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한국보건행정학회> 보건행정학회지> 진료비 고가도 지표의 한계와 개선 방향

KCI등재

진료비 고가도 지표의 한계와 개선 방향

Limitations and Improvement of Using a Costliness Index

장호연 ( Ho Yeon Jang ) , 강민석 ( Min Seok Kang ) , 정서현 ( Seo Hyun Jeong ) , 이상아 ( Sang Ah Lee ) , 강길원 ( Gil Won Kang )
  • : 한국보건행정학회
  • : 보건행정학회지 32권2호
  • : 연속간행물
  • : 2022년 06월
  • : 154-163(10pages)
보건행정학회지

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Background: The costliness index (CI) is an index that is used in various ways to improve the quality of medical care and the management of appropriate treatment in medical institutions. However, the current calculation method for CI has a limitation in reflecting the actual medical cost of the patient unit because the outpatient and inpatient costs are evaluated separately. It is desirable to calculate the CI by integrating the medical cost into the episode unit.
Methods: We developed an episode-based CI method using the episode classification system of the Centers for Medicare and Medicaid Services to the National Inpatient Sample data in Korea, which can integrate the admission and ambulatory care cost to episode unit. Additionally, we compared our new method with the previous method.
Results: In some episodes, the correlation between previous and episode-based CI was low, and the proportion of outpatient treatment costs in total cost and readmission rates are high. As a result of regression analysis, it is possible that the level of total medical costs of the patient unit in low volume medical institute and rural area has been underestimated.
Conclusion: High proportion of outpatient treatment cost in total medical cost means that some medical institutions may have provided medical services in the ambulatory care that are ancillary to inpatient treatment. In addition, a high readmission rate indicates insufficient treatment service for inpatients, which means that previous CI may not accurately reflect actual patient-based treatment costs. Therefore, an integrated patient-unit classification system which can be used as a more effective CI indicator is needed.

UCI(KEPA)

간행물정보

  • : 의약학분야  > 예방의학및보건학
  • : KCI등재
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  • : 계간
  • : 1225-4266
  • : 2289-0149
  • : 학술지
  • : 연속간행물
  • : 1991-2022
  • : 1018


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KCI등재

1변화에 부응하는 보건의료정책 전환이 필요하다

저자 : 이선희 ( Sun-hee Lee )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 4호 발행 연도 : 2022 페이지 : pp. 345-346 (2 pages)

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2022 was a time when the global healthcare system was challenged and has grown in response to the coronavirus disease 2019 pandemic. In addition, various issues accumulated in the process of quantitative growth have emerged in the Korean healthcare system. For instance, problems of sustainability in health insurance finances and removing bubbles from excessive medical utilization should be urgently resolved as tasks that occurred in the process of expanding the coverage of the health insurance system. The deficit of applicants for the pediatrician residency program suggests that expanding health insurance coverage alone has limitations in providing essential medical services. There is a need to incentivize doctors who provide essential medical care services. In 2023, we hope that efforts to enhance and internally reinforce the healthcare system will be concentrated.

KCI등재

2퇴원 의지가 요양병원의 성공적 퇴원에 미치는 영향에 대한 다수준 분석

저자 : 강하렴 ( Haryeom Ghang ) , 이연주 ( Yeonju Lee )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 4호 발행 연도 : 2022 페이지 : pp. 347-355 (9 pages)

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Background: Since November 2019, long-term care hospitals have been able to provide patients with discharging programs to support the elderly in the community. This study aimed to identify both patient- and hospital-level factors that affect successful community discharge from long-term care hospitals.
Methods: A multilevel logistic regression model was performed using hospitals as a clustering unit. The dependent variable was whether a patient stayed in the community for at least 30 days after discharge from a long-term care hospital. As for the patient-level independent variables, an agreement between a patient and the family about discharge, length of hospital stay, patient category, and residence at discharge were included. The number of beds and the ratio of long-stay patients were selected for the hospital-level factors. The sample size was 1,428 patients enrolled in the discharging program from November 2019 to December 2020.
Results: The number of patients who were discharged to the community and stayed at least for 30 days was 532 (37.3%). The intraclass correlation coefficient was 22.9%, indicating that hospital-level factors had a significant impact on successful community discharge. The odds ratio (OR) of successful community discharge increased by 1.842 times when the patients and their families agreed on discharge. The ORs also increased by 3.020 or 2.681 times, respectively when the patients planned to discharge to their own house or their child's house compared to those who didn't have a plan for residence at discharge. The ORs increased by 1.922 or 2.250 times when the hospitals were owned by corporate or private property compared to publicly owned hospitals. The ORs decreased by 0.602 or 0.520 times when the hospital was sized over 400 beds or located in small and medium-sized cities compared to less than 200 bedded hospitals or located in metropolitan cities.
Conclusion: The results of the study showed that the patients' and their family's willingness for discharge had a great impact on successful community discharge and the hospital-level factors played a significant role in it. Therefore, it is important to acknowledge and support long-term care hospitals to involve active in the patient discharge planning process.

