Factors Associated with the Exercise of Right to Self-determination about non-benefit Medical Services

의료소비자의 비급여 진료에 대한 자기결정권 행사와 관련 요인

  • Kim, Ji Eun (Department of Medical Science, Soonchunhyang University Graduate School) ;
  • Hahm, Myung-il (Department of Medical Science, Soonchunhyang University Graduate School) ;
  • Lee, Hyewon (Department of Health Administration and Management, Soonchunhyang University, College of Medical Science) ;
  • Kim, Sun Jung (Department of Health Administration and Management, Soonchunhyang University, College of Medical Science)
  • 김지은 (순천향대학교 일반대학원 의료과학과) ;
  • 함명일 (순천향대학교 일반대학원 의료과학과) ;
  • 이혜원 (순천향대학교 의료과학대학 보건행정경영학과) ;
  • 김선정 (순천향대학교 의료과학대학 보건행정경영학과)
  • Received : 2022.01.27
  • Accepted : 2022.02.23
  • Published : 2022.03.30

Abstract

Purposes: This study was to investigate intention to exercise the patient's right of self-determination on adopting the non-benefit medical services and was to identify factors associated with intention to self-determined decision. Methodology: A total of 1,000 adult respondents aged 20 to 65 years were recruited using stratified random sampling and surveyed by online. Multivariate logistic regression analysis was performed to identify factors associated with intention to self-determined decision using SAS 9.4(SAS Institute Inc. Cary, NC, USA). Findings: 61.9% of total participants(n=592) had intention to exercise patient's right of self-determination on adopting the non-benefit medical services. Significant differences were observed in the exercise of self-determination in relation to prior explanation and opportunity for self-determination. Practical Implications: This study suggested that explanation duty of provider might influence on increasing intention to exercise the patient's right of self-determination. Considering appropriate use of non-benefit services, it is important to enhance explanation duty of provider.

