산업재해 환자의 의료서비스 경험과 주관적 건강 인식과의 관계

최령,황병덕,Choi, Ryoung,Hwang, Byung Deog 보건의료산업학회 2020 보건의료산업학회지 Vol.14 No.2

Objectives: This study intends to analyze the relationship between medical service experience and subjective health awareness by using data from Panel Study of Worker's Compensation Insurance(PSWCI). Methods: Tte χ2-test was performed to investigate subjective health awareness and medical service experience relevance. Logistic analysis was performed to analyze the influencinge factors. Results: The subjective health awareness scored "bad" in"'lack treatment period" compared to "adequate treatment period" in medical service experience (OR = 2.603 [95% CI = 1.666-2.555]). Conclusions: To improve the subjective health awareness of patients with industrial accidents, the industrial accident compensation and medical care approval system should be improved, and long-term industrial accident insurance policies should be developed to accommodate direct and indirect medical services.

공적연금유형에 따른 은퇴자들의 보건의료비지출 결정요인

최령 ( Ryoung Choi ),황병덕 ( Byung Deog Hwang ) 한국보건행정학회 2015 보건행정학회지 Vol.25 No.2

Background: This study aims to identify the monthly average medical expenses of public pension recipients, and analyze the determinants of total health and medical expenses and Western and Oriental medicine expenses, medical service expenses, and medical supplies expenses. Methods: This study used the fifth year data of 2013 out of the raw data of the Korean Retirement and Income Study collected by the National Pension Research Institute. This study conducted t-test, analysis of variance, and linear regression to verify publicly the relevance between pension recipients’ general characteristics and health and medical expenses status using IBM SPSS ver. 21.0 for data analysis. Results: It was analyzed that there is a difference in the spending of expenditure and health care costs according to public pension recipients. Medical expenses of the national pensioners was higher compared to the special corporate pensioners. The national pensioner is related expenditure size, education level, family members living together, residential areas, status of spouse, number of chronic illness, and status of limitation in daily life with psychological health status. Conclusion: Therefore, fairness does not occur fire to the medical use between the special corporate pensioners and national pensioners, aggressive of government such as health policy and financial support for the retiree pension policy that reflects the reality intervention would be required.

건강보험 건강검진 대상자들의 예방적 의료서비스 이용 특성

최령(Ryoung Choi),황병덕(Byung-Deog Hwang) 한국콘텐츠학회 2011 한국콘텐츠학회논문지 Vol.11 No.2

본 연구의 목적은 건강검진 수검자들을 대상으로 예방과 예방적 의료서비스에 미치는 공통요인을 비교ㆍ분석, 요인별 분석에 따른 원하는 건강검진 항목의 비중을 분석하여 각각의 상대적인 검진으로 예방과 치료에 소요되는 비용절감을 할 수 있도록 기초자료를 제공하고자 시도하였다. 이 조사는 건강검진 수검자를 대상으로 2010년 04월 01일부터 05월31일까지 설문조사하여 707명을 분석한 결과는 다음과 같다. 남성의 경우 연령이 높을수록, 배우자와 함께 사는 사람은 건강검진과 암검진, 예방접종을 많이 받으며, 민간의료보험 가입자, 본인건강상태 좋을수록, 학력이 높을수록 건강검진, 암검진, 예방접종을 적게 받으며, 여성의 경우 연령이 높을수록, 임금근로자는 건강검진과 암검진을 많이 받고, 민간의료보험 및 고학력일수록 건강검진, 암검진과 예방접종을 적게 받았다. 건강상태 및 배우자와 함께 사는 사람은 암검진과 예방접종을 많이 받는 것으로 나타났다. The purpose of this research is to target the health examination examinees to compare and analyze the common elements that influence prevention and preventive medical services and to analyze the share of the physical examination categories desired following the analysis by element. Likewise, this research was attempted to provide base data so that it is possible to reduce cost required for the prevention and treatment of each examination. This research targeted health examination examinees and conducted survey from April 1to May 31, 2010. The key findings after conducting analysis on 707 examinees are as follows. In case of men, those who are older and who live their spouses tended to be subjected to health examination, cancer examination and preventive injections. Those who had subscribed to the medical policy from the private sector, those with healthy state, those with higher educational level, tended to get health examination, cancer examination and preventive injections less. In case of women, those who are older, tended to get health examination and cancer examination more while those who had subscribed to the medical policy from the private sector and those with higher educational level tended to get health examination, cancer examination and preventive injections less. Those who are healthy and who live their spouse tended to get more cancerexamination and preventive injections.

