베이비 부머의 의료이용 관련 영향요인 분석 연구

이은환 ( Lee Eun-whan ),최현진 ( Choi Hyeon-jin ),김희선 ( Kim Hee-sun ) 한국보건사회연구원 2015 保健社會硏究 Vol.35 No.3

본 연구는 우리나라의 베이비 부머 세대(1955~1961년생)들의 시간적 흐름에 따른 사회경제적 요인을 비롯한 건강행태 및 건강상태 등 건강관련 요인들에 어떠한 변화가 있는지를 살펴보고, 베이비 부머 세대들의 의료이용에 영향을 미치는 요인을 찾고자 수행되었다. 연구 데이터는 고령화연구패널조사 1~3차 원자료(2006~2010년)를 활용 하였는데, 이중 베이비 부머 세대인 1955~1961년생을 분석대상으로 하였고, 분석방법은 표본 가중치를 적용한 fixed effect 모델을 사용하였다. 분석결과를 살펴보면, 성별, 경제활동, 소득수준, 건강행태, 만성질환 등이 베이비 부머세대의 의료이용 영향요인으로 나타났다. 또한 베이비 부머 세대의 특수성을 파악하기 위해 이전 세대와 비교 분석한 결과 베이비 부머 세대는 전반적으로 이전 세대보다 양호한 건강상태를 보였으나 시간이 지날수록(2006~2010년) 만성질환 유병률이 지속적으로 증가하였고, 건강행태 또한 나빠지는 것으로 나타났다. 본 연구는 최근 이슈가 되고 있는 베이비 부머 세대가 직면한 다양한 문제 및 이슈들 중 인간의 기본권 중 하나인 건강과 의료이용 행태에 대한 첫 번째 연구라는 데에 의의가 있다. 특히, 베이비 부머들의 은퇴가 본격화 되고 이들의 건강에 대한 관심이 높아지는 현 시점에서 이 연구의 결과들은 향후 베이비 부머 세대 들의 의료이용과 관련된 정책을 비롯한 건강증진 및 예방 정책을 수립하는데 중요한 근거자료로 활용될 수 있을 것이다. This study aims to explore factors associated with healthcare service utilization among Korean baby boomers. The Korean Longitudinal Study of Ageing (KLoSA) data was used, and we employed the Andersen`s healthcare service utilization model. Fixed effect model was used to examine the association between each independent variable and healthcare utilization for Korean baby boomers. Moreover, we identified changes in their characteristics including socio-economic status, healthcare service utilization, health behaviors and chronic illness from 2006 to 2010. Our results show that sex (male), economic activity (having job), income level (the lower), health behavior (the worse), and chronic illness are statistically significant. Furthermore, we found that the prevalence of chronic illness is growing steadily, and their health behaviors are getting worse and worse. This study is the first to explore factors associated with healthcare service utilization among Korean baby boomers. Our findings can provide valuable information to make policy for Korean baby boomers.

입원환자 시장세분화에 관한 연구

이은환 ( Eun Whan Lee ) 한국병원경영학회 2012 병원경영학회지 Vol.17 No.2

Purpose : This study aims to suggest application of patients DB to hospital marketing by performing market segmentation and selecting target market. Consequently help to establish suited strategy of marketing. Method : 14,072 patients hospitalized in a University Medical Center were recruited into this study. In order to classify the customer groups, cluster analysis was used with RFM(Recency, Frequency, Monetary) model, and 1- way ANOVA verified the differences among groups. And then, socio- demographical status, healthcare utilization and diagnosis(ICD-10) of each group were compared to draw a marketing strategy. Results : Four groups were classified through clustering analysis, and``high use and high profit`` and``low use and high profit`` groups were selected as a target market. The features of target market were as follows, the female proportion was high; used a private room; hospitalized through the emergency room; had operation; length of stay was long; had many comorbidity and cooperative treatment. There was difference in each feature of target market: as for the``high use and high profit`` group, many patients were diagnosed with ``certain infectious and parasitic diseases``; and as for the``low use and high profit``group, the proportion of patients who purchased``industrial accident compensation insurance``and``auto insurance``was relatively high; many patients were diagnosed with``Injury, poisoning and certain other consequences of external causes``. Conclusion : It is needed to establish``positioning`` strategy by monitoring and communicating with``high use and high profit`` group. And for the case of``low use and high profit`` group, it is necessary to make a follow-up management and lead them to have a medical check-up.

