Purpose: The purpose of this study was to investigate determinants of purchasing indemnity private health insurance and its impact on the healthcare utilization among outpatients with chronic disease. Methods: The study analyzed 4,997 chronic ill patients using 2015 Korean Health Panel data. Logistic regression analysis was conducted to analyze the factors affecting the purchase of indemnity private health insurance and multiple regression analysis was conducted to analyze the effect of private health insurance on the number of outpatient visits and outpatient expenditures. Findings: The age, education level, and number of chronic diseases were significant factors affecting the purchasing of indemnity private health insurance among chronic patients. As a result of analyzing the impact of indemnity private health insurance on healthcare utilization, the number of outpatient visits for those who enrolled in the indemnity private health insurance was higher than the number of outpatient visits for those who did not. But there was no statistically significant difference in outpatient medical expenses. Practical Implications: The results of this study shows that indemnity private health insurance may cause inequality in the healthcare utilization of the socially vulnerable. It is necessary to seek ways to strengthen the health security of chronic disease patients and high-risk elderly people who need more healthcare.

Objectives: The purpose of this study was to investigate the effect of the perception on the quality of nosocomial infection control on perceived risk, trust, and the intention to revisit among the medical consumers. Method: 361 patients and their guardians who were hospitalized in women's hospital, Gangnam-gu, Seoul, participated in this study. The data was analyzed using SPSS Statistics 21.0. Results: The perception on the quality of nosocomial infection control had a negative(-) effect on perceived risk, a positive(+) effect on trust, a positive(+) effect on the intention to revisit. The perceived risk had a negative(-) effect on trust, a negative(-) effect on the intention to revisit. The trust had a positive(+) effect on the intention to revisit. The perceived risk was partially mediated by the perception on the quality of nosocomial infection control and the intention to revisit, while the trust was fully mediated by the perception on the quality of nosocomial infection control and the intention to revisit. Thus, it indicated that the perceived risk and trust had dual mediated effects as well as full mediated effects in the relationship between the perception on the quality of nosocomial infection control and the intention to revisit. Conclusions: The nosocomial infection control can be an important factor to contribute to hospital management by attract the loyal medical customers, not just cost-expenditure. The nosocomial infection control can help hospital revenue and customer management strategy. Thus, it will contribute to the effective marketing strategy in the medical field.

Purpose: The Purpose of this study is to provide basic data for solving mental health problems of people with disabilities by analyzing the relationship between leisure activities and the mental health. Methods: We used the chi-square test and the logistic regression model to analyze the data of the National Survey of People with Disabilities in 2017. 6,437 responses of secondary processed data were used in the analysis, Socio-economic, health behaviors and risk variables that affect the mental health of people with Disabilities were used as control variables. Result: As a result of the analysis, People with disabilities who are satisfied with their leisure activities have less depression for two weeks and less suicidal impulses (Depression: [OR]=1.80 p-value<.0001, Suicide Impulse: [OR]=2.26 p-value<.0001). In the case of the experience of leisure activities, some significance was relevant to depression for two weeks (Depression: [OR]=1.65 p-value=0.0052). Conclusion: In order to improve mental health of people with disabilities, it is necessary to provide opportunities for participation in leisure activities by improving the socioeconomic status of them. In addition, a high quality leisure program should be provided that meets the individual's needs to increase the satisfaction of leisure activities for people with disabilities.

Purposes: Rapid aging and increase of high chronic diseases of the elderly are increasing the needs for expanding elderly care beyond the concept of treatment in medical institutions. This study is to discuss the core values, functions, and roles of municipal hospitals and suggest a suitable community care model. Methodology: The survey was collected twice derived from the domestic expert groups. This study analyzed experts' responses using Delphi method and Analytic Hierarchy Process, using Microsoft Excel 2016. Findings: Among the core values of the municipal hospitals, it was shown that community linkage had the highest priority. The publicity had the highest priority among the functions and roles of the municipal hospitals. In the community care models presented in this study, the model focused on 'Community Care Integration Center' showed highest relevance, suitability and applicability. Practical Implications: This study suggested three different community care models and derived the most suitable model for community care, which is focused on the municipal hospitals. It suggested effective application of the community care model to promote community care in each community.

Purposes: This study aimed to compare the perception between nurses and patients about comprehensive care services and to evaluate patient-centeredness experiences at comprehensive nursing care units. Methodology: We enrolled 267 nurses and 184 patients from comprehensive nursing care units of seven general hospitals. We performed data collection and analysis using structured questionnaires and SPSS/PC 23.0 program, respectively, with frequency, percentage, mean, standard deviation, and ${\chi}^2$. test. Findings: We observed a significant difference in perception about comprehensive nursing care services between nurses and patients(p < .001). While the patient-centeredness experience score was the highest in the nursing service, it was the lowest in patient right assurance. Regarding patients' right assurance, "easy-to-express complaints" and "opportunity to participate in decision making" exhibited the lowest score. Practical Implication: This study suggests that it is imperative to assess the above-mentioned problems comprehensively to enhance patient centeredness at comprehensive nursing care units.

Purposes: The purpose of this study is to analyze nurses' perception on the clinical career ladder system which was introduced to enhance the nursing capabilities in general hospital. Methods: Research data has been collected for approximately 30 days since March 28, 2017 from 171 nurses who had been involved in the clinical career ladder system, 177 nurses who had not participated, and a total of 348. Finding: The study results showed that nurses' perception on the cost effectiveness of clinical career ladder system is significantly different depending on the sex, age, program experience, personal stage in the clinical career ladder system and the individual's health condition. In addition, the nurses' willingness to pay for the clinical career ladder system was significantly associated with their department and the needs for the system. With adjusted age, gender, position, education and marital status, nursing competency was 8.71(95% Confidence Interval; 4.79 to 12.63) in the presence of system experience, but the perception on clinical career ladder system was 4.34(95% Confidence Interval; -6.84 to -1.84). Practical Implications: Based on the study results, we expect that more hospitals introduce the clinical career ladder system and also use these study results as basic data for securing excellent nurses.