Future Elderly Model을 활용한 중·고령자의 연령집단별 3대 만성질환 의료비 변화 예측

백미라 ( Mi Ra Baek ),정기택 ( Kee Taig Jung ) 한국보건행정학회 2016 보건행정학회지 Vol.26 No.3

Background: The purpose of this study is to forecast changes in the prevalence of chronic diseases and health expenditure by age group. Methods: Based on the Future Elderly Model, this study projects the size of Korean population, the prevalence of chronic diseases, and health expenditure over the 2014-2040 period using two waves (2012, 2013) of the Korea Health Panel and National Health Insurance Service database. Results: First, the prevalence of chronic diseases increases by 2040. The population with hypertension increases 2.04 times; the diabetes increases 2.43 times; and the cancer increases 3.38 times. Second, health expenditure on chronic diseases increases as well. Health expenditure on hypertension increases 4.33 times (1,098,753 million won in 2014 to 4,760,811 million won in 2040); diabetes increases 5.34 times (792,444 million won in 2014 to 4,232,714 million won in 2040); and cancer increases 6.09 times (4,396,223 million won in 2014 to 26,776,724 million won in 2040). Third, men and women who belong to the early middle-aged group (44-55 years old) as of 2014, have the highest increase rate in health spending. Conclusion: Most Korean literature on health expenditure estimation employs a macro-simulation approach and does not fully take into account personal characteristics and behaviors. Thus, this study aims to benefit medical administrators and policy makers to frame effective and targeted health policies by analyzing personal-level data with a microsimulation model and providing health expenditure projections by age group.

UTAUT를 활용한 NFC 보건의료서비스 수용 의도에 관한 연구 -의료인 및 의료기관 실무자 중심으로-

백미라 ( Mi Ra Baek ),최훈화 ( Hun Hwa Choi ),김용민 ( Yong Min Kim ),이훈영 ( Hoon Young Lee ) 경희대학교 경영연구원 2014 의료경영학연구 Vol.8 No.2

The purpose of this research is to examine the impact on intention to use of NFC Healthcare service with medical institutions; doctors and staffs of hospital level. Additionally, we looked over the intermediary role of voluntariness, as the variable in their circumstance. Therefore, this research looks into the impact on NFC healthcare service, will be feasible as the basic data for the use of NFC healthcare service. The results proved that each factors of independent variable(performance expectation, effort expectation, social impact, effort expectation had a positive effect on intention to use. In addition, all factors affected positively on voluntariness, which have an positive influence on intention to use. Finally, it is proved that voluntariness plays an absolute mediating role between independent variable(performance expectation, effort expectation, social impact, effort expectation) and intention to use. This research has limitations to generalize that it used voluntariness as the mediating variable, which was moderating variable of UTAUT model, that we measured partial portion of medical institutions from the perspective of medical employees

중,고령자의 주요 만성질환 유병인구 예측: Future Elderly Model을 적용

백미라 ( Mi Ra Baek ),민인식 ( In Sik Min ),정기택 ( Kee Taig Jung ) 한국보건정보통계학회(구 한국보건통계학회) 2016 보건정보통계학회지 Vol.41 No.2

Objectives: Korea is currently facing a super-aged society. Chronic diseases, due to the required long-term treatment, cause the harsh burden not only for the patients but also for the family members who support them. Additionally, the nations with a high rate of chronic diseases often experience the heavy financial burden. Therefore, it is important to estimate the number of patients with chronic conditions in order to formulate national policies for the chronic disease prevention and management. Methods: Using the Korea Health Panel data in 2012 and 2013, this study calculates the transition probability and disease-specific mortality rates and micro-simulates the Korean population by 2040 and the number of patients with 8 leading chronic conditions. Results: The estimated results are as follows. The population with hypertension increases 2.53 times (5,713,500 in 2014 to 14,468,680 in 2040); the population with diabetes increases 1.95 times (2,616,820 in 2014 to 5,103,020 in 2040); the population with hyperlipidemia increases 1.64 times (2,956,790 in 2014 to 4,842,290 in 2040); the population with polyarthrosis increases 2.3 times (3,888,330 in 2014 to 8,934,990 in 2040); the population with tuberculosis increases 2.26 times (84,520 in 2014 to 190,700 in 2040); the population with ischaemic heart disease increases 2.39 times (888,010 in 2014 to 2,123,440 in 2040); the population with cerebrovascular disease increases 2.35 times (877,490 in 2014 to 2,063,170 in 2040); and the population with cancer increases 1.82 times (988,400 in 2014 to 1,794,790 in 2040). Conclusions: In conclusions, it showed an increase in the number of patients of all chronic diseases. This study has a significance as the first study applying the FEM to Korea, the findings of this study data are expected to be utilized as the basis for the data of chronic diseases policy and securing financial resources to prevent and manage future chronic diseases.

