노인장기요양보험제도가 노인진료비에 미치는 영향

한남경 ( Nam Kyung Han ),정우진 ( Woo Jin Chung ),김노을 ( Ro Eul Kim ),임승지 ( Seung Ji Lim ),박종연 ( Chong Yon Park ) 한국보건행정학회 2013 보건행정학회지 Vol.23 No.2

Background: The purpose of this study was to analyze the medical expense change and influencing factors after introducing long­term care insurance system. The study period was 2 years before and after introduction of the system. Methods: We analyzed data collected from two divided group lived in Incheon. Four hundred and eighty-five elderly who received long-term care wage for one year were selected for experimental group. For control group, 1,940 elderly were selected by gender and age stratified random sampling. Difference-In-difference analyses was used for evaluating policy effectiveness. Also multiple re­gression analyses were conducted to identify the factors associated with total medical expenditures. The control variables were de­mographic variables, economic status, diseases, and medical examination variables. Results: Difference-in-difference analyses showed that total average medical expenses among long-term patients has decreased by 61.85%. Of these, the hospitalization expenses have decreased by 91 .63% and the drug expenses have increased by 3 1 .85%. Multi­ple regression analyses results showed that total average medical expenses among long-term patients have significantly decreased by 46.5% after introducing the long-term care insurance. The hospitalization expenses have significantly decreased by 148.5%, whereas the drug expenses have increased by 53.60/0. And outpatient expenses have increased by 10.40/0, but the differences were not statistically significant. Conclusion: The results showed that total medical expenses and hospitalization expenses have decreased after introducing the long-term care insurance. These results could support the opinion that the health insurance spending among long-term patients will be reduced gradually by long-term care insurance through changing medical demand.

노인장기요양보험제도가 노인진료비에 미치는 영향: 일개 농촌지역을 중심으로

한남경(Han, Nam-Kyung) 대한고령친화산업학회 2019 대한고령친화산업학회지 Vol.11 No.2

목적 : 본 연구의 목적은 일개 농촌지역의 노인장기요양보험제도 도입 전후 노인진료비 지출의 변화와 영향요인을 분석하여, 노인장기요양보험과 건강보험의 재정적 관련성을 분석하고자 하였다. 연구방법 : 일개 농촌 지역의 전체 노인 중 장기요양 급여 이용자 53명의 성별과 연령을 1:4로 매칭하여 무작위로 추출한 급여 미이용군 212명의 노인장기요양보험제도 도입 전후 각 1년간의 노인진료비와 영향요인을 이중차이분석방법(Difference-In-Difference method)과 다중회귀분석을 통해 비교 분석하였다. 연구결과 : 노인장기요양보험제도 도입 이후 일개 농촌지역 장기요양 급여 이용군의 연간 총 노인진료비는 미이용군에 비해 45.12% 감소한 것으로 나타났고 총 노인진료비 중 입원진료비가 88.61%로 가장 큰 폭으로 감소하였으며 이어서 약제비가 45.12% 감소하였다. 반면에 외래진료비는 10.10%로 증가한것으로 나타났다. 결론 : 본 연구결과는 노인장기요양보험 제도 도입이 노인진료비에 미치는 정책효과를 분석함으로써 건강보험 및 의료급여와 장기요양보험의 재정적 관련성을 예측하여 향후 지속가능한 제도 운영에 참고하기 위한 기초자료로 활용 가능할 것이다. Objective : This study aimed to analyze the financial relevance to the Long-term Care Insurance and National Health Insurance by analyzing the changes in expenditure on elderly care before and after the introduction of the long-term care insurance system in rural areas. Methods : Analyzing data collected from two divided group lived in Yangpyeong-gun. One group was 53 elderly people have received long-term care health wage for one year and control group was 212 people chosen by gender and age stratified random sampling. The data of total medical expending was analyzed by Difference-In-Difference method and also conducted multiple regression for variables of socio-demographic, economic, disease characteristics. Results : The average total medical expense of group receiving long-term health insurance decreased by 45.12% compared to control group as a result of Difference-in-Difference analysis. In the cost segmentation, the hospitalization expense decreased by 88.61% and the medicine cost decreased by 45.12%. Multiple regression Analysis results showed that the average medical expense of people using long-term health insurance decreased by 15.4% after introducing this insurance system, but its difference was not statistically significant. The hospitalization expense increased by 2.5% and the medicine cost increased by 5.9% And the outpatient service cost increased by 5.9%, but its difference was not statistically significant. Conclusion : The results of this study could be used as a basic data for predicting the financial relevance of National Health Insurance and Long-term Care Insurance and referring to the efficient operation of future finances.

