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수록정보
수록범위 : 1권1호(1991)~29권3호(2019) |수록논문 수 : 853
보건행정학회지
29권3호(2019년 09월) 수록논문
최근 권호 논문
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KCI등재

1보건의료발전계획 수립의 시급한 필요성

저자 : 박은철 ( Eun-cheol Park )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 29권 3호 발행 연도 : 2019 페이지 : pp. 247-249 (3 pages)

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Although 19 years have passed since the enforcement of the Framework Act on Health and Medical Services, the Plans for Development of Health and Medical Services has not been established. This Plan is a 5-year basic long-term plan that covers the whole of health and medical services. This Plan should point to the direction of 30 long-term plans of healthcare, and this Plan should serve as a combination and coordination of 30 long-term plans and 22 related laws. The United States, the United Kingdom, and Japan have established long-term healthcare plans (4-, 10-, and 20-year plans, respectively). The long-term health plan of the United States has been approached bottom-up, those of the United Kingdom and Japan have been approached top-down. The rapid environmental changes that Korea is and will be experiencing emphasize urgently the need for establishing the Plan for Development of Health and Medical Services.

KCI등재

2건강보험수가제도 개선을 통한 의료전달체계 확립방안

저자 : 오영호 ( Youngho Oh )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 29권 3호 발행 연도 : 2019 페이지 : pp. 248-261 (14 pages)

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Establishing a healthcare delivery system is key to building a cost-effective healthcare system that can prevent the waste of healthcare resources and increase efficiency. Recently, the rapid increase in the national medical expenditures due to the aging of the population and the increase in chronic diseases has raised the question about the sustainability of the healthcare system including the health insurance system. This is why we need to reform the medical delivery system, including the function setting of medical institutions. Accordingly, gradual and practical efforts based on the recognition of reality are needed for solving the problems and improving the medical delivery system. The first effort is to secure policy measures to establish functions and roles of medical institutions which are the basis of the healthcare delivery system, and a systematic medical use system for appropriate medical use. This approach can be achieved through a reasonable health insurance schemes. Without reasonable reform efforts, it will be difficult for Korea's health care system to develop into a system that can provide cost-effective and high-quality medical services that the people want.

KCI등재

3당뇨병 환자의 일차의료 외래 지속성이 입원에 미치는 영향: 2012년도 신규 당뇨병 환자를 중심으로

저자 : 신양준 ( Yang-jun Shin ) , 우경숙 ( Kyung-sook Woo ) , 신영전 ( Young-jeon Shin )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 29권 3호 발행 연도 : 2019 페이지 : pp. 262-276 (15 pages)

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Background: The most important thing to strengthen primary care is to prove that the continuity of primary care is an essential area for good health outcomes. The purpose of this study is to analyze the effect of outpatient continuity of primary care on the hospitalization experience of diabetes mellitus in new diabetic patients.
Methods: Using the Korean National Health Insurance Service national sample cohort (NHIS-NSC 2011-2015) data, 3,391 new diabetic patients in 2012 were selected for the study. Multiple logistic regression was performed to investigate the effect of outpatient continuity of primary care on hospitalization in new diabetic patients.
Results: The outpatient continuity of primary care in new diabetic patients was measured by the continuity of care index, which showed that 69.4% (n=2,352) were high level and 30.6% (n=1,039) were low level. Patients who had high continuity of primary care at the early stage of diabetes diagnosis showed 3.49 times more likely to maintain high continuity of primary care in the second year (95% confidence interval [CI], 2.72-4.49). Patients with low continuity of primary care for 2 years from the initial diagnosis of diabetes were 2.56 times more likely to be hospitalized due to diabetes than those who did not (95% CI, 1.55-4.25).
Conclusion: This study identified the need for policies to increase the continuity of primary care for new diabetic patients and could contribute to lowering the admission rate of diabetic patients if the policy for this would work effectively.

KCI등재

4건강보험 청구자료를 이용한 진료 연속성이 당뇨 관련 예방 가능 입원에 미치는 영향 분석: 중·고령군을 중심으로

저자 : 김보아 ( Boah Kim )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 29권 3호 발행 연도 : 2019 페이지 : pp. 278-288 (11 pages)

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Background: Diabetes is known as one of the most important ambulatory care sensitive conditions. This study purposed to assess the status of continuity of care (COC) and diabetes-related avoidable hospitalizations (DRAHs) of a group of middle- and old-aged patients and to observe the relationship of the two elements by the two age groups.
Methods: This study utilized the National Health Insurance Service's National Sample Cohort data and the subjects are diabetes patients of 45 and over, classified into two groups of 'middle-aged'(45-64 years) and 'old-aged'(≥65 years) patients. The dependent variable was DRAHs, which was defined in accordance with the definition of the Organization for Economic Cooperation and Development “Health Care Quality Indicators” project. COC, as an independent variable, is measured by the COC index in this study. Two-part model (multi-variate and multi-level analyses) was utilized.
Results: Factors associated with the status and the number of DRAHs differed by each age group. Meanwhile, the two-part model showed that higher COC was associated with a lower risk of preventable hospitalizations in both middle- and old-aged groups.
Conclusion: Study findings can provide health policy insights and implications in order to strengthen the primary care system for further improvement of diabetes management, especially for middle- and old-aged groups.

