• Korean Journal of Social Welfare
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• v.57 no.2
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• pp.71-92
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• 2005

This study investigated social support, quality of life, and the impact of social support on quality of life among medicaid recipient with chronic illness such as hypertension, arthritis, diabetes, and stroke in Dec, 2003(N=221). Subjects were collected using stratified sampling by sex, age, diagnosis, and domicile on national data from National Health Insurance Corporation. Descriptive analysis and regression were performed. Results showed social support and quality of life was very low and social support was different in diagnosis and domicile, and social support, especially emotional support from family members, positively impacted on quality of life. The relationship of the two variables showed the differences in sex, diagnosis and domicile. This study will be used as theoretical bases for enhancing social support and quality of life among medicaid recipient with chronic illness.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.8
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• pp.5430-5441
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• 2015

The purpose of this study is to investigate the effect of Medicaid case management (CM) performed by Medicaid case managers on health management and to examine the overall health care utilization with high risk Medicaid beneficiaries. The subjects involved in this research were 113 Medicaid beneficiaries who were recipients CM in Y-gu between October 1st, 2012 and March 31th, 2013. The results show that there were significant differences in 'recognition of own disease', 'understanding of Medicaid policy', 'medication' and 'healthy lifestyle'. Also there were significant differences in 'appropriateness of health utilization', 'number of medical institutions', 'level of social isolation' and 'general health status'. In addition, significant differences were found in Medicaid days, outpatient days, medication days and Medicaid costs. It was found that the Medicaid CM had a positive effect on health care utilization. The study suggests the need of strengthening and diversifying Medicaid CM as well as supporting the management and monitoring after the termination of Medicaid CM.

• Journal of Korean Academy of Nursing Administration
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• v.15 no.1
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• pp.136-146
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• 2009

Purpose: The purpose of this study was to investigate the effects of copayments for doctor visits and prescription drugs on health services utilization in the Type I Medicaid beneficiaries in Korea. Method: This study examined data from the 2007 survey on Health Services Use and Health Status of Medicaid Beneficiaries performed by the Ministry for Health Welfare and Family Affairs. To analyze these sample survey data, the SURVEYFREQ, SURVEYMEANS, and SURVEYREG procedures which incorporate the sample design into the analyses were used. Results: Findings of this study indicate that copayments for doctor visits and prescription drugs of Medicaid Type I beneficiaries have cut overall medical costs. However, although results should be interpreted very carefully because of the relatively low $R^2$, copayments have cut more health services utilization of people who need more health services because of their complex diseases and disability. In addition, besides copayment, several factors are affecting differences in health services utilization before and after copayments implementation. Conclusion: These results highlight the need to examine the effects of copayments more thoroughly according to the kinds of disease, the severity of disease, and the level of copayment.

• The Journal of the Korea Contents Association
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• v.16 no.5
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• pp.477-487
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• 2016

This study attempts to comprehensively evaluate differences in sociodemographic characteristics, health behavior, disease morbidity, medical care and health-related quality of life of medical aid beneficiaries and health insurance beneficiaries. To achieve this, this study analyzes primitive data of community health survey that each health center had recently conducted in 2013. Study socioeconomic characteristics, health behavior, disease morbidity, medical care showed that various factors affecting health-related quality of life. It was found that medical aid beneficiaries showed lower health related-quality of life than health insurance beneficiaries because not good socioeconomic characteristics, health behavior, disease morbidity, and medical care and even as a comparative result after controlling socioeconomic characteristics, it was found that medical aid beneficiaries health-related quality of life was lower because of not good health behavior, disease morbidity, and medical care. Therefore, to improve health-related quality of life in medical aid beneficiaries as effectively as possible, improving mental health including managing chronic disease and stress and depression and daily living activities is above all important and our national concern with developing systematic program and policies focusing on health promotion behaviors such as moderate drinking habits and regular exercise and eating habits is required.

