환자 특성 및 의료기관 특성에 따른 자동차보험 환자의 한방 진료행태 분석 Analyzing the oriental medical care aspects of automobile insurance patients according to characteristics of patients and characteristics of medical institutions원문보기
본 연구의 목적은 자동차보험에서 한방진료의 양태와 특성에 대한 실증적 분석을 통해 한방 진료비 증가 원인의 근거를 파악하는데 있다. 즉, 자동차보험 진료비에 대한 본인 부담이 없다는 조건에서 한방 진료의 양태와 특성을 탐색해보고자 한다. 이를 위해 자동차보험 한방진료수가 청구 자료에서 성별, 연령별, 상병(중증, 경증)별, 의료기관의 종별, 지역별 진료일수와 투약일수, 진료비의 차이를 분석하고자 한다. 본 연구는 2018년 1월부터 12월까지 경기도 지역 의료기관에서 자동차보험 한방수가로 지급된 257,563건(의료기관의 환자 에피소드 기준 합산)의 진료비 청구내역을 연구 대상으로 하였다. 본 연구의 ...
본 연구의 목적은 자동차보험에서 한방진료의 양태와 특성에 대한 실증적 분석을 통해 한방 진료비 증가 원인의 근거를 파악하는데 있다. 즉, 자동차보험 진료비에 대한 본인 부담이 없다는 조건에서 한방 진료의 양태와 특성을 탐색해보고자 한다. 이를 위해 자동차보험 한방진료수가 청구 자료에서 성별, 연령별, 상병(중증, 경증)별, 의료기관의 종별, 지역별 진료일수와 투약일수, 진료비의 차이를 분석하고자 한다. 본 연구는 2018년 1월부터 12월까지 경기도 지역 의료기관에서 자동차보험 한방수가로 지급된 257,563건(의료기관의 환자 에피소드 기준 합산)의 진료비 청구내역을 연구 대상으로 하였다. 본 연구의 독립변수는 환자의 성, 연령대, 상병과 의료기관 종별, 지역이고, 종속변수는 진료일수, 투약일수, 진료비이다. 환자의 특성 및 의료기관의 특성에 따른 자동차보험 한방 진료행태 차이의 분석을 위해 SPSS를 이용하여 일변량분산분석(ANOVA)과 다변량분산분석(MANOVA)을 시행하였다. 연구결과는 다음과 같다. 첫째, 성별에 따른 진료일수, 투약일수, 진료비의 차이는 유의하며, 남성보다 여성의 진료일수, 투약일수, 진료비 평균이 모두 높게 나타났다. 즉 자동차보험 환자 중에서 여성이 남성보다 한방진료를 더 선호하고 더 많이 이용한다는 것을 알 수 있다. 둘째, 모든 연령대별로 진료일수의 차이가 유의한 것으로 나타났으며, 투약일수와 진료비의 차이도 유의하였다. 그리고 연령대가 높아질수록 진료일수, 투약일수, 진료비의 평균이 점점 높아지는 것으로 나타났다. 즉 연령이 높을수록 한방진료를 더 많이 이용한다는 것을 알 수 있다. 셋째, 상병에 따른 진료일수, 투약일수, 진료비의 차이는 유의하게 나타났으며, 중증보다 경증의 진료일수, 투약일수, 진료비 평균이 모두 높게 나타났다. 이를 통해, 중증인 경우 병원진료를 우선적으로 하고, 경증인 경우 한방진료를 우선적으로 한다고 판단할 수 있다. 