환자의 안전과 비용부담 적정화를 위한 「임의비급여 관리 방안」

민인순 건강보험심사평가원 심사평가정책연구소 2013 HIRA 정책동향 Vol.7 No.2

의원 외래환자 건강보험 진료비 청구에서 심사조정률에 영향을 미치는 요인

민인순,임정수,김세라 대한의사협회 2010 대한의사협회지 Vol.53 No.11

The aim of this study was to investigate the adjustment amount for outpatient services of clinics and to identify the factors affecting the variation of the cost between clinics in National Health Insurance in South Korea. Adjustment rate in the process of claims data review was defined as the percentage of the adjusted amount in the total claimed amount. From a total of 23,593 clinics in South Korea, 4,160 clinics accounting for 17.6% of total were selected for the study. The National Health Insurance claim data were collected during April 2007. To identify factors affecting the variation in adjustment rate between clinics, multiple regression method was used for the analysis. Older physicians were more likely to have high adjustment rate. General practitioners,orthopedic surgeons, and family physicians were more likely to have higher adjustment rate than those of internists. Physicians who have practiced between 1 and 10 years and physicians practicing in metropolitan areas had lower than their counterparts. There was a great variation in adjustment rate among physicians and the variation was affected by physicians’clinical behaviors as well as the characteristics of the clinics. Therefore, introduction of an effective management scheme for physicians’clinical behaviors is essential. Since many review adjustment occur due to the incomplete understanding about the review criteria and rules and procedure of claiming, continuing education will be a way of preventing these unnecessary review adjustments. The fact that no review adjustments were found even from the close-review implies that the current two-tiered review system (close-review and indicator-review) is an efficient way of review. Future studies are needed to classify possible cause of review adjustment such as simple errors, errors in applying the benefit scheme, and over use of services.

의료보험 급여자로서의 약사회

민인순 약사공론 1992 대한약사회지 Vol.1992 No.1

의료정책 변화에 따른 병원경영의 변화

이해종,민인순 한국병원경영학회 2015 병원경영학회지 Vol.2015 No.S

This article reviews hospital management trend in Korea. At early times (until about 1990), hospitals were focused on internal management for efficiency. There was no need to think about the patient, since medical service demand was more than supply. But now (after 1990), the hospitals move the management focus into the patient, because the medical service demand is less than supply. So, it is time to change for management concepts and technique into the patient oriented organizations. Additionally, hospitals also must give more focus to outside interest groups, such as government and patient, in the future. Specially the hospitals must have a negotiation power with the government for service fee decision and hospital industry development. For this, hospitals must have aggregated hospital performance data by the network alliance among hospitals. In future, hospitals will have more developed managerial techniques for internal control. In addition, hospitals must give focus to outside interest group and make the effort for service market extension.

우리나라 성인 흡연자의 전자담배 이용경험과 금연행태의 관련성

이윤노,김복미,민인순,함명일 한국보건행정학회 2017 보건행정학회지 Vol.27 No.4

Background: Electronic cigarette (e-cigarette) has rapidly increased. Even though e-cigarettes are actually not smoking cessation alternative supplies, some people perceive them as smoking cessation alternative supplies. The purpose of this study is to identify the relationship between e-cigarette experiences and smoking cessation behaviors among Korean adults. Methods: Cross-sectional data was collected from 7,550 participants of Korea National Health and Nutrition Examination Survey in 2014. A total of 867 participants who were current smokers were enrolled in this study. Multi-variable logistic regression analysis were performed to identify the relationship between the smoking cessation behavior and the e-cigarette experience. Results: The e-cigarette experience rate of current smokers was 22.1%. The e-cigarette experience rate was higher in groups with the higher income, the higher education level, and the white collar jobs. Smokers with experience of smoking cessation (odds ratio [OR], 3.03; 95% confidence interval [CI], 1.67 to 5.76) and with intention to smoking cessation in the future (OR, 1.59; 95% CI, 1.05 to 2.43) were more likely to experience the e-cigarette. Especially, smokers who used smoking cessation alternative supplies were more likely to experience the e-cigarette than smokers who did not use it (OR, 2.87; 95% CI, 1.59 to 5.18). Conclusion: We confirmed that e-cigarette experiences were associated with smoking cessation experience, smoking cessation plan, and use of smoking cessation aid among smokers in Korea. Additional studies should be continued to confirm whether e-cigarette are continuously influencing the smoking cessation of current smokers in South Korea as one of the smoking cessation alternative supplies.