• Journal of East-West Nursing Research
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• v.15 no.2
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• pp.63-70
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• 2009

Purpose: The purpose of this study was to evaluate hospital service utilization by the types of hospitals in Type I Medicaid claims frequently cited by elderly beneficiaries. Methods: Three frequently claimed inpatient diseases were selected: cerebral infarction, hypertension and diabetes mellitus. Relevant data were collected for the year 2008 from the computer database of the National Health Insurance Corporation. The data was analyzed using SPSS by descriptive statistics, ANOVA and coefficient of variation. Results: The coefficient of variance of hospitalization per episode was higher than daily hospital expenditure among hospitals for all three diseases. The coefficient of variance of hospitalization per episode was highest for cerebral infarction. The coefficient of variation of hospital expenditure per hospital day was highest for hypertension. Conclusions: Evaluating of the volume and pattern of hospital service utilization and the appropriateness for hospital admission for Type-I Medicaid elderly beneficiaries is important for Medicaid-based case management.

• Journal of Digital Convergence
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• v.12 no.3
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• pp.289-297
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• 2014

This study is meaningful by offering basic data that is able to enhance satisfaction with the use of medical services by the qualified recipients of medical aid and to promote health consistently while looking into their satisfaction with the use of medical services, using independent variables for the period after the introduction of the selected medical center system. The study period from August 16, 2013 was 23 August, In conclusion, with a view to enhancing satisfaction with the use of medical services by qualified recipients of medical aid after the execution of the selected medical center system, it is most important to identify with greater sufficiency and accuracy the effect of medical services by qualified recipients of medical services and any unsatisfied desire for medical services. Also, in pursuit of the use of appropriate medical services, there is a need to prepare active cooperation between medical centers and various political alternatives of the government for the effective discovery of accessibility to medical services, overcome inefficiencies in administrative procedures, establish a reasonable medical service delivery system with the guarantee of appropriate medical treatment, and improve health management.

• Journal of agricultural medicine and community health
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• v.44 no.4
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• pp.195-208
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• 2019

Objectives: The purpose of this study was to analyze whether there are differences in medical expenses according to medical security type in the use of medical services with high disease burden such as coronary intervention. Methods: Chi-square test and covariance analysis(ANCOVA) were conducted to identify the differences in the characteristics and costs according to medical security type of 1,904 patients who underwent coronary intervention in a university hospital from 2011 to 2012. Hierarchical regression analysis was conducted to determine whether the cost affects medical expenses. Results: In the medical aid group, the proportion of women, those without a job, those without a spouse, and those who received hemodialysis was high, length of stay was high, patients using the emergency room and those who died was high. The medical aid patients were significantly higher in the non-benefit medical expenses, optional medical expenses, physician and admission, meals, medications and injections. National health insurance patients were significantly higher in procedure. The medical security type was found to be significant as a variable affecting the medical expenses. Conclusions: Provision of medical expenses should be managed in advance by providing prevention and education services for the vulnerable, and care services in the region should be provided to suppress the occurrence of medical expenses due to the increase in the number of days spent. In addition, it is necessary to support medical expenses to prevent unsatisfactory medical services from occurring for non-benefit and optional care.

• Journal of Korean Academy of Nursing
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• v.39 no.4
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• pp.480-489
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• 2009

Purpose: The purpose of this study was to identify the factors which influence health-related quality of life (HRQoL) in Korean Medicaid beneficiaries. The relationships among sociodemographic factors, health status, health behavior, and HRQoL were analyzed. Methods: Data from the 2007 survey on Health Services Use and Health Status of Medicaid Beneficiaries conducted by the Ministry for Health Welfare and Family Affairs were examined. To analyze the sample survey data, descriptive statistics, correlation and hierarchical multiple survey regression analysis with SAS 9.1.3 package were used with SURVEYMEANS and SURVEYREG procedures, which incorporate the sample design into the analyses in order to make statistically valid inference for the whole Medicaid population. Results: The HRQoL correlated with limitations in Activities of Daily Living (ADL) (r=-.509, p<.001), stress (r=-.387, p<.001), depression (r=-.385, p<.001), alcohol consumption (r=.216, p<.001), and exercise (r=.293, p<.001). Significant factors that affect HRQoL of Medicaid beneficiaries were gender, region, limitations in ADL, stress, depression, alcohol consumption, and regular exercise. These variables explained 44.6% of HRQoL (F= 215.00, p<.001). Conclusion: The