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권호별목차 / 소장처보기

H : 소장처정보

T : 목차정보

보건행정학회지 = Korean journal of health policy and admi... 8건

  1. [국내논문]   미국 병원의 네트워크 유형 선택에 영향을 미치는 요인분석  

    김양균 (경희대학교 경영대학 의료경영학과)
    보건행정학회지 = Korean journal of health policy and administration v.14 no.2 = no.37 ,pp. 1 - 16 , 2004 , 1225-4266 ,

    초록

    The study purpose was to find which factors affect selection of hospital network types. This study used the 1998 American Hospital Association Annual Survey Database from Health Forum. Among these U.S. hospitals, the researcher selected hospitals located in Metropolitan Statistical Areas. Therefore the final observation cases for analysis are 1,971 Metropolitan Statistical Area hospitals in the United States. To identify significant variables influencing hospital network types, the study used proportional odds logistics regression model on population size, Health Maintenance Organization penetration rate, and market competition rate of area including a hospital, types of hospital ownership, hospital bed size, proportion of Medicare patients and Medicaid patients in total hospital patients, and occupancy rate. Contrary to conventional wisdom, selection of hospital network types was influenced by population size of area which a hospital located, types of ownership, hospital bed size, and proportion of medicare patients rather than Health Maintenance Organization penetration. Population size 1,000,000-2,499,999 had the highest probability of selecting type IV (clinical-vertical integration) from an independent hospital, and a religious group owned hospitals and for-profit owned hospitals had the highest probability of selecting Type IV (clinical-vertical integration) from an independent hospital. A bed size had positive relation on selecting Type IV (clinical-vertical integration) from an independent hospital. Unlikely general belief that the selecting types of hospital network was determined by the change of health insurance policy such as Health Maintenance Organizations and Preferred Provider Organizations, the types of hospital network were influenced by community characteristics such as population size, and hospital characteristics.

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  2. [국내논문]   가구 소득과 보건의료비 지출의 형평성 : 누진성과 소득재분배 효과  

    신호성 (서울대학교 치과대학 치과경영정보학 ) , 김명기 (서울대학교 치과대학 치과경영정보 ) , 김진숙 (UCLA 보건대학원)
    보건행정학회지 = Korean journal of health policy and administration v.14 no.2 = no.37 ,pp. 17 - 33 , 2004 , 1225-4266 ,

    초록

    The present study attempts to examine the progressivity of health care financial sources based on the income approach, for which it decomposes redistributive effects into vertical, horizontal, and re-ranking components. The study data include Korean Household Expenditure Survey (2000) conducted every 5 year by Korea National Statistical Office. The data were sampled from the national population by the multistage probabilistic sampling method, and amounts to 23,270 households. For the better application of the income approach, the study employs household total expenditure in Korea instead of total income, because the former data source is more reliable and less fluctuated over time. Progressivity of health care financing was measured by Kakwani index. Aronson's decomposition equation was used in case of the analysis where differential treatment of health care expenditure needs to be considered. Despite the progressivity of Korea's governmental contributions, total expenditure of health care showed regressive pattern, which may largely be attributable to the higher regressivity in out-of-pocket money. With the result of negative Kakwani index, differential treatment increased income redistribution biased for better-off. It is worth to note that social insurance displays not only negative Kakwani index, but also horizontal inequality, suggesting that the first step of health care financing reform should be the revision of social insurance premium rates toward effective and equable way.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

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  3. [국내논문]   건강보험 기본급여의 우선순위   피인용횟수: 3

    정형선 (연세대학교 보건행정학과 ) , 김주경 (연세대학교 보건행정학 ) , 이규식 (연세대학교 보건행정학 ) , 신의철 (가톨릭의대예방의학교실)
    보건행정학회지 = Korean journal of health policy and administration v.14 no.2 = no.37 ,pp. 34 - 57 , 2004 , 1225-4266 ,