KCI등재

3신종감염병의 양적 및 질적 혼합 위험 평가 모델 개발

저자 : 우다래 ( Darae Woo ) , 최은미 ( Eunmi Choi ) , 최영준 ( Young June Choe ) , 예정용 ( Jungyong Yeh ) , 박상신 ( Sangshin Park )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 4호 발행 연도 : 2022 페이지 : pp. 356-367 (12 pages)

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Background: The emergence of new infectious diseases threatens public health, increasing socioeconomic damage, and national risks. This study aimed to develop an evidence-based risk assessment tool to quickly respond to new infectious diseases.
Methods: The risk elements were extracted by reviewing the risk assessment methods of the World Health Organization, United States, Europe, United Kingdom, and Germany, and the validity and priority of elements were determined through expert meetings and Delphi surveys. Then, the scale and level for each risk element were defined and a final score calculation method according to the risk evaluation result was derived. The developed risk assessment tool was verified using data at the time of domestic transmission of an emerging infectious disease.
Results: In case of spread of actual infectious diseases, priority is determined based on the criticality of the elements in each area of transmissibility and severity, from which the weighted score of the risk assessment is derived. Then, the risk score for each element was calculated by multiplying the average value of the risk evaluation by its weight and the evaluation risk assessment score for the two areas was calculated. At last, the final score is plotted in a matrix where the x-axis indicates the transmissibility and the y-axis the severity and plotted on the coordinate plane for time series use.
Conclusion: With respect to transmissibility and severity, this risk assessment method to respond to new and re-emerging infectious diseases enables rapid and evidence-based evaluation by quantitatively and qualitatively assessing various risk elements.

KCI등재

4한국 노인장기요양시설 및 재가 요양보호사들의 노동환경과 노동조건 개선방안

저자 : 손미아 ( Mia Son ) , 김태운 ( Tae Un Kim ) , 예상은 ( Sang Eun Yeh ) , 황은아 ( Eun A Hwang ) , 최민서 ( Minseo Choi ) , 윤재원 ( Jae-won Yun )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 4호 발행 연도 : 2022 페이지 : pp. 368-379 (12 pages)

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Background: This study aimed to establish a strategy to improve the poor working environment and working conditions among long-term healthcare workers in Korea.
Methods: A total of 600 questionnaires with which long-term health care workers participated in the targeted base areas of each city and province nationwide were distributed directly and 525 responses were collected and 506 responses were analyzed. Surveys, on-site field visits, and in-depth interviews were also conducted to understand the working environment as well as conditions and establish a strategy for improving the working environment among long-term healthcare workers to understand the demands of working conditions and working conditions.
Results: Korean long-term care workers firstly and mostly enumerated their risk factors for ill-health when lifting or moving elderly recipients directly by hand (69.9%), followed by increased physical workload with old beds, tools, and facilities (42.3%) in the workplaces, shortage of manpower (32%), and source of infection (30%). To improve the working environment as well as conditions, Korean long-term care workers considered improving low-wage structures, ergonomic improvements to solve excessive physical loads, and increasing various bonus payments as well as implementing the salary system, positive social awareness, and increasing resting time. Of 506 responses, 92.3% replied that the long-term care insurance system for the elderly should be developed to expand publicization at the national level.
Conclusion: This study proposes to improve the low-wage structure of Korean long-term care workers, automation and improvement of facilities, equipment, and tools to eliminate excessive physical loads (beneficiary elderly lifting), and reduction of night labor.

