전동휠체어 경제성 평가를 위한 사회적 비용과 가치 조사: 전동휠체어 사용자를 중심으로 = A Survey of Social Costs and Values for Powered Wheelchair Economic Evaluation: Focused on Powered Wheelchair Users

국문 초록 (Abstract)

목적 : 본 연구의 목적은 전동휠체어 사용자의 경험에 근거하여 정량적, 정성적 질문으로 구성된 설문조사를 통해 전동휠체어가 사용자에게 서비스되기까지 발생하는 비용과 가치를 사회적 관점에서 도출하고 전동휠체어 경제성 평가를 위한 근거를 제시하는 것이다.
연구방법 : 2024년 3월부터 2024년 5월까지 서울과 원주시에 거주하는 63명의 장애인을 조사하였으며, 전동휠체어를 사용하지 않거나, 동력보조장치를 사용하고 있는 조사대상자(n=5)를 제외하고, 전동휠체어를 구매하여 지역사회에서 사용하고 있는 척수손상(n=12), 소아마비(n=11), 근육(n=19) 그리고 뇌병변 장애인(n=16) 총 58명의 응답을 분석하였다. 조사지는 선행 연구를 근거하여 네 개 영역, 17개 대표 문항과 22개의 세부 문항으로 재구성하였으며, 조사 시 욕창의 단계, 전동휠체어 시트 옵션 그리고 건강의 개념을 설명하기 위해 시각 자료가 활용되었다.
결과 : 본 연구에 참여한 조사대상자의 정량적, 정성적 응답은 각각 분석하여 전동휠체어 구매 현황과 사용 만족도, 사용 경험 그리고 사회적 가치와 비용으로써 정리되었다. 조사대상자들은 전동휠체어를 사용하는데 전반적으로 만족하였지만, 구매 비용 부담으로 인한 아쉬운 구매를 하고 있었다. 전동휠체어 사용 이후 활동의 변화는 다양하였으며, 이는 '작업'의 변화라고 할 수 있다. 전동휠체어 사용으로 인한 '작업', 도움의 감소, 정서적인 가치와 수리, 교육 및 훈련, 외출 비용 등이 사회적 관점에서 고려되었다.
결론 : 본 연구에서는 사회적인 관점에서 전동휠체어의 비용과 가치를 조사하였다. 조사대상자가 사용하는 전동휠체어 유형에 따라 가치 차이가 있었으며. 향후 전문가 논의를 통해 다양한 가치를 산출하고, 경제성 평가에 반영하려는 노력이 필요하다.

다국어 초록 (Multilingual Abstract)

Objective: The purpose of this study is to derive the costs and values associated with the provision of power wheelchairs to users from a societal perspective, based on the experiences of power wheelchair users, using a survey composed of both quantitative and qualitative questions, and to provide a basis for the economic evaluation of power wheelchairs.
Methods: The study surveyed 63 disabled individuals residing in cities Seoul and Wonju-si from March to May 2024, excluding five participants who either did not use a power wheelchair or used a power assist device. The responses of 58 participants, including those with spinal cord injuries (n=12), polio (n=11), muscular diseases (n=19), and cerebral lesions (n=16), who purchased and used power wheelchairs in the community, were analyzed. The questionnaire was restructured based on prior research into four areas, consisting of 17 main and 22 detailed items.
Results: The quantitative and qualitative responses from the participants were analyzed to summarize the current status of power wheelchair purchases, user satisfaction, experiences, and the social costs and values associated with their use. Participants generally expressed satisfaction with the use of power wheelchairs, despite regrets about their purchase due to the financial burden. Changes in activities post-wheelchair use were diverse and could be described as changes in 'tasks'. Social considerations included reductions in the need for assistance, emotional value, and costs related to maintenance, education, training, and outings.
Conclusion: This study identified the costs and values of power wheelchairs from a societal perspective. There were value differences depending on the type of power wheelchair used by the participants. Future discussions among experts are needed to derive various values and incorporate them into economic evaluations.

