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질환군별 재택의료 시범사업 효과평가 연구

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Metadata Downloads
Type
Research report
Author(s)
지영건이동현이상규장석용함명일김영애김지만김경이김지은홍민지최서영이지은
Issued Date
2023-11
Publisher
건강보험심사평가원
URI
https://repository.hira.or.kr/handle/2019.oak/3233
Table Of Contents
제1장 연구의 필요성 및 시범사업 개요 1
제1절 연구의 필요성 ··················································································· 3
제2절 재택의료 시범사업 개요 ····································································· 5
1. 재택의료 시범사업의 목적 ············································································· 5
2. 시범사업의 개요 ·························································································· 5
3. 재택의료사업에 참여하고 있는 의료기관 현황 ················································· 8

제2장 연구방법 11
제1절 연구방법의 개요 ·············································································· 13
제2절 청구자료 분석 ················································································· 15
1. 심장 재택의료 청구자료 분석 ······································································ 15
2. 재활 재택의료 청구자료 분석 ······································································ 17
3. 결핵 재택의료 청구자료 분석 ······································································ 18
4. 암(장루) 재택의료 청구자료 분석 ································································· 20
제3절 환자 만족도 조사 ············································································ 22
제4절 의료진 심층면접과 설문조사 ····························································· 24

제3장 심장질환자 재택의료 시범사업 25
제1절 시범사업 운영현황 ··········································································· 27
1. 시범사업 개요 ··························································································· 27
2. 시범사업 등록현황 ····················································································· 30
3. 수가별 점검서식 제출 건수 ········································································· 32
제2절 청구자료 분석 ················································································· 34
1. 심장질환자 재택의료 수가 발생현황 ····························································· 34
2. 전체 의료이용 ··························································································· 42
3. 전체진료비 ································································································ 47
4. 외래 의료이용 ··························································································· 52
5. 외래진료비 ································································································ 57
6. 입원 의료이용 ··························································································· 62
7. 입원진료비 ································································································ 75
8. 응급 의료이용 ··························································································· 80
9. 응급진료비 ································································································ 85
10. 합병증 ···································································································· 90
제3절 환자 만족도 조사 ·········································································· 107
1. 조사대상자 선정 및 설문 방법 ·································································· 107
2. 응답자 특성 ···························································································· 109
3. 효과성/반응성 ·························································································· 111
4. 효율성 ···································································································· 112
5. 수월성 ···································································································· 113
6. 삶의 질(EQ-5D) ····················································································· 115
제4절 의료진 심층 인터뷰 및 설문조사 ····················································· 116
1. 의료진 심층 인터뷰 ·················································································· 116
2. 의료진 설문조사 ······················································································ 122

제4장 재활환자 재택의료 시범사업 129
제1절 시범사업 운영현황 ········································································· 131
1. 시범사업 개요 ························································································· 131
2. 시범사업 등록현황 ··················································································· 134
3. 수가별 점검서식 제출 건수 ······································································· 137
제2절 청구자료 분석 ··············································································· 140
1. 재활환자 재택의료 수가 발생현황 ······························································ 140
2. 전체 의료이용 ························································································· 148
3. 전체진료비 ······························································································ 154
4. 외래 의료이용 ························································································· 160
5. 외래진료비 ······························································································ 166
6. 입원 의료이용 ························································································· 172
7. 입원진료비 ······························································································ 188
8. 응급 의료이용 ························································································· 194
9. 응급진료비 ······························································································ 200
10. 합병증 ·································································································· 206
제3절 환자 만족도 조사 ·········································································· 224
1. 조사대상자 선정 및 설문 방법 ·································································· 224
2. 응답자 특성 ···························································································· 226
3. 효과성/반응성 ·························································································· 228
4. 효율성 ···································································································· 230
5. 수월성 ···································································································· 231
6. 삶의 질(EQ-5D) ····················································································· 233
제4절 의료진 심층 인터뷰 및 설문조사 ····················································· 234
1. 의료진 심층 인터뷰 ·················································································· 234
2. 의료진 설문조사 ······················································································ 239