소득계층과 주관적 계층인식에 따른 의료이용: 『한국의료패널』자료를 중심으로

최령(Ryoung Choi),박재용(Jae Yong Park),황병덕(Byung Deog Hwang) 한국보건사회학회 2013 보건과 사회과학 Vol.0 No.33

이 연구는 한국보건사회연구원과 국민건강보험공단에서 수집한 한국의료패널(Korea Health Panel) 의 원자료 중 2009년 연간통합데이터를 분석자료로 이용하였다. 의료이용에 영향을 미치는 요인을 파악하기 위하여 다중 회귀분석을 실시하였고, 계층요인과 건강상태요인에 따른 영향을 좀 더 명확하게 분석하기 위하여 Model 1,2,3을 개발하였다. 외래의료비의 경우 소득계층과 주관적 계층인식이 낮을수록, 연령이 낮을수록, 외래와 입원상병진단을 받을수록 의료비지출이 높았으며, 입원의료비의 경우 배우자가 있는 경우, 사업주 및 자영업자, 임금근로자에 해당하지 않는 경우, 경제적인 어려움으로 인한 스트레스를 받는 경우, 입원진단상병을 받은 경우 의료비 지출이 높은 것으로 분석되었다. 이러한 결과는 상위계층에 비해 하위계층의 의료이용과 의료비 지출이 상대적으로 증가하고 있다는 것으로 의료보장의 목적에 바람직한 일이라고 할 수 있지만, 한편으로는 하위계층일수록 주관적 건강상태가 나빠지고, 급여 및 비급여 의료비부담률 등이 증가하고 있는 것으로 판단된다. 객관적 지위가 되는 소득계층뿐만 아니라 일상적인 삶에서 생활양식과 나와 남을 처지를 구분하는 주관적 계층인식에 따른 범주형 분석을 시행하고 의료이용에 미치는 영향을 비교 분석함으로써 소득계층뿐만 아니라 주관적 계층인식에 따른 건강보험의 보장성 강화, 의료보장정책 및 전달체계, 서비스, surveillance 등 보건의료서비스 체계개발이 필요할 것이다. The study used the ‘2009 annual total data as an analysis material among other raw data of Korea Health Panel collected by Korea Institute for Health and Social Affairs and National Health Insurance Corporation. In order to understand causing factors to the medical use, the multiple regression analysis was conducted with Model 1, 2 and 3 designed to get social stratification factors and health condition factors analyzed even more thoroughly. In terms of the outpatient medical expenses, more money would be spent on the medical service as the perceptions of income class and subjective income class are low, as the age is low, and as the outpatient care and inpatient diagnosis are frequent. Regarding the inpatient medical expenses, more money would be spent as a patient has a spouse, as the patient is not regarded as a business owner, an owner-operator and a paid worker, as the patients get stressed by financial difficulties and lastly as the patient gets diagnosed while in hospital. As the results confirmed, it is good to see how the purposes of the medical security are being satisfied here while more medical uses and more medical expenses spending are conducted by the lower class than the upper class. However, at the same time, the results also argued that subjective health conditions of the lower class are getting worse constantly and that such phenomenon would, in return, increase the paid and unpaid medical benefit rates and others. In order to deal with such problems, a categorical analysis should be conducted not only on the income class, the objective position, but also on the regular life styles and the subjective income class perception that would distinguish one’s own situations from others. Not only that, with results from the categorical analysis, health and medical care system such as health insurance guarantee, medical social security and information delivery system, service and surveillance shall be developed.