KCI등재

51인 가구의 의료이용 형평성: 다인 가구와의 비교를 통하여

저자 : 나비 ( Bee Na ) , 은상준 ( Sang Jun Eun )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 29권 3호 발행 연도 : 2019 페이지 : pp. 288-302 (15 pages)

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Background: The one-person households (OPH) are rapidly increasing and vulnerable to socioeconomic and health problems. Because it is predicted to be inequitable to health care utilization, we would like to find out about the equity of health care utilization of the OPH by comparison with the multi-person households (MPH).
Methods: This study followed the theoretical framework of Wagstaff and van Doorslaer (2000), O'Donnell and his colleagues (2008), where the horizontal inequity index is the difference between the concentration indices of actual health care utilization and health care needs. This study employed the 9th Korea Health Panel survey, and a total of 10,807 cases were analyzed. Health care needs were measured by age, sex, subjective health status, chronic disease count, Charlson's Comorbidity Index, limitation of activities, and disability.
Results: Compared with the MPH, there were pro-poor inequities in hospitalization, emergency utilization, hospitalization out-of-pocket payments, and pro-rich inequities in outpatient out-of-pocket payments for the OPH. The decomposition of the concentration index revealed that chronic disease count made the largest contribution to socioeconomic inequality in outpatient utilization. Age, health insurance, economic activities, and subjective health status also proved more important contributors to inequality. The variables contributing to the hospitalization and emergency utilization inequity were age, education, Charlson's Comorbidity Index, marital status, and income.
Conclusion: Because the OPH was more vulnerable to health problems than the MPH and there were pro-poor inequities in medical utilization, hospitalization, and emergency costs, it is necessary to develop a policy that can correct and improve the portion of high contribution to medical utilization of the OPH.

KCI등재

6뇌혈관질환의 예측인자로서의 악력

저자 : 정석환 ( Seok-hwan Jung ) , 김재현 ( Jae-hyun Kim )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 29권 3호 발행 연도 : 2019 페이지 : pp. 303-311 (9 pages)

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Background: Cerebrovascular disease is included in four major diseases and is a disease that has high rates of prevalence and mortality around the world. Moreover, it is a disease that requires a high cost for long-term hospitalization and treatment. This study aims to figure out the correlation between grip strength, which was presented as a simple, cost-effective, and relevant predictor of cerebrovascular disease, and cerebrovascular disease based on the results of a prior study. And furthermore, our study compared model suitability of the model to measuring grip strength and relative grip strength as a predictor of cerebrovascular disease to improve the quality of cerebrovascular disease's predictor.
Methods: This study conducted an analysis based on the generalized linear mixed model using the data from the Korea Longitudinal Study of Ageing from 2006 to 2016. The research subjects consisted of 9,132 middle old age people aged 45 years or older at baseline with no missing information of education level, gender, marital status, residential region, type of national health insurance, self-related health, smoking status, alcohol use, and economic activity. The grip strength was calculated the average which measured 4 times (both hands twice), and the relative grip force was divided by the body mass index as a variable considering the anthropometric figure that affects the cerebrovascular disease and the grip strength. Cerebrovascular diseases, a dependent variable, were investigated based on experiences diagnosed by doctors.
Results: An analysis of the association between grip strength and found that about 0.972 (odds ratio [OR], 0.972; 95% confidence interval [CI], 0.963-0.981) was the incidence of cerebral vascular disease as grip strength increased by one unit increase and the association between relative grip strength and cerebrovascular disease found that about 0.418 (OR, 0.418; 95% CI, 0.342-0.511) was the incidence of cerebral vascular disease as relative grip strength increased by unit. In addition, the model suitability of the model for each grip strength and relative grip strength was 11,193 and 11,156, which means relative grip strength is the better application to the predictor of cerebrovascular diseases, irrespective of other variables.
Conclusion: The results of this study need to be carefully examined and validated in applying relative grip strength to improve the quality of predictors of cerebrovascular diseases affecting high mortality and prevalence.