넷째, 의료기관 종별에 따른 진료일수, 투약일수, 진료비의 차이는 유의하며, 진료일수와 진료비 평균은 한방병원이 한의원 보다 더 높게 나타났으며, 투약일수 평균은 한의원이 한방병원 보다 더 높게 나타났다. 한의원이 한방병원 보다 투약일수 평균이 더 높게 나타난 것은 한의원의 경우 입원환자 보다 외래환자가 더 많기 때문이다. 다섯째, 의료기관 지역에 따른 진료일수, 투약일수, 진료비의 차이는 통계적으로 유의하게 나타났다. 진료일수의 평균은 농촌‧소도시가 가장 높았고, 투약일수와 진료비의 평균은 대도시가 가장 높은 것으로 나타났다. 진료일수의 평균이 농촌‧소도시에서 가장 높게 나타난 것은, 농촌‧소도시의 경우 한의원이 상대적으로 많으며, 회복속도가 느린 노인층이 많고 만성기 질환을 포함한 미병 치료를 병행하기 때문인 것으로 판단할 수 있다. 반면 투약일수와 진료비의 평균이 대도시가 가장 높은 것은 병원급인 한방병원이 대도시에 많기 때문인 것으로 판단할 수 있다. 여섯째, 환자의 연령대와 상병에 따른 진료비의 평균에서 차이가 있는 것으로 나타났다. 50대 이하에서 경증의 진료비가 더 높게 나타난 반면, 60세 이상에서는 중증의 진료비가 더 높게 나타났다. 50대 이하의 경증 진료비가 중증보다 높은 것은, 중증 환자의 경우 병원 진료를 우선적으로 선택하고, 경증 환자는 한방 진료를 우선적으로 선택하기 때문인 것으로 볼 수 있다. 일곱째, 의료기관의 지역과 환자의 상병에 따른 진료비의 평균이 모두 차이가 있는 것으로 나타났다. 모든 지역에서 경증의 진료비가 더 높았다. 경증의 진료비는 대도시가 가장 높았고, 중증은 중도시가 가장 높았다. 한방에서는 의료기관의 규모가 작은 경우에도 어느 정도 종합적인 진료가 가능하므로 중도시에서 한방진료를 찾게 되는 교통사고 중증환자가 많은 것으로 판단한다.
본 연구의 목적은 자동차보험에서 한방진료의 양태와 특성에 대한 실증적 분석을 통해 한방 진료비 증가 원인의 근거를 파악하는데 있다. 즉, 자동차보험 진료비에 대한 본인 부담이 없다는 조건에서 한방 진료의 양태와 특성을 탐색해보고자 한다. 이를 위해 자동차보험 한방진료수가 청구 자료에서 성별, 연령별, 상병(중증, 경증)별, 의료기관의 종별, 지역별 진료일수와 투약일수, 진료비의 차이를 분석하고자 한다. 본 연구는 2018년 1월부터 12월까지 경기도 지역 의료기관에서 자동차보험 한방수가로 지급된 257,563건(의료기관의 환자 에피소드 기준 합산)의 진료비 청구내역을 연구 대상으로 하였다. 본 연구의 독립변수는 환자의 성, 연령대, 상병과 의료기관 종별, 지역이고, 종속변수는 진료일수, 투약일수, 진료비이다. 환자의 특성 및 의료기관의 특성에 따른 자동차보험 한방 진료행태 차이의 분석을 위해 SPSS를 이용하여 일변량분산분석(ANOVA)과 다변량분산분석(MANOVA)을 시행하였다. 연구결과는 다음과 같다. 첫째, 성별에 따른 진료일수, 투약일수, 진료비의 차이는 유의하며, 남성보다 여성의 진료일수, 투약일수, 진료비 평균이 모두 높게 나타났다. 즉 자동차보험 환자 중에서 여성이 남성보다 한방진료를 더 선호하고 더 많이 이용한다는 것을 알 수 있다. 