소득계층에 따른 응급의료이용

최령 ( Ryoung Choi ),황병덕 ( Byung Deog Hwang ) 한국병원경영학회 2013 병원경영학회지 Vol.18 No.4

The purpose of this study is to analyze the emergency health care utilization using status according to income class. The target was the 2011 data out Korea Health Panel`s raw data. 2011 data composed of total 17,035 people from total 5,741 households. This study set total 1,101 adults over full-20-years old having used an emergency health care utilization as its analysis target. In order to find out the number of emergency health care utilization use according to income class and the influential factors on emergency health care utilization cost, this study conducted the multiple regression analysis. And in order to more accurately analyze the emergency health care utilization use status depending on the income class and the features of emergency health care utilization use status, this study developed Models. As the result, this study found following findings. First, as the income class was lower, the gender was male, the age was lower, and the user has spouse, the user was not a business owner or a paid worker, the user is a house owner, the emergency medical facility type was a clinic, the means of transportation was others rather than 119 ambulance, the reason visiting emergency medical facility was belonged to others rather than accidents or poisoning, then the number of emergency was increased. Second, as the user was in higher income class, received the health insurance benefits, the using medical facility was general hospital, used 119 ambulance more often, stay days in emergency was shorter, then health care utilization cost was increased. In this study investigating the data out of Korea Health Panel, it was found that while the number of emergency health care utilization use was increased in the lower income class, but the emergency health care utilization cost was increased for higher income class. It is considered that this finding was caused from the facts that lower income class was more often exposed to dangers for physical health, so the number of emergency health care utilization use was increased, but their health care utilization cost was decreased because of their economic burdens against various examinations and their difficulties to pay such costs, comparing to that of higher income class. Therefore, in order to solve unequal problem of emergency health care utilization use between lower and higher income classs, it is required to set suitable solutions like the disease prevention effort by facilitating national health check-up programs, the enhancement of public health services in quantity and quality, the emergency health care utilization securing policy at using medical facilities, the promotional, educational activities about emergency health care utilization delivery system, the enhanced accessibility of emergency health care utilizations and emergency medical facilities.

산재근로자의 의료서비스 경험에 따른 삶의 질 분석

최령(Ryoung Choi),황병덕(Byung-Deog Hwang) 한국보건사회학회 2021 보건과 사회과학 Vol.- No.57

본 연구는 치료가 종결된 산재근로자를 대상으로 산업재해로 인해 의료기관에서 제공받은 의료서비스 경험과 삶의 질을 분석하고자 한다. 연구대상은 근로복지공단에서 실시한 산재보험패널 5차(2017년) 조사 자료 중 통합데이터를 활용하여 의료서비스 경험 관련 문항에 응답한 산재근로자1,565명을 최종 분석 하였다. 연구결과 산재근로자의 삶의 질은 일반적 특성뿐만 아니라 의사로부터상세 설명, 주기적 회복 평가 그리고 치료기간 적정과 관련이 있었으며, 의료기관의 의학적 소견과 근로복지공단의 치료기간 연장 승인과정에 의해 결정되는 요양기간, 즉 치료기간의 적정성이 통계적으로 유의한 차이가 있었다. 그리고 연령이 낮을수록, 근로기간이 대체로 짧은 산재근로자일수록 전반적 만족도가 나쁜 것으로 분석되었다. 따라서, 의료기관 구성원은 산재보상 및 의료서비스 관련 전문상담과 원활한 행정업무처리 등 질적·양적으로 향상된 의료서비스 제공과 산재근로자를 위한 산재보상 및 보건정책, 서비스 프로그램 모니터링과 환류가 실행되어야 한다. The purpose of this study is to analyze the medical service experience and quality of life provided by medical institutions due to industrial disasters. The χ 2 -test was performed to investigate quality of life and medical service experience relevance. Logistic analysis was performed to analyze the influence factors. The quality of life of the injured workers was associated with general characteristics as well a detailed descriptions from doctors, periodic recovery evaluation and treatment period titration. The lower the age, the more the working period is generally short medsalyses, the overall satisfaction was analyzed as poor. Workers compensation and health policies and service programs for injured workers should be monitored and returned, and opportunities to continuously listen to workers injured should be provided.

