病院 患者의 受療行態에 對한 地理學的 硏究

Abstract

의료 서어비스를 利用하는 行態는 서어비스 施設의 立地, 의료정책 그리고 個人의 社會·經濟的 特性의 영향을 받는다. 本 硏究는 都市內部의 의료자원의 不均等한 分布가 서어비스 利用에 미치는 영향을 距離의 測面에서 考察하였다. 硏究地域은 서울로 定하였고 硏究對象은 高級 의료시설인 病院을 利用하는 患者로 하였다. 資料는 서어비스 受療現場인 病院에서 直接 質間紙 調査를 通하여 蒐集하였다. 通院距離는 患者의 居住地와 病院間의 직선 거리 (地圖上의 거리)와 時間거리 (個別 受療旅行에 소요된 時間)로 測定하였다. 社會·經濟的 地位는 患者의 職業 敎育 所得으로 測定하였다. 通院距離의 多樣性은 병원 서어비스 水準과 患者의 社會·經濟的 地位에 따라 分析하였다. 分析의 結果 病院 서어비스 機會의 分布는 患者의 居住 分布와 관계가 없었다. 즉, 대부분의 서어비스 機會가 都心 혹은 副心에 集中되어 있고,患者의 居住分布는 全 方向으로 分散되어 있었다. 患者들이 都心에 立地하는 病院을 利用하게 된 動機는 主로 診療水準 및 距離費用이었다. 距離費用에 대한 選好의 結果는 病院의 서어비스 水準과 患者의 社會·經濟的 地位에 따라 多樣性을 나타냈다. 즉, 서어비스 水準이 높은 病院을 利用하는 患者들은 距離의 增加에 따른 費用의 增加에 鈍感하였다. 또한 相對的으로 社會·經濟的 地位가 높은 患者들은 平均 通院距離가 더 길었다. 특히 時間距離는 社會·經濟的 地位가 높을수록 더 짧은 경향이 있었다.;This thesis attempts to study the spatial behavior of hospitel patients focussing on the travel distance to hospital services. Most of the hospital facilities in Seoul are concentrated to the urban center. This spatial disparity of medical service may affect patient utilization of hospital facilities. The study proceeded as follows: 1) Data Collections; a. Three hospitals located near the urban center were chosen according to their service level. b. Data were collected using the questionaire by the random sampling method of hospital patients. The questionaire included informations on sex,age,education,job,incom,address,time taken for trip to hospital, and the motivation of their hispital selection. 2) Data Analyses; a. Three maps were made to identify and explain spatial patterns of hospital patients. The maps described size and location of hospitals, density of hospital beds compared to a number of population in the census district, and residential place of hospital patients. b. Distances to hospitals were measured by two methods: physical distance between hospital and central point of cecsus district on the map; time distance shown on the questionaire. c. The socio-economic status was classified into five classes according to the total z-score of job, income, and education, d. Distance decay function shown by frequency distribution was uses to analyze the relationship between distance and level of hispital services. e. The relation of distance and socio-economic status was analyzed by mean distance measured by each class of socio-economic status. The results are summarized as follows: 1) The distance decay function in the relation of the distance and the level of hospital services was shown more clearly in the low level hospital services than in the high level: i.e., the number of patients using the facilities did not fall off rapidly with increasing distances in the high level of hospital services. 2) The socio-economic status of patients also showed relationships with hospital trip behaviors: i.e., as the socioeconomic status became higher, real distance to hospitals was getting longer and time distance shorter. 3) Distribution of hospital service opportunities had an effect on travel patterns of patients.