의료이용 통계생산 개선에 관한 연구
A Study for Improving the Production of Health Care Use Statistics
도세록; 김진수; 강성홍; 고혜연; 신은숙
국내의 의료이용통계 생산 활동을 재검토하여 우리의 의료이용통계 개선방안을 모색코자 하며, 이를 위한 방안으로 의료기관 조사자료, 가구조사 자료, 국민건강보험자료를 활용한 의료이용 통계생산에서의 개선점으로 제시
Statistics on healthcare utilization can be produced based on surveys or administrative data. A survey has a flexibility responding to changing demand on statistics but it is expensive, while collecting administrative data costs less but collected data are limited, lacking diversity. Therefore, the production of statistics on healthcare utilization is required to apply the merit of each datum and efficient data collection. In addition, the purposes, items and methods of surveys are different, and they have been little compared and complemented to one another. Thus, the methods and items of surveys need to be standardized. Data on patients’ healthcare utilization are collected through the health insurance system, but they have been limited to statistical data on simply business performances, and have not been diverse. As sample data on patients benefitted from the health insurance system are produced and provided, the foundation for utilizing the data of researchers and the general public has been established. This study analyzes the characteristics and the merits and demerits of data related to the production of statistics on healthcare utilization following the examination of the surveys of medical institutions, household interview surveys, and health insurance data for producing statistics on healthcare utilization, and suggests some improvements in the data. A patient survey as a part of surveys of medical institutions needs to be improved in its data collection, and to develop survey items on the characteristics of medical practices by type of medical institution. Furthermore, as a way of expanding the target population of National Injury Hospital Discharge Survey, this study suggests that the statistical results or the sampling design of the patient survey should be connected with the target population. In addition, the study also emphasizes that the Korea Health Care Panel Study needs measures to prevent households surveyed from dropping out of the panel study, and it should be the most important data in national health expenditure estimations. Since the health insurance data is collected for reimbursement purposes, a data set is needed to be produced for various areas. In other words, data sets for diseases episodes, personnel, and facilities should be established and provided with the general public, and at the same time, they should be key data sources for producing statistics on healthcare utilization by area, and rare diseases. In this study, policy recommendations are also given for establishing comprehensive data collection system, standardizing survey items, and setting up an organization specialized in healthcare statistics.
Abstract 요 약 제1장 서 론 1. 연구의 배경 및 필요성 2. 연구 목적 및 내용 3. 의료이용 통계의 범위 및 정의 제2장 의료이용통계 생산현황 1. 국내 통계생산 활동 및 현황 2. 외국의 의료이용통계 생산활동 및 방법 제3장 의료이용통계 결과비교 및 시사점 1. 퇴원손상심층조사와 환자조사 비교 2. 환자조사와 건강보험자료 비교 3. 재원일수 비교 4. 의료이용 환자수 변동 5. 시사점 제4장 의료이용통계의 개선방안 1. 의료기관조사의 개선 2. 가구조사의 개선 3. 행정자료 활용의 개선 4. 통합적 의료이용자료 활용 제5장 결론 및 정책 제언 1. 통합적인 의료이용통계 생산계획 2. 의료기관 특성별 통계의 개발 3. 등록제도의 활성화 4. 의료정보 표준화 5. 기본적인 보건통계전담 기관의 설립 참고문헌 부 록