둘째, 모든 연령대별로 진료일수의 차이가 유의한 것으로 나타났으며, 투약일수와 진료비의 차이도 유의하였다. 그리고 연령대가 높아질수록 진료일수, 투약일수, 진료비의 평균이 점점 높아지는 것으로 나타났다. 즉 연령이 높을수록 한방진료를 더 많이 이용한다는 것을 알 수 있다. 셋째, 상병에 따른 진료일수, 투약일수, 진료비의 차이는 유의하게 나타났으며, 중증보다 경증의 진료일수, 투약일수, 진료비 평균이 모두 높게 나타났다. 이를 통해, 중증인 경우 병원진료를 우선적으로 하고, 경증인 경우 한방진료를 우선적으로 한다고 판단할 수 있다. 넷째, 의료기관 종별에 따른 진료일수, 투약일수, 진료비의 차이는 유의하며, 진료일수와 진료비 평균은 한방병원이 한의원 보다 더 높게 나타났으며, 투약일수 평균은 한의원이 한방병원 보다 더 높게 나타났다. 한의원이 한방병원 보다 투약일수 평균이 더 높게 나타난 것은 한의원의 경우 입원환자 보다 외래환자가 더 많기 때문이다. 다섯째, 의료기관 지역에 따른 진료일수, 투약일수, 진료비의 차이는 통계적으로 유의하게 나타났다. 진료일수의 평균은 농촌‧소도시가 가장 높았고, 투약일수와 진료비의 평균은 대도시가 가장 높은 것으로 나타났다. 진료일수의 평균이 농촌‧소도시에서 가장 높게 나타난 것은, 농촌‧소도시의 경우 한의원이 상대적으로 많으며, 회복속도가 느린 노인층이 많고 만성기 질환을 포함한 미병 치료를 병행하기 때문인 것으로 판단할 수 있다. 반면 투약일수와 진료비의 평균이 대도시가 가장 높은 것은 병원급인 한방병원이 대도시에 많기 때문인 것으로 판단할 수 있다. 여섯째, 환자의 연령대와 상병에 따른 진료비의 평균에서 차이가 있는 것으로 나타났다. 50대 이하에서 경증의 진료비가 더 높게 나타난 반면, 60세 이상에서는 중증의 진료비가 더 높게 나타났다. 50대 이하의 경증 진료비가 중증보다 높은 것은, 중증 환자의 경우 병원 진료를 우선적으로 선택하고, 경증 환자는 한방 진료를 우선적으로 선택하기 때문인 것으로 볼 수 있다. 일곱째, 의료기관의 지역과 환자의 상병에 따른 진료비의 평균이 모두 차이가 있는 것으로 나타났다. 모든 지역에서 경증의 진료비가 더 높았다. 경증의 진료비는 대도시가 가장 높았고, 중증은 중도시가 가장 높았다. 한방에서는 의료기관의 규모가 작은 경우에도 어느 정도 종합적인 진료가 가능하므로 중도시에서 한방진료를 찾게 되는 교통사고 중증환자가 많은 것으로 판단한다.
The purpose of this study is to gain a basis for the cause of the increase of oriental medical expenses through the empirical analysis of the characteristics of oriental medicine in car insurance. In other words, we tried to explore the characteristics of oriental medicine treatment under the condit...
