의료서비스경험자의 보건의료제도 인식도와 영향 요인

서영우,박초열,박영희 보건의료산업학회 2018 보건의료산업학회지 Vol.12 No.4

Objectives : This study was performed to investigate health care system recognition and influential factors using the data from the “2017 Health Care Experience Survey”. Methods : Data on 7,000 participants in the Health Care Experience Survey were drawn and statistically examined using a t-test, ANOVA, and multiple regression analysis. Results : First, the significant factors of health care service satisfaction were education, income, region, chronic diseases, unmet medical needs, satisfaction with doctors and institutions, and the health care system's reliability and importance. Second, the influential factors of willingness to pay additional health insurance premium were age, occupation, income, health status, chronic diseases, unmet medical needs, satisfaction with health care institutions, limit to utilization of medical services, necessity of health care reform, and the health care system's reliability, satisfaction, importance. Conclusions : Since the additional burden for improving the health care has been negative to the socially disadvantaged, there should be efforts to provide stable health care funding for financial stability of the health insurances by considering public opinions and reaching social consensus.

한국 65세 이상 노인의 치과의료 이용률과 미치료율에 관한 조사

장지언 ( Ji Eon Jang ),전성희 ( Sung Hee Jun ),정선락 ( Sun Rak Jeong ) 대한예방치과·구강보건학회 2023 大韓口腔保健學會誌 Vol.47 No.4

Objectives: This study used data from the seventh National Health and Nutrition Survey, a dataset which signifies that dental services in the country exhibit relatively low health insurance coverage and high copay rates compared to other medical healthcare services. We surveyed the utilization rate of dental care and the prevalence of untreated conditions among Korean elders aged over 65. Furthermore, we aimed to present policy implications to improve dental care accessibility and expand health insurance coverage for elders, especially vulnerable individuals who are bedridden or living alone. Methods: We used raw data from the seventh National Health and Nutrition Survey to investigate Korean elders’ dental service utilization and untreated conditions. We opted for elders aged over 65 and finalized 1,712 subjects for the analysis. Statistical analysis was performed using IBM SPSS 25.0 (IBM Corp., Chicago, IL, USA). Groups were detailed in terms of strata of variation estimation and elders aged over 65, cluster of district enumeration, and weighted oral survey. We generated a scheme file and employed complex sampling analysis with a statistical significance level of P<0.05. Results: This study intended to survey the rate of dental care use and untreated care of Korean elders over 65 using the seventh National Health and Nutrition Survey data which represents our country. 1. Dental care use rate based on general traits showed statistically significant relevance (P<0.01) with lower age, higher income, higher education level, residence of ‘Dong’, and ‘with’ private insurance. 2. In untreated rate of dental care by general traits showed the significant total of 26.1% with female, lower income, lower education level, ‘recipient’ of basic living, and subjectively poor status of oral health. 3. The multiple answers of the patients who went to the dentists over the past year showed dental care details of dental checkups 54.3%, prosthetic dentistry 32.1%, preventive treatment 30.9%, cavity of root canal treatment 25.7%, gum treatment 17.1%, and tooth extraction 14.7%. 4. The reasons for untreated dental care of those untreated subjects showed the highest 34.0% of economic reason, mild condition 32.3%, lack of time 8.2%, and scared of treatment 8.0% in order. Based on this analysis, we intended to suggest policy implications for the necessity of dental checkup expansion and the activation of prevention treatment. Conclusions: To improve dental care accessibility for elders aged 65 and above, especially the vulnerable individuals who are bedridden or living alone, it is imperative to expand outpatient insurance coverage and tailor the dental services as per their specific needs. Shifting the focus from treatment-oriented health insurance to preventive measures and examination service expansion and invigoration is essential to improve dental health and overall quality of life. It is deduced that expansion of dental care health insurance coverage and checkup services is critical for vulnerable elders, such as those who are bedridden or living alone.