대학생들의 연명치료중지에 대한 인식 및 태도가 장기기증의사에 미치는 영향

최령(Ryoung Choi),황병덕(Byung-Deog Hwang) 한국생명윤리학회 2012 생명윤리 Vol.13 No.2

본 연구는 사회적 정의와 이상을 실천하고자하는 욕구가 강한 대학생들을 대상으로 연명치료중지에 대한 지식과 인식 및 태도가 장기기증의사에 미치는 영향을 분석하였다. 또한 앞으로 장기기증의 문제를 해소할 수 있는 단초를 마련하고 대학생들의 생명존중에 대한 가치관 형성과 생명윤리교육에 필요한 기초자료를 제공하고자 시도하였다. 대상은 부산광역시에 소재하고 있는 3개 대학교의 대학생들을 대상으로 2010년 3월 14일부터 4월 3일까지 21일간 설문지를 배부하여 자기기입식으로 작성 후 최종 303명을 대상으로 분석을 하였다. 장기기증의사와의 관련성은 종교, 윤리적 정당성, 법률제정여부, 연명치료중지 인지, 자발적 연명치료중지 태도에서 통계적으로 유의한 차이가 있었으며, 장기기증의사에 영향을 미치는 요인은 유일하게 종교가 통계적으로 유의한 차이가 있었다. 의료에 관한 전문 지식과 경험을 가지고 있지 않고, 가족 등의 임종을 많이 경험하지 못한 대학생들에게 의학적으로 회생 불가능한 환자에 대해 마지막으로 존엄하게 죽을 수 있는 권리를 인정하고 더불어 장기기증이라는 고귀한 결정을 내릴 수 있는 긍정적 신념과 태도를 가질 수 있도록 사회문화적으로 다양한 노력들이 필요할 것이다. University students have a strong desire for realizing social justice and ideals. Targeting the students of such tendency, the present study analyzed their knowledge, prejudice, recognition and attitudes to withdrawing life-sustaining treatment so that it could learn how those factors would affect the students in making organ donation. For a second purpose, the study aimed to come up with any solutions to the organ donation-related issues, providing basic data which would be used to tell the students about the respect for life and bioethics. Students from three different university in Busan were selected for the research and a survey was carried out for 21 days from March 14, 2010 to April 3, 2010. The students were asked to answer questions by themselves and answers from a total of 303 students were analyzed. According to the results, religious factors would have an influence on the organ donation. They were the one and only factors that was found statically meaningful from other factors. In terms of the recognition of the life extension treatment cease, the organ donation which is expected to be made by the students was believed to be affected as the more the students fail to understand the life extension treatment cease. For the attitudes to the life extension treatment cease. the students’ organ donation turned out to be more influenced as the more the students would go against the voluntary life extension treatment cease and the involuntary life extension treatment cease. The findings were, however, observed not to be statically significant. The students in the research were not those with professional medical knowledge nor experiences of families’ deaths. Nevertheless, they would still need to understand that patients with incurable diseases have rights to die with dignity and to live on a life of a human being. In addition, social and cultural attempts to make the students have positive ideas and attitudes to the organ donation should be conducted.

병원경영자의 직위에 따른 관리자의 역할 인식도

최령(Ryoung Choi),황병덕(Byung-Deog Hwang),박재용(Jae-Young Park) 한국콘텐츠학회 2010 한국콘텐츠학회논문지 Vol.10 No.1

