Ex) Article Title, Author, Keywords
그 간 발표된 두 권의 학술지에는 새로운 도전에 원동력이 될 만큼 열정과 관심 속에서 총 25편의 논문이 게재되었습니다. 창간호에는 보건의료 발전 방향과 감염병 대유행의 대응 방안을 다뤘고, 더불어 건강보험심사평가원이 앞으로 이끌어가야 할 역할 등에 대해 거침없는 목소리가 담겨졌었습니다. 이어서 두 번째는 정부에 바라는 보건의료정책과 보건의료의 질 향상, 그리고 빅데이터 활용 전략 등 더욱 다양한 학술적 논의의 기회가 펼쳐지기도 했었습니다.
창간 초기, 우리 학술지는 다양한 분야의 시각을 통해 의견을 나누고 토론할 수 있는 학술적 공론의 장이 되기를 다짐했었습니다. 그리고 다양한 형태의 논문을 수렴하겠다고 했습니다. 1년을 맞이하면서 HIRA Research가 건강보험 분야에 전문성 있는 학술지로 초석을 다질 수 있었던 것은 짧은 시간이지만 많은 연구자, 전문가들께서 일궈주신 값진 토양이 있었기 때문입니다.
보건의료 환경의 정점을 찍을 만큼 세상을 흔들어 놓은 코로나19 확산은 보건의료계가 디지털 헬스케어, 인공지능, 빅데이터 등 디지털 기술이라는 미래 도약에 주목할 수 있도록 하였습니다. 반면에 이를 가속화하기 위한 찬반 논쟁이 이어져오는 가운데 이번 세 번째 학술지에는 디지털 기술의 보상체계에 대한 국외 사례와 정책 제언 등을 다뤘습니다. 한편 코로나19 실제 터전인 생활치료센터와 선별진료소의 운영에 대한 현장의 소리가 생생하게 입수되었습니다. 더불어 환자와 일반인을 대상으로 한 경험과 지식 등을 조사한 탐색적 연구가 전개되었고, 의료기관과 간호 인력 등 보건의료 자원 관리에 고려해야 할 요인들을 분석한 연구들을 담았습니다.
2022년, 새 정부 출범으로 보건의료계는 전략과 도전의 해가 될 것입니다. 건강한 보건의료가 소통으로 수립해 나갈 수 있도록 새 정부에 바라는 보건의료 정책 의견을 모아주시기 바랍니다. HIRA Research의 문은 언제나 열려있습니다. 감사합니다.
HIRA Research 2022; 2(1): 7-7
HIRA Research 2022; 2(1): 9-23
HIRA Research 2022; 2(1): 24-35
HIRA Research 2022; 2(1): 36-46
Methods: This study conducted an online survey on digital therapeutics with stakeholders such as digital therapeutics companies and medical institutions. The questionnaire for the company consisted of a total of 11 questions, including ones on the current development status of their products, requirements for development, and data exchange. The physicians are asked six questions about the field of interest in digital therapeutics and the clinical validation process.
Results: As a result of inquiring about the factors necessary for the development of digital therapeutics on a 5-point scale, the necessity of standard development processes for the product and commercialization guidelines was high (mean±standard deviation [SD]: 4.43±0.76 and 4.14±0.77, respectively). The connectivity between digital therapeutics and electronic medical record/order communication system was in high demand (mean±SD: 4.29±0.73 and 4.21±0.70, respectively). Participants in the companies answered that data exchange such as medical records and results of several tests in clinics are needed. Also, they replied that they could provide the data such as compliance and patients’ behavioral change to medical institutions or governmental regulation organizations.
Conclusion: First, a support program for companies developing digital therapeutics is required to help them prepare for approval and registration of the product. There is also a requirement for a platform system in which digital therapeutics can operate well in a medical institution environment. Finally, it is necessary to develop evaluation methods and indicators suitable for digital therapeutics.
HIRA Research 2022; 2(1): 47-56
Methods: Logistic regression analysis was employed to examine the association between hospital profitability and hospital adoption of mobilebased PHR providing the following functions: (1) booking, (2) past or current prescription information, and (3) test results.
Results: We observed a statistically significant association between prescription information service and hospital profitability (operating margin: odds ratio [OR], 0.93; 95% confidence interval [CI], 0.89?0.96; net profit to gross revenues: OR, 0.94; 95% CI, 0.89?0.99). Also, there was a statistically significant relationship between test result service and hospital profitability (operating margin: OR, 0.94; 95% CI, 0.90?0.98; net profit to gross revenues: OR, 0.93; 95% CI, 0.88?0.98). However, we could not observe a significant association between hospital profitability and the provision of booking services.
Conclusion: Further studies are warranted to confirm our findings on the inverse association between hospital profitability and the adoption of mobilebased PHR systems.
HIRA Research 2022; 2(1): 57-64
Methods: This study analyzed the raw data of the 2020 (n=12,133) and 2021 (n=13,546) MSES. In order to secure the homogeneity of data between years, 8,707 people were selected for analysis by matching 1:1 through propensity score matching. The experience of using medical services was divided into outpatient and inpatient, and each of them was investigated in the four areas (doctor service, nurse service, overall use of medical institutions, and safety). All analyses used STATA ver. 16.1 (Stata Corp., College Station, TX, USA).
