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KMID : 0371019970300010195
Journal of Preventive Medicine and Public Health
1997 Volume.30 No. 1 p.195 ~ p.207
Adoption and Its Determining Factors of Computerized Tomography in Korea
Yoon Seok-Jun

Kim Sun-Mean
Kang Chul-Whan
Kim Chang-Yup
Shin Young-Soo
Abstract
High price equipment is one of the major factors that increases national health expenditure in developed countries. Computerized Tomography(CT), one of the important high price equipment, has been concerns of health service researchers and policy makers in many countries. In Korea, CT, first introduced in 1984, have spreaded nationwide with rapid speed. Though the Committee for Approving Import of High Price Medical Equipment, founded in 1981, tried to regulate the introduction of high price medical equipment including CT, the effort resulted in failure. ¢¥The exact situation of diffusion of the high price equipment, however, was not yet investigated.

We aimed at the description of the diffusion of CT in Korea and analysis of influencing factors on hospitals for the adoption of CT.

We mainly used the database of CT, made in 1996 by the National Federation of Medical Insurance for the purpose of insurance payment for CT. Also characteristics of hospitals were gathered from yearbooks published by the central and local governments and by the Korean Hospital Association.

We calculated the cumulative number of the CT per one million population year by year. In turn, multiple linear logistic regression was done to find out the contributing factors for the adoption of CT by each hospital. In the logistic re gression model, it is regarded as dependent factor whether a hospital retained CT or not in 1988 and 1993. The major categories of the independent factors were hospital characteristics, environmental factors and competitive conditions of hospitals at the period of adoption.

The results are as follows:

Number of CT scanners per one million persons in Korea marked more higher level compared with those of most OECD countries. Major influencing factors on the adoption of CT scanners were hospital characteristics, such as hospital referral level and competitive condition of hospitals, such as number of CT scanner per 10,000 persons in each district where the hospital was located.

In Korea, CT diffused with rather rapid speed, comparable with those of the United States and Japan. The major factors contributing on the adoption of CT for hospitals were competitive condition and hospital characteristics rather than regional health care need for CT. In conclusion, a kind of regulating mechanism would be necessary for the prevention of the indiscreet adoption and inefficient use of high price equipment including CT.
KEYWORD
Technology assessment, Computerized tomography, Adoption, Number of CT scanners per one million persons
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