(A) study on perception, attitude, and satisfaction level of the subjects of DRG payment system

보건정책 및 관리학과/석사[한글] 우리나라는 1997년 2월 이후 만 7년이 지난 현재까지 DRG 지불제도를 시행중인데, 대상자들의 인식과 태도 및 만족도에 관한 연구는 거의 없었다. 이에 DRG 지불제도를 시행중인 경기도 신도시 지역 2개 종합병원에서 7주간에 걸쳐 DRG 지불제도로 퇴원수납을 마친 200명을 대상으로 설문조사를 실시하여 인식, 만족도, 태도, 추천, 재이용의사와 특성별 상관관계를 분석하였다. 이 연구의 주요결과를 보면, DRG 지불제도는 75% 이상이 모르고 입원했다가 78%가 퇴원시점에 알게 되었으나 지불방식이나 진료비 만족도는 58% 이상 높았고, 불만족은 4% 미만이었다. 추천, 재이용의사도 55% 이상의 높은 지지를 받았고 60% 이상이 DRG지불제도가 확대되길 바라고 있었다. 또한, 향후에 DRG지불제도가 점차 많은 의료기관에서 참여할 것 이라고 응답한 경우가 55% 이상으로서 대부분이 DRG에 대해 호의적인 반응을 보였다. 특성별 상관관계를 보면 모든 항목에서 남자가 여자보다 높았고, 대졸이상이 높았으며 30대가 가장 높은 추천의사를 보였고 제왕절개술이 가장 낮은 추천, 재이용의사를 보였는데 백내장수술은 제왕절개술보다 무려 6배 이상의 추천의사를 보였다. 이 연구의 제한점으로는 2개 병원이 전부 신도시에 위치한 지리적 특성과 700병상규모의 종합병원이기 때문에 다른 곳과 환자군이 다를 수 있었고, 퇴원계산 후 퇴원계에서만 설문을 받았기 때문에 두병원의 전체 환자를 대표하기에는 한계가 있다. 이러한 제한점이 있긴 하지만 DRG 지불제도 대상자들의 인식과 태도, 만족도, 추천, 재이용 의사 등의 의식조사의 결과를 바탕으로 DRG에 대한 의료계와 국민들의 이해도를 증진시키기 위해 대폭적인 지원방안을 마련해야 하며, 홍보부족의 문제점을 인지하여 대국민 홍보활동을 강화해야한다. [영문]Korea has been enforcing the DRG payment system for 7 years since February 1997, but there were almost no research done on the perception, attitude, and satisfaction level of the subjects. Thus, a survey was done over 7 weeks on 200 people having completed their hospital bill payment through the DRG payment system at 2 general hospitals in the new towns of Kyonggido, which provide the DRG payment system, and analysis was done on their perception, satisfaction level, attitude, recommendation, and intentions for repeated usage as well as correlations of each of the characteristics. The main results of this study show that 75% were unaware of the DRG payment system when being admitted and 78% found out at the time of discharge, but the satisfaction level of payment method and treatment cost was high at over 58% while 4% or less were dissatisfied. Recommendation and intention for repeated use had a high support of over 55%, while more than 60% hoped for expansion of the DRG payment system. In addition, more than 55% responded that many more medical institutions will participate in the DRG payment system in the future, showing that the majority expressed a favorable reaction to DRG. In terms of correlation among characteristics, in all categories, male was higher than female, and university graduate or above was higher, while subjects in the 30''s showed the highest intention for recommendation, but caesarean section had the lowest recommendation and intention for repeated use. Cataract surgery had as much as 6 times or more the recommendation as the caesarean section. Limitations of this study would be the geographical issue that both hospitals were in new towns, the patient group may differ from other institutions, since general hospitals with 700 beds were covered, and surveys were done at the discharge stage after discharge settlement was done. Thus, the subjects would have limitations in representing all the patients of the two hospitals. Despite these limitations, it may be concluded that based on the results of an awareness investigation on the perception, attitude, satisfaction level, recommendation, and intention for repeated use of the subjects of the DRG payment system, extensive support measures should be provided to help the medical world and the general public understand DRG better and PR activities should be reinforced by recognizing the issue of insufficient advertisement.ope