis, and generalized estimation equation analysis.
Findings: Compared to the patients who used admission services decided by doctors, those who used admission services decided by patients or their family had a longer length of stay and a lower daily medical expense.
Practical Implications: Inappropriate admission decided by patients or their family can increase the risk of hospital-acquired infections, impairing the health of elderly patients, and has a negative impact on the efficiency of health resources. Therefore, it is necessary to prevent and properly manage inappropriate admission decided by patients or their family.

KCI등재

5회피가능한 사망에 미치는 지역 영향요인 분석: 2010~2019

저자 : 이현지 ( Hyun-ji Lee ) , 이광수 ( Kwang-soo Lee )

발행기관 : 한국병원경영학회 간행물 : 한국병원경영학회지 27권 1호 발행 연도 : 2022 페이지 : pp. 43-57 (15 pages)

다운로드

(기관인증 필요)

초록보기

Background: Avoidable mortality rate has been widely used as an indicator of the quality of health care and the degree of inequality in health levels. The purpose of this study was to identify the factors affecting the avoidable mortality rate in the region.
Methods: The data was MDIS(Microdata Integrated Service) Causes of Death Statistics, and the analysis period was from 2010 to 2019. Panel analysis was performed to identify the influencing factors on the avoidable mortality rate.
Findings: Result showed that the current smoking rate had a significant positive effects on the avoidable mortality rate of both men and women. And the smoking cessation trial rate, low salt diet rate, weight control trial rate, annual vaccination rate had a significant negative effect. In the social environment, the divorce rate had a significant positive effect. In the economy environment, financial independence and social welfare budget rate had a significant negative effect. In the physical environment, the factory area rate had a significant positive effect.
Practical Implication: Practical implication in order to lower the local avoidable mortality rate, various social determinants of health as well as health care resources should be considered together.

1
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KCI등재

1건강보험빅데이터의 고혈압 입원율 분석을 통한 장애인의 의료접근성 실증 분석

저자 : 전희원 ( Huiwon Jeon ) , 홍민정 ( Minjung Hong ) , 정재연 ( Jaeyeon Jeong ) , 김예순 ( Yesoon Kim ) , 이창우 ( Changwoo Lee ) , 이해종 ( Haejong Lee ) , 신의철 ( Eulchul Shin )

발행기관 : 한국병원경영학회 간행물 : 한국병원경영학회지 27권 1호 발행 연도 : 2022 페이지 : pp. 1-10 (10 pages)

다운로드

(기관인증 필요)

초록보기

Background: This study aims to empirically compare and evaluate the current status of medical accessibility and health inequality between people with disabilities and without. We calculated the ACSC hospitalization rate, which is a medical accessibility index, for hypertension, a major risk factor for cardiovascular disease that accounts for more than 20% of deaths among people with disabilities using the 2016 National Health Insurance Big Data.
Methods: The subjects of the study were a total of 601,520, including 64,018 people with disabilities and 537,501 people without. Logistic regression was performed to analyze the differences in hypertension hospitalization rates adjusted for demographic and sociological characteristics and disease characteristics using SAS 9.4 program.
Results: Before adjusting for the characteristics, the hypertension hospitalization rate of people with disabilities was 1.55%, and the people without disabilities were 0.49%. After adjusting, it was found that people with disabilities were 2.11 times higher than people without disabilities, and it was statistically significant.
Conclusion: The preventable hospitalization rate of people with disabilities is higher than that of people without, suggesting that the disabled have problems with access to medical care and health inequality. Therefore, the government's policy improvement is required to close the medical gap for the disabled.

KCI등재

2의료소비자의 비급여 진료에 대한 자기결정권 행사와 관련 요인

저자 : 김지은 ( Ji Eun Kim ) , 함명일 ( Myung-il Hahm ) , 이혜원 ( Hyewon Lee ) , 김선정 ( Sun Jung Kim )

발행기관 : 한국병원경영학회 간행물 : 한국병원경영학회지 27권 1호 발행 연도 : 2022 페이지 : pp. 11-19 (9 pages)

다운로드

(기관인증 필요)

초록보기

Purposes: This study was to investigate intention to exercise the patient's right of self-determination on adopting the non-benefit medical services and was to identify factors associated with intention to self-determined decision.
Methodology: A total of 1,000 adult respondents aged 20 to 65 years were recruited using stratified random sampling and surveyed by online. Multivariate logistic regression analysis was performed to identify factors associated with intention to self-determined decision using SAS 9.4(SAS Institute Inc. Cary, NC, USA).
Findings: 61.9% of total participants(n=592) had intention to exercise patient's right of self-determination on adopting the non-benefit medical services. Significant differences were observed in the exercise of self-determination in relation to prior explanation and opportunity for self-determination.
Practical Implications: This study suggested that explanation duty of provider might influence on increasing intention to exercise the patient's right of self-determination. Considering appropriate use of non-benefit services, it is important to enhance explanation duty of provider.