서울시 소재 한 대학병원 퇴원환자의 재입원 관련요인

이은환 ( Eun Whan Lee ),유승흠 ( Seung Hum Yu ),이해종 ( Hae Jong Lee ),김석일 ( Suk Il Kim ) 한국병원경영학회 2010 병원경영학회지 Vol.15 No.4

Objective: To determine demographic, clinical, health care utilization factors predicting unplanned readmission(within 28 days) to the hospital. Methods: A case-control study was conducted from January to December 2009. Multiple logistic regression was used to examine risk factors for readmission. 180 patients who had been readmitted within 28 days and 1,784 controls were recruited from an university hospital in Seoul. Results: Six risk factors associated with readmission risk were identified and include mail sex, medical service rather than surgical service, number of comorbid diseases, type of patient`s room, lenth of stay, number of admissions in the prior 12 months. Conclusions: One of the association with readmission risk identified was the number of hospital admissions in the previous year. This factor may be the only risk factor necessary for assessing prior risk and has the additional advantage of being easily accessible from computerized medical records without requiring other medical record review. This risk factor may be useful in identifying a group at high readmission risk, which could be targeted in intervention studies. Multiple risk factors intervention approach should be considered in designing future prevention strategies.

중고령자에서의 건강행위 군집과 건강결과와의 상관성 연구

이은환 ( Eun-whan Lee ),유빛나 ( Bit-na Yoo ),김욱 ( Wook Kim ),김희선 ( Hee-sun Kim ) 대한보건협회 2017 대한보건연구 Vol.43 No.3

연구목적 : 이 연구는 급격한 고령화가 진행되고 있는 우리나라에서 노년기를 바로 앞든 중고령자들을 대상으로 포괄적인 건강행태 군집 유형을 분류하고, 유사 건강행위 군집별 특성을 분석하기 위해 수행되었다. 연구방법 : 본 연구에서는 흡연, 음주, 규칙적 운동 여부를 표준화하고 이에 대한 군집분석을 실시하여, 수동적 태도군, 적극적 태도군, 흡연군, 음주군, 건강염려군, 건강무관심군 등 총 6개의 군집으로 분류하였다. 연구결과 : 수동적 태도군은 흡연/음주/운동 점수가 모두 낮은 군이었고, 적극적 태도군은 흡연/음주는 낮고 운동 점수는 높았다. 흡연군은 음주/운동은 낮고, 흡연 점수가 높았고, 음주군은 흡연/운동 점수는 낮고 음주 점수가 높은 군이었다. 건강염려군은 흡연/음주 점수가 높으면서 운동 점수 또한 높았고, 건강무관심군은 흡연/음주 점수가 높고 운동 점수는 낮은 군이었다. 결론 : 본 연구는 개별 건강행태들이 분절적이 아닌 상호 연계성을 가지고 있는 것을 고려하여 이를 종합한 포괄적 지표를 제공하였다는데 의의가 있다. 특히 이 연구에서는 선행연구에서 고려하지 못한 다양한 중고령층의 특성을 반영하여 군집을 분류하였고, 그 결과 모든 연령층을 대상으로 한 선행연구의 군집 특성과 다른 양상을 보임을 확인할 수 있었다. 이 연구는 건강한 노년을 위한 중고령층의 건강위험행위 중재 정책에 있어서 유용한 기초자료로 활용될 수 있을 것이다. Objective : This study focuses on the types of health-related behavior clusters in middle-aged persons and examines the nature of each cluster, the relationship between the clusters, and health-related outcomes. Methods : Cluster analysis was performed on standardized items, such as smoking, drinking, and exercise. Results : As a result of cluster analysis, we categorized the items into the following clusters: passive attitude cluster, active attitude cluster, smoking cluster, drinking cluster, health anxiety cluster, and health indifference cluster. Conclusion : This study contributes to the field by conducting exploratory research on clustering health behaviors and examining the correlation between their general characteristics and chronic disease status. Especially, we found that the results of this study have different aspects compared to previous studies that were conducted in all ages. This study can be valuable information to serve as a foundational source for mediating middle-aged persons` health risk factors.