KCI등재

5국외 감염병 위험도 평가체계의 비교분석

저자 : 최은미 ( Eunmi Choi ) , 우다래 ( Darae Woo ) , 최영준 ( Youngjune Choe ) , 예정용 ( Jungyong Yeh ) , 박상신 ( Sangshin Park )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 4호 발행 연도 : 2022 페이지 : pp. 380-388 (9 pages)

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Background: Emerging infectious diseases, such as Middle East respiratory syndrome or coronavirus disease 2019, pose a continuous threat to public health, making a risk assessment necessary for infectious disease control and prevention. Therefore, we aimed to investigate the risk assessment methods for infectious diseases used by major foreign countries and organizations.
Methods: We conducted an investigation and comparative analysis of risk assessment and risk determination methods for infectious diseases. The risk assessment tools included the strategic toolkit for assessing risks, influenza risk assessment tool, pandemic severity assessment framework, and rapid risk assessment methodology.
Results: The most frequently reported risk elements were disease severity, antiviral treatment, attack rate, population immunity, and basic productive ratio. The risk evaluation method was evaluated quantitatively and qualitatively by the stakeholders at each institution. Additionally, the final risk level was visualized in a matrix, framework, and x and y-axis.
Conclusion: Considering the risk assessment tools, the risk element was classified based on the duplicate of each indicator, and risk evaluation and level of risk assessment were analyzed.

KCI등재

6노인장기요양보험 서비스 이용에 따른 의료이용 및 의료비 지출 양상의 변화

저자 : 강희진 ( Hee-jin Kang ) , 장수현 ( Suhyun Jang ) , 장선미 ( Sunmee Jang )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 4호 발행 연도 : 2022 페이지 : pp. 389-399 (11 pages)

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Background: This study aimed to analyze changes in medical utilization and cost before and after long-term care (LTC) implementation.
Methods: We used the National Health Information Database from National Health Insurance Service. The participants were selected who had a new LTC grade (grade 1-5) for 2015. Medical utilization was analyzed before and after LTC implementation. Segmented regression analysis of interrupted time series was conducted to evaluate the overall effect of the LTC implementation on medical costs.
Results: The total number of participants was 41,726. A major reason for hospitalization in grade 1 was cerebrovascular diseases, and dementia was the top priority in grade 5. The proportion of hospitalization in grade 1 increased sharply before LTC implementation and then decreased. In grade 5, it increased before LTC implementation, but there was no significant difference after LTC implementation. As for medical cost, in grades 1 to 4, the total cost increased sharply before the LTC implementation, but thereafter, changes in level and trend tended to decrease statistically, and for grade 5, immediately after LTC implementation, the level change was decreasing, but thereafter, the trend change was increasing.
Conclusion: Long-term care grades showed different medical utilization and cost changes. Long-term care beneficiaries would improve their quality of life by adequately resolving their medical needs by their grades.

1
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KCI등재

1새정부 보건의료정책 개선을 기대한다

저자 : 이선희 ( Sun-hee Lee )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 2호 발행 연도 : 2022 페이지 : pp. 123-124 (2 pages)

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With the inauguration of a new government, expectations for policy changes are also rising. In the hope that this will serve as an opportunity to improve health care policy, I would like to outline the principles strategies. First, considering the growing socioeconomic impact of the health care sector, the government's policy priorities should be notably increased compared to the past. Second, policy improvement measures based on evidence should be sought instead of dwelling on presidential pledges. While easing regulations, we should improve the quality of regulatory approaches. Therefore, it is a time when efforts are needed to strengthen the stability of policies in response to economic crises.

KCI등재

2미국의 혁신의료기술 지불보상제도: 인공지능 의료기기를 중심으로

저자 : 이보람 ( Boram Lee ) , 임재준 ( Jaejun Yim ) , 양장미 ( Jangmi Yang )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 2호 발행 연도 : 2022 페이지 : pp. 125-136 (12 pages)

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The costliness index (CI) is an index that is used in various ways to improve the quality of medical care and the management of appropriate treatment in medical institutions. However, the current calculation method for CI has a limitation in reflecting the actual medical cost of the patient unit because the outpatient and inpatient costs are evaluated separately. It is desirable to calculate the CI by integrating the medical cost into the episode unit. We developed an episode-based CI method using the episode classification system of the Centers for Medicare and Medicaid Services to the National Inpatient Sample data in Korea, which can integrate the admission and ambulatory care cost to episode unit. Additionally, we compared our new method with the previous method. In some episodes, the correlation between previous and episode-based CI was low, and the proportion of outpatient treatment costs in total cost and readmission rates are high. As a result of regression analysis, it is possible that the level of total medical costs of the patient unit in low volume medical institute and rural area has been underestimated. High proportion of outpatient treatment cost in total medical cost means that some medical institutions may have provided medical services in the ambulatory care that are ancillary to inpatient treatment. In addition, a high readmission rate indicates insufficient treatment service for inpatients, which means that previous CI may not accurately reflect actual patient-based treatment costs. Therefore, an integrated patient-unit classification system which can be used as a more effective CI indicator is needed.

