건강보험 가입자와 의료급여 수급권자의 의료이용과 건강관련 삶의 질

이현옥(Hyun Ok Lee),김교성(Kyo seong Kim) 연세대학교 사회복지연구소 2015 한국사회복지조사연구 Vol.44 No.-

본 연구의 목적은 건강보험 가입자와 의료급여 수급권자의 건강관련 삶의 질 차이와 영향요인을 규명하고, 의료이용이 삶의 질에 미치는 조절효과를 파악하는데 있다. 이를 위해 한국의료 패널자료를 활용하여 대상에 따른 의료이용과 건강관련 삶의 질의 현황 및 특성, 그리고 영향요인을 분석하였다. 분석 결과, 의료급여 수급권자의 외래 이용횟수, 입원일수, 응급 이용횟수 등은 건강보험 가입자에 비해 많은 반면, 건강관련 삶의 질 수준은 낮은 것으로 나타났다. 또한 의료이용 정도가 많을수록 건강관련 삶의 질이 낮아지지만, 의료보장유형과 이용횟수의 상호작용효과는 존재하지 않았다. 다만 의료보장유형과 총 진료비의 상호작용효과는 검증되어, 건강보험 가입자와 의료급여 수급권자의 건강관련 삶의 질에 대한 총 진료비의 조절효과가 확인되었다. 이는 의료급여 수급권자가 의료서비스의 접근성 제약으로 인해 적시에 치료를 받지 못한 결과이며, 이들의 치료지연을 방지하고 삶의 질 수준의 향상을 위해 비급여 부담을 줄이고 의료보장성 강화 및 예방적 의료서비스의 확대가 요구된다. The purpose of this study is to examine the differences and influencing factors of health-related quality of life between the insured in National Health Insurance(NHI) and the recipients in Medical Aid Program, and to investigate the moderating effects of health-care utilization on health-related quality of life. For the empirical analysis, multiple regression analysis was employed using the Korea Medical Panel Data of 2011. The recipients in Medical Aid Program have more health-care utilization including out patient utilization frequencies, hospital days, and emergency use frequencies, however their health-related quality of life is lower than the insured of NHI. And the more health-care utilization, lower degree of health-related quality of life is also confirmed. There is an interaction effect of total health-care expenditure and types of health-care system on the health-related quality of life. This is the result of that the recipients in Medical Aid Program did not receive a timely treatment due to the access constraints of health-care services. Therefore, the expansion of health-care system and preventive health services are required to improve the health accessibility among the poor and near poor in Korea.

중장년층의 구강보건행동과 구강건강상태에 따른 건강관련 삶의 질

문보애 ( Bo Ae Moon ),정선락 ( Sun Rak Jeong ),장정유 ( Jung Yoo Jang ),김건엽 ( Keon Yeop Kim ) 한국치위생학회(구 한국치위생교육학회) 2015 한국치위생학회지 Vol.15 No.2

Objectives: The purpose of this study was to investigate the relation between health-related quality of life and oral health behavior and oral health status, and to provide the basic data for national oral health policy. Methods: The primary data of the 5th National Health Examination and Nutritional Survey(NHANES) in 2012 were used in this study. The subjects were 2,243 middle-aged people(40-59 years old), 827 persons were excluded for missing value or having diseases affecting quality of life(depression, stroke, cardiac infarction, angina, liver cancer, stomach cancer, colon cancer, breast cancer, cervical cancer, lung cancer, thyroid cancer, other cancers, arthritis), and 1,416 data were finally analyzed. Results: In health-related quality of life by subjects`` characteristics, there was significant difference in gender, age, education, family income, and employment status(p<0.01) except for current smoking. Oral health behavior didn``t have significant relation to health-related quality of life, but better oral health status showed better health-related quality of life(p<0.01). Conclusions: In conclusion, this study suggested that there was close relationship between the oral health status and health-related quality of life in moddle aged people. Therefore, national oral health policy is needed for the oral health promotion with commitment of oral prophylaxis and care programs to the individual and community.