정신적 장애인의 근로소득 결정요인에 관한 연구 -장애인고용패널 데이터를 활용하여-

이현경 ( Hyun Kyung Lee ),정현정 ( Hyun Chong Chong ),이은환 ( Eun Whan Lee ) 경희대학교 경영연구원 2014 의료경영학연구 Vol.8 No.2

This study aims to investigate factors associated with income of workers with mental disability. The Korean Panel Survey of Employment for the Disabled 2009 was used. The data of KPSED is a stratified multistage clustered probability design survey which have a sample representing the entire population of Korea. We analyzed characteristics of work status, income for workers with mental disability, and the factors associated with income of workers with mental disability. In this study, factors associated with income of workers with mental disability are position level at worksite, occupational category, age, length of disability, average working time for a week and so on. Especially, we find the difference in income between occupational categories.

우리나라 남녀 노인의 문제음주 관련요인

이현경 ( Hyun Kyung Lee ),이승희 ( Seung Hee Lee ),이은환 ( Eun Whan Lee ) 한국보건정보통계학회 (구 한국보건통계학회) 2012 보건정보통계학회지 Vol.37 No.1

Objectives: The purpose of this study is to analyse characteristic and factors associated with problem drinking among the elderly in Korea. Methods: 2009 National Health and Nutrition Survey was used sample of 1,086 the elderly more than 65 age who had problem drinking. Data were analyzed by frequency, X2 test, and hierarchical multiple logistic regression. Results: The main results are as follows. In man, hierarchical multiple logistic regression analysis showed that age, perceived health condition, smoking, sleeping were significantly related to problem drinking: age had OR 0.3, perceived healthy condition had OR 1.5, smoking had OR 0.5, sleeping had OR 0.5. In woman, only perceived health condition was significantly related to problem drinking: perceived healthy condition had OR 3.4. Conclusions: In association influenced factors of problem drinking, it is important to develop appropriate health promotion programs for problem drinking behavior in the elderly.

지역거점 공공의료원 종사자들의 이직의도 영향요인

최현진 ( Hyeon-jin Choi ),이원재 ( Won Jae Lee ),이은환 ( Eun-whan Lee ) 대한보건협회 2016 대한보건연구 Vol.42 No.4

연구목적 : 최근 정부는 공공의료 강화 정책으로 전국에 있는 공공의료원의 지원을 확대하고, 공익적 기능을 강화하기 위한 노력을 기울이고 있다. 그럼에도 불구하고 전국의 많은 공공의료원들은 여러 문제점들로 고심하고 있는데, 그 중 하나가 종사자들의 이직으로 인한 양질의 인력관리 문제이다. 이 연구에서는 공공의료원의 종사자들을 대상으로 이직의도에 영향을 미치는 요인을 찾고자 수행되었다. 연구방법 : 이 연구에서는 전국 33개 공공의료원의 종사자를 대상으로 설문조사를 실시하였다. 웹기반의 자기기입식 설문 지를 전자메일로 발송하여 진행하였고, 총 527명의 응답자가 참여하였다. 이직의도는 선행연구에서 널리 쓰이는 총 4문항으로 구성된 리커트 5점 척도의 설문도구를 사용하였고, 그 외 응답자의 인구사회학적 특성을 비롯하여 직무 관련 특성 및 사회심리적 특성을 포함하여 연구모형을 구성하였다. 분석방법은 위계적 다중회귀분석을 사용하였고, 유의수준은 0.050를 기준으로 하였다. 연구결과 : 이 연구에서 공공의료원 종사자들의 이직의도에 영향을 미치는 요인을 찾기 위해 다중회귀분석을 수행한 결과 연령이 낮을수록, 교육수준이 높을수록, 중간 경력층의 경우, 그리고 병상규모가 큰 의료기관의 종사자인 경우 이직의도가 유의하게 높은 것으로 나타났다. 또한 사회심리적 요인으로는 업무스트레스가 높을수록, 그리고 업무만족도가 낮을수록 이직 의도는 높아지는 것으로 나타났다. 결론 : 이 연구가 가지는 의의는 최근 정부의 공공의료원 기능강화 정책을 뒷받침하기 위해 양질의 인력관리를 위해 중요한 참고자료로 활용될 수 있다는 것이다. 특히 지금까지 연구되지 않은 공공의료원의 다양한 직종의 종사자를 대상으로 이직의도 영향요인을 분석한 첫 연구라는 점에서 그 의의가 크다. 이 연구의 결과 중 일부는 민간의료기관 종사자를 대상으로 한 선행연구의 결과와 다른 점들이 발견되었는데, 이는 공공의료기관의 인력관리 전략 수립에 유용할 것으로 판단된다. Objective : Recently, the Korean government is implementing various policies to strengthen roll of the public medical centers. But many of the public medical centers have problems of its employees turnover. This study aims to explore factors affecting turnover intention among public medical centers employees. Methods : In this study, we surveyed employees who are working in public medical centers, and 527 employees responded. Turnover intention was measured using a Lawler`s 4-item scale. Multiple regression model was used. Results : The results showed that the factors affecting turnover intention were younger age, higher level of education, longer career(years), bigger size of organization(the number of beds), higher job stress, and lower job satisfaction. Conclusions : This study is meaningful in that it is the first to date which explores the turnover intention among public medical centers employees. In this study, several results were inconsistent with previous studies that were conducted in private medical centers. These results can be used to make policies and strategies of human resources management in the public medical centers.

