근골격계 질환자에서 한·양방 외래 의료 이용에 영향을 미치는 요인과 의료이용 양상 비교
Patterns and Factors Associated with the Utilization of Oriental and Western Medical Care in Musculoskeletal Disease Outpatients
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objectives: The purpose of this study is to find out the factors associated with the probability of using the Western medicine only (WMO), Oriental medicine only (OMO), and both in patients with musculoskeletal disorder in ambulatory care settings. Methods: We used the Korea Health panel data in 2009 to analyze the expenditure of using WMO, OMO, and both. Factors associated with using WMO, OMO, and both were examined by applying multinomial logit model. Results: We identified 3,163 patients aged above 20 years with musculoskeletal disease who used the western medicine or oriental medicine. About 70% of patients used WMO. The number of visits per year was the highest in the patients who used both services followed by patients using WMO and OMO. The total medical expenditure for outpatient visits was the highest in patients using both services. However, there were no significant differences in costs per outpatient visit among three groups. Distance to clinics was the common factor that affected three groups of using services. The longer distance, the lower probability of using OMO [odds ratio (OR)=0.987; 95% confidence interval (CI)=0.979−0.995] and using both (OR=0.989; 95% CI=0.983−0.996) compared with using WMO. Probabilities of using OMO versus WMO was significantly higher in persons with better perceived health status, with younger age (20’s−30’s) versus older age (over 60’s), and who live alone. Persons with higher education were more likely to use both services compared with using WMO. Conclusion: The factor affected using OMO, WMO, and both services was distance to clinic. The longer distance, the fewer visits to oriental medical clinic. Better perceived health, younger age, living alone, and higher education were associated with more visits to oriental medicine hospital than western medicine hospital. This finding enhances our understanding of the characteristics of oriental medical care users, which might contribute to the health care policy making. This finding suggests that accessibility issue might be considered to facilitate the use of oriental medical care. However, outcomes studies comparing these services should be preceded.
Abstract
Objectives: The purpose of this study is to find out the factors associated with the probability of using the Western medicine only (WMO), Oriental medicine only (OMO), and both in patients with musculoskeletal disorder in ambulatory care settings. Methods: We used the Korea Health panel data in 2009 to analyze the expenditure of using WMO, OMO, and both. Factors associated with using WMO, OMO, and both were examined by applying multinomial logit model. Results: We identified 3,163 patients aged above 20 years with musculoskeletal disease who used the western medicine or oriental medicine. About 70% of patients used WMO. The number of visits per year was the highest in the patients who used both services followed by patients using WMO and OMO. The total medical expenditure for outpatient visits was the highest in patients using both services. However, there were no significant differences in costs per outpatient visit among three groups. Distance to clinics was the common factor that affected three groups of using services. The longer distance, the lower probability of using OMO [odds ratio (OR)=0.987; 95% confidence interval (CI)=0.979−0.995] and using both (OR=0.989; 95% CI=0.983−0.996) compared with using WMO. Probabilities of using OMO versus WMO was significantly higher in persons with better perceived health status, with younger age (20’s−30’s) versus older age (over 60’s), and who live alone. Persons with higher education were more likely to use both services compared with using WMO. Conclusion: The factor affected using OMO, WMO, and both services was distance to clinic. The longer distance, the fewer visits to oriental medical clinic. Better perceived health, younger age, living alone, and higher education were associated with more visits to oriental medicine hospital than western medicine hospital. This finding enhances our understanding of the characteristics of oriental medical care users, which might contribute to the health care policy making. This finding suggests that accessibility issue might be considered to facilitate the use of oriental medical care. However, outcomes studies comparing these services should be preceded.
참고문헌 (21)
- 국민건강보험공단, "2019년 건강보험통계연보", 국민건강보험공단, 건강보험심사평가원, ~ (2019)
- Andersen RM, "Revisiting the behavioral model and access to medical care: does it matter?", J Health Soc Behav, 36, pp.1~10 (1995)
- 박지은, "한방의료 이용현황 및 이용결정요인에 관한 연구 -고령화 패널을 이용하여-", 대한한의학회지, 32(1), pp.97~108 (2011), 대한한의학회
- 이정원, "양한방 의료 서비스 선택요인에 관한 연구", 동의생리병리학회지, 28(4), pp.440~445 (2014), 한의병리학회
- 이은경, "한방의료기관 외래이용환자 중 근골격계 질환자의 특성연구 -2011년 한방의료이용 및 한약소비실태조사보고서(보건복지부)자료를 중심으로-", 대한예방한의학회지, 18(2), pp.31~45 (2014), 대한예방한의학회
- Kim KS, "A study on the customer’s use of and satisfaction with oriental medical services by local resident-focused on Asan city", Journal of Haehwa Medicine, 19, pp.143~151 (2010)
- 정건, "근골격계 통증에 따른 양·한방 의료서비스 및 보완대체요법 이용실태 비교: 서울, 인천, 경기도를 중심으로", 보건사회연구, 31(4), pp.478~493 (2011), 한국보건사회연구원[DOI]
- 김성영, "근골격계질환자의 양‧한방 외래 의료이용과 관련요인", 보건의료산업학회지, 6(1), pp.27~38 (2012), 보건의료산업학회
- 한방의료이용및 한약소비실태조사, "조재국", 보건복지부, 한국보건사회연구원, ~ (2009)
- 삶의 질 조사도구 (EQ-5D)의 질 가중치 추정 연구 보고서, "남해성", 질병관리본부, ~ (2007)
- 최병희, "근골격계 질환에 대한 한방의료기관 이용이 양방의료기관 이용에 미치는 영향- 한국의료패널 자료를 이용하여 -", 대한한의학회지, 35(3), pp.22~31 (2014), 대한한의학회
- Haynes R, "Potential accessibility, travel time, and consumer choice: geographical variations in general medical practice registrations in Eastern England", Environ Plan A, 35, pp.1733~1750 (2003)
- Berkman ND, "Health literacy interventions and outcomes: an updated systematic review", Evid Rep Technol Assess (Full Rep), 199, pp.1~941 (2011)
- Cutilli CC, "Understanding the health literacy of America results of the national assessment of adult literacy", Orthop Nurs, 28, pp.27~32 (2009)
- Hasan SS, "Use of complementary and alternative medicine among patients with chronic diseases at outpatient clinics", Complement Ther Clin Pract, 15, pp.152~157 (2009)
- Shumay DM, "Determinants of the degree of complementary and alternative medicine use among patients with cancer", J Altern Complement Med, 8, pp.661~671 (2002)
- Sharma U, "Complementary medicine today: practitioners and patients" (1992), Routledge
- Duan N, "Choosing between the sample-selection model and the multi-part model", J Bus Econ Stat, 2, pp.283~289 (1984)
- 김대환, "양·한방 의료 이용 및 의료기관 선택에의 영향요인에 관한 연구", 박사, 보건학, pp.2006
- 성동민, "한방의료기관 이용자 중 근골격계질환자와 비근골격계질환자의 인식도 및 만족도 특성연구", 대한예방한의학회지, 24(3), pp.27~38 (2020), 대한예방한의학회[DOI]
- 박민정, "한방외래의료 이용의 사회경제적 결정요인 연구: 의료패널자료를 이용한 고정효과모형과 합동 Ordinary Least Square 모형의 비교", 보건행정학회지, 24(1), pp.47~55 (2014), 한국보건행정학회[DOI]