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응급실 기반 자살시도자 사후관리 시범사업 평가 연구

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Type
Research report
Author(s)
홍기정이경민
Issued Date
2023-02
Publisher
건강보험심사평가원
URI
https://repository.hira.or.kr/handle/2019.oak/3228
Table Of Contents
제1장 연구수행 내용 ·············································································· 1
가. 연구 배경 ····························································································· 1
1) 시범사업 참여기관별 역할 ········································································· 3
가) 일반응급의료기관 ··················································································· 3
나) (거점)생명사랑위기대응센터 ····································································· 4
2) 시범사업 서비스 제공자별 업무 분담 ··························································· 6
3) 시범사업 대상 ··························································································· 7
4) 시범사업 수가: 자살시도자 사후관리료 ························································· 7
가) 의뢰환자관리료 ······················································································ 8
나) 심층평가료 ···························································································· 9
다) 사례관리 계획수립료 ·············································································· 9
라) 자살시도자 응급관찰 관리료 ··································································· 9

나. 연구 목적 ··························································································· 11

다. 연구 내용 ··························································································· 12
1) 시범사업 현황 분석 및 효과성 평가 ··························································· 12
2) 시범사업 모형 적절성 및 재정적 적절성 평가 ············································· 12
3) 시범사업 방향성 제시 ··············································································· 13

라. 연구 방법 ··························································································· 14
1) 시범사업 현황 분석 및 효과성 평가 ··························································· 14
가) 현황 분석 ··························································································· 14
나) 효과성 평가 ························································································ 15
2) 시범사업 모형 적절성 및 재정적 적절성 평가 ············································· 17
가) 모형 적절성 평가 ················································································ 17
나) 재정적 적절성 평가 ············································································· 17
3) 시범사업 방향성 제시 ··············································································· 18

마. 연구 결과 ··························································································· 19
1) 시범사업 운영현황 및 효과성 평가 ··························································· 19
가) 시범사업의 운영현황 ············································································ 19
나) 시범사업의 효과성 평가 ······································································· 24
(1) 평가지표 선정 ··················································································· 24
(2) 조사 대상 추출 ·················································································· 27
(3) 효과성 평가를 위한 데이터 구축 ························································· 30
(4) 시범사업 효과성 평가 결과 ································································· 37
(가) COVID-19 유행 전후의 자살시도자 특성 비교 ································ 38
(나) 인천지역의 시범사업 전후 시범사업 평가지표 비교 ··························· 44
(다) 인천지역과 그 외 지역의 시범사업 평가지표 비교 ···························· 53
다) 고찰 ································································································· 62
2) 시범사업 모형 적절성 및 재정적 적절성 평가 ············································· 64
가) 시범사업 모형 적절성 평가 ································································· 64
(1) 시범사업 모형 적절성 평가 방법 ························································ 64
(가) 참여기관 간담회 ·········································································· 64
(나) 설문조사 ······················································································ 64
(2) 시범사업 모형 적절성 평가 결과 ························································ 71
(가) 간담회 결과 ················································································ 71
(나) 설문조사 결과 ············································································· 73
(3) 고찰 ······························································································· 84
나) 시범사업 모형의 재정적 적절성 평가 ····················································· 85
(1) 시범사업 모형의 재정적 적절성 평가 방법 ·········································· 85
(가) 시범사업 수가(행위분류, 상대가치점수, 산정기준) 적절성 ··············· 85
(나) 비용 효과성 평가 및 본인부담률 적절성 평가 ·································· 88
(2) 시범사업 모형의 재정적 적절성 평가 결과 ············································ 93
(가) 시범사업 수가(행위분류, 상대가치점수, 산정기준) 적절성 평가 ··········· 93
(나) 시범사업 수가 적절성 평가 결과 ··················································· 108
(다) 비용 효과성 평가 및 본인부담률 적절성 평가 ································ 119
(3) 고찰 ······························································································· 124
3) 응급실 기반 자살시도자 사후관리 시범사업 방향성 제시 ···························· 126
가) 지자체 단위 맞춤형 자살시도자 응급의료체계 모형 개발 ·························· 129
나) 자살시도자 응급의료체계 통합조정 ························································ 130
다) 자살시도자 응급의료체계 및 정신응급의료체계 통합조정 ·························· 131
라) 자살시도자 수용 응급의료기관 제반지원 강화 ········································· 135
마) 응급의료기관 자살시도자 정보제공 및 관리 ············································ 136

바. 결론 ································································································· 137

사. 제언 ································································································· 140

제2장 연구분담표 ·············································································· 142

제3장 중요 연구변경 사항 등 기재 ·············································································· 143

제4장 기타 점검 사항 ·············································································· 144

제5장 연구비 집행 내역 ·············································································· 145
Publisher
건강보험심사평가원
Location
KOR
Citation
홍기정. (2023-02). 응급실 기반 자살시도자 사후관리 시범사업 평가 연구.
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