전문병원 충성고객의 병원 선택에 영향을 미치는 요인

김복미,함명일,민인순,김선정 한국병원경영학회 2018 병원경영학회지 Vol.23 No.4

Purpose : Customers with loyalty are very important to hospitals for sustainable growth in their medical market. Individuals with loyalty are likely to visit same hospital repeatedly when they need medical services. This study was to identify factors associated with selection of specialty hospitals among customers with loyalty. Methods : The subjects of this study were 735 inpatients in 22 specialty hospitals in 6 designated fields(joints, spine, colorectal-anal, obstetrics and gynecology, ophthalmology, otolaryngology). Customer types classified as customers with high loyalty, neutral customers, and customers with low loyalty according to net promoter score(NPS). Factor analysis was conducted to classify 22 hospital selection factors into some similar properties. Logistic regression analysis was conducted to confirm the selection factors related to loyal customers. Findings : Most of specialty hospitals received high NPS of 8 points or higher in all the designated fields. Five factors associated with selection of specialty hospital are (1) hospital facilities and convenience, (2) trust in doctor and hospital, (3) rapidness of treatment, (4) hospital awareness, and (5) accessibility. As a result of logistic regression analysis, selection factors related to loyal customers were ʻhospital facilities and convenienceʼ, ʻtrust in doctor and hospitalʼ and ʻrapidness of treatmentʼ. Differences in the degree of importance of three selection factors by customer types appeared for each designated field. Practical Implications : This study confirms the high level of patient experience among inpatients of specialty hospitals. Factors associated with selection of hospital among inpatients with loyalty are ʻfacilities and convenience of hospitalsʼ, ʻtrust of doctor and hospitalʼ and ʻrapidness of treatmentʼ. This study will be meaningful as basic data to systematically enhance the roles and functions of the health care system and to provide securing competitiveness according to designated fields in the management aspect of specialty hospitals.

민간의료보험 유형과 미충족 의료와의 관련성

한종욱,김동준,민인순,함명일 한국보건행정학회 2019 보건행정학회지 Vol.29 No.2

Background: The extent of coverage rate of the public health insurance is still insufficient to meet healthcare needs. Private health insurance (PHI) plays a role to supplement coverage level of national health insurance in Korea. It is expected that reduce unmet need healthcare. This study was aimed to identify relationship between PHI type and the unmet healthcare need and its associated factors. Methods: Data were obtained from the 2014 Korea Health Panel Survey using nationally representative sample was analyzed. Respondents were 8,667 who were adults over 20 years covered by PHI but have not changed their contract. According to the enrollment form, PHI was classified into three types: fixed-benefit, indemnity, and mixed-type. To identify factors associated with unmet needs, multiple logistic regression conducted using the Andersen model factors, which are predisposing factors, enabling factors, and need factors. Results: Our analysis found that subjects who had PHI with mixed-type were less likely to experience unmet health care needs compared than those who did not have it (odds ratio, 0.80; 95% confidence interval, 0.66–0.98). As a result of analyzing what affected their unmet healthcare needs, the significant factors associated with unmet medical need were gender, marital status, residence in a metropolitan area, low household income, economic activity participation, self-employed insured, physically disabled, low subjective health status, and health-risk factors such as current smoking and drinking. Conclusion: The results of this study suggest that having PHI may reduce experience of unmet healthcare needs. Findings unmet healthcare needs factors according to various subjects may be useful in consideration of setting policies for improving accessibility to healthcare in Korea.

의료의 질 향상을 위한 정책 방향

이상일,석승한,민인순 건강복지정책연구원 2017 건강복지정책연구원 Issue Paper Vol.24 No.1

진료비 확인 민원신청 경험과 의사 및 의료기관에 대한 신뢰도와의 관련성

함명일 ( Myung Ll Hahm ),민인순 ( Insoon Min ) 한국보건행정학회 2013 보건행정학회지 Vol.23 No.3

암가족력 유무에 따른 부정적 심리요인과 유방암 검진과의 관련성: 우리나라 여성을 중심으로

김복미 ( Bokmi Kim ),최귀선 ( Kui Son Choi ),이윤노 ( Yoon Noh Lee ),민인순 ( In Soon Min ),함명일 ( Myung-il Hahm ) 한국보건행정학회 2017 보건행정학회지 Vol.27 No.2

Background: Women with family history of breast cancer are more likely to be worried about having cancer and participate in breast cancer screening. However, few studies have examined relationship between family history, cancer worries, and participating in breast cancer screening in Korea. This study is to identify relationship between family history, cancer worries, and participating in breast cancer screening among women with and without family history of cancer. Methods: Respondents were 2,364 women who based on the 2013 Korean National Cancer Screening Survey which is done by National Cancer Center in Korea. Chi.square tests were performed to determine differences of cancer worries, undergoing of breast cancer screening and methods such as mammogram and ultrasonogram with and without cancer family history. Univariate and multiple logistic regression were performed to identify if family history and cancer worries are related factors on participating in breast cancer screening and methods. Stratified analysis was performed to confirm the effect of ultrasonogram on the dense breast by age. Results: Women with cancer family history frequently checked condition for conscious of having cancer (p=0.0299) and had highly perception of risk about having cancer in the future (p≤0.0001). Women aged 30-49 did not perform significantly more ultrasonogram than women aged over 50 years old. Checking condition (moderate odds ratio [OR], 1.38; 95% confidence interval [CI], 1.20-2.08; frequently OR, 1.58; 95% CI, 1.08-1.76) and perception of risk (moderate OR, 3.12; 95% CI, 1.06-7.06; high OR, 2.74; 95% CI, 1.20-8.08) were related to participate in mammogram and ultrasonogram. A positive family history was related to 1.35 higher odds of performing only breast ultrasonogram (95% CI, 1.04-1.75). Conclusion: This study requires national education and publicity to reduce the unnecessary cost of screening, to be possible cost effective screening and to encourage women to receive more mammogram, especially women aged over 50 years old and with socioeconomic factors related to opportunistic screening.