참고문헌 (Reference)

• 1 Korea’s Disabled people’s Development Institute(KODDI), "White paper on disability 2022" KODDI 2022
• 2 Sarsak, H. I., "Wheeled and seated mobility devices provision : quantitative findings and SWOT thematic analysis of a global occupational therapist survey" 11 : 1075-, 2023
• 3 Maxwell, J., "Understanding and validity in qualitative research" 62 (62): 279-301, 1992
• 4 김덕주 ; 양영애, "The research of the satisfaction and current state with repair service of assistive technology devices for the disabled" 16 (16): 481-492, 2016
• 5 강지현 ; 전지수 ; 한상진 ; 김혜원 ; 한새별 ; 심선화, "Survey on the priority assistive products list of occupational therapists and assistive technology professionals in Korea" 13 (13): 57-78, 2021
• 6 우지희 ; 장완호 ; 김종배, "Study on the needs and experiences in using powered wheelchair by severely disabled people : Based on focus group interview" 24 (24): 121-134, 2016
• 7 Alqahtani, S., "Stakeholder perspectives on research and development priorities for mobility assistive-technology : A literature review" 16 (16): 362-376, 2019
• 8 Andrich, R., "Service delivery systems for assistive technology in Europe : An AAATE/EASTIN position paper" 25 (25): 127-146, 2013
• 9 Larsson Ranada, Å., "Satisfaction with assistive technology device in relation to the service delivery process—A systematic review" 31 (31): 82-97, 2019
• 10 Masselink, C. E., "Retrospective chart review examining differences and timelines in recommended and delivered wheelchair equipment in a midwestern dedicated seating department" 103 (103): 944-951, 2022
• 11 World Health Organization, "Rapid assistive technology assessment tool (rATA). WHO/MHP/HPS/ATM/2021.1"
• 12 Elsaesser, L. J., "Provision of assistive technology services method(ATSM)according to evidence-based information and knowledge management" 6 (6): 386-401, 2011
• 13 World Health Organization, "Priority assistive products list" World Health Organization
• 14 Cook, A. M., "Principles of Assistive Technology Introducing the Human Activity Assistive Technology Model In Assistive Technologies Principles & Practice 4th edition" Elsevier Inc 2015
• 15 Samuelsson, K., "Powered wheelchairs and scooters for outdoor mobility : a pilot study on costs and benefits" 9 (9): 330-334, 2014
• 16 Woo, J. H., "Perceived barriers and facilitators to execution of an assistive technology service delivery process" 11-13, 2022
• 17 National Evidence-based healthcare Collaborating Agency (NECA), "NECA’s Methodological Guide for Economic Evaluation of Medical Intervention" N. E.-b. H. C. Agency
• 18 김수연 ; 손민성 ; 김귀현 ; 최만규, "Impact of chronic elderly patients with private health insurance on medical use" 40 (40): 152-177, 2020
• 19 World Health Organization, "Global report on assistive technology" World Health Organization
• 20 Ministry of Health and Welfare (MoHW), "Enhancing accessibility to treatment for severe diseases and expanding support for assistive devices to reduce public burden"
• 21 Schein, R. M., "Effect of the assistive technology professional on the provision of mobility assistive equipment" 102 (102): 1895-1901, 2021
• 22 Abbott, J. H., "Economic evaluation : A reader’s guide to studies of cost-effectiveness" 12 (12): 28-, 2022
• 23 Health Insurance Review & Assessment Service(HIRA), "Drug economic evaluation paper chip" HIRA 2021
• 24 Hagberg, L., "Cost-effectiveness of powered mobility devices for elderly people with disability" 12 (12): 115-120, 2015
• 25 Duff, P., "Cost-benefit analysis of assistive technology to support independence for people with dementia–part 2 : Results from employing the ENABLE cost-benefit model in practice" 19 (19): 79-90, 2007
• 26 김묘경 ; 전경숙 ; 김유미 ; 유선주, "Care experiences of personal assistant for the disabled : A mixed method study" 31 (31): 507-521, 2019
• 27 Madara Marasinghe, K., "Assistive technologies in reducing caregiver burden among informal caregivers of older adults : A systematic review" 11 (11): 353-360, 2016
• 28 Pousada García, T., "Assessment and counseling to get the best efficiency and effectiveness of the assistive technology (MATCH): Study protocol" 17 (17): e0265466-, 2022
• 29 Sugawara, A. T., "Abandonment of assistive products : assessing abandonment levels and factors that impact on it" 13 (13): 716-723, 2018
• 30 National Health Insurance Service (NHIS), "A study on the development and application of standard specification for assistive technology devices" National Health Insurance Services 2022
• 31 김동완 ; 김종배, "A literature review on economic analysis and value measurement tools applied in assistive technology" 16 (16): 29-47, 2024