The purpose of this study is to gain a basis for the cause of the increase of oriental medical expenses through the empirical analysis of the characteristics of oriental medicine in car insurance. In other words, we tried to explore the characteristics of oriental medicine treatment under the condition that there is no burden on the automobile insurance oriental medicine fee. The differences in medical expenses, treatment period, and medication period were analyzed according to gender, age, illness (severe, mild) in this study. The subjects of the study were 257,563 medical expenses, which were paid from the medical institutions in Gyeonggi province from January to December 2018. First, the characteristics of patients affecting the medical expenses, duration of treatment, and duration of medication are classified by sex, age group, and sickness (middle class, middle class). Next, we analyzed the differences in the cost of medical care, treatment period, and medication period according to the type of medical institutions (Korean medicine, oriental medicine hospital), added regional (large scale city, middle size city, rural and small city). Thus, independent variables in this study are the patient's sex, age, sickness, medical institution, and region, and the dependent variables are the cost of care, the duration of treatment, and the duration of medication. The statistical analysis was done using SPSS to identify the claims of medical insurance for automobile insurance and correlation analysis was performed to find out the correlation between dependent variables. ANOVA and MANOVA were applied to analyze the difference of car insurance policy according to patient characteristics and the characteristics of the medical institutions. MANOVA was performed for each independent variable, with three variables of consultation days, days of medication, and medical expenses as dependent variables. Before MANOVA was performed, it was confirmed that the correlation between the dependent variables was high. Next, the two-way ANOVA was conducted for the two cases, which were confirmed to have an interaction effect by two independent variables, with the medical expenses as a dependent variable. The results of analyzing the difference of the medical treatment behavior according to the characteristics of the patient and the characteristics of the medical institution in the medical expenses of oriental medicine of car insurance are summarized as follows. First, the difference of the number of days of care, days of medication, and medical expenses were significant, and the average number of days of care, days of medication, and cost of medication were higher in females than males. In other words, it can be seen that among the auto-insured patients, women prefer, and use oriental medicine more than men . Second, there were significant differences in the number of days of care between all age groups. The higher the age group, the higher the average number of days, days of medication, and medical expenses. That is, the higher the age, the higher the use of oriental medicine. Third, the differences in the number of days of treatment, days of medication, and cost of medical treatment for the disease were significant. In addition, the average number of days of treatment, days of medication, and cost of medical treatment of mild cases were higher than those of severe cases. Through this, it can be judged that priority is given to western medical care in case of a severe condition, and priority is given to the oriental medical care when the case is mild. Fourth, there were significant differences in the number of days of treatment, days of medication, and medical expenses according to the types of medical institutions. The average number of days and the cost of medical treatment were higher in oriental medicine clinics than in oriental medicine hospitals. The average number of medication days was higher in oriental medicine hospitals. The average number of medication days was higher in oriental medicine clinics because the number of outpatients is higher. Outpatients are prescribed treatments with a longer duration than inpatients. Fifth, the difference in the number of days of treatment, days of medication, and cost of medical care were statistically significant according to the location of the medical institution. The average number of days of care was higher in rural and small towns, and the average of medication days and medical expenses was the highest in the metropolitan area. The average number of clinic days was higher in rural and small towns because they had a relatively large number of clinics. This is because the elderly people who have a slow recovery rate and many other illnesses are treated together. On the other hand, the average number of days of medication and the cost of medical treatment is the highest in large cities because many oriental hospitals are located there. Sixth, there was a difference in the average of the medical expenses according to the patient's age and the disease. In the case of under 20 years, 20-30 years old, and 40-50 years old, the average mild medical expenses were higher than the severe one, but over 60 years old, the average severe medical cost was higher than the mild. In the younger age group of less than 50, the mild medical fee average was higher than that of the severe one because, for serious patients, preference is given to western care, while mild patients prefer to be treated with oriental medicine. The elderly prefer oriental medicine, therefore, it can be concluded that the average medical costs are higher for them. Seventh, the average of the medical expenses according to the area of the medical institution and the average of the medical expenses due to the patient's illness were all different. In all regions, the average mild medical expenses were higher than that of severe. The mild medical fees average was the highest in the metropolitan area, and the severe cost was the highest in the middle city. In the middle city, western hospitals are rare, so comprehensive medical treatment related to traffic accidents is difficult. On the other hand, comprehensive medical treatment is possible even in a small-sized oriental clinic in a middle city. Therefore, it is judged that many serious traffic accidents seek for medical treatment in the middle city.