현역군인의 건강행태 및 의료이용 행태 조사 (`15년 군 건강조사를 활용한)

장태호 ( Taeho Chang ),배은경 ( Eunkyoung Bae ),이재무 ( Jae Moo Lee ),정소연 ( Cpt Soyeon Jung ),정철우 ( Chul Woo Jung ),배락 ( Rag Bae ) 국군의무사령부 2016 대한군진의학학술지 Vol.47 No.1

Objective : 2015 Military A Health Survey was performed to survey health behavior, mental health and medical care service utilization of soldiers on active duty. The finding from this study is expected to be the basis of future public health policy evaluations, and play an important role in the establishment of the Korean Military. Method : 2,785 of military officials and 3,497 of enlisted soldiers participated in this study. This study, a self-administered questionnaire, consisted of general characteristics, health behavior, life quality, mental health state, social support and medical care service utilization. Result : From observing military officials, current smoking rate was 39.4%, the highest rate was the Navy, 46.5%, and the combat arms marked the highest. From observing enlisted soldiers, current smoking rate was 36.2%, the Army was 46.0%, the highest, however, the rate was decreased in comparison to the result of 2014 Military Health Survey. The High risk drinking rate was decreased to 19.5%. The Obesity rate in both military officials and enlisted soldiers was increased to each 36.5% and 17.2%. The rate of cognitive stress in military officials was increased to 30.4%, however, the rate was decreased to 27.2% in enlisted soldiers. The rate of those who could not receive medical treatment in military officials was 22.9%. The main reason they could not receive treatment was that they had “no time to visit”, and that “it might affect promotion.” Futhermore, 17.0% of enlisted soldiers did not receive treatment because they had “no time to visit,” and that they do not trust the military medical centers. Conclusion : The military Health Survey needs to form a complete charge department in order to be further developed and conducted survey professionally. And it could be the result of this survey cause influence the military public health policy.

Association between Types of Usual Source of Care and User Perception of Overall Health Care Service Quality in Korea

Nak-Jin Sung,Jae-Ho Lee 대한가정의학회 2019 Korean Journal of Family Medicine Vol.40 No.3

Background: Patients’ perceptions of care tend to correlate with the quality of care provided. Different health care systems and service environments may show different associations between types of usual source of care (USC) and overall service quality assessment. We attempted to analyze this association as a benefit of having a USC.Methods: This study used the 2012 Korea Health Panel data version 1.1 as representative national household sur-vey data. The total number of subjects aged 18 years or more was 12,708. The number of subjects in the final analy-sis was 10,665. Multiple logistic regression analysis was used to assess the association between types of USC and overall health care service quality. The main outcome variable was users’ ratings of the quality of health care ser-vice.Results: People having a usual doctor (n=1,796) were more likely to positively assess the quality of health care they received than those not having a USC (n=7,920; odds ratio [OR], 1.39; 95% confidence interval [CI], 1.20–1.60) or with those having only a place as a USC without a usual doctor (n=949; OR, 1.29; 95% CI, 1.05–1.58) after adjust-ment for demographic characteristics and health-related variables.Conclusion: People having a usual doctor rated overall health care service quality as high, which might be due to benefits of primary care attributes related to usual doctors. Further studies are needed to elucidate the causal rela-tionship. This finding implies that health policies encouraging people to have a usual doctor are needed in Korea.

의료이용자의 보건의료제도 만족도와 변화 요구도

김지온 한국의료정보교육협회 2021 보건의료생명과학논문지 Vol.9 No.1

This study was performed to investigate health care system satisfaction and reform need using the data from the ‘2019 Health Care Experience Survey’. For 8,349 data with experience in medical use, health care system satisfaction and reform need level was analyzed by t-testing and ANOVA by characteristics of the study subjects, and multiple regression was conducted. Research has shown that health care users' recognition of the health care system is relatively low compared to reliability and satisfaction. It is necessary to promote policies and health care systems for senior citizens, low education levels. Since the reliability has the biggest impact on the satisfaction of the health care system, government should establish policies that they can trust, and in the process, they should gather opinions from the public and secure credibility through social consensus. Medical users were sympathetic to the need for reforms in the health care system, and felt the need to support vulnerable areas and vulnerable groups the most. 본 연구는 2019년 의료서비스경험조사의 자료를 활용하여, 실제 의료를 이용한 사람들의 보건의료제도에 관한 만족도, 변화 요구도를 인구사회학적 요인 및 건강상태, 의료이용 경험에 따라 분석하고, 보건의료제도 신뢰도 및 만족도, 변화 요구도에 영향을 주는 요인을 알아보고자 하였다. 연구대상자는 20세 이상의 건강보험대상자 중 최근 1년 간 외래와 입원을 이용한 의료이용 경험자 8,349명으로 하였다. 분석은 독립표본 t-test 및 ANOVA, Scheffe 검증, 다중회귀분석을 실시하였다. 연구결과 의료이용자들의 보건의료제도에 대한 인지도는 신뢰도와 만족도에 비해 상대적으로 낮은 편이었다. 고연령층, 낮은 교육수준, 읍면지역, 비용부담 의료이용제한 경험자 등의 인지도가 낮아 이들에 대한 정책과 보건의료제도 홍보가 필요하다. 보건의료제도 신뢰도는 보건의료제도 만족도에 가장 큰 영향을 미치고 있으므로, 국민들이 신뢰할 수 있는 정책수립을 해야 하고, 이 과정에서 국민의 의견수렴과 사회적 합의의 과정을 거쳐 신뢰성을 확보해 나가야 할 것이다. 의료이용자들은 보건의료제도의 변화 필요성에 공감하고 있었고, 취약지역·취약계층에 대한 지원 필요성을 가장 크게 느끼고 있었다. 의료기관 입원 및 외래 이용의 만족은 보건의료제도에 대한 신뢰와 만족에 영향을 주고, 나아가 제도 개선에 대한 국민적 합의에 긍정적 영향을 미칠 수 있음을 확인할 수 있었다.