    초록

    Universal health insurance normally requires a basic benefit package, whose design intersects with almost all other aspects of the health insurance debate. Despite its central importance, basic benefit package has not received the analysis it deserves in Korea. The issue of how to decide which health services should be delivered and to whom has been a matter for consistent policy debate. Many industrialized countries observed in this study have been dealing explicitly or implicitly with the basic benefit package. The methods vary from having a specific positive list of services (Bismarkian countries) to the use of guidelines (Beveridgian countries). The purpose of this paper is to form the underlying principles and process for determining what is included or left out by getting accurate and representative responses from health-related personnel. Mail survey is used. Economic burden for treatment, seriousness of disease and urgency of treatment are ranked at the first three priorities. Services that had been suspended because of financial crisis in health insurance scheme in 2001 were selected as items which should firstly be expanded into coverage. Diagnostic test against heart disease and vaccination were also selected as items which should additionally belong to the list of covered services.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

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  4. [국내논문]   보건의료 경제성 평가 방법론 고찰 -연구 설계와 비용 추정을 중심으로-   피인용횟수: 1

    이건세 (건국대학교 의과대학 예방의학교실 ) , ( ) , 이상일 (울산대학교 의과대학 예방의학교 ) , 구혜원 (건국대학교 의과대학 예방의학교실)
    보건행정학회지 = Korean journal of health policy and administration v.14 no.2 = no.37 ,pp. 58 - 77 , 2004 , 1225-4266 ,

    초록

    Cost containment has become high political issues since financial crisis of the Korean Health Insurance fund in 2000. Korean Government has developed and implemented several measures to reduce the pharmaceutical expenditures. Pharmaceutical economic evaluation can be a tool in decision to allocate scare resource efficiently. In order to increase the quality of economic evaluation for pharmaceuticals, the Korean Health Insurance Review Agency(HIRA) is considering the development of a guideline for economic evaluation. It mandates that pharmaceutical companies could submit the result of an economic evaluation when demanding reimbursement of new pharmaceutical drugs. The purpose of this study is to provide a critical review of the economic evaluations of health care technologies published in the Korean context whether they have been performed according to current guidelines and therefore whether their results are directly useful for decision making. We found there exist important problems and deviation from, good practice' both in the general features of the studies, like the study design and perspective, and in terms of cost measurement and valuation. There are needs to develop clear guidelines and to educate and train researchers in performing economic evaluations.

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    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  5. [국내논문]   건강보험 체납예측모형을 통한 체납세대의 유형화 및 특성  

    이애경 (국민건강보험연구센터 ) , 최인덕 (국민건강보험연구센터)
    보건행정학회지 = Korean journal of health policy and administration v.14 no.2 = no.37 ,pp. 78 - 98 , 2004 , 1225-4266 ,

    초록

    The purpose of this study was to categorize the contribution evasion and develop the expected models for contribution arrears in National Health Care System. The modified logistic regression model in non-payments was used as logistic regression model based on the statistical method. By using this model, we arranged non-payment types and typical branches those are appeared by statistical technique. First fact, sex and age branches those are able to take a part in economy had effect mostly. Also they had difference in non-payment probability by existence of their incomes and property. Especially people who didn't have their own house and car were appeared in high non-payment probability, disease and reduction characteristic(rare diseases, reduction of seniors, handicaps, numbers of medical treatments) didn't effect much in probability. The reason for some characteristic of non-payment which is higher than the correct threshold value of Logistic Regression Model (a suggested model for predicting non-payment)'s distribution of probability was mostly moral hazard. Living difficulty was the bigger reason for non-payment, but moral slackening was the bigger reason for non-payment. But it is careless to decide that moral hazard is just the reason, there is a necessity to examine on the side of sociology based in family. By the reason, the member's non-payment reason can be classified by economy, population, and psychology, but there was a comprehension that losing of work desire could be one reason. So we analyzed informations for composition of family of members. In conclusion, we grasped that family conflict makes non-payment and conversion of member in the National Basic Livelihood Protection System difficult.

