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국가단위 난임시술 통계관리 모델 개발 연구

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Type
Research report
Author(s)
이다용이정렬이중엽이재환최승아홍연희최영식장성인
Issued Date
2022-11
Keyword
난임시술통계관리체외수정시술인공수정시술InfertilityIn vitro fertilizationIntrauterine inseminationStatistics
Abstract
As a social problem of continuous low fertility and increasing age of childbirth, the demand for and importance of infertility treatment in Korea is becoming more important. Recently, national infertility treatment medical institutions have been regularly evaluated for several years. To this end, high-quality data related to infertility treatment are being collected every year. Therefore, if the data is appropriately processed, it will be possible to figure out the current status of infertility treatment in Korea, compare it with the international trends, and satisfy the public demand for information related to infertility treatment.
In order to fulfill these demands, this study attempted to design a process model for calculating infertility treatment statistics that could be published regularly. In addition, we tried to maintain reliability and consistency in the statistics production process. Through this, a data provision model that meets the purpose of public interest was developed.
We analyzed the current domestic infertility-related statistics producing status and representative overseas cases, and analyzed the main outcome indicators commonly utilized. As a result, it is necessary to focus on the live birth rate in evaluating the outcome of infertility treatment. In addition, it was analyzed that singleton births should also be of interest. Moreover, it is necessary to figure out the cumulative success rate for each ovum pick-up. In order to generate these statistics, it is necessary to establish a data collection system linked by annual follow up, and to develop an interlocking system between infertility treatment data and childbirth-related data.
Through the results of this study, a statistical calculation model and specific indicators were presented. After collecting data and generating statistics, it will be necessary to properly verify them using sufficient time interval and additional data. Methods for disclosing statistical results, frequency, and utilization plans were also suggested. In order to achieve the suggested target in this study, it is necessary to set up specific national plans for the short, medium and long term duration and make steady progress. Through this process, it will be possible to meet the various statistical needs of government and community health care policy officials, infertile couples, infertility clinicians, and researchers related to infertility, and to develop international competitiveness in the field.
Publisher
건강보험심사평가원
URI
https://repository.hira.or.kr/handle/2019.oak/3097
Alternative Title
Development of National Infertility Treatment Statistics Management Model
Table Of Contents
제1장 서론 1
1. 연구 배경 및 목적 ·················································································· 3
가. 연구의 배경 ···························································································· 3
나. 연구의 목적 ·························································································· 13
2. 연구의 내용 및 방법 ············································································· 13
가. 연구의 내용 ·························································································· 13
나. 연구의 방법 ·························································································· 13

제2장 난임시술 통계의 공표 가능성 및 범위 진단 17
1. 해외 난임시술 통계관리 및 통계 지표 현황 분석 ····································· 19
가. 미국 난임시술 통계관리 및 공개 지표 분석 ·············································· 19
나. 영국 난임시술 통계관리 및 공개 지표 분석 ·············································· 33
다. 일본 난임시술 통계관리 및 공개 지표 분석 ·············································· 35
라. 호주/뉴질랜드 난임시술 통계관리 및 공개 지표 분석 ································ 36
마. 국제 보조 생식 모니터링 위원회(ICMART) ·············································· 39
바. 해이 사례 고찰에 대한 소결 및 제언 ······················································· 40
2. 국내 난임시술 국가 단위 데이터 수집 및 활용 현황 ································ 44
가. 국내 난임시술 의료기관 평가를 위한 난임시술 데이터 활용 현황 ··············· 44
나. 난임시술 의료기관 평가 수집 데이터 활용 방안 ········································ 53

제3장 난임시술 통계관리 업무를 위한 개인정보 수집 및 이용 등에 관한 법률상의 근거와 규제에 관한 검토 67
1. 보건의료통계와 개인정보보호와의 관계에 대하여 ······································ 69
2. 개인정보보호법상 개인정보 보호의 기본원칙과 개인정보의 수집, 이용 및 파기단계에서의 제한규정에 관하여 ························································· 69
가. 개인정보의 정의 ···················································································· 69
나. 개인정보보호의 기본원칙 ········································································ 70
다. 개인정보에 대한 구체적인 제한규정에 관하여 ··········································· 70
3. 난임시술정보의 법적 성격에 관하여 ························································ 72
가. 개인정보보호법상 민감정보 ····································································· 72
나. 생명윤리 및 안전에 관한 법률상 유전자정보와의 관계 ······························· 73
4. 난임시술 통계관리 업무를 위한 개인정보의 수집, 이용 및 파기 단계에서의 검토사항 ····························································································· 73
가. 난임시술 통계관리 업무의 수행주체 ························································· 73
나. 난임시술 통계관리 업무를 수행하기 위하여 수집, 분석하여야 하는 자료 ····· 74
다. 위 업무를 수행하기 위한 자료요청의 법적 근거 ········································ 74
5. 심평원이 보유하는 건강보험관련 정보의 성격과 이용범위에 대하여 ············ 76
6. 심평원이 난임시술 통계관리 업무를 수행하는 과정에서 별도로 수집하여 보유하고 있는 건강보험관련 정보를 활용할 수 있는지 여부에 관하여 ······················ 78
7. 수집한 자료의 보관 및 파기에 관하여 ···················································· 79
가. 개인정보의 보관 및 파기에 관한 기본원칙 ··············································· 79
나. 심평원이 보유하고 있는 건강보험 관련 정보들 중 심사청구서와 명세서에 대한 보관기간에 관한 관련 규정들의 검토 ············································································· 80
다. 난임시술 통계관리 업무 수행을 위하여 수집한 개인정보의 보관기간에 관한 근거규정의 정비방안에 대하여 ·························································································· 81
8. 난임시술 통계의 공표에 관한 기타 쟁점들에 관하여 ································· 82
가. 난임시술 통계의 공표 주체에 관하여 ······················································· 82
나. 난임시술 통계의 공표 시기에 관하여 ······················································· 83
다. 난임시술 통계의 공표 범위에 관하여 ······················································· 83

제4장 대한민국 난임시술 통계관리 지표 및 모델 제안 85
1. 난임시술 통계관리 지표 제안 및 분석 ···················································· 87
가. 통계 수요자 및 이용 목적 ······································································ 87
나. 체외수정시술 연단위 지표 ······································································ 88
다. 체외수정시술 세부 지표 ········································································ 111
라. 체외수정시술 연도별 추이 ····································································· 126
마. 인공수정시술 지표 ··············································································· 133
바. 난임시술기록지 개선이 필요한 사항 ······················································· 139
2. 출산 관련 난임시술 통계 및 산출 모델 ················································· 144
가. 출산 관련 자료 통합 및 지표 설정 ························································ 144
나. 연결 자료를 통한 출생률 예측 모형 생성 ··············································· 158
다. 난임시술 통계 지표별 결과 해석 및 정책적 해석 ···································· 164
3. 난임시술 통계 사후 관리 모델 ····························································· 167
가. 통계 공개 방법 ··················································································· 167
나. 통계 관리 방안 ··················································································· 171

◾ 참고 문헌 ····················································································· 177
◾ ABSTRACT ················································································· 179
Publisher
건강보험심사평가원
Location
KOR
Citation
이다용. (2022-11). 국가단위 난임시술 통계관리 모델 개발 연구.
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