Exploring Health Journalists’ Professional Role Conceptions: A Comparative Analysis of Newspaper and Other Health Journalists

정지연 사단법인 한국융합기술연구학회 2023 아시아태평양융합연구교류논문지 Vol.9 No.8

Health journalists play a vital role in shaping public perceptions and decisions regarding personal and public health-related issues. However, there has been limited research exploring health journalists’ professional role conceptions, and the significance of these roles for sustaining the health industries remains understudied. This research aims to address this gap and enhance understanding of the profession by exploring how health journalists perceive their professional roles and their impact on the sustainability of the health industries. By utilizing secondary data from a professional research center that conducted a national survey (N=774) of health journalists, this study reveals that health journalists prioritize their role conceptions similarly to previous research, with the order being interpretive, disseminator, adversarial, and populist mobilizer. Notably, health journalists perceive the adversarial and populist mobilizer roles much more important than journalists previously surveyed. Newspaper health journalists attribute greater importance to their professional roles than health journalists working for other news delivery channels or general newspaper journalists. Overall, health journalists earnestly strive to fulfill an educator role, which is critical for translating scientific medical information. This research sheds light on the complexities of health journalists' role perceptions and contributes to a deeper understanding of the distinct professional identity of health journalism. The study’s findings challenge conventional assumptions and have significant implications for advancing the field, fostering informed and impactful health journalism that serves both the audience and society at large.

모든 정책의 건강: 건강증진과 부문 간 협력의 진화

장원기 ( Won Gi Jhang ) 한국보건행정학회 2016 보건행정학회지 Vol.26 No.1

‘Health in All Policies’ is a new strategy for governance for health in 21st century. The evolution of health promotion has affected the creation of the strategy through the efforts to tackle health inequalities by addressing social determinants of health. More concern about health inequalities, involving wider policy areas, and higher level of institutionalization distinguish the strategy from the old intersectoral collaboration such as intersectoral action for health and healthy public policy. Making intersectoral collaboration the mainstream of policy making is important to address integrated policy agendas such as ‘Health in All Policies’ and ‘Sustainable Development Goals.’ Political leadership and interpersonal skills are also required to strengthen the capacity of public health sector for implementing ‘Health in All Policies’ in local, national, and international circumstances.

GIS 및 공간통계를 활용한 낙동강 유역 수생태계의 건강성 평가

조명희 ( Myung Hee Jo ),심준석 ( Jun Seok Sim ),이재안 ( Jae An Lee ),장성현 ( Sung Hyun Jang ) 한국지리정보학회 2015 한국지리정보학회지 Vol.18 No.2