KCI등재

3공공 및 민영의료보험의 비급여 관리정책에 대한 국가별 비교

저자 : 김하윤 ( Ha Yun Kim ) , 장종원 ( Chong Won Chang )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 2호 발행 연도 : 2022 페이지 : pp. 137-153 (17 pages)

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In the process of promoting policies to strengthen health insurance coverage, the relationship between public health insurance and private health insurance, along with the management of non-benefit, is also emphasized as a policy issue. First, the concept and scope of non-benefit were comparatively analyzed by country. Second, the interaction between the public and private health insurance was classified as 'large or small,' and the government's regulation and management policy on private health insurance was classified as 'strong or weak.' Korea has relatively smaller benefits covered by public health insurance, higher copayment expenses, and more areas and scope of non-benefits. In countries where the interaction between public and private health insurance is small, private health insurance-related policies are weak. And in countries with large interactions had public-private partnerships and the government's management policies were also strong. On the other hand, Korea has a large interaction, but the actual structure of cooperation between public and private insurance and management policies were weak. Because the non-benefit sector in Korea is relatively wide, it is difficult to manage compared to other countries where the concept of non-benefit is limited. In addition, the health authorities rarely perform the role of supervision over private health insurance, and they have so few linkages and cooperation for public-private insurance. Therefore, practical policy enforcement is necessary to achieve the easing of the burden of national medical expenses through linkage and cooperation of public-private health insurance with reference to relevant other countries' cases.

KCI등재

4진료비 고가도 지표의 한계와 개선 방향

저자 : 장호연 ( Ho Yeon Jang ) , 강민석 ( Min Seok Kang ) , 정서현 ( Seo Hyun Jeong ) , 이상아 ( Sang Ah Lee ) , 강길원 ( Gil Won Kang )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 2호 발행 연도 : 2022 페이지 : pp. 154-163 (10 pages)

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Background: The costliness index (CI) is an index that is used in various ways to improve the quality of medical care and the management of appropriate treatment in medical institutions. However, the current calculation method for CI has a limitation in reflecting the actual medical cost of the patient unit because the outpatient and inpatient costs are evaluated separately. It is desirable to calculate the CI by integrating the medical cost into the episode unit.
Methods: We developed an episode-based CI method using the episode classification system of the Centers for Medicare and Medicaid Services to the National Inpatient Sample data in Korea, which can integrate the admission and ambulatory care cost to episode unit. Additionally, we compared our new method with the previous method.
Results: In some episodes, the correlation between previous and episode-based CI was low, and the proportion of outpatient treatment costs in total cost and readmission rates are high. As a result of regression analysis, it is possible that the level of total medical costs of the patient unit in low volume medical institute and rural area has been underestimated.
Conclusion: High proportion of outpatient treatment cost in total medical cost means that some medical institutions may have provided medical services in the ambulatory care that are ancillary to inpatient treatment. In addition, a high readmission rate indicates insufficient treatment service for inpatients, which means that previous CI may not accurately reflect actual patient-based treatment costs. Therefore, an integrated patient-unit classification system which can be used as a more effective CI indicator is needed.

KCI등재

5코로나19 전·후 응급실로 내원한 소아청소년 호흡기계 환자의 유사점과 차이점

저자 : 허영진 ( Young-jin Huh ) , 박윤숙 ( Yun-suk Pak ) , 김은아 ( Eun-ah Kim ) , 오미라 ( Mi-ra Oh )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 2호 발행 연도 : 2022 페이지 : pp. 164-172 (9 pages)