수도권 지역거점 지방의료원 종사자의 이직의도 영향요인

장동균 ( Chang Dong-gune ),김희선 ( Kim Hee-sun ),이은환 ( Lee Eun-whan ) 경희대학교 경영연구원 2016 의료경영학연구 Vol.10 No.3

This study aims to investigate factors associated with turnover intention among public medical centers employees in capital areas. We surveyed employees who are working in public medical centers in capital areas, and 756 employees responded. Turnover intention was measured using a Lawler`s 4-item scale and multiple regression model was used. The results showed that the factors affecting turnover intention were age, education, occupational category, year of career, size of organization, and job stress. This study is meaningful in that it is the first to date which explores the turnover intention among public medical centers employees. Given that the Korean government is implementing various policies to strengthen roll of the public medical centers, these results can be used to make policies and strategies of human resources management in the public medical centers.

소득계층에 따른 비만 위험 요인의 차이에 관한 연구: 2012년 국민건강영양조사를 활용하여

최현진 ( Hyeon Jin Choi ),김희선 ( Hee Sun Kim ),이은환 ( Eun Whan Lee ) 경희대학교 경영연구원 2014 의료경영학연구 Vol.8 No.4

This study aims to explore differences of factors associated with obesity between low income people and high income people. The data was derived from 2012 Korea National Health and Nutrition Examination Survey. We classified the subjects in four groups by house hold income quartiles. And then logistic regression was used to investigate the risk factors of obesity in each groups separately. In the lowest income group, the factors associated with obesity were sex, age and presence of diabetes, whereas the highest income group was influenced by sex, age, education and smoking. As for age, interestingly, woman was more likely to have a risk of obesity in the lowest income group, whereas man was more risky in the highest income group. In this study, we found the differences of factors associated with obesity between low and high income people when we analyzed separated sub-group according to income level. It is very meaningful implication to develop policy for obesity prevention or intervention.

청소년의 음주여부 및 문제음주에 영향을 미치는 요인: 2013 청소년 건강행태온라인조사를 활용하여

장동균 ( Dong Gune Chang ),김희선 ( Hee Sun Kim ),차승현 ( Seung Hyun Cha ),최현진 ( Hyeon Jin Choi ),이은환 ( Eun Whan Lee ) 경희대학교 경영연구원 2015 의료경영학연구 Vol.9 No.2

This study aims to explore the factors associated with drin king and problem drinking among Korean adolescents. The 2013 Youth Risk Behavior Web-based Survey (KYRBS) data was used. And logistic regression model was employed to investigate the risk factors of drinking and problem drinking. Our results show that sex, age, scholastic performance, pocket money, mental health and deviation factors are related to drinking and problem drinking. However, in the sex and educational background of their parents, the results were different from each other. In the case of drinking risk, boys are more likely to have a risk of drinking, whereas girls have more risk of problem drinking. Moreover, the educational background of their parents was risk factor in the risk of drinking whereas not in the problem drinking. These results deserve great attention, and the authorities need to keep it in perspective. It demonstrated that different health policies are essential for different outcomes, ie. the risk of drinking and problem drinking.