본 연구는 낙동강 유역의 수생태계 건강성 조사지점에서 생물 및 서식환경, 수질에 대한 건강성을 조사 및 평가한 결과자료를 이용하여 공간정보로 재구축하고 공간분석기법을 활용하여 낙동강유역의 수생태계 보전 및 복원 정책의 합리적인 의사결정을 지원하고 효율적인 관리방안을 제시하는데 목적이 있다. 낙동강 유역의 수생태계 건강성을 분석하기 위하여 250개 조사구간의 수생태계 건강성 조사 및 평가 결과자료를 각 지점별 위치정보를 기반으로 점형 자료로 구축하였다. 그리고 공간적인 분석기법의 적용을 위해 면형 자료로 재구축 할 필요성이 있으며, 이를 위해 Kriging 보간법(ArcGIS 10.1, Geostatistical Analysis)을 활용하여 공간적 영향력 및 트랜드를 분석하였고 면형 자료로 재구축 하였다. 이를 바탕으로 낙동강 유역 건강성의 공간분포 특성을 분석하기 위해 Hotspot(Getis-Ord Gi,)과 LISA(Local Indicator of Spatial Association), 표준편차타원체(Standard deviational ellipse) 분석을 활용하였다. Hotspot 분석 결과 생물지수(TDI, BMI, FAI)의 Hotspot 유역은 안동댐 상류, 왕피천, 임하댐 유역으로 생물지수의 건강성 등급이 양호한 것으로 분석되었으며, Coldspot 유역은 낙동강 남해, 낙동강 하구, 수영강 등의 유역으로 나타났다. LISA 분석 결과 이례지역은 가화천, 합천댐 상류, 영강 상류 유역으로 분석되었으며 이 지역은 생물 건강성 지수가 높은 유역이지만 주변 유역의 건강성이 낮아 수생태계 건강성에 대한 관리가 필요한 유역으로 분석되었다. 이화학적 요인(BOD)의 Hotspot 유역은 낙동강하류 유역과 수영강, 회야강, 낙동강남해 유역으로 나타났으며, Coldspot 유역은 안동댐, 임하댐,영강 등 낙동강 지류의 상류 유역으로 분석되었다. 서식 및 수변환경(HRI)요인의 Hotspot과LISA 분석결과 요인별 Hotspot과 Coldspot이 다르게 분석되었으나 일반적으로 낙동강 상류, 안동댐, 임하댐, 합천댐 유역 등 낙동강 본류와 지류의 상류 유역 서식 및 수변환경 건강성이 좋은것으로 분석되었다. 서식 및 수변환경 요인이 Coldspot으로 나타난 유역들은 생물지수와 이화학적 요인의 건강성 지수도 낮게 나타나 서식 및 수변환경의 관리가 필요한 유역으로 판단할 수 있다. 표준편차타원체로 분석한 시계열 분석결과 생물과 서식 및 수변환경에 의한 수생태계 건강성이 좋은 지역이 점점 북쪽으로 이동하는 경향을 나타내고 있으며 BOD 결과는 조사년도에 따라 방향과 집중도가 각각 다르게 나타나는 것으로 분석되었다. 이러한 수생태계 건강성 분석 결과는 조사지점별 건강성 관리정보뿐만 아니라 향후 공간정보 기술기반 수환경 연구와 실무연구진을 위한 집수구역 단위 수생태계를 관리할 수 있는 정보를 제공할 수 있을 것으로 판단된다. The objective of this study was to reconstruct spatial information using the results of the investigation and evaluation of the health of the living organisms, habitat, and water quality at the investigation points for the aquatic ecosystem health of the Nakdong River basin, to support the rational decision making of the aquatic ecosystem preservation and restoration policies of the Nakdong River basin using spatial analysis techniques, and to present efficient management methods. To analyze the aquatic ecosystem health of the Nakdong River basin, punctiform data were constructed based on the position information of each point with the aquatic ecosystem health investigation and evaluation results of 250 investigation sections. To apply the spatial analysis technique, the data need to be reconstructed into areal data. For this purpose, spatial influence and trends were analyzed using the Kriging interpolation(ArcGIS 10.1, Geostatistical Analysis), and were reconstructed into areal data. To analyze the spatial distribution characteristics of the Nakdong River basin health based on these analytical results, hotspot(Getis-Ord Gi,), LISA(Local Indicator of Spatial Association), and standard deviational ellipse analyses were used. The hotspot analysis results showed that the hotspot basins of the biotic indices(TDI, BMI, FAI) were the Andong Dam upstream, Wangpicheon, and the Imha Dam basin, and that the health grades of their biotic indices were good. The coldspot basins were Nakdong River Namhae, the Nakdong River mouth, and the Suyeong River basin. The LISA analysis results showed that the exceptional areas were Gahwacheon, the Hapcheon Dam, and the Yeong River upstream basin. These areas had high bio-health indices, but their surrounding basins were low and required management for aquatic ecosystem health. The hotspot basins of the physicochemical factor(BOD) were the Nakdong River downstream basin, Suyeong River, Hoeya River, and the Nakdong River Namhae basin, whereas the coldspot basins were the upstream basins of the Nakdong River tributaries, including Andong Dam, Imha Dam, and Yeong River. The hotspots of the habitat and riverside environment factor(HRI) were different from the hotspots and coldspots of each factor in the LISA analysis results. In general, the habitat and riverside environment of the Nakdong River mainstream and tributaries, including the Nakdong river upstream, Andong Dam, Imha Dam, and the Hapcheon Dam basin, had good health. The coldspot basins of the habitat and riverside environment also showed low health indices of the biotic indices and physicochemical factors, thus requiring management of the habitat and riverside environment. As a result of the time-series analysis with a standard deviation ellipsoid, the areas with good aquatic ecosystem health of the organisms, habitat, and riverside environment showed a tendency to move northward, and the BOD results showed different directions and concentrations by the year of investigation. These aquatic ecosystem health analysis results can provide not only the health management information for each investigation spot but also information for managing the aquatic ecosystem in the catchment unit for the working research staff as well as for the water environment researchers in the future, based on spatial information.

대학생의 건강정보이해능력과 건강증진행동(식습관, 신체활동과 스트레스)과의 관련성

김윤선 대한지역사회영양학회 2022 대한지역사회영양학회지 Vol.27 No.2

Objectives: This study attempted to examine the association between health literacy and health-promoting behavior, and identify the major variables that affect the health-promoting behavior of university students. Methods: This was a descriptive correlation study that identified the degree of health literacy and health-promoting behavior of 248 university students (119 male and 129 female) and examined the correlation between the two and factors influencing them. The questionnaire covering health literacy comprised 66 questions, and that for health-promoting behavior comprised 10 questions covering eating habits, 3 questions about physical activity, and 10 questions involving stress. Results: The score for health literacy was 41.56 ± 18.38 out of 66 points, and that for health-promoting behavior was 65.27 ± 11.21 points (27.61 ± 6.72 points for eating habits, 7.23 ± 2.56 points for physical activity, and 30.44 ± 5.61 points for stress). Health literacy and health-promoting behavior had a significant positive correlation (r = 0.175, P < 0.01). The perceived health status (β = 0.391, P < 0.001) was the most important variable in health- promoting behavior, followed by health literacy (β = 0.236, P < 0.001). Conclusions: It is necessary to develop a systematic educational strategy and implement educational programs to improve health literacy as well as encourage health-promoting behavior and thus increase the perceived health levels of university students.