흡연율· 비만율 감소 시나리오에 따른 주요 만성질환 의료비 절감 효과

백미라 ( Baek Mi Ra ),정기택 ( Jung Kee Taig ) 경희대학교 경영연구원 2017 의료경영학연구 Vol.11 No.3

The purpose of this study is to forecast changes in the prevalence of chronic diseases and health expenditure and to test policy scenarios using the Future Elderly Model(FEM). The FEM is a Markov microsimulation model which predicts current trends and future shifts imply for policy by forecasting the future medical expenditure and health status of the elderly(Chen et al., 2014). Based on the FEM developed by Goldman et al.(2004), this study aims to explore ways to reduce spending growth associated with population aging. To achieve this goal, this study projects the size of Korean population and the prevalence of chronic diseases(hypertension, diabetes, cancer, other diseases) up to 2040 and tests smoking and obesity scenarios, using two waves(2012, 2013) of the Korea Health Panel(KHP) data and National Health Insurance Service(NHIS) database. The results of the simulated model are as follows. health expenditure decreases when policy intervention scenarios for obesity and smoking succeed. Health expenditure on chronic diseases(hypertension, diabetes, cancer) under the smoking and obesity intervention scenarios, respectively, decreases by 136,598 million won and 54,773 million won by 2020; 867,699 million won and 248,328 million won by 2030; and 1,493,707 million won and 318,299 million won by 2040. Although this study uses the coefficient estimates of transition probabilities only from two waves(2012, 2013) and focuses on three main chronic diseases(hypertension, diabetes, cancer) categorizing the rest diseases under “others,” it would serve as a meaningful foundation for future research as the first study adapting the FEM to Korea.

JCI 인증이 내부 직원의 의료서비스 질 향상 의도에 미치는 영향

한재훈(Han, Jae Hoon),백미라(Baek, Mi-Ra),정기택(Jung, Kee-Taig) 대한경영학회 2013 대한경영학회 학술발표대회 발표논문집 Vol.2013 No.1

본 연구는 의료기관인증제도(JCI) 인증 병원의 QA 실무자들을 대상으로 JCI가 질 향상 활동 의도에 미치는 영향을 알아보고자 하였다. 현재 JCI를 받고자 하는 국내 병원이 증가하고 있는 추세이다. 의료기관 인증제를 준비하는 과정에서 소요되는 국부유출, 시간적·인력적 부담은 부정적인 요소로 인식되고 있으며 제반시설이 부족한 중소병원에는 인증절차에 대한 부담이 클 수밖에 없는 상황이다. 따라서 JCI가 인증된 의료기관들의 의료서비스 질 향상에 어느 수준으로 기여하였는지 실증적으로 분석해 볼 필요성이 제기되며, 현재 국내에 유행처럼 도입되고 있는 병원들의 JCI의 인증으로 인한 의료의 질 향상 효과 인식에 대한 연구는 그 시발점이 될 것으로 보인다. [진료의 접근성과 연속성], [환자평가], [환자진료], [마취 및 수술], [약제관리], [환자안전관리체계], [감염예방 및 관리] 총 7가지 영역에 대한 연구결과, 인지된 유용성에는 [환자평가], [마취 및 수술], [약제관리], [감염관리] 부분에 정(+)의 영향을 미친 것으로 나타났다. 인지된 용이성에는 [환자진료], [약제관리] 부분에 부(-)의 영향을 미친 것으로 나타났다. 마지막으로 내부 구성원들의 질 향상 활동의도에는 인지된 용이성이 정(+)의 영향을 미치는 것으로 나타났으며, 인지된 용이성은 인지된 유용성에도 정(+)의 영향을 미치는 것으로 나타났다. 단, 조사과정에 있어 전 직군 대상이 아닌 QA 실무자와 간호사를 중심으로 의도를 측정하여 전 직군의 의도까지 파악하지는 못하였다. 또한 JCI 인증으로 인한 개선효과와 의료서비스 질 향상 의도간 직접적인 인과관계까지 파악하지 못하였다는 한계점을 갖는다. Many korean healthcare organizations have been obtaining Hospital Accreditation(JCI) to join the Global Healthcare industry. But main question that arises is whether QA staffs are willing to do healthcare quality improvement activities. The proposed model was empirically tested using data collected from a survey in the JCI accredited hospitals. A exploratory factor analysis and confirmative factor analysis were performed to examine the reliability and validity of the measurement model and a structural equation modeling technique and path analysis were used to evaluate the causal model. The result indicated that [Assessment of Patients], [Anesthesia and Surgical Care], [Medication Management and Use] and [Prevention and Control of Infections] had a direct effect on Perceived usefulness. [Care of Patients] and [Medication Management and Use] had a direct effect on perceived ease of use. Perceived usefulness did not have a significant effect on a Quality improvement behavioral intention. But perceived ease of use had a significant effect on a Quality improvement behavioral intention and perceived usefulness. The proposed model provides a means to understand which factors determine the Quality improvement behavioral intention of QA staff to use JCI Accreditation standards and how this may affect future use. In addition, understanding the factors contributing to Quality improvement behavioral intention of QA staff may potentially be used in advance system development to predict Hospital accreditation acceptance.

