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김춘배,이도성,김한중,손명세,Kim, Chun-Bae,Lee, Do-Sung,Kim, Han-Joong,Sohn, Myong-Sei 대한예방의학회 1995 예방의학회지 Vol.28 No.2
This paper tested by using Micro TSP, an empirical econometric analysis to approve officially a hypothesis of price elasticity of the demand for medical care services in Korean national medical insurance and the economic effect of health care delivery system with time-series datas of Medical Insurance Statistical Yearbook$(1981\sim1993)$. The results suggest that the Korean medical insurance system shows moral hazard due to the change of coinsurance and the economic effect according to intervention of the health care delivery system, but it is different by insurers regardless of the same structure of the medical insurance scheme.
김춘배,고광욱,박재성,최헌 韓國保健敎育.健康增進學會 2003 보건교육건강증진학회지 Vol.20 No.1
Purpose: Although there is a lot of secondary data available for comparing community health status and planning health policies in terms of large area such as metropolitan cities or provinces, there is restricted data for establishing community health policies of the small areas such as towns, Gun(i.e.,districts), and Gu. Specifically, the problems of producing a valuable index for health promotion in small areas are three fo1d: First, there is not an appropriate index model for measuring a small community health status. Second, a large part of secondary data in the small areas has been produced in an irregular time interval. In addition, all valuable data can not be integrated without time consuming work. Thus this study tries to establish a health promotion index model for assisting community health promotion initiatives of local governments. Methods and materials: Literature review, community health specialist consultation and a questionnaire survey was performed. Result: Based on Dever's model, a prototype of health promotion indicators was proposed and modified by the community health specialists. 15 classification scheme of statistical yearbook reorganized into the six areas. Those six areas were comprised in 24 indicator class with 96 specific indicators. Through further modification processes by a questionnaire survey, we developed a health promotion indicator model that contains six areas with 23 indicator class encompassed by 87 specific indicators. Conclusions: This study proposed a model of health promotion indicator comprised in the six areas with 23 indicator classes for measuring small area health promotion status. However, more specific or additional data in human biology, environment and socioeconomic data is essential for producing a stronger model for health promotion measurement.
한국인 치료순응도 향상을 위한 개입 효과에 대한 메타분석
김춘배,조희숙,현숙정,박애화 한국보건행정학회 2002 보건행정학회지 Vol.12 No.2
The purpose of this study was to analyze the results of 133 studies related to patient compliance published between 1980 and 2001 and to assess the effectiveness of intervention on compliance by using meta-analysis. We collected the existing literatures by using web and manual search 'patient compliance', 'sick role behavior', ‘major clinical disease', and 'intervention' as key words and by reviewing content of journals related to medicine, nursing and public health. The compliance interventions were classified by theoretical focus into educational, behavioral, and affective categories within which specific intervention strategies were further distinguished. The compliance indicators broadly represent five classes of compliance- related assessments: (1) health outcomes (eg, blood pressure and hospitalization), (2) direct indicators (eg, urine and blood tracers and weight change), (3) indirect indicators (eg, pill count and refill records), (4) subjective report (eg, patients' or others' reports), (5) utilization (appointment making and keeping, use of preventive services). Quantitative meta-analysis was performed by MetaKorea program which was developed for meta-analysis in Korea. Among the 133 articles, 10 studies were selected through the qualitative meta-analysis process, and then only 6 studies were selected for the quantitative meta-analysis finally. The interventions produced significant effects for all the compliance indicators with the magnitude of common effect size (4.1192) than the non-intervention group in a random effect model. The largest effects were each study for patient of hypertension using health outcome such as blood pressure (0.4679) and diabetes mellitus using direct indicator such as glucose level in blood and urine (0.7753). These results suggest that strategic interventions showed clear advantage for improvement of patient compliance compared with non- intervention group.