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당뇨병 외래환자의 상급병원 이용에 영향을 미치는 요인 = Factors associated with diabetes outpatient use of tertiary or general hospitals as their usual source of care in Korea

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dc.contributor.author이정찬
dc.contributor.author김계현
dc.contributor.author김한나
dc.contributor.author김남순
dc.date.accessioned2017-01-25T04:11:06Z
dc.date.available2017-01-25T04:11:06Z
dc.date.issued2012-12-31
dc.identifier.issn1975-8456
dc.identifier.urihttps://repository.kihasa.re.kr/handle/201002/25137
dc.description.abstractDeterioration in the health care delivery system has been a growing problem in Korea. The concentration of mild patients with chronic disease in tertiary care centers or general hospitals other than in clinics results in the distortion of functional differentiation among various types of providers. This brings about not a coordination of care through well-organized a referral system but an undesirable competition between clinics and hospitals. In this study, we used a multivariate binary logistic model to estimate the factors associated with the diabetes outpatients’ choice of tertiary care centers (TCCs) or general hospitals as their usual source of care. Data were collected from the 2008 Korean Health Panel. The unit of analysis was a diabetes outpatient (n=910). Our study results showed that 56% of all of the diabetes outpatients studied only used clinics for their care during the year of 2008 followed by general hospitals (16%), mixed (12%), TCCs (10%) and hospitals (6%). Among the various types of providers, TCC or general hospital users had the highest out-of-pocket payments per visit, but the lowest number of visits, tests, and prescriptions during the year of 2008. According to our regression analysis, patients with higher education, income, and Charlson Comorbidity Index levels were more likely to use TCCs or general hospitals. Compared with patients who enrolled in the National Health Insurance program, Medical Aid program enrollees were more likely to visit TCCs or general hospitals. In addition, being enrolled in private health insurance or having any disability was also positively associated with the greater use of TCCs or general hospitals. Our findings suggest that policy-makers should take into consideration the characteristics of patients in implementing policies related to the healthcare delivery system. It is also necessary to employ diverse approaches, such as regulation and incentives considering patent characteristics to reform the current defective aspects of health care utilization and provision.
dc.format.extent11
dc.languagekor
dc.publisher대한의사협회
dc.title당뇨병 외래환자의 상급병원 이용에 영향을 미치는 요인
dc.title.alternativeFactors associated with diabetes outpatient use of tertiary or general hospitals as their usual source of care in Korea
dc.typeArticle
dc.type.localArticle(Academic)
dc.identifier.apprname학술논문평가
dc.subject.keyword의료전달체계
dc.subject.keyword상급종합병원
dc.subject.keyword종합병원
dc.subject.keyword당뇨병
dc.subject.keyword외래환자
dc.subject.keywordDelivery of health care
dc.subject.keywordTetiary care centers
dc.subject.keywordGeneral Hospitals
dc.subject.keywordDiabetes
dc.subject.keywordOutpatients
dc.contributor.affiliatedAuthor김남순
dc.identifier.doi10.5124/jkma.2012.55.12.1215
dc.identifier.urlhttps://doi.org/10.5124/jkma.2012.55.12.1215
dc.citation.title대한의사협회지
dc.citation.volume55
dc.citation.number12
dc.citation.startPage1215
dc.citation.endPage1225
dc.identifier.bibliographicCitation대한의사협회지, vol. 55, no. 12, pp. 1215 - 1225
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