Exploring the Development of Public Health Care through Health Care Utilization Survey

Eun-Mee CHOI,Yong-Sik JUNG,Lee-Seung KWON 한국유통과학회 2021 The Journal of Industrial Distribution & Business( Vol.12 No.12

Purpose: The purpose of this study was to provide comprehensive measures for the development of public health care through a survey on consumers awareness of health care use from the point of view of local residents. Research design, data and methodology: For about one week from January 07 to January 14, 2021, questionnaires were distributed to 800 local residents and analyzed. For statistical analysis of collected data, frequency analysis and cross-analysis were performed. Results: Regarding public health service, ‘providing medical services that can be used by all citizens and protect and promote health’ had the highest response rate of 95.2% of total respondents. Regarding health care system satisfaction, ‘Accessibility to general treatment’ had the highest score with an average of 3.31 points. Regarding comprehensive measures for the development of public health care, ‘Establishment of an infection and patient safety system’ had the highest score with an average of 3.91 points. Conclusions: The direction of public health care and services should include management of infectious diseases during national disasters, reduction of gaps in medical use by region and class, improvement of access to emergency medical care, and quality improvement of specialized medical care.

중년여성의 주관적 건강상태에 미치는 영향요인 -제 6기 국민건강영양조사 2차년도 자료(2013-2016) 활용

박미라 사단법인 인문사회과학기술융합학회 2019 예술인문사회융합멀티미디어논문지 Vol.9 No.6

This study was to investigate the factors affecting subjective health status of middle - aged women aged 40-60 years and to provide nursing care for improving the subjective health status of middle-aged women. Data were stratification sampling by sex and age, utilized the National Health and Nutrition Examination Survey(2013-2016), and reflected a weight. The variable were age, economic statel, sleep time per day, time spent sitting per day, subjective body recognition, the degree of perceived stress. Result are as follows: The higher the age, the worse the subjective health status, The less the economic activity, the less the subjective health condition. The more perceived stress was, the less the subjective health condition was. The more that the subjective body perception is closer to obesity subjective health status was poor. The higher the degree of perceived stress in everyday, the better the subjective health status. The subjects' subjective health status was found to be influenced by the degree of perceived stress, the subjective body recognition, age and job state among the various health-related factors. Also, It is required to find the factors affecting stress, age, subjective body recognition and to provide care for middle-age women of at that time. 본 연구는 만 40-60세의 중년여성을 대상으로 주관적 건강상태의 영향 요인을 확인하고, 추후 중년여성의 주관적 건강상태 향상을 위한 간호를 제공하는 데 도움이 되고자 시행되었다. 보건복지부와 질병관리본부의 제 6기 국민건강영양조사 2차년도 자료(2013-2016)를 이용하여 성별과 연령으로 2차 층화추출 하였고 가중치가 적용된 자료를 이용하였다. 변수로는 연령, 경제활동상태, 하루평균 수면시간, 하루동안 앉아 있는 시간, 주관적 체형인식, 스트레스 인지정도로 정하였다. 연구결과는 다음과 같다. 주관적 건강상태는 연령이 높을수록 좋지 않았으며, 경제활동을 하고 있지 않을수록 주관적 건강상태는 좋지 않았다. 주관적 체형인식이 비만에 가깝다고 인지할수록 주관적 건강상태는 좋지 않았다. 스트레스 인지 정도가 높을수록 주관적 건강상태는 좋지 않았다. 주관적 건강상태에 가장 영향을 미치는 요인은 스트레스 인지정도(β= -.233)이였고, 그 다음으로는 주관적 체형인지(β= .184), 연령(β= .081), 직업유무(β= .070) 순으로 나타났다. 그러므로, 주관적 건강상태의 향상을 위해서 중년여성의 연령과 직업유무에 따른 스트레스 감소와 주관적 체형인지 증가에 도움이 되는 프로그램마련이 요구되며, 이를 도와줄 수 있는 간호제공이 필요하다.

