[논문]지역사회 일반 및 취약계층 노인의 건강기능상태와 의료서비스 이용 행태

오두남; 정효선; 황정해

doi:10.5392/jkca.2021.21.06.404

지역사회 일반 및 취약계층 노인의 건강기능상태와 의료서비스 이용 행태
Functional Health Status and Medical Service Utilization Pattern of General and Vulnerable Older People in Community 원문보기

한국콘텐츠학회논문지 = The Journal of the Korea Contents Association, v.21 no.6, 2021년, pp.404 - 414

오두남 (호서대학교 간호학과) , 정효선 (경기도 공공보건의료지원단) , 황정해 (한양사이버대학교 보건행정학과)

초록
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최근 고령 사회에서는 지역사회중심의료로의 전환에 대한 관심이 증가하고 있다. 이에 일반 노인과 취약계층 노인 각각에 대해 기능중심의 건강상태를 파악하고, 이를 기반으로 의료서비스 이용 경험 및 요구 인식에 대해 살펴보는 것은 필요하다. 본 연구는 2016년 11월부터 12월까지 서울시 일개지역에 거주하는 65세 이상 노인을 방문하여 구조화된 설문을 통해 노인의 건강기능 상태와 의료서비스 이용 행태를 파악하였다. 취약계층 노인은 일반 노인보다 인지기능, 영양, 통증, 낙상 등에서 기능적 건강상태 저하를 더 많이 경험하는 것으로 나타났다. 인지기능, 영양과 같은 기능적 건강문제를 경험한 일반 노인은 취약계층보다 유의하게 의료서비스를 이용하는 것으로 나타났다. 한편 취약계층 노인은 통증 건강문제 영역에 있어서는 일반 노인보다 의료서비스 이용의 필요성을 더 유의하게 인식하는 것으로 나타났다. 이는 지역사회 노인을 대상으로 공공 서비스 확대의 방향과 범위를 설정함에 있어, 일반 노인과 취약계층 노인 간에는 차별화된 정책이 설정되어야 함을 알 수 있었다. 또한 취약계층의 의료접근성 향상을 위해서는 경제적 장벽으로 인해 필요한 의료이용의 장애가 초래되지 않도록 공공의료기관의 적극적인 지원이 이루어져야 하겠다.

Abstract ▼ AI-Helper

This study was to investigate the differences of functional health status and medical service experience and needs between general and vulnerable older people in community. This study is a cross-sectional descriptive research. The data obtained through direct visit surveys from November to December 2016. The target population of the study was older people over 65 years old, the final study subjects were 444 older people residing in one district of Seoul. The chi-square test was conducted to confirm the difference in their functional health areas and medical service experiences, and the necessity of medical service utilization in accordance to the social class. In the experience of abnormality in functional health, the vulnerable older people had higher experience in cognitive function, nutrition, hydration, pain, and falling than the general older people. The rate of experience of using medical service to solve the cognitive function problem for general older people was 31.9%, higher than that of the vulnerable older people. In contrast, the medical service utilization needs of the vulnerable older people in the pain management category was significantly higher than that of the general older people. In setting policy of public medical service programs for general and vulnerable older people in community may be differentially developed based on this study. In order to improve the medical accessibility of the vulnerable older people, public medical institutions should be actively supported to overcome obstacles to medical use due to economic barriers.

주제어

표/그림 (4)

표 Table 1. General characteristics
표 Table 2. Functional health status (N=444)
표 Table 3. Medical service utilization experiences by those who experienced health functional abnormality
표 Table 4. Medical service utilization needs by those who experienced health functional abnormality

AI 본문요약
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문제 정의

The objectives of this study was to investigate the differences of functional health status and medical service experience and needs between general and vulnerable older people in community. On the basis of the analysis results of this research, it was found that the policy for the vulnerable older people and the general older people should be differentiated when setting the direction and scope of the public service expansion for the older people in a community.
The purpose of this study is to classify the differences of medical service needs and service utilization on functional health issues, and to identify the functional health status by using the tools focused on functional health. This will be used as a basic data for establishing the direction and scope of public service extension for the older people in the community by identifying the major functional health problems in the older people in the community.
The purpose of this study is to classify the differences of medical service needs and service utilization on functional health issues, and to identify the functional health status by using the tools focused on functional health. This will be used as a basic data for establishing the direction and scope of public service extension for the older people in the community by identifying the major functional health problems in the older people in the community.