Building a Concept of Health -Focusing on the Debate between Christopher Boorse and Lennart Nordenfelt over Health-

Lee, Meekyoung(이미경) 이화여자대학교 생명의료법연구소 2018 Asia Pacific Journal of Health Law & Ethics Vol.12 No.1

‘건강’은 사람의 신체와 정신 상태가 온전할 때 그 사람의 삶이 평온할 수 있음을 내포하면서도 주로 ‘질병의 부재’로 정의되어 왔다. 그러나 자원 분배나 삶의 질과 같은 보다 포괄적인 의미에서 건강을 조망해야 할 필요성에서 최근 서구 학계에서는 ‘질병의 부재’로서의 협의의 건강 개념과 ‘삶의 질의 전제’로서의 광의의 건강 개념을 둘러싼 논쟁이 이어지고 있다. 이러한 논쟁은 건강과 치료의 범위를 어디까지로 한정할 것인가와 같은 의학 뿐 아니라 건강 관련 정책과도 관련하여 중요한 의미를 지닌다. 더욱이, 실제로 좋은 삶의 질에 대한 기대가 높아지고, 그 실현을 위한 정책의 중요성에 대한 인식이 점점 더 강조되고 있는 현실에서, 건강에 대한 보다 정교한 이해가 요구된다. 그에 따라서 이 글은 건강 개념을 둘러싸고 제시된 논의들을 통해 건강에 대한 그와 같은 정교한 이해를 제시하고자 한다. 그러므로 각각 ‘질병의 부재’로서 제시한 미국의 생명윤리학자인 크리스토퍼 부어즈(Christopher Boorse)의 자연주의적 건강 개념과 건강을 인간 삶 전반에 중요한 영향을 끼치는 광의의 개념으로 파악해야 한다는 스웨덴 철학자, 레나르트 노르덴펠트(Lennart Nordenfelt)의 규범주의적(normativist) 건강 개념을 살펴본 후에 두 개념을 종합하는 중층적인 개념으로 건강을 제시하고자 한다. ‘Health’ has been mainly defined as ‘absence of disease’, even though it implies that one’s life is in a good state when one’s physical and mental status is sound. However, in order to view health in more comprehensive perspectives, including the issues of distribution of sources or quality of life, then there have been debates between the narrow definition of health as ‘absence of disease’ and a broader definition of it as ‘the base of quality of life’ in the Western world. These debates are significant in medicine for the scope of health and treatment as well as healthcare policies. Moreover, with the reality that better quality of life is highly expected and the importance of policies to realize it is being empathized, it is necessary to understand health more elaborately. Accordingly, this article aims to suggest an exquisite understanding of health through debates over the core concept of health. Therefore, after reviewing the naturalistic concept of health as ‘absence of disease’ by American bioethics theorist Christopher Boorse, and the normativist concept of health affecting human life significantly by Swedish philosopher Lennart Nordefelt, a layered concept of health that synthesizes both theories will be possible.

농촌 고령자의 건강정보문해력이 건강증진행위에 미치는 영향 : 자기효능감의 매개효과

최현우,손주리,최윤지,최정신 한국생활과학회 2023 한국생활과학회지 Vol.32 No.5

Health promotion behaviors among rural elderly are known to be influenced by health literacy, self-efficacy, and a variety of sociodemographic and health-related factors. Although health literacy and self-efficacy have been found to be important factors affecting individuals' health promotion behaviors, few studies have examined the relationship between them. The purpose of this study was to determine the mediating effect of self-efficacy on the relationship between health literacy and health promotion behaviors. A total of 552 elderly people aged 60 years or older living in 75 towns and villages in 21 cities and counties in Korea were enrolled. A structured questionnaire was used to survey them. Multiple regression analysis was conducted to examine the mediating effect of self-efficacy on the relationship between health literacy and health promotion behaviors. Results showed that health promotion behaviors were positively related to health literacy and self-efficacy, with self-efficacy having a mediating effect on the relationship between health literacy and health promotion behaviors. This suggests that self-efficacy should be considered in the development of health promotion education and programs for rural elderly living in rural areas. It means that it is necessary to find ways to increase self-efficacy as a strategy to improve health literacy.