우리나라 지역주민의 보건소 구강보건서비스이용률 분석: 2011-2012년 지역사회건강조사 자료이용

박수경 ( Su Kyung Park ),김춘배 ( Chun Bae Kim ),정원균 ( Won Gyun Chung ),안양희 ( Yang Hee Ahn ),김남희 ( Nam Hee Kim ) 대한예방치과·구강보건학회 2014 大韓口腔保健學會誌 Vol.38 No.3

Objectives: To determine the utilization of oral health services in community health centers in Korea. Methods: This cross-sectional study involved secondary analysis of data obtained from the 2011-2012 Community Health Survey. The data were analyzed to determine the utilization of community oral health services. A total of 458,417 people (weighted sample was 80,268,227) were included. A multistage probability proportional systematic sampling method was used. The dependent variable was the utilization of community oral health services. The independent variables were region (city, town, and district), demographic characteristics (gender, age, education, income, occupation, and basic livelihood security), oral health status, and overall health status. The differences in the utilization of community oral health services related to independent variables were analyzed using an independent t-test and ANOVA. Additionally, a Scheffe post-hoc test was performed. Statistical analysis was performed using PASW statistics 20.0 (SPSS Inc., Chicago, IL, USA), at the 5% significance level. Results: The average utilization rate was 26.3% for community health care services and 4.3% for oral health services during the study period in Korea. Utilization was associated with old age and lower education and income levels (P<0.01). Furthermore, residents having poor oral health, chewing discomfort, and unmet dental needs most frequently used the community oral health services. Conclusions: The utilization of community oral health services was low in Korea. The needs and circumstances of communities should be considered and unique regional structural characteristics should be identified to plan and execute oral health programs and incorporate them with community health care services for overall community health.

Effects of the elderly’s oral health status and dental care utilization on their health-related quality of life

Seong Hyeon Chae,김춘배 조선대학교 치의학연구원 2019 Oral Biology Research (Oral Biol Res) Vol.43 No.1

The objective of this study was to investigate the oral health status, dental care utilization and health-related quality of life of elderly living alone to collect basic data on how to improve quality of life using the components of the European Quality of Life-5 dimension (EQ-5D) scale. The study used raw data of the community health survey from 2016 for South Jeolla Province. The data entailed 2,671 elderly people of aged 65 years and above living alone. Statistical analysis was performed by frequency analysis and chi-squared and t-tests. Analysis of variance was performed using multiple regression analysis. The significance level was determined to be 0.05. Chewing problems and speaking discomfort, oral health examination and unmet dental needs (p<0.001) were all significantly related. In the effect on the components of the EQ-5D by logistic regression analysis, gender, age, education level, economy activity, chewing problems, speaking problem, oral health examination and unmet dental needs were the significant variables in the quality of healthrelated life. The results showed that oral health status and dental care utilization significantly influenced the quality of life in elderly living alone. Through the recognition of the impact of oral health on health-related quality of life, we expect that the data from this study will help promote the development of oral health and oral health education programs for the maintenance and promotion of adult health.

Relationship Between Unmet Dental Care Needs and Mental Health: Using Data From the 7th Korea National Health and Nutrition Examination Survey

김지량,김재현 한국보건사회연구원 2022 保健社會硏究 Vol.42 No.1

This study utilizes the data from the 7th Korea National Health and Nutrition Examination Survey (data from 2016-2017) to understand the relationship between unmet dental care needs and mental health to suggest policies to reduce proportions of unmet dental care needs, stress, and suicide rates. The analysis was conducted using data from 9,294 respondents from a total of 16,277 respondents. Unmet dental care needs were surveyed using a self-reported questionnaire on requiring, but failing to receive, dental care; the data were analyzed using a chi-square test and multiple logistic regression analysis of the survey. Individuals who had unmet dental care needs had 1.56 times higher perceived stress (OR: 1.56, CI: 1.282-1.893, p<0.001) and 2.11 times higher risk of suicidal ideation (OR: 2.11, CI: 1.296-3.431, p=0.003) compared to those who did not have unmet dental care needs. Because it was implemented through secondary data analysis, it was not possible to add correction variables other than those presented in the raw data. There was a close relationship between unmet dental care needs and mental health. Therefore, to reduce perceived stress and risk of suicidal ideation, policy measures that reduce unmet dental care needs are necessary.