Keywords

Acknowledgement

이 연구는 건강보험심사평가원 및 순천향대학교 학술연구비 지원으로 수행하였음

References

  1. Parsons, T. ''The sick Role and the Role of the Physician Reconsidered" Health and Society. 1975;53(2):257-278
  2. Fox, R. C. The Sociology of Medicine: a Participant Observer's View. 1989; Englewood Cliffs, NJ: Prentice Hall
  3. Yoon KJ, Choi JH, Jo BH. Consumer Rights in Healthcare Service. 2013. Korea Institute for Health and Social Affairs.
  4. Mooney G, Ryan M. Agency in health care: getting beyond first principals, Journal of Health Economics, 1993; 12(2):125-135. https://doi.org/10.1016/0167-6296(93)90023-8
  5. Jang IS. Expanding the disclosure of non-covered services to enhance the public's right to know. HIRA RESEARCH, 2020;14(6): 30-38.
  6. Kim KW. Constitutional Self-Determination. Law Review 2005;20: 161-179.
  7. Jung YH. Compare Patient Right and Consumer Right in Medial field. Health Policy and Management 2017;27(1): 3-17. https://doi.org/10.4332/KJHPA.2017.27.1.3
  8. Nordgren, S., & Fridlund, B. Patients' perceptions of self-determination as expressed in the context of care. Journal of advanced nursing 2001;35(1), 117-125. https://doi.org/10.1046/j.1365-2648.2001.01828.x
  9. Suh JH. Consumer Attitude towards Physicians' Duty to Provide Information and Patients' Self-determination Options and Related Variables. Journal of the Korean Home Economics Association, 1992; 30(3) : 193-204.
  10. Kim Y. Changes in patient-centered medical services: focused on improvements on communication between doctors and patients. Journal of Science & Technology Studies, 2013;13(2) : 71-110.
  11. Kim JH. Advance beneficiary notice of noncoverage. HIRA RESEARCH 2020;14(6): 47-55.
  12. Rock, M. J., & Hoebeke, R. Informed consent: whose duty to inform?. Medsurg Nursing 2014;23(3), 189.
  13. Dae Seog Heo. Patient Autonomy and Advance Directives in Korea. Journal of the Korean Medical Association 2009;52(9): 865-870. DOI: https://doi.org/10.5124/jkma.2009.52.9.865
  14. Edwards, Adrian, & Elwyn, Glyn. Inside the black box of shared decision making: distinguishing between the process of involvement and who makes the decision. Health Expectations, 2006;9(4): 307-320. https://doi.org/10.1111/j.1369-7625.2006.00401.x
  15. Rimondini, Michela, Del Piccolo, Lidia, Goss, Claudia, Mazzi, Mariangela, Paccaloni, Monica, & Zimmermann, Christa Communication Skills in Psychiatry Residents-How Do They Handle Patient Concerns? Psychotherapy and psychosomatics, 2006;75(3):161-169. https://doi.org/10.1159/000091773
  16. Kim SA, Song IH, Wang JH, Kim YK, Park WS. The Prevalence of Chronic Diseases, Status of Health Behaviors and Medical Service Utilization - Focused on Female Blue-Collar Workers - J Agr Med Commun Health, 2010;35(3):239-248. https://doi.org/10.5393/JAMCH.2010.35.3.239
  17. Noh HJ, Kim YT. The Major Characteristics and Impact Factors of NEET Youth in Korea: An analysis of population groups by level of education. Journal of Public Society, 2019;9(4): 73-105. https://doi.org/10.21286/jps.2019.11.9.4.73
  18. Kong IS. Policy on non-covered health services. HIRA RESEARCH, 2020;14(6): 7-22.
  19. Kim JS. A Study on the Scope and Limitations of Doctors' Responsibility to Obtain Informed Consent from Patients. The Journal of Property Law 2011;28(1): 341-361. https://doi.org/10.1080/09599916.2011.592207
  20. Oh HL, Moon SW. Effect of the coverage of fee-for-service medical insurance on the healthcare utilization. Health and Social Science 2019;51(1): 153-176.
  21. Institute of Medicine Health literacy: A prescription to end confusion. Washington, DC: National Academies Press. 2004.
  22. Aboumatar HJ, Carson KA, Beach MC, Roter DL, Cooper LA. The impact of health literacy on desire for participation in helathcare, medical visit communication, and patient reported outcomes among patient with hypertension. J Gen Intern Med 2013;28(11): 1469-1476. https://doi.org/10.1007/s11606-013-2466-5
  23. A. Schneider, T. Korner, M. Mehring, M. Wensing, G. Elwyn & J. Szecsenyi. Impact of age, health locus of control and psychological co-morbidity on patients' preferences for shared decision making in general practice. Patient Education and Counseling 2006;61(2), 292-298. DOI : 10.1016/j.pec.2005.04.008
  24. Kang MS, Song CS, Shin JC. Service Employee Expertise and Relational Behavior and Relationship Consequences. korean management review 2006;6:961-985.
  25. Jeong HS, Kim YS, Kim SH. A Study on the Effects of Patients' Individual Factors, Medical Institute Factors, and Health Care Provider Factors on Trust, Role Clarity, and Compliance with Treatment. KOREAN NPO REVIEW 2015;14(1):45-59.
  26. Jo KH & Kim GM Types of Shared Medical Decision Making for Terminally Ill Patients. The Korean Journal of Hospice and Palliative Care. 2014;17(4):278-288. https://doi.org/10.14475/kjhpc.2014.17.4.278
  27. Kim Y. Changes in patient-centered medical services: focused on improvements on communication between doctors and patients. Journal of Science and Technology Studies 2013;13(2): 71-110.
  28. Wolfe, A. Institute of Medicine report: crossing the quality chasm: a new health care system for the 21st century. Policy, Politics, & Nursing Practice 2001;2(3):233-235. https://doi.org/10.1177/152715440100200312
  29. Han, J. J., Lee, M. J., & Im, H. J. Comprehension of patient-physician interaction through analysis of relationships between domains in clinical performance examination. Korean journal of medical education 2010;22(3):177-184. https://doi.org/10.3946/kjme.2010.22.3.177
  30. Ajzen, I. Constructing a theory of planned behavior questionnaire [Internet]. Ireland: Measurement Instrument Database for the Social Sciences Ireland. 2013 [cited 2022 February 22]. Available from: http://people.umass.edu/aizen/pdf/tpb.measurement.pdf