생애전환기에 따른 의료서비스 이용에 영향을 미치는 요인 = Determinants of Health Utilization by Life Transitional Period

국문 초록 (Abstract)

생애전환기는 개인의 생애에 있어 그 전 연령대와 비교하여 만성질환 이환 등 건강이상을 경험할위험이 높아지는 시기이다. 연령이 증가할수록 높아지는 만성질환의 이환율은 의료이용을 증가로 이어지고 있다. 건강이상을 인지한 이후 개인의 질병행태는 다양한 요인에 의해 영향을 받으며, 이를예측하기 위해 많은 이론적 모형을 통해 연구가 진행되고 있다.
이번 연구는 한국의료패널 자료를 이용하여 경험적 연구들을 통해 모형의 타당성이 검증된 ‘의료서비스 이용행태 모형’을 활용하여 생애전환기별 의료서비스 이용 여부 및 이용행태에 영향을 미치는요인을 밝히고자 하였다.
이번 연구 결과 외래의 경우에는 소인성 요인, 가능성 요인, 필요요인, 건강행태 및 맥락적 특성등이 고르게 영향을 미치고 있었다. 모형이 설명력은 외래, 입원, 치과 이용 순으로 높았다. 생애전환기별로는 장년기는 의료이용 여부에 있어 가능성 요인과 필요요인이 주로 영향을 미쳤으며, 이용 행태에서도 유사한 경향을 보였다. 노년기의 경우에는 소인성 요인, 가능성 요인, 필요요인이 고르게 영향을 미치고 있었다.
이번 연구를 통해 동일한 이론적 모형을 사용함에 있어서도 생애전환기에 따라 전체 모형이 설명력과 유의미한 변수에 차이가 있음이 확인되었다. 그리고 외래 의료서비스의 경우 개인적 특성을 통해 많은 부분 설명이 가능하지만, 입원 의료서비스의 경우 개인적 특성만으로는 제한적 설명만이 가능했다.
이번 연구는 경험적 연구를 통해 검증된 모형을 바탕으로 전국 대표성 있는 자료를 분석하였다.
생애전환기별 의료서비스 이용에 유의한 영향을 미치는 요인의 차이를 밝힘으로서 향후 보건의료정책수립 전략과 동시에 추후 관련 연구 진행에 중요한 자료를 제공할 수 있을 것이다.

다국어 초록 (Multilingual Abstract)

A life transitional period is a period in personal life when the risk of experiencing health issues such as chronic diseases increases compared to previous age periods. The increase of chronic diseases, increasing proportionately with age, leads to increase in health service use.
Personal sickness behavior, after acknowledging health issues, is affected by various factors, and many researches are being conducted on theoretical models to predict these factors.
This research utilizes ‘A Behavioral Model of Health Service Use’, which was proved of its validity through many empirical studies, by using the data of Korea Healthcare Panel in order to reveal the factors affecting health service utilization in terms of each life transitional period.
This research showed that for outpatients, the predisposing factors, possibility factors, necessity factors, health behavior and contextual characteristics equally affected personal disease behavior. The explaining power of the model was strongest for outpatient service, and inpatient service subsequently followed. For each life transitional period, the possibility factors and necessity factors mainly affected the middle-aged group and similar trends were shown in use behavior.
For the old-aged group, the predisposing factor, possibility factors, and necessity factors were found to be equally affecting factors.
This research confirmed that even when using the same theoretical model, the explaining power of the entire model and belief variables can depend on the life transitional period. The outpatient health service could be explained solely by personal characteristics while the inpatient health service could only be explained in a limited manner by personal characteristics.
This research has analyzed representative data in the nation based on models verified through empirical researches. By revealing the belief factors affecting the use of health service per life transitional period, this research attempts to provide a valuable material for subsequent researches and to provide a strategy to establish health and welfare policies in the future.

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