국민기초생활보장제도 맞춤형 급여체계 개편과 빈곤층 의료보장

유원섭 참여연대사회복지위원회 2016 월간 복지동향 Vol.- No.208

지역사회정신보건서비스 이용자의 만족도 측정을 위한 한국어판 Verona Service Satisfaction Scale-82 (VSSS-82)의 개발 및 신뢰도와 타당도 평가

유원섭,문옥륜,남정현,신영전,Yoo, Weon-Seob,Moon, Ok-Ryun,Nam, Jung-Hyun,Shin, Young-Jeon 대한예방의학회 2001 Journal of Preventive Medicine and Public Health Vol.34 No.3

Objectives : To develop a Korean version of VSSS-82 for measuring the multi-dimensional satisfaction with community-based mental health services in psychiatric patients and to investigate both the reliability and validity of the Korean version. Methods : The VSSS-82 English version was translated and back-translated with some modification. Data from 68 psychosis patients using community-based mental health services in three Community Mental Health Centers (CMHCs) was collected through a personal interview survey regarding the satisfaction and suitability of service. Variability of satisfaction and internal consistency, discriminant validity, and concurrent validity of the VSSS-82 Korean version were evaluated. Results : A higher number of dissatisfied subjects and significant pairwise differences for the dimensions were found. The Crohnbach's alpha coefficient, a measure of internal consistency, ranged from 0.56(overall satisfaction) to 0.90(skills and behavior) and significant differences in satisfaction was found in patients by the self-rated suitability of service. Conclusions : The VSSS-82 Korean version is a reliable and valid instrument for measuring multi-dimensional satisfaction with community-based mental health service.

병행 세션 : 세션2 ; 발제1 : 지역보건사업에서의 건강형평성 -국내외 현황과 문제점-

유원섭 한국보건행정학회 2008 한국보건행정학회 학술대회 논문집 Vol.2008 No.1

외국에서의 건강불평등 개선을 위한 노력: 건강영향평가, 건강도시

유원섭,고광욱,김건엽,Yoo, Weon-Seob,Koh, Kwang-Wook,Kim, Keon-Yeop 대한예방의학회 2007 예방의학회지 Vol.40 No.6

In order to reduce the health inequalities within a society changes need to be made in broad health determinants and their distribution in the population. It has been expected that the Health impact assessment(HIA) and Healthy Cities can provide opportunities and useful means for changing social policy and environment related with the broad health determinants in developed countries. HIA is any combination of procedures or methods by which a proposed 4P(policy, plan, program, project) may be judged as to the effects it may have on the health of a population. Healthy city is one that is continually creating and improving those physical and social environments and expanding those community resources which enable people to mutually support each other in performing all the functions of life and in developing to their maximum potential. In Korea, social and academic interest regarding the HIA and Healthy Cities has been growing recently but the need of HIA and Healthy Cities in the perspective of reducing health inequality was not introduced adequately. So we reviewed the basic concepts and methods of the HIA and Healthy Cities, and its possible contribution to reducing health inequalities. We concluded that though the concepts and methods of the HIA and Healthy Cities are relatively new and still in need of improvement, they will be useful in approaching the issue of health inequality in Korea.

저소득층 의료비 지원사업

유원섭 한국보건사회연구원 2009 보건복지포럼 Vol.155 No.-

건강보험과 의료급여 등 의료보장제도의 보장성을 보완하기 위해 정부와 민간부문에서 다양한 의료비 지원사업을 시행하여 일부 저소득층 국민들에게 의료비로 인한 과중한 부담을 덜어주는데 도움을 주고 있다. 그러나 사업마다 대상자 선정기준, 지원범위, 지원수준, 의료비 지원방식이 서로 다르고, 적절한 예산 확보의 어려움 등으로 인해 의료비 사업마다 보장성 수준이 크게 다르고, 수혜자의 과중한 의료비 부담을 덜어주기에는 미흡한 사례가 발생하고 있다. 이 글에서는 정부에서 시행하고 있는 주요 의료비 지원사업 현황을 소개하고, 의료비 지원사업의 대상자 선정, 지원범위와 지원수준, 의료비 지원방식, 예산운용 측면에서 개선과제를 제시하고, 의료비 지원사업의 중장기적 개선방향을 제안하였다.

노숙인 등 의료지원의 성과와 과제

유원섭 한국도시연구소 2023 도시와 빈곤 Vol.123 No.-

일부 병원에서의 입원비 본인부담양상

신영전,유원섭,하헌영,정설희 한양대학교 의과대학 2000 한양의대 학술지 Vol.20 No.1

The purpose of this study was to estimate the proportion of user charges out of total treatment costs and to investigate the occuring status of the charge of non-benefit service. The data were collected from 6 hospitals in 3 cities (Seoul 2, Incheon 3, Shihung 1), which containing 1,752 discharge-bills of discharged patients insured by health insurance. The data were analyzed after standardization of the items of non-benefit services. The result are as follows; 1. the average percent of the cost-sharing of discharged patients was 38.1%(benefit : 15.5%, non-benefit : 22.6%) and the proportion of the cost-sharing due to non-benefit services was greater than that due to benefit services. 2. The occurrence rate and the occurred number of non-benefit services were different among hospitals and showed characteristic occurrence rate in individual hospitals. 3. In acute appendicitis, the characteristics of the occurrence rate and the occurred number of non-benefit services by individual hospitals was similar to those of hospitals. It suggest that the hospitals intentionally applied non-benefit item to patients in order to increase their profit. These findings suggest that the burden of cost-sharing is still high especially due to non-benefit services, so it is necessary to extend the coverage of insurance benefits and to develop management system for the appliance of non-benefit services. Regarding the discharge-bill, all service charges should be included in the bill.