성인간호학회지(2010~2014)에 게재된 논문의 연구동향 분석

한남경(Han, Nam Kyung),김상희(Kim, Sanghee),김명신(Kim, Myoung Shin),김종근(Kim, Jong Gun),김창환(Kim, Chang Hwan),최승혜(Choi, Seung Hye) 한국성인간호학회 2015 성인간호학회지 Vol.27 No.5

간호간병통합서비스병동과 일반병동 간호사가 지각하는 타 직종 근무자에 대한 신뢰, 협력 및 팀워크 비교연구

한남경(Han, Nam Kyung),이태화(Lee, Taewha),김종근(Kim, Jonggun) 한국간호행정학회 2020 간호행정학회지 Vol.26 No.4

Purpose: This study was performed to compare the perceived level of trust, collaboration, and teamwork about other healthcare personnel, professionals and assistants between nurses who work on integrated nursing care service wards and general wards. Methods: Participants were 216 nurses working on integrated nursing care service wards and general wards of 5 general hospitals located in Kyeongido and Kyeongsangbuk-do (integrated nursing wards: 109, general wards: 107). Data were collected using structured questionnaires and analyzed using x² test, two sample independent t-test and Multivariate Analysis of Covariance (MANCOVA) with SPSS/WIN 23.0 programs. In particular, MANCOVA was conducted after controlling two independent variable covariants which are marital status (p=.045) and work department (p=.022) which had significant differences for both groups and three dependent variables which is trust, collaboration, and teamwork that highly correlated. Results: There were significant differences in the dependent variables of trust (p=.001), collaboration (p=.014), and teamwork (p<.001) between the two groups of nurses. The mean scores for trust, collaboration, and teamwork with other healthcare personnel as perceived by nurses working on integrated nursing care service wards were significantly lower than that of nurses on general wards. Conclusion: These findings show that strategies are needed to strengthen the trust, collaboration, and teamwork among nurses working on integrated nursing care service wards and other healthcare personnel.

간호사의 정치적 역량 개념 개발

한남경(Han, Nam Kyung),김광숙(Kim, Gwang Suk) 한국간호과학회 2020 Journal of Korean Academy of Nursing Vol.50 No.1

Purpose: The purpose of this study was to define and clarify the concept of political competence for nurses. Methods: A hybrid model method was used to investigate the dimensions, attributes, and definitions of the concept. In the theoretical stage of the study, literature on nursing, politics, and other discipline were reviewed. In the fieldwork stage, individual in-depth interviews and focus groups interviews were conducted with politically seasoned experts or activists who had an understanding of the concept of political competence for extensive descriptions in nursing and field of health care. Results: The concept of political competence was represented in four dimensions as political knowledge, political efficacy, political interaction, and political activity. In the political knowledge dimension, there were three attributes, namely, political knowledge, political information and systematic analysis ability. The political efficacy dimension had three attributes of internal political efficacy, external political efficacy, and self-pride of nursing profession. The political interaction dimension had three attributes of organizations and community service, networking, and persuasive power. The political activity dimension had six attributes of political leadership, political expression, assertive behavior, political advocacy, political participation, and policy intervention. Conclusion: This concept development might provide a basic understanding of developing a measurement tool and for constructing a theory promoting nurses’ political competence.