본 연구는 목적은 변화하고 있는 병원관리자의 역할비중을 분석하여 병원의 내ㆍ외부환경에 효과적으로 대응하는데 도움을 주고자 시도하였다., 이 조사는 부산, 울산 그리고 경상남도지역의 병원급 이상 의료기관에 종사하고 있는 최고관리자와 행정 관리자를 2007년 11월 20일부터 2008년 02월 29일까지 설문조사하여 191명을 분석한 결과는 다음과 같다. 최고관리자는 현재 가장 중요하다고 인식하는 관리자역할은 지도자역할이고 향후에 중요하다고 여기는 역할은 기업가역할이지만 실제 수행하고 있는 관리자역할은 대표자역할이었다. 경쟁이 날로 격심해지는 현재의 의료환경을 이겨내기 위해 경쟁력 강화와 조직성장 등의 심경이 미래에는 기업가역할이 더욱 더 중요해 질 것이라고 예측하고 있는 것으로 생각된다. 행정 관리자는 현재인식과 향후 생각하는 중요도, 그리고 실제수행하고 있는 관리자역할 모두가 지도자 역할이 가장 높았다. 이들은 여러 직위의 사람이 모여 있는 병원조직의 특성상 팀웍과 질서, 조직의 목표ㆍ전략ㆍ정보교환 등이 가장 중요하다 생각하고 있는 것으로 생각된다. This study aims to be of help to cope with internal and external circumstances of hospital effectively by analyzing the weight of role for a hospital manager which has been changing. It surveyed 191 top managers and administrators working in a medical institute like hospital located in Busan, Ulsan and Kyungnam area from 20 November, 2007 to 29 February, 2008. The results of this study were as follows: The top manager thought that the role as a leader is the most important role as a manager in present, but the role as an enterpriser is also very important in future, however, they had troubles in the role of a representative which they have carried out in present. In order to overcome the current medical situation that competition is getting keen, it seemed that they expected the role as an enterpriser would be more important in future for competition and organization improvement. The administrator thought the role as a leader is the most important in present, in future and in current performance. It was considered that they recognized the importance of team work, order, goal of the organization, strategies, and information interchange regarding the characteristics of hospital that there are people of various kinds of occupations.

고용형태별 소득계층과 사회경제적 계층인식에 따른 건강상태 영향 요인

최령(Ryoung Choi ),황병덕(Byung-Deog Hwang) 한국산학기술학회 2017 한국산학기술학회논문지 Vol.18 No.2

이 연구의 목적은 고용형태별 소득계층과 사회경제적 계층인식에 따른 건강상태 영향 요인을 알아보고자 하는데 있다. 한국노동연구원에서 실시한 한국노동패널 자료 중 18차 자료를 활용하여 만 20세 이상의 성인 5,158명을 최종 분석대상으로 하였다. 연구결과 정규직과 비정규직 모두 소득계층과 사회경제적 계층인식 간 통계적으로 유의한 차이가 있었으며, ‘중하’만이 계층 간 일치하였다. 이러한 결과는 우리사회의 정규직과 비정규직에 상관없이 실제 소득계층에 비해 상대적으로 낮게 인식하고 있기 때문으로 분석된다. 회귀분석결과 정규직은 사회경제적 계층인식이 낮을수록, 비정규직은 소득계층이 낮을수록, 사회경제적 계층인식이 낮을수록, 특히 비정규직의 경우 연금이 가입되지 않은 경우 건강상태가 나쁜 것으로 분석되었다. 따라서 비정규직 근로자들의 연금보험 납부금액의 적정성은 물론 소득이 상실되는 시점에 현실을 반영한 적절한 연금액이 지급 될 수 있도록 하여야 한다. 또한 다양한 교육과 홍보를 위한 정부, 경영계, 노동계간의 협력 등 다양한 방법을 모색하여야 한다. This study examined the factors influencing the health status according to class and socioeconomic class recognition by the employment type. To take advantage of the 18 original sources of the Korea Labor panel materials carried out in the South Korea Labor Institute, 5,158 adults over 20 years old were included in the final analysis. The research results revealed that the incomes of regular workers and non-regular workers between the hierarchy and socioeconomic hierarchy recognition showed a statistically significant difference between the cage; it was consistent between the hierarchy in only the "heavy" category. Regular workers of society, and regardless of non-regular workers, were analyzed to be relatively low compared to the actual income. Regression analysis showed that regular jobs had higher socioeconomic hierarchy recognition. Non-regular workers had a lower income bracket and lower socioeconomic hierarchy recognition. In particular, in the case of non-regular workers, the pension was not subscribed and they had a poorer state of health. Therefore, the pension insurance payment for non-regular workers needs to compensate for the lost income during non-employment periods. In addition, the government should improve public relations through education, management fields, and cooperation with labor.

노년기 자살생각의 요인과 변화추이 분석

최령(Ryoung Choi),황병덕(Byung-Deog Hwang) 한국보건교육건강증진학회 2014 보건교육건강증진학회지 Vol.31 No.5