의료보험 급여자로서의 약사회

민인순 약사공론 1992 대한약사회지 Vol.1992 No.1

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.

환자의 안전과 비용부담 적정화를 위한 「임의비급여 관리 방안」

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

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.

의료의 질 향상을 위한 정책 방향

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

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.

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.

진료비 확인 민원신청 경험과 의사 및 의료기관에 대한 신뢰도와의 관련성

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

지역사회 건강관련 삶의 질에 영향을 미치는 요인

정용래(Yong-Rae Jeong),함명일(Myung-Il Hahm),민인순(In-Soon Min),강은정(Eunjeong Kang) 한국콘텐츠학회 2015 한국콘텐츠학회논문지 Vol.15 No.1

이 연구의 목적은 우리나라의 지역사회 건강관련 삶의 질에 영향을 미치는 지역사회 요인을 확인하기 위함이다. 2012년 단면연구이며, 국가통계포털의 209개의 시군구별 2차 자료를 사용하였다. 기본 틀은 International Council of Science(ICSU)에서 제시한 지역사회 건강결정요인을 바탕으로 구성하였고, 6가지 측면으로 분류하였다. 분석방법은 지역사회 EQ-5D지수와 지역사회 요인들에 다변량 회귀분석을 실시하였다. 분석결과로, 흡연율, “양호한” 주관적 건강수준 인식률, 상수 및 하수도 보급률 그리고 재정자립도가 EQ-5D에 통계적으로 유의하게 긍정적인 연관성이 있었다. 순인구이동률, 비만율, 필요서비스 미치료율 그리고 지역사회 유형이 EQ-5D에 통계적으로 유의하게 부정적인 연관성이 있었다. 이 연구는 지역사회 수준의 건강관련 삶의 질에 영향을 미치는 지역사회 요인들의 연관성을 확인했으며, 이것은 지역사회 건강 정책 개발에 유용한 증거를 제공할 수 있다. The aim of this study was to identify the impact of community factors on the community-level Health-Related Quality of Life (HRQOL) in Korea. This was a cross-sectional study conducted in 2012 using secondary data(n=209) of the Korean Statistical Information Service. The framework was based on community factors provided by the International Council of Science (ICSU) and community factors were categorized based on six aspects. Multiple regression was applied to community factors depending on the community EQ-5D index. Smoking rate, “Good” self-rated health rate, water and wastewater coverage rate, and financial independency rate were significantly and positively associated with the EQ-5D score. Net migration rate(more move out than move in), obesity rate, unmet needed health care rate, and community type(rural than urban) were significantly and negatively associated with the EQ-5D score. This study identifies association for the impact of community factors on the community-level HRQOL and can provide useful evidence for development of community health promotion policies.