제안 방법

This study used a cross-sectional descriptive design. The data collected through face-to-face survey which was structured for identifying the functional health status and medical service utilization patterns of the older people.
The purpose of this study was to identify the general older people and vulnerable older people who are in different environments and their functional health status, in order to set specific policies and directions of public services for older people in the community and studies were made to observe the current situation.
This study used a cross-sectional descriptive design. The data collected through face-to-face survey which was structured for identifying the functional health status and medical service utilization patterns of the older people.

대상 데이터

The target population was the older people over the age of 65 in one district of Seoul. To compare the functional health status of each social class, the samples were determined by dividing the general older people and the vulnerable older people.
The subjects who were uncooperative or rejected during the survey was excluded from the study. The total selected was 444 respondents, including 333 general older people and 111 vulnerable older people.

데이터처리

All data related to the characteristics of respondents and the medical service utilization patterns were obtained their frequency and percentages through descriptive statistics. Chi-square test was conducted to identify the abnormality experience per social class, the difference in medical service utilization experience and awareness on the need to use medical service.

성능/효과

In the function of nutrition and excretion, general older people, unlike vulnerable older people, showed the need to use or actively use medical services if they experienced health problems, and the prevalence of prophylactic health services was higher than that of vulnerable older people which indicated that due to less burden of medical service expenses, general older people shows higher utilization than the vulnerable older people.
It is generally considered that income is one of factors increasing the accessibility of medical service by facilitating the utilization of medical service. In this study, the vulnerable older people for pain used the medical service in spite of the financial burden caused by medical expenses because pain deteriorated physical functions and they need medication to control pain since pain had the direct impact on a daily life. But they did not used medical service those like loss of appetite or depression.
Moreover, in the state of health function recognized as a health problem, the general older people evaluated the necessity of the medical service utilization for the difficulty of water and food swallowing and the urination portion significantly higher than the vulnerable older people. Obviously, the need for medical service on pain for vulnerable older people was significantly higher than that of general older people than any other functional health problems.
The objectives of this study was to investigate the differences of functional health status and medical service experience and needs between general and vulnerable older people in community. On the basis of the analysis results of this research, it was found that the policy for the vulnerable older people and the general older people should be differentiated when setting the direction and scope of the public service expansion for the older people in a community. The progressive support from the public medical institutions is mandatory for improving the accessibility of the vulnerable older people to the medical service not to make financial barrier interrupt the utilization of required medical service.
On the basis of the analysis results of this research, it was found that the policy for the vulnerable older people and the general older people should be differentiated when setting the direction and scope of the public service expansion for the older people in a community. The progressive support from the public medical institutions is mandatory for improving the accessibility of the vulnerable older people to the medical service not to make financial barrier interrupt the utilization of required medical service. Therfore, Policy of public medical service programs for general and vulnerable older people in community may be differentially developed.
The progressive support from the public medical institutions is mandatory for improving the accessibility of the vulnerable older people to the medical service not to make financial barrier interrupt the utilization of required medical service. Therfore, Policy of public medical service programs for general and vulnerable older people in community may be differentially developed.
When the older people in community was asked if they recognized the need of the medical service utilization and whether they actually went to get medical service in case the older people experienced health function problems, the general older people and the vulnerable older people showed each different results.

후속연구

For the older people living at home after termination of hospitalization at medical institutions or for the vulnerable older people with moderate nursing problems that cannot be solved by home health care services, services including preventive interventions such as exercise and diet in addition to actual medical services should be developed and provided. Furthermore, it is necessary to secure the service embracing the population group beyond individuals from prevention to rehabilitation related to overall factors influencing on the health as well as to support the individual access and provide treatment service in order to improve the health of the vulnerable older people.

참고문헌 (22)

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