KCI등재

3가감지급사업 실행 후 급성기 출혈성 뇌졸중의 원내 사망률 변화 분석

저자 : 설진주 ( Jin-ju Seol ) , 유기봉 ( Ki-bong Yoo ) , 이광수 ( Kwang-soo Lee )

발행기관 : 한국병원경영학회 간행물 : 한국병원경영학회지 27권 1호 발행 연도 : 2022 페이지 : pp. 20-30 (11 pages)

다운로드

(기관인증 필요)

초록보기

Purposes: This study purposed to evaluate the effect of a value incentive program(VIP) on the in-hospital mortality of acute stroke.
Methodology: Study period was from January 2010 to December 2018. This study included 63 hospitals for acute hemorrhagic stroke that the mortality rate per month was more than one during study period. Independent variables were time variables and hospital characteristics such as hospital type, district and bed number. Interrupted time series analysis was applied to analyze the data.
Findings: In case of general hospitals, the in-hospital mortality rate per month for acute hemorrhagic stroke tends to be increased by 0.03% in overall study periods but decreased by 0.32% after the implementation of the policy. On the other hand, tertiary hospital changes are not statistically meaningful.
Conclusion: This study provides evidences how the VIP was effective in improving quality of acute hemorrhagic stroke care. General hospitals showed higher policy effect compare to that of tertiary hospitals.

KCI등재

4노인 환자 및 보호자에 의한 입원서비스 결정 여부가 재원일수와 진료비에 미치는 영향

저자 : 손예리 ( Yehrhee Son ) , 김규나 ( Kyuna Kim ) , 서영준 ( Youngjoon Seo )

발행기관 : 한국병원경영학회 간행물 : 한국병원경영학회지 27권 1호 발행 연도 : 2022 페이지 : pp. 31-42 (12 pages)

다운로드

(기관인증 필요)

초록보기

Purposes: This study aims to investigate the changes in the length of stay and medical expenses by the impact of the admission decided by patients or their family.
Methodology: The analysis was conducted using data from elder patients aged 65 or older who have used admission services more than once from year 6(2012) to year 12(2017) of the Korean Medical Panel Data(KOWEPS). The statistical analysis was performed through the Chi-square test, mean difference analysis, and generalized estimation equation analysis.
Findings: Compared to the patients who used admission services decided by doctors, those who used admission services decided by patients or their family had a longer length of stay and a lower daily medical expense.
Practical Implications: Inappropriate admission decided by patients or their family can increase the risk of hospital-acquired infections, impairing the health of elderly patients, and has a negative impact on the efficiency of health resources. Therefore, it is necessary to prevent and properly manage inappropriate admission decided by patients or their family.

KCI등재

5회피가능한 사망에 미치는 지역 영향요인 분석: 2010~2019

저자 : 이현지 ( Hyun-ji Lee ) , 이광수 ( Kwang-soo Lee )

발행기관 : 한국병원경영학회 간행물 : 한국병원경영학회지 27권 1호 발행 연도 : 2022 페이지 : pp. 43-57 (15 pages)

다운로드

(기관인증 필요)

초록보기

Background: Avoidable mortality rate has been widely used as an indicator of the quality of health care and the degree of inequality in health levels. The purpose of this study was to identify the factors affecting the avoidable mortality rate in the region.
Methods: The data was MDIS(Microdata Integrated Service) Causes of Death Statistics, and the analysis period was from 2010 to 2019. Panel analysis was performed to identify the influencing factors on the avoidable mortality rate.
Findings: Result showed that the current smoking rate had a significant positive effects on the avoidable mortality rate of both men and women. And the smoking cessation trial rate, low salt diet rate, weight control trial rate, annual vaccination rate had a significant negative effect. In the social environment, the divorce rate had a significant positive effect. In the economy environment, financial independence and social welfare budget rate had a significant negative effect. In the physical environment, the factory area rate had a significant positive effect.
Practical Implication: Practical implication in order to lower the local avoidable mortality rate, various social determinants of health as well as health care resources should be considered together.

1
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