JCI 인증이 내부 직원의 의료서비스 질 향상 의도에 미치는 영향

한재훈(Han, Jae-Hoon),백미라(Baek, Mi-Ra),정기택(Jung, Kee-Taig) 대한경영학회 2013 大韓經營學會誌 Vol.26 No.6

유헬스케어의 의료서비스 질 향상 및 효과인식에 관한 연구

정기택(Jung Kee-Taig),조철호(Cho Chul-Ho),백미라(Baek Mi-Ra) 대한경영학회 2012 大韓經營學會誌 Vol.25 No.3

유헬스케어의 의료서비스 질 향상 및 효과인식에 관한 연구

정기택(Jung, Kee-Taig),조철호(Cho, Chul-Ho),백미라(Baek, Mi-Ra) 대한경영학회 2012 대한경영학회 학술발표대회 발표논문집 Vol.2012 No.2

본 연구는 의료서비스 질 향상을 유헬스케어에 적용한 초기 연구로서 대학병원 실무자 중심으로 유헬스케어질 향상 및 효과에 대한 인식을 알아보고자 하였다. 아직 국내에서는 유헬스케어가 보편화되지 못한 이유 때문에 유헬스케어의 의료서비스 질 향상에 대한 연구가 부족하기에 초기적 연구라는 점에서 시사점을 제공할 것이다. 연구 결과, 운동관리 및 검사측정관리는 의료서비스 질 향상에 부분적으로 영향력에 차이가 있는 것으로 나타났다. 그러나 예외적으로 영양관리는 의료서비스 질 향상에 유의한 영향을 주지 못하였다. 그리고 의료서비스질 향상이 고객만족과 질병개선에 미치는 효과는 긍정적인 영향을 미치는 것으로 나타났다. 본 연구는 연구기관을 전체를 측정하지 못했으며, 의료종사자 측면에서 질 향상을 측정했다는 연구대상의 한계점을 갖는다. As an early stage research on U-healthcare to be applied to improvement healthcare service quality, this study tried to see employees’ recognition in terms of effectiveness and achievements of U-healthcare on the process of healing. Since the U-healthcare industry is the middle of stage of spreading in Korea, there is laking in accumulating base research on U-healthcare. Therefore, this study could offer basic implications on U-healthcare study. The result of this study reveal that U-healthcare system affects partly on management of patients’ workout and physical examination, but against the expectation it has no impact on management of patients’ nutrition. In addition, this study show that the improvement of healthcare quality influence positively to patients’ satisfaction and treatments. In spite of this results, this study has limitations on the aspects of not encompassing the whole medical centers in Korea and targeting only employees in medical centers.