재가 중증 뇌병변 장애인의 기능상태 및 케어요구 목록 평가

고려진,유원섭,이꽃메,이소나,김교현,오희영 대한간호행정학회 2008 간호행정학회지 Vol.14 No.4

Purpose: Using comprehensive and valid instrument, MDS-HC 2.0, this study aimed to analyze the functional status and to evaluate the care needs of the community-dwelling disabled with cerebral impairment. Method: With a convenient sample of 88 disabled with cerebral impairment, the data were collected at a community health center located in rural area in Choongchung providence in August 2005. Subject's functional status and care needs were evaluated using Minimum Data Set-Home Care version 2.0. Result: Significant proportion of subjects were totally dependent for locomotion-outdoor (26.1%), personal hygiene (24.1%), bathing (24.1%). For IADLs, over 40% of subjects were totally dependent for ordinary house work, managing finances, or shopping. Top five ranked care needs were preventive health care measures (100%), communication disorders (71.6%), visual function (55.7%), health promotion (52.3%), and pressure ulcers (48.9%). The proportion of triggered clinical assessment protocols were significantly higher in disability level I group for the risk of institutionalization (p=<.001), communication disorders (p=.004), cognitive problems (p=.001), pressure ulcers (p=<.001), skin and foot conditions (p=.010), and urinary incontinence and indwelling catheters (p=<.001). Conclusions: It is necessary to provide community based rehabilitation services that are individualized for their service needs thus enhance optimal level of functioning.

의료보호 진료비의 증가양상과 진료비 구성요소별 기여도 변화 -1992년부터 1999년까지 의료보호 진료비청구자료를 중심으로-

신영전,유원섭,염용권 한국보건행정학회 2001 보건행정학회지 Vol.11 No.3

Medical Aid expenditure Increased rapidly at a higher rate than that of Medical Insurance during the period 1992-1999. To establish an effective cost containment strategy, knowledge of the cause and the nature of the increase of Medical Aid expenditure is required. The purpose of this study was to analyze increasing rates of Medical Aid expenditure by the components of medical expenses. Data were collected using the Medical Aid Statistical Yearbook during the period of 1992-1999. The major findings were as follows: 1. The annual mean increasing rate of Medical Aid expenditure between 1992 and 1999 was 22.8%, which exceeding that of Medical Insurance expenditure (17.5%) between 1992 and 1999. Since 1998, Medical Aid expenditure increased even more rapidly than in previous years, with the increase in number of Medical Aid beneficiaries. 2. Of Medical Aid expenditure, that of inpatient and outpatient annually increased 24.2% and 22.8% respectively and that of type 1 and type 2 increased annually 28.8% (outpatient) ∼29.9% (inpatient), 14.3% (outpatient) ∼ 15.5% (inpatient). Therefore, Medical Aid expenditure of inpatient and type 1 led the increase of Medical Aid expenditure. 3. Between 1992 and 1997, the frequencies of utilization per beneficiary and the charges per case positively contributed to the increase of Medical Aid expenditure while the number of beneficiaries contributed negatively, but since 1998, the number of beneficiaries increased and positively contributed to the increase of Medical Aid expenditure. 4. According to the analysis of the charges per case, the increase of the price index led to the increase of the charges per case but the days of medication and service intensity also contributed to the increase of the charges per case variably by year. Considering the above findings, factors associated with the Medical Aid system affected the increase of Medical Aid expenditure in addition to the general factors of the increase in medical expenditure. In conclusion, it appears that a more intensive cost containment strategy is required to control rapidly increasing Medical Aid expenditure. For this, more precise analysis and development of policy considering the effect of the number of beneficiaries and the increase of price index is needed.

만성질환자의 한방의료서비스 이용 결정요인 : 2005년도 국민건강영양조사

이현주,유원섭,정수경,Lee, Hyun-Joo,Yoo, Weon-Seob,Chung, Su-Kyoung 대한예방한의학회 2011 대한예방한의학회지 Vol.15 No.3

Objectives : The aim of this study is to investigate the relevant factors which determine the use of oriental healthcare services among subjects with chronic illnesses. Method : This study utilized the data from the Korean National Health and Nutrition Examination Survey in 2005. Out of all the participants of the survey, 11,665 individuals who are older than 19 years old and have one or more chronic diseases were included in this study. Results : The factors that affect utilization of oriental healthcare services were significantly associated with gender, educational level, job, personal income, the number of chronic illnesses, experiences of nontreatment or delayed treatment and admission experiences for the last one year(p<.001). Although some of these factors need further studies, the determining factors for the use of oriental healthcare services are the presence of chronic illness and the number of chronic disease. That is, the chronically ill are more likely to seek oriental healthcare services. And the more chronic diseases the clients have the higher probability of seeking oriental healthcare services was found. Conclusions : The results suggest that the national integrated care services should be established for diverse development of policy regarding the quality of care of chronic illness and cost-effectiveness.