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Background: The purpose of this study was to the impact of the coronavirus disease 2019 (COVID-19) outbreak on emergency departments (EDs) in patients under the age of 18 years with respiratory disease. Also, we analyzed similarities and differences in patients including revisit before and after the COVID-19 outbreak.
Methods: This study population was respiratory patients under the age of 18 years who visited all 403 EDs in Korea between January 1st, 2019 and December 31st, 2020, using the National Emergency Department Information System Database. The primary outcome was the number of respiratory patients according to age, sex, the type of EDs, season, Korean Triage and Acuity Scale (KTAS) levels, the result of ED, and length of stay. The secondary outcome was the number of revisit respiratory patients within 72 hours. We calculated the risk-adjusted revisit rates according to the KTAS level using a multiple logistic regression model.
Results: The number of ED visits decreased from 274,526 in 2019 to 79,007 in 2020; this number was 71.2% lower than that before COVID-19. In spring 2020, this number was 90.1% lower than during the same period in 2019. For the revisit rate in the study population, the adjusted odds ratio (95% confidence interval) was 1.22 (1.05-1.41) in 2019 and 1.39 (1.07-1.81) in 2020.
Conclusion: Implementing appropriate emergency care policies in severe respiratory patients would have contributed to improving the safety of reducing in revisit rate.

KCI등재

6요양병원에서 응급실로 전입된 노인환자의 경향분석, 2014-2019

저자 : 고성근 ( Sung-keun Ko ) , 김선지 ( Seonji Kim ) , 이태영 ( Tae Young Lee ) , 이진희 ( Jin-hee Lee )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 2호 발행 연도 : 2022 페이지 : pp. 173-179 (7 pages)

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Background: This study aimed to identify patterns of elderly patients who transferred from long-term care hospitals to emergency rooms and provide the evidence of emergency medical systems to prepare for a super-aged society.
Methods: The data source was the National Emergency Department Information System database from January 2014 to December 2019 in Korea. We performed a cross-sectional study among elderly patients (≥65 years) who transferred from a long-term care hospital to an emergency room. Trend analysis was conducted by year.
Results: We identified 225,765 elderly patients who were transferred from long-term care hospitals to emergency rooms between January 1, 2014 and December 31, 2019. The proportion of the study population and their mean age were recently increased (p<0.001, respectively). The proportion of elderly patients being re-transferred (p=0.049) and the patients re-transferred to long-term care hospitals is significantly increased (p=0.005).
Conclusion: The establishment of efficient emergency medical services for an aging society is important. It is necessary to develop a healthcare network with the government, long-term care hospitals, and medical institutions in the community suitable for preventing disease deterioration.

KCI등재

7산업재해 근로자의 사회적 지지가 주관적 건강에 미치는 영향

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

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 2호 발행 연도 : 2022 페이지 : pp. 180-189 (10 pages)

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Background: Social support contributes directly and indirectly to maintaining physical, mental, and social well-being. The aim of the study was to identify the impact of social support on self-rated health among Korean industrial accident workers.
Methods: This study used data from the panel study of workers' compensation insurance (PSWCI). The final subjects were 2,759 workers who responded to a 2018 to 2020 PSWCI. Social support was defined as social contact with friends, neighbors, family, and social participation activities like religious activity, social activity, and club activity. Multivariate logistic regression analysis was performed to investigate causal relationships between social support and self-rated health using a generalized estimating equation model.
Results: Proportion of workers' good self-rated health steadily increased (2018: n=1,447, 63.2%; 2019: n=1,542, 66.2%; 2020: n=1,653, 67.3%). Higher levels of social contacts with friend (worse: reference; same: β=0.442) and higher levels of social activity (yes: reference; no: β=-0.173) were especially associated with good self-rated health.
Conclusion: This study confirmed social support positively influenced self-rated health among the self-rated health of industrial injured workers. The results of this study suggested that recovery policies that the government served should include programs enhancing social support for improving health among industrial injured workers.

KCI등재

8우리나라 노인의 가구형태와 주관적 건강상태의 관련성: 2017년 노인실태조사 자료를 이용하여

저자 : 최민지 ( Minji Choi ) , 주혜진 ( Hye Jin Joo ) , 김태현 ( Taehyun Kim ) , 백상숙 ( Sang Sook Beck ) , 정우진 ( Woojin Chung )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 2호 발행 연도 : 2022 페이지 : pp. 190-204 (15 pages)

