경․요추부 염좌 환자의 민영의료보험 가입과 입원기간의 관련성

Abstract

ABSTRACT The Relations Between Private Health Insurance of Patients with Sprain of Cervical and Lumbar Spine and Length of Stay

Jang Dong Ryul Advisor : Choi Seong-Woo M.D., Ph.D. Department of Health science, Graduate School of Chosun University

Background : There have been only a few domestic studies which defined medical service areas according to specially designated diseases such as sprain of cervical and lumbar spine which are not accompanied by complications demonstrated and demonstrated them through empirical research. These days, social confusion has been increasing as more patients who have been insured by several private health insurance services at the same time have intended to stay in hospital for such a long time although they had insignificant damages or diseases, Therefore, to overcome such problem, relevant institutes desperately need further studies on it. Method : The subjects of the study were 410 patients selected from those who stayed in or discharged from hospitals or clinics of Gwangju and Jeonnam. They were diagnosed as having sprain of cervical and lumbar spine without neurological symptoms in hospitals and clinics ( 4 western medicine hospitals with less than 80 beds, 5 oriental medicine hospitals and 10 western medicine hospitals with less than 29 beds) from July 1, 2010 to February 29, 2012 and were given codes of S13.4 and S33.5 according to the Korean Standard Classification of Diseases(KCD). 364 copies of the questionnaire were collected fro the final analysis. Results : This study made a univariate analysis of the responses to the questionnaire and a multiple regression analysis using independent variables which had significant relations with the period of hospitalization. The results and implications are presented as follows: With relevant factors controlled, when the number of private health insurance was input as an independent variable, explanatory power increased to 38.5%. When the subjects had one or two accidental insurances(β=2.731, P=0.013), length of stay in beds was longer than they had no accidental insurance and when they had more than three ones(β=4.991, P=0.000), length of stay was significantly longer. Conclusions : This study has a meaning in that it is domestic practical study which identified relationships between entry of private health insurance and length of stay, and partly existence and degree of moral hazards in their entry, targeting patients who were diagnosed as having sprain of cervical and lumbar spine and treated at hospitals and clinics. It suggests that external effects may exist in motor insurance and industrial disaster insurance as well as public health insurance, and it is judged that proper measures should be developed to internalize the ranges of double guaranty and appropriateness of diagnosis.

＊Key Words: Private health insurance, Moral hazard, Sprain of cervical and lumbar spine, Admission, Length Of Stay