KCI등재

7남성 자살률의 공간 군집패턴 변화와 지역특성요인의 관계 분석

저자 : 최소영 ( Soyoung Choi ) , 이광수 ( Kwang-soo Lee )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 29권 3호 발행 연도 : 2019 페이지 : pp. 312-322 (11 pages)

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Background: Since 2003, Korea has consistently shown the highest suicide rate among the Organization for Economic Cooperation and Development countries, and suicide remains the major cause of death. In particular, men are 2-3 times more likely to commit suicide than women, which called the 'gender paradox of suicide.' The areas with frequent suicide have spatially clustered patterns because suicide with a social contagion spreads around the neighborhood. The purpose of this study was twofold. The first was to estimate the hotspot areas of age-standardized male suicide mortality from 2008 to 2015. The second was to analyze the relationship between the hotspot areas and the regional characteristics for study years.
Methods: The data was collected through the Korean Statistical Information Service. The study areas were 227 si · gun · gu administrative districts in Korea. The hotspot area was used as a dependent variable. Socio-demographic variables (number of marriages per 1,000 population, number of divorces per 1,000 population, and urbanization rate), financial variables (financial independence and social security budget), and health behaviors (EuroQol-5 dimension [EQ-5D], and depression experience rate) were used as independents variables.
Results: The hotspot areas were commonly located in Gangwon-do, Chungcheongnam-do, Gyeongsangbuk-do, and Chungceongbuk-do. According to the results of panel logit regression, the number of divorces per 1,000 population, social security budget, and EQ-5D were statistically significant variables.
Conclusion: The results of hotspot analysis showed the need for establishing a prevention zone of suicide using hotspot areas. Also, medical resources could be considered to be preferentially placed in the prevention zone of suicide. This study could be used as basic data for health policymakers to establish a suicide-related policy.

KCI등재

8공공의료서비스 제공의 공평성이 주관적 건강행복에 미치는 영향: 공공의료서비스 질의 매개효과

저자 : 문승민 ( Seung Min Moon )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 29권 3호 발행 연도 : 2019 페이지 : pp. 323-331 (9 pages)

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Background: The purpose of this study is to analyze the effect of impartiality in providing public health services on subjective health happiness and the mediated effects of public health service quality. Based on this, this study intends to present policy implications to improve public health services.
Methods: The research method is multiple linear regression analysis. The analysis of the mediating effects is performed by Baron & Kenny's test, Sobel-Goodman's test, and Bootstrap.
Results: The impartiality of public health services and the quality of public health services are shown to have a statistically significant effect on subjective health happiness. Quality of public health service appears to be mediating the relationship between impartiality in providing public health care and subjective health happiness.
Conclusion: To promote people's subjective health happiness, it is necessary to secure impartiality in providing public health services in the first place and improve the quality of public health services.

KCI등재

9우리나라의 건강수요 및 의료수요에 대한 분석: Grossman Model을 중심으로

저자 : 황용하 ( Yongha Hwang ) , 사공진 ( Jin Sakong )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 29권 3호 발행 연도 : 2019 페이지 : pp. 332-341 (10 pages)

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Background: This study analyzes the effects of the individual's health behavior on the health and the medical demand for the management of health and medical expenses.
Methods: This study uses the Korea Health Panel Survey data from 2010 to 2015. We utilize the panel ordered logit model and the panel Tobit model with the subjective health status and the medical expenses as the dependent variables.
Results: Chronic diseases would cause the deterioration of his or her health and the increase in medical expenses. Smoking and drinking alcohol would deteriorate one's health. The total amount of cigarettes increases medical expenses. Exercises could make people healthier, whereas excessive exercise might increase medical expenses. Private health insurance would increase medical expenses.
Conclusion: Since health could reduce the medical expenses, people should promote one's health by changing one's behavior for health.

KCI등재

10Comparative Study of Health Care System in Three Central Asian Countries: Kazakhstan, Kyrgyzstan, Uzbekistan

저자 : Yuliya Dronina , Eun Woo Nam

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 29권 3호 발행 연도 : 2019 페이지 : pp. 342-356 (15 pages)

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Background: The objectives of the study are to find out the effect of the implementing reform in three Central Asian countries, identify its impact on health status and health care delivery systems. This study address to identify strong and weak points of the health systems and provide a recommendation for further health care organization.
Methods: A comparative analysis was conducted to evaluate the effects of implemented policy on health care system efficiency and equity. Secondary data were collected on selected health indicators using information from the World Health Organization Global Health Expenditure Database, European Health Information Platform, and World Bank Open Data.
Results: In terms of population status, countries achieved relatively good results. Infant mortality and under-5 mortality rate decreased in all countries; also, life expectancy increased, and it was more than 70 years. Regulations of the health systems are still highly centralized, and the Ministry of Health is the main organ responsible for national health policy developing and implementation. Among the three countries, only Kyrgyzstan was successful in introducing a national health system. Distribution of health expenditure between public expenditure and out-of-pocket payments was decreased, and out-of-pocket payments were less the 50% of total health expenditure in all countries, in 2014.
Conclusion: After independent, all three countries implemented a certain number of the policy reform, mostly it was directed to move away from the old the Soviet system. Subsequent reform should be focused on evidence-based decision making and strengthening of primary health care in terms of new public health concepts.

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1연안해역에서 석유오염물질의 세균학적 분해에 관한 연구

(2006)홍길동 외 1명심리학41회 피인용

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2미국의 비트코인 규제

(2006)홍길동심리학41회 피인용

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2미국의 비트코인 규제

(2006)홍길동41회 피인용

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