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Background: In Korea, the population is rapidly aging, and the types of households for the elderly are also diversifying. The self-rated health of the elderly is a valuable health indicator that can comprehensively represent the overall quality of life along with physical, mental, and functional health. On the other hand, studies on the association between household type and self-rated health of the elderly are still insufficient. Thus, this study analyzed the association between household type and self-rated health by gender in Korean older adults.
Methods: Using data from the analysis of the National Survey of Older Koreans 2017, 10,299 elderly people aged 65 and over were targeted. For the accuracy of the analysis data, 9,910 people were selected as the study sample by excluding proxy responses, those diagnosed with dementia, and non-response. And technical analysis, univariate analysis using the Rao-Scott chi-square test, and logical regression analysis involving survey characteristics were conducted by gender.
Results: According to the adjusted model with all variables, in both men and women, the odds ratio of self-rated health 'bad' in 'couple (with ill spouse)' was significantly higher than 'couple (with spouse)'. It was 2.54 (95% confidence interval [CI], 2.05-3.15) for men and 2.11 (95% CI, 1.70-2.62) for women. In addition, the odds ratio of self-rated health 'bad' in 'living with adult children' was 1.43 (95% CI, 1.09-1.87) for men and 1.42 (95% CI, 1.15-1.75) for women, which was more significant in women than men.
Conclusion: This study states that there is an association between gender, household type, and self-rated health of the elderly, and the health of a spouse and cohabitation with children have a significant effect on self-rated health. As a result, in order to improve the health status of the elderly, health promotion and health care policies involving the characteristics of the elderly's gender and household type are needed.

KCI등재

9지역쇠퇴 유형별 의료이용행태 영향요인: 도시쇠퇴 지표와 의료취약지 지표를 활용하여

저자 : 정지윤 ( Ji Yun Jeong ) , 정재연 ( Jae Yeon Jeong ) , 윤인혜 ( In Hye Yoon ) , 최화영 ( Hwa Young Choi ) , 이해종 ( Hae Jong Lee )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 2호 발행 연도 : 2022 페이지 : pp. 205-215 (11 pages)

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Background: The purpose of this study is to identify the factors infecting the medical care utilization from a new perspective by newly classifying the categories of administrative districts using the urban decline index and medical vulnerability index as indicators.
Methods: This study targeted 150,940 people who used medical services using the 2015 cohort database (DB), 2010-2015 urban regeneration analysis index DB, and 2014-2015 public health and medical statistics DB. The decline of the region was classified using the urban decline index typed using k-means clustering and the medical vulnerability index typed using the quantile score calculation. Regression analysis was performed 3 times with medical expenditure, length of stay, and the number of outpatient visits as dependent variables.
Results: There were 37 stable region (47.4%), 29 health vulnerable region (37.2%), and 12 decline region (15.4%). The health vulnerable region had lower medical expenditure, fewer outpatient visits, and a higher length of stay than the stable region. The decline region was all higher than the stable region but had no significant effect.
Conclusion: The factors that cause the health disparity between regions are not only factors related to individual health behavior but also environmental factors of the local community. Therefore, there is a need for a systematic alternative that properly considers the resources within the community and reflects the characteristics of the population.

KCI등재

10가구 식품불안정 상태와 정신건강 및 건강 관련 삶의 질과의 연관성

저자 : 김유진 ( Yu-jin Kim ) , 박종은 ( Jong Eun Park ) , 김소영 ( So Young Kim ) , 박종혁 ( Jong-hyock Park )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 2호 발행 연도 : 2022 페이지 : pp. 216-227 (12 pages)

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Background: Food insecurity may contribute to mental health indicators such as stress, anxiety, or depression. We investigated whether food insecurity was associated with mental health indicators and health-related quality of life (HRQoL) in a representative sample of the Korean population.
Methods: This study enrolled 12,987 adults without a history of medically serious disease from the 2012, 2013, and 2015 Korea National Health and Nutrition Examination Survey. Household food security status was categorized as “food security,” “mild food insecurity,” and “moderate/severe food insecurity.” The association between mental health and HRQoL was evaluated using a multivariate logistic regression model with food security as the reference group.
Results: The adjusted odds ratio of adverse mental health or low HRQoL increased significantly in mild or moderate/severe food insecurity compared to food security. In the moderate/severe food insecurity group, it was 1.98% (95% confidence interval [CI], 1.31- 2.99) higher for perceived stress, 3.58% (95% CI, 2.44-5.26) higher for depression symptoms, 4.16% (95% CI, 2.68-6.45) higher for suicidal ideation, and 2.81% (95% CI, 1.91-4.15) higher for quality of life.
Conclusion: Food insecurity was strongly associated with negative mental health status and poor HRQoL. There is a need for a dietary support program that provides psychosocial support to those experiencing food insecurity.

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