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김재경,정인아,이지연,김정현,한아연,김소연,조준성 대한결핵및호흡기학회 2018 Tuberculosis and Respiratory Diseases Vol.81 No.3
Background: The “Tuberculosis Relief Belt Supporting Project (Tuberculosis Patient Management Project for Poverty Groups)” is a national program for socioeconomically vulnerable tuberculosis (TB) patients. We sought to evaluate the clinical and socioeconomic characteristics of poverty-stricken TB patients, and determined the need for relief. Methods: We examined in-patients with TB, who were supported by this project at the National Medical Center from 2014 to 2015. We retrospectively investigated the patients’ socioeconomic status, clinical characteristics, and project expenditures. Results: Fifty-eight patients were enrolled. Among 55 patients with known income status, 24 (43.6%) had no income. Most patients (80%) lived alone. A total of 48 patients (82.8%) had more than one underlying disease. More than half of the enrolled patients (30 patients, 51.7%) had smear-positive TB. Cavitary disease was found in 38 patients (65.5%). Among the 38 patients with known resistance status, 19 (50%) had drug-resistant TB. In terms of disease severity, 96.6% of the cases had moderate-to-severe disease. A total of 14 patients (26.4%) died during treatment. Nursing expenses were supported for 12 patients (20.7%), with patient transportation costs reimbursed for 35 patients (60%). In terms of treatment expenses for 31 people (53.4%), 93.5% of them were supported by uninsured benefits. Conclusion: Underlying disease, infectivity, drug resistance, severity, and death occurred frequently in socioeconomically vulnerable patients with TB. Many uninsured treatment costs were not supported by the current government TB programs, and the "Tuberculosis Relief Belt Supporting Project" compensated for these limitations.
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김영현,이지연,정인아,김정현,김주혜,한지연,정은진,한아연,조준성,박정덕 대한내과학회 2022 대한내과학회지 Vol.97 No.1
Background/Aims: Although the incidence and mortality of tuberculosis are decreasing in South Korea, the number of applications for financial assistance with the cost of tuberculosis treatment made by individuals from vulnerable groups was 3.8 times higher in 2019 compared to 2017 (Tuberculosis Relief Belt Project, 2019). Methods: We analyzed the data of patients who received financial aid for tuberculosis treatment (in the period 2014-2018) from the Tuberculosis Relief Belt Project, which was designed to assist vulnerable groups. This study analyzed 137 subjects, and the independent variables included patient factors (age, gender, nationality, tuberculosis type, number of comorbidities, and place of residence) and treatment type (outpatient or inpatient). The dependent variable was the treatment outcome. Results: The likelihood of treatment success was significantly lower for patients with one (odds ratio [OR] 0.202), two (OR 0.147), or three or more (OR 0.070) comorbidities compared to those with no comorbidities. This was also the case for patients living alone (OR 0.097), and for those classified as homeless (OR 0.053). Korean patients (OR 8.512) had a significantly higher probability of a successful treatment outcome than foreigners. Conclusions: Appropriate community-based management of individuals with tuberculosis from vulnerable groups, including foreigners, people with comorbidities, people living alone, and people with an unstable residential situation or homeless status, is important.
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F-18 취약계층 결핵환자 관리사업(결핵안심벨트 지원사업) 2014년~2015년
김재경,조준성,정인아,이지연,김정현,한아연,김소연 대한결핵 및 호흡기학회 2016 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.121 No.0
목적: 국가적 결핵관리의 일환으로 2014년부터 결핵안심벨트 지원사업이 의료사각지대에 있는 취약계층의 권역치료 연계시스템으로 도입되었다. 본 연구는 이를 평가하고자 하였다. 방법: 2014년 4월부터 2015년 12월까지 국립중앙의료원에 입원하여 결핵안심벨트 지원을 받은 환자들을 대상으로 사회경제적 특성, 과거력, 결핵의 임상적 특성, 사업지출내역을 후향적으로 분석하였다. 성적: 서북, 마산, 목포에서 권역연계 시스템을 통해 전원 된 27명을 포함하여 전체 인원수 58명, 평균 연령 58±12.6세, 남자 54명(93.1%)이었다. 주거형태에서는 월세(47.8%) 다음으로 노숙 및 행려(30.4%)가 많았다. 등록노숙인을 포함한 의료급여1종 환자가 20명(46%), 건강보험 환자가 28명(48%)이었으나 건강보험 환자의 수입현황에서도 수입이 없는 경우가 14명(58%)이었다. 주거가족 구성수는 1인 가족이 40명(80%)이었고, 연락가능 가족이 있는 수는 29명(47.3%)이었다. 환자들의 albumin 평균값은 2.6±0.86g/dL, 평균 BMI는 14.6±9.04이었다. 전체 환자 중 폐결핵이 100%, 재발 결핵이 21명(36%)이었다. AFB 도말 양성환자가 30명(51.7%), 흉부방사선 촬영에서 공동이 있는 환자가 38명(65.5%)이었다. 내성결핵환자는 19명(50%)이었고, 이중 14명(73.7%)에서 다재내성 결핵이었다. 미국국가결핵원에 따른 영상학적 중증도 분류에서는 중증이 36명(62.1%), 중등증이 20명(34.5%), 경증이 2명(3.4%)이었다. 치료 결과에서 사망, 자의중단, 치료실패, 치료 중, 치료종결 환자는 각각 14명(26.4%), 7명(13.2%), 3명(5.7%), 9명(17.0%), 20명(37.7%)이었다. 치료비의 대부분은 비급여 약제, 검사, 재료(60%) 및 수술로 인한 비급여 재료비(23.3%)에 해당되었다. 결론: 국립중앙의료원을 통해 결핵안심벨트 지원을 받은 취약계층 환자들의 폐결핵은 중증도, 내성율, 사망율이 높았다.
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