제5장 결핵환자 재택의료 시범사업 245
제1절 시범사업 운영현황 ········································································· 247
1. 시범사업 개요 ························································································· 247
2. 시범사업 등록현황 ··················································································· 250
3. 수가별 점검서식 제출 건수 ······································································· 253
제2절 청구자료 분석 ··············································································· 256
1. 결핵환자 재택의료 수가 발생현황 ······························································ 256
2. 전체 의료이용 ························································································· 262
3. 전체진료비 ······························································································ 268
4. 외래 의료이용 ························································································· 274
5. 외래진료비 ······························································································ 280
6. 입원 의료이용 ························································································· 286
7. 입원진료비 ······························································································ 302
8. 응급 의료이용 ························································································· 308
9. 응급진료비 ······························································································ 314
10. 합병증 ·································································································· 320
제3절 환자 만족도 조사 ·········································································· 328
1. 조사대상자 선정 및 설문 방법 ·································································· 328
2. 응답자 특성 ···························································································· 330
3. 효과성/반응성 ·························································································· 332
4. 효율성 ···································································································· 333
5. 수월성 ···································································································· 334
6. 삶의 질(EQ-5D) ····················································································· 335
제4절 의료진 심층 인터뷰 및 설문조사 ····················································· 336
1. 의료진 심층 인터뷰 ·················································································· 336
2. 의료진 설문조사 ······················································································ 338

제6장 암(장루)환자 재택의료 시범사업 343
제1절 시범사업 운영현황 ········································································· 345
1. 시범사업 개요 ························································································· 345
2. 시범사업 등록현황 ··················································································· 348
3. 수가별 점검서식 제출 건수 ······································································· 350
제2절 청구자료 분석 ··············································································· 352
1. 암(장루) 재택의료 수가 발생현황 ······························································· 352
2. 전체 의료이용 ························································································· 358
3. 전체진료비 ······························································································ 363
4. 외래 의료이용 ························································································· 368
5. 외래진료비 ······························································································ 373
6. 입원 의료이용 ························································································· 378
7. 입원진료비 ······························································································ 391
8. 응급 의료이용 ························································································· 396
9. 응급진료비 ······························································································ 401
10. 합병증 ·································································································· 406
제3절 환자 만족도 조사 ·········································································· 423
1. 조사대상자 선정 및 설문 방법 ·································································· 423
2. 응답자 특성 ···························································································· 425
3. 효과성/반응성 ·························································································· 426
4. 효율성 ···································································································· 428
5. 수월성 ···································································································· 428
6. 삶의 질(EQ-5D) ····················································································· 430
제4절 환자 집단심층면접 ········································································ 431
1. 조사대상자 선정 및 설문 방법 ·································································· 431
2. 응답자 특성 ···························································································· 432
3. 시범사업 경험 ························································································· 433
4. 시범사업에 대한 기대 ··············································································· 435
제5절 의료진 심층 인터뷰 및 설문조사 ····················································· 438
1. 의료진 심층 인터뷰 ·················································································· 438
2. 의료진 설문조사 ······················································································ 442

제7장 고찰, 제언 및 결론 447
제1절 청구자료 분석에 대한 고찰 ····························································· 449
1. 재택의료 시범사업의 수행 실적(performance) ··········································· 449
2. 재택의료 시범사업의 비용(cost) ································································ 450
3. 재택의료 시범사업의 효과와 편익 ······························································ 451
제2절 비용과 편익 관점에서의 고찰 ·························································· 456
1. 비용-편익 분석의 개요와 한계 ·································································· 456
2. 재택의료에 대한 비용과 편익 ···································································· 457
제3절 환자 만족도 조사에서의 고찰과 제언 ··············································· 462
제4절 의료진 심층면접에서 나타난 현황과 제안 ········································· 465
제5절 재택의료 활성화 방안 ····································································· 466
제6절 결론 ····························································································· 469
Publisher
건강보험심사평가원
Location
KOR
Citation
지영건. (2023-11). 질환군별 재택의료 시범사업 효과평가 연구.
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HIRA 연구 > 2. 위탁연구
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