Results: It was confirmed that the level of positive experience in the 2 years changed when the statistical significance of the differences in age group (
Conclusion: Improving patient experience is one of the goals of the health care system. In order to properly understand the performance of the health care system and to find the direction for improvement through the patient experience, it is necessary to analyze and interpret it using more scientific techniques.
HIRA Research 2022; 2(1): 65-74
Methods: A face-to-face survey was conducted to identify the total dementia knowledge (general and risk factors) and socio-demographics from September 20th to November 16th, 2021. Proportionate quota sampling was used to select a representative sample of Nam-gu residents. A total of 345 participants’ data were analyzed, using frequency analysis, independent
Results: The average score for the total dementia knowledge was 9.03 of 15, while the average scores for the general and risk factors were 3.54 of 8 and 5.46 of 7, respectively. A group of females under 39-year-old with an education level higher than college scored the highest in the general and risk factors. Educational level was the only socio-demographic factor statistically significant with the average scores of the total (
Conclusion: The study results encourage educating and promoting the general dementia knowledge, reflecting its relatively low average score compared to the risk factors. This effort would prevent the delayed diagnosis and treatment due to a lack of awareness of dementia types and symptoms.
HIRA Research 2022; 2(1): 75-94
Methods: We analyzed the National Health Insurance (NHI) claims data in the year of 2014. The 5,714,547 cases were constructed from 8,625,758 claims which were inpatient through the emergency room and outpatient for emergency medicine. The utilization and transfer rates are analyzed by the characteristics of patients and medical facilities.
Results: The transfer rate was 5.1% in total emergency patients and 8.4% in severe patients. The transfer rates were higher in patients with myocardial infarction (12.8%), stroke (13.9%), and severe trauma (11.6%). And 52.6% of transferred patients and 76.8% of transferred severe patients received main procedures at the transferred medical facilities. Patients who had not received main procedures at the first-visit medical facilities were transferred to the hospital located in the same region or Seoul.
Conclusion: As a result of analyzing NHI claims data, there was a difference in the utilization and transferred rate from the results analyzed National Emergency Department Information System (NEDIS) data. It is necessary to establish an information system that can complement the strengths and weaknesses of the NHI claims data and NEDIS.
HIRA Research 2022; 2(1): 95-105
Methods: In this study, the data reported to the Health Insurance Review and Assessment Service were used. The subjects were nurses who worked in hospitals from 2017 to 2019. Nurse turnover, a dependent variable determined by a continuous work episode, was constructed in consideration of the date of employment and resignation. A total of 194,343 nurse staff in 1,316 hospitals and 245,004 work episodes were examined.
Results: Among the work episodes analyzed, the turnover rate was 40.3%. The turnover of nurses was higher at a younger age, with lower clinical experience, and lower length of stay (odds ratio [OR], 1.56; 95% confidence interval [CI], 1.51?1.63; OR, 2.11; 95% CI, 2.02?2.21; OR, 1.38; 95% CI, 1.33?1.44). Irregular work nurses had a very significant risk of turnover compared to regular work (OR, 3.15; 95% CI, 2.99? 3.33). After stratification by age, irregular work nurses in the working environment and nurse rate grade of the hospital were the main factors affecting a turnover in all age groups.
Conclusion: Nurse turnover was significantly differed according to the hospital characteristics and working environment. In the future, system design or health policy development to reduce the nurse turnover requires a customized design considering age, not introducing a comprehensive system for managing nurses.
HIRA Research 2022; 2(1): 106-119
Methods: The units of analysis are small medical institutions: small hospitals, medical clinics, and dental clinics. This study had a retrospective study design and used the secondary health insurance administrative data. The study pulled out the medical institution data closed from January 1, 2020 to December 31, 2021. A total of 52,809 medical facilities were analyzed as the denominator of study population. For statistical analysis, multi-variate logistic regression was used using the event of hospital and clinic closure.
Results: This study found that number of computed tomography (odds ratio [OR], 0.499; 95% confidence interval [CI], 0.316 to 0.790;
Conclusion: This study found that several factors were associated with closure of small hospitals, clinics, and dental clinics. Healthcare policy makers need to be aware of these factors to prevent unexpected resource allocation in local communities.
HIRA Research 2022; 2(1): 120-130
HIRA Research 2022; 2(1): 131-137
Methods: From January 2020 to February 2022, participants who visited a screening center for COVID-19 confirmation in Seoul were included. Data was investigated participant’s reason for getting screening tests and reimbursement rates among the cases. And after the whole investigation period was divided into three groups according to the reimbursement criteria changes, COVID-19 positive ratio was compared in each period with the number of cases that were positive in Korea.
Results: Retrospectively, the period of applying the most recent reimbursement criteria shows the highest positive COVID-19 diagnosis ratio among the periods. Additionally possible cases that have symptoms and epidemiologic correlation were the most positive COVID-19 diagnosis ratio. Most recent reimbursement criteria have a more strict selection than previous criteria, and the result shows that more strict criteria leads to a higher test positivity rate.
Conclusion: According to the results found in the present study, reimbursement criteria for the COVID-19 screening test has changed to be performed more efficiently. If we study the COVID-19 diagnosis rate and quarantine effect according to the PCR test reimbursement criteria, we will be able to develop more efficient screening clinics for infectious diseases in the future.
HIRA Research 2022; 2(1): 138-144