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병원의 의료기술 수준에 대한 측정 방법론 개발과 이를 이용한 실증 분석

Method Development and Empirical Analysis of Hospital Technology Level

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한국보건경제정책학회 (The Korean Association of Health Economics and Policy)|2022.06|보건경제와 정책연구 (The Korean Journal of Health Economics and Policy)|제28권 제2호|pp. 75-104

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의료기술영상진단 의료기기치료 의료기기사이딘 지수QATL indexMedical TechnologyImaging Medical DeviceTreatment medical device Saidin IndexQuantity Adjusted Technology Level (QATL)
주제분류사회과학일반

초록

CT, MRI, PET 등의 고가 의료기기의 도입과 확산을 연구할 때 사용하는 병원의 기술수준의 측정은 보유여부를 고려하는 거트먼 지수, 사이딘 지수가 주로 사용되고 있다. 1970년대 초반부터 도입되기 시작한 고가 의료기기에 대해, 병원의 규모에 따라 특정 의료기기를 2대 이상 보유하는 상황을 고려하는 병원의 의료기술 측정 방법은 활용되고 있지 않다. 본 연구는 여러 종류의 의료기기의 보유 여부와 병원별 보유 대수를 고려하는 Quantity-adjusted technology level (QATL) index를 개발하여 이 지수와 사이딘지수를 비교 분석하였다. 실증 연구 결과에 따르면 Saidin index와 QATL index간의 병원의 의료기술 수준에 대한 영향요인들의 유의성 차이는 크지 않았다. 그러나 QATL index는 Saidin index에 비교하여 상급종합병원에서의 토빗 회귀분석의 계수가 다소 크다는 점은 주목할 만하다. CT와 MRI 등 영상진단 의료기기는 병원 종별로 병원당 의료기기 보유대수의 편차가 큰데, 보유 대수를 고려하는 QATL index는 병원의 의료기기 보유 상황을 고려하는 의미있는 측정방법이다. 연구 결과를 토대로 QATL index의 구성개념 타당성을 평가하고 향후 연구를 위한 후속 과제를 제시하였다.

Abstract

The Guttman scale and Saidin index are commonly used to measure the availability of expensive medical devices such as CT, MRI, and PET. However, they do not account for critical aspects that larger-sized hospitals have two or more per medical device (modality). This study developed an alternative measure of the aggregated estimates of technology availability in hospitals. The quantity-adjusted technology level (QATL) index - accommodates multiple medical technologies (modalities) and the number of hospitals’ installments - compared with the Saidin index. According to the results of the empirical study, the statistically significant factors between the Saidin index and the QATL index are not much different. However, it is noteworthy that the coefficients of Tobit regression analysis in the tertiary hospitals were slightly larger in the QATL index than in the Saidin index. Evidence shows that the QATL index was meaningful in measuring hospital input resources. Based on the empirical test, this paper discussed the construct validity of the QATL index and presented future research directions.

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