근대 동아시아 위생 개념의 확산과 공공의료 담론의 형성

신규환 대한의사학회 2022 醫史學 Vol.31 No.3

If public health can be defined as “all activities to ensure universal medical use of the people and protect and promote health,” it can be said that public health emerged in the process of developing the concept of hygiene in East Asia. While traditional hygiene emphasized individual curing and longevity, modern hygiene was the state in charge of individual body and discipline. East Asian countries had to practice modern tasks in the field of hygiene and medical care in line with the construction of modern countries, and it was considered legitimate for modern countries to intervene in individual bodies. As the demand for modern national construction became stronger, interest in public health rather than personal hygiene increased. In East Asia, a new interpretation of the concept of hygiene began in Japan. Sensai Nagayo(1838-1902) newly defined the concept of ‘sanitation’ to justify the physical intervention of the modern state in Meiji period. The concept of ‘public health’ began to be used in earnest in 1890, when Ogai Mori(1862-1922) translated Western-style health protection measures for the public as public health. Since then, public health has evolved into a universal social discourse in Japan. Japan’s public health expanded to colonial Joseon, Taiwan, and China. Japan’s victory in the Sino-Japanese War led East Asian countries to believe that hygiene was the root of the Japanese nation’s power. In the early 20th century, the government of the Republic of China began to imitate the case of Japan while promoting modern education reform and institutional reform. Japanese-style ‘public health’ was transplanted into various hygiene laws and sanitary equipment. In Korea, modern hygiene was introduced and spread from the end of the 19th century to the first half of the 20th century, and the concept of ‘public health’ in Japan was mainly spreading. Public health in Japan was vaguely defined as an activity to protect and promote the health of the people, but in practice, it was focused on improving quarantine and environmental infrastructure. In response, the concept of American-style public health, which values prevention and treatment at the same time, has already begun to emerge under the Japanese colonial rule. In East Asia in the 1920s and 1930s, Japanese-style public health and American-style public health discourse competed, and measures to solve medical inequality were discussed in earnest. Interestingly, in common in East Asian countries, Actual Medical Expenses Campaigns to improve medical access at low cost and social medicine to universally provide prevention and treatment to the people have drawn attention. This was also a phenomenon caused by intensifying medical inequality as rapid urbanization and industrialization progressed in East Asian countries in the first half of the 20th century. Although it was impossible to resolve social contradictions or move toward fundamental reform of the national medical system due to the nature of the private movement, the actual medical movement further imprinted the need for public health care in the country and society. Social medicine studied the effects and relationships of the social environment on diseases and health, and studied ways to promote public health by using preventive medicine and therapeutic medicine. If social medicine was supported by state power, it was possible to go forward with practice such as State Medicine like China, otherwise it would only be a civilian movement such as the People’s Health Movement, as in colonial Korea. Liberation and the Korean War were a dramatic turning point in American-style health that led to Japanese-style hygiene. Immediately after Liberation, there was a discussion between the left and right camps over medical nationalization to enhance the publicity of medical care. The medical community was sympathetic to the nationalization of medical care, but due to the lack of medical personnel an...

건강식생활 유형 및 건강증진 동기가 힐링체험 욕구에 미치는 영향

이상민,윤지영,정희선,Lee, Sang-Min,Yoon, Jiyoung,Jeong, Hee Sun 한국식품조리과학회 2015 한국식품조리과학회지 Vol.31 No.4

The purpose of this study was to examine the effects of a lifestyle consisting of a health oriented diet and personal motivation toward health improvement on an individual's desire to participate in condolence or "healing" -workshops and programs. In order to examine the influence of the "health diet" and motivation, the "health diet" lifestyle was classified into nutrition pursuit factors, psychological factors, food safety factors, and health conscious consumption factors. Personal motivation was categorized into perceived benefits, environmental factors and the individual's desire for happiness. Empirical analysis showed that nutrition pursuit factors had an impact on perceived benefits and the desire for happiness. Psychological aspect factors had a significant influence on perceived benefits, environmental factors and the desire for happiness. However, food safety factors and health conscious consumption factors did not have an effect on individual motivation to improve health. Regarding personal motivation toward health improvement on the desire for "healing", perceived benefits and environmental factors had significant influence. However, the individual's desire for happiness did not influence the demand for "healing". Regarding the effect of a "health diet" on the desire for "healing", only the psychological aspects of a "health diet" had any significant effects on the desire for "healing". The results from this study can help local organizations or service companies that provide "healing" programs with developing effective marketing strategies that could lead to greater customer satisfaction. Especially, the significant influence of psychological aspects of a "health diet" on the demand for "healing" is noteworthy in that this could play a key role in establishing a more effective marketing strategy to attract increasing numbers of consumers using health conscious diets.