The purpose of this study is to gain a basis for the cause of the increase of oriental medical expenses through the empirical analysis of the characteristics of oriental medicine in car insurance. In other words, we tried to explore the characteristics of oriental medicine treatment under the condition that there is no burden on the automobile insurance oriental medicine fee. The differences in medical expenses, treatment period, and medication period were analyzed according to gender, age, illness (severe, mild) in this study. The subjects of the study were 257,563 medical expenses, which were paid from the medical institutions in Gyeonggi province from January to December 2018. First, the characteristics of patients affecting the medical expenses, duration of treatment, and duration of medication are classified by sex, age group, and sickness (middle class, middle class). Next, we analyzed the differences in the cost of medical care, treatment period, and medication period according to the type of medical institutions (Korean medicine, oriental medicine hospital), added regional (large scale city, middle size city, rural and small city). Thus, independent variables in this study are the patient's sex, age, sickness, medical institution, and region, and the dependent variables are the cost of care, the duration of treatment, and the duration of medication. The statistical analysis was done using SPSS to identify the claims of medical insurance for automobile insurance and correlation analysis was performed to find out the correlation between dependent variables. ANOVA and MANOVA were applied to analyze the difference of car insurance policy according to patient characteristics and the characteristics of the medical institutions. MANOVA was performed for each independent variable, with three variables of consultation days, days of medication, and medical expenses as dependent variables. Before MANOVA was performed, it was confirmed that the correlation between the dependent variables was high. Next, the two-way ANOVA was conducted for the two cases, which were confirmed to have an interaction effect by two independent variables, with the medical expenses as a dependent variable. The results of analyzing the difference of the medical treatment behavior according to the characteristics of the patient and the characteristics of the medical institution in the medical expenses of oriental medicine of car insurance are summarized as follows. First, the difference of the number of days of care, days of medication, and medical expenses were significant, and the average number of days of care, days of medication, and cost of medication were higher in females than males. In other words, it can be seen that among the auto-insured patients, women prefer, and use oriental medicine more than men . Second, there were significant differences in the number of days of care between all age groups. The higher the age group, the higher the average number of days, days of medication, and medical expenses. That is, the higher the age, the higher the use of oriental medicine. Third, the differences in the number of days of treatment, days of medication, and cost of medical treatment for the disease were significant. In addition, the average number of days of treatment, days of medication, and cost of medical treatment of mild cases were higher than those of severe cases. Through this, it can be judged that priority is given to western medical care in case of a severe condition, and priority is given to the oriental medical care when the case is mild. Fourth, there were significant differences in the number of days of treatment, days of medication, and medical expenses according to the types of medical institutions. The average number of days and the cost of medical treatment were higher in oriental medicine clinics than in oriental medicine hospitals. The average number of medication days was higher in oriental medicine hospitals. The average number of medication days was higher in oriental medicine clinics because the number of outpatients is higher. Outpatients are prescribed treatments with a longer duration than inpatients. Fifth, the difference in the number of days of treatment, days of medication, and cost of medical care were statistically significant according to the location of the medical institution. The average number of days of care was higher in rural and small towns, and the average of medication days and medical expenses was the highest in the metropolitan area. The average number of clinic days was higher in rural and small towns because they had a relatively large number of clinics. This is because the elderly people who have a slow recovery rate and many other illnesses are treated together. On the other hand, the average number of days of medication and the cost of medical treatment is the highest in large cities because many oriental hospitals are located there. Sixth, there was a difference in the average of the medical expenses according to the patient's age and the disease. In the case of under 20 years, 20-30 years old, and 40-50 years old, the average mild medical expenses were higher than the severe one, but over 60 years old, the average severe medical cost was higher than the mild. In the younger age group of less than 50, the mild medical fee average was higher than that of the severe one because, for serious patients, preference is given to western care, while mild patients prefer to be treated with oriental medicine. The elderly prefer oriental medicine, therefore, it can be concluded that the average medical costs are higher for them. Seventh, the average of the medical expenses according to the area of the medical institution and the average of the medical expenses due to the patient's illness were all different. In all regions, the average mild medical expenses were higher than that of severe. The mild medical fees average was the highest in the metropolitan area, and the severe cost was the highest in the middle city. In the middle city, western hospitals are rare, so comprehensive medical treatment related to traffic accidents is difficult. On the other hand, comprehensive medical treatment is possible even in a small-sized oriental clinic in a middle city. Therefore, it is judged that many serious traffic accidents seek for medical treatment in the middle city.
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