2015년 한국의료패널 자료 기반 아동의 장애여부에 따른 사회인구학적 특성, 만성질환, 의료이용의 차이 분석
Comparison Analysis of Sociodemographic Characteristics, Chronic Disease, and Medical Expenditures Between Children with and Without Disabilities Based on the Korea Health Panel, 2015
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초록
본 연구의 목적은 아동의 장애 여부에 따른 사회인구학적 특성, 만성 질환 여부, 의료비 지출을 비교하기 위함이다. 2015년 한국의료패널 자료를 이용하여 만 19세 이하인 아동 및 청소년 3,481명을 추출하였다. 사회인구학적 특성에는 나이, 성별, 교육수준, 가구소득, 의료급여 수급 여부가 포함되었다. 그리고 만성질환 여부, 의료이용(응급실 이용, 입원이용, 외래이용), 의료비 지출이 변수로 사용되었다. 장애 여부에 따른 변수 간의 차이를 분석하기 위하여 독립 t 검정, Mann-휘트니 U 검정, 카이제곱 검정, 그리고 로지스틱 회귀분석을 사용하였다. 연구 결과, 전체 3,481명의 아동 중, 32명(0.9%)이 장애아동으로 나타났다. 장애아동은 비장애아동과 비교하여 남아의 비율이 높았고 소득수준이 낮았으며, 만성질환과 개인지출 의료비가 유의하게 더 많았다. 장애 영향 요인은 성별, 의료수급여부, 만성질환으로 나타났다. 장애아동에서, 장애유형이 뇌손상인 경우가 의료비 지출이 높은 수준을 나타냈다. 이러한 결과는 장애아동을 위한 건강관리 서비스의 접근성이 낮음을 의미하고 있으므로 장애아동을 위한 합리적인 사회보장체계의 확립이 요구된다.
Abstract
The purpose of this study was to compare the sociodemographic characteristics, chronic disease, and medical expenditures between children with and without disabilities. Data from 3,481 children aged < 20 years and no university students were extracted from the Korea health panel 2015 database. The socio-demographic characteristics included age, sex, education level, family income and presence of national basic livelihood act recipients. The variables used were chronic disease, medical use (emergency room use, hospitalization use, hospital outpatient use), and medical expenditure. Differences of variables according to presence or absence of disability were analyzed by independent t test, Mann-Whitney u test, chi-square test, and logistic regression analysis. In results, of the 3,481 children, 32 (0.9%) were children with disabilities. Rate of male, rate of low income, chronic disease and medical expenditure were significantly higher in the disability group than the non-diability group (p<.05). Factors affecting disability of children were sex, presence of national basic livelihood act recipients and chronic disease. In children with disabilities, high levels of medical expenditure were found in cases of brain injury. These findings imply that the accessibility of health care services for children with disabilities is very low. A reasonable social security system for children with disabilities should be established.
참고문헌 (26)
- F. P. Grad, "The preamble of the constitution of the World Health Organization", Bulletin of the World Health Organization, 80(4), pp.981~984 (2002)
- Childhood health and differences in late-life health outcomes between England and the United States, "J. Banks", NBER, 1~26, pp.NBER Working Paper, No. 17096 (2011)
- V. Shilling, "The experience of disabled children as inpatients: A structured review and synthesis of qualitative studies reporting the views of children, parents and professionals", Child: Care, Health and Development, 38(6), pp.778~788 (2012)
- R. Ayyangar, "Health maintenance and management in childhood disability", Physical Medicine and Rehabilitation Clinics of North America, 13(4), pp.793~821 (2002)
- E. Petridou, "Injuries among disabled children: A study from Greece", Injury Prevention, 9, pp.226~230 (2003)
- M. Prince, "No health without mental health", Lancet, 370(9590), pp.859~877 (2007)
- P. W. Newacheck, "Childhood chronic illness: prevalence, severity and impact", American Journal of Public Health, 82(3), pp.364~371 (1992)
- R. E. Stein, "Comparing different definitions of chronic conditions in a national data set", Ambulatory Pediatrics, 2(1), pp.63~70 (2002)
- M. S. Eberhardt, "Urban and rural health chartbook. health, United States, 2001", pp.235~237 (2001), National Center for Health Statistics
- F. Pitta, "Characteristics of physical activities in daily life in chronic obstructive pulmonary disease", American Journal of Respiratory and Critical Care Medicine, 171(9), pp.972~977 (2005)
- K. H. Bønaa, "The associations of age, lifestyle factors and chronic disease with testosterone in men: the Tromso Study", European Journal of Endocrinology, 149(2), pp.145~152 (2003)
- J. Juenger, "Health related quality of life in patients with congestive heart failure:comparison with other chronic diseases and relation to functional variables", Heart, 87(3), pp.235~241 (2002)
- D. Cadman, "Chronic illness and functional limitation in Ontario children: findings of the Ontario Child Health Study", Canadian Medical Association Journal, 135(7), pp.761~767 (1986)
- P. Lozano, "Health Care utilization and cost among children with asthma who were enrolled in a health maintenance organization", Pediatrics, 99(6), pp.757~764 (1997)
- E. Chan, "Health care use and costs for children with attention-deficit", hyperactivity disorder:national estimates from the medical expenditure panel survey, 2002, pp.156(5), 504~511
- J. S. Ringel, "National estimates of mental health utilization and expenditures for children in 1998", The Journal of Behavioral Health Services &Research, 28(3), pp.319~333 (2001)
- V. Kancherla, "Medical expenditures attributable to cerebral palsy and intellectual disability among Medicaid-enrolled children", Research in Developmental Disabilities, 33(3), pp.832~840 (2012)
- S. L. Gortmaker, "Chronic childhood disorders: prevalence and impact", Pediatric Clinics of North America, 31(1), pp.3~18 (1984)
- Y. Li, "Factors affecting catastrophic health expenditure and impoverishment from medical expenses in China: policy implications of universal health insurance", Bulletin of the World Health Organization, 90(9), pp.664~671 (2012)
- M. B. Olsson, "Depression in mothers and fathers of children with intellectual disability", Journal of Intellectual Disability Research, 45(6), pp.535~543 (2001)
- A. S. Eisenhower, "Preschool children with intellectual disability: syndrome specificity, behaviour problems, and maternal well‐being", Journal of Intellectual Disability Research, 49(9), pp.657~671 (2005)
- N. Shields, "Perceived barriers and facilitators to physical activity for children with disability:a systematic review", British Journal of Sports Medicine, 46(14), pp.989~997 (2012)
- 강정희, "Relationship Between Catastrophic Health Expenditures and Income Quintile Decline", Osong Public Health and Research Perspectives, 9(2), pp.73~80 (2018), 질병관리청[DOI]
- S. A. Sinclair, "Injuries among US children with different types of disabilities", American Journal of Public Health, 98(8), pp.1510~1516 (2008)
- P. W. Newacheck, "Health services use and health care expenditures for children with disabilities", Pediatrics, 114(1), pp.79~85 (2004)
- Child Poverty and disability, "Government of Western Australia", ~, pp.Working paper no. 21 (2012)