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  6. [국내논문]   국민의료비 결정요인분석   피인용횟수: 6

    최병호 (한국보건사회연구원 ) , 남상호 (국회 예산정책 ) , 신윤정 (한국보건사회연구원)
    보건행정학회지 = Korean journal of health policy and administration v.14 no.2 = no.37 ,pp. 99 - 116 , 2004 , 1225-4266 ,

    초록

    This study estimates the determinants of national health expenditures of OECD countries using panel regression method. The data used are OECD Health Data(2003) covering 33 countries and from 1970 to 2001. This study shows several important different results compared to the previous studies. Further this study estimates the determinants of Korean case using data from 1m to 2000, and compare with the results of OECD panel. The main findings are as follows. The income elasticity of health expenditures is estimated below 1.0, but is shown above 1.0 when the different health systems of each country are controlled. The women's labor participation influences strongly positive effect on the health expenditures. The diffusion of new technologies is positively related with the increasing expense. The increasing government expenditures have a tendency not to contain health expenses, but to increase expenses. The expansion of public health insurance holders is containing the expenses, and the increasing number of doctors is pushing expenditures. This implies the health expenditures are influenced more by the induced demand of providers rather than the moral hazard of patients. However, the above result is opposite in Korean case. The existence of primary care doctors affects slightly up warding rather than containing expenditures. Finally the determinants are seriously depending upon which factors are included in the model and which statistical model is chosen. Therefore it must be cautious to interpret the results of statistical model.

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    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  7. [국내논문]   도시지역 노인의 성에 따른 건강행위 및 관련요인의 차이   피인용횟수: 2

    김혜경 (권선구 보건소 ) , 배상수 (한림대학교 의과대학 사회의학교실)
    보건행정학회지 = Korean journal of health policy and administration v.14 no.2 = no.37 ,pp. 117 - 137 , 2004 , 1225-4266 ,

    초록

    The purpose of the study is to examine gender differences in health behaviors and the related factors for the urban elderly population. This study utilized the data from the Suwon city health survey of the elderly in 2001. The data consisted of a random sample of 979 (388 males, 591 females) elderly people aged over 65. The results of the study were as follows. First, the elderly people's health behaviors were different by gender. Concerning health risk-taking behavior, the frequencies of smoking and drinking were higher in males than in females. In terms of health promotive behavior, the regular exercise rate was higher in males than in females. Second, there were different factors that influenced health behaviors by gender. The factors that influenced the health risk-taking behaviors were health status factors for male, and socioeconomic factors for female. The factors that significantly influenced the health promotive behaviors were social supports networks for both gender. Therefore, program priorities need to be modulated in accordance with these gender differences in health behaviors. Moreover, different program strategies are needed that reflect the gender differences in health behavior determinants.

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  8. [국내논문]   일반외과 영역 다빈도 수술률의 소규모 지역간 변이   피인용횟수: 6

    김윤미 (서울보건대학 ) , 양봉민 (서울대학교 보건대학원)
    보건행정학회지 = Korean journal of health policy and administration v.14 no.2 = no.37 ,pp. 138 - 162 , 2004 , 1225-4266 ,

    초록

    This study was performed to investigate small area variation in rates of three common surgeries in general surgery department across 156 small areas. Three surgery rates were analyzed; Anal and/or stomal procedures, inguinal and/or femoral hernia procedures, appendectomy. Methods: We used health insurance claims data and the number of patients were 13,845, 2,154 and 7,151 persons respectively. Surgery rates were directly standardized with age and sex and logistic regression was used to analyze surgery rates. Results: Mapping of the surgery rates, there was small area variation in anal and/or stomal procedures. The clinic which was located in more competitive market and chose DRG payment system tends to do more anal and/or stomal procedures. There was no factor except DRG bed rates had effect on rate of inguinal and/or femoral hernia procedures. Conclusions: Findings of this study will contribute to developing investigation method on small area variation and policy to reduce the variation such as developing evidence based medical practice guideline.

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