암생존자의 암검진 미수검 관련 요인분석: 국민건강영양조사(2007-2012년) 자료 이용

양송이 ( Song Ei Yang ),한남경 ( Nam Kyung Han ),이선미 ( Sun Mi Lee ),김태현 ( Tae Hyun Kim ),정우진 ( Woojin Chung ) 한국보건행정학회 2015 보건행정학회지 Vol.25 No.3

Background: The aim of the current study was to investigate the factors related to the non-practice of cancer screening in cancer survivors, who are at high risk of developing second cancers. Methods: This study is a cross-sectional analysis of 1,125 cancer survivors ≥19 years old who participated in the Korean National Health and Nutrition Examination Surveys IV and V (2007-2012). A Rao-scott chi-square test and a survey logistic regression analysis were employed respectively to analyze the difference of cancer survivors in cancer screening by each characteristic and the factors related to the non-practice of cancer screening in cancer survivors. Results: Among total subjects, 33.5% did not participate in cancer screening in the last two years. Results from a fully adjusted logistic model showed that the non-practice of cancer screening in cancer survivors was significantly associated with variables such as sex, age, marital status, education level, monthly income, and drinking a alcoholic beverage Specifically, the odds ratio of non-practice of cancer screening was higher in males than in females, in the younger group than in older group, in the group with no spouse than in the group with a spouse; in a group with a low level of education than in a group with a high level of education; in a group with the lowest income level than in a group with the other levels of income; or in non-drinkers than in drinkers. Conclusion: Health policies to reduce the non-practice rate of cancer screening in cancer survivors should be designed and implemented with close attention to cancer survivors’ socio-economic characteristics such as sex, age, marital status, education, and income, along with a health behavioral characteristic as drinking.

병원급 이상 의료기관의 간호등급 상승 요인 분석

최현민 ( Hyun Min Choi ),한남경 ( Nam Kyung Han ),이상규 ( Sang Kyu Lee ),김한성 ( Han Sung Kim ),최성경 ( Sung Kyoung Choi ),정우진 ( Woo Jin Chung ) 한국보건행정학회 2015 보건행정학회지 Vol.25 No.1

Background: The purpose of this study was to analyze the increase in Grade of Nursing Management Fee of medical institutions and establish a reasonable government policy by examining which factors affect the increase of nurse staffing. Methods: Analyzing data collected from the Health Insurance Review & Assessment Service resource management department with targets of 1,104 medical institutions. The study period was 5 years from June 30, 2008 to June 30, 2013. SAS ver. 9.2 (SAS Institute Inc., Cary, NC, USA) was used for statistical analysis. The data was analyzed by a chi-square test and also conducted muiltivariate logistic regression analyses for variables of basic characteristics, human resource characteristics, and material resources. Results: Adjusted odds ratio (AOR) of the rise in Grade of Nursing Management Fee among other hospitals compared to hospitals owned by government or universities was 0.264. The AOR in hospitals established after November 2006 compared to those before June 1995 was 2.383. The AOR in Gangwon, Chungcheng South, and Jeolla South Provinces compared to Seoul was 0.084, 0.036, and 0.194, respectively. The AOR in hospitals with more than 6.75 specialists per 100 beds compared to those with less than 6.75 specialists per 100 beds was 7.514. The AOR in hospitals with more than 17.48 nurse per 100 beds compared to those with less than 17.48 nurse per 100 beds was 3.300. The AOR in hospitals with 50% to 75% bed utilization, 75% to 90% bed utilization and more than 90% bed utilization compared to those with less than 50% bed utilization was 5.428, 9.884, and 10.699, respectively. The AOR in hospitals with one magnetic resonance imaging (MRI) and more than two MRI compared to those with no MRI was 2.018 and 2.942, respectively. Conclusion: This result has showed policies to induce the rise in Grade of Nursing Management Fee among old hospitals and the incentive system for local medical institutions are needed. Also we need to develop a governmental policy for medium-small hospitals with low operation rate of beds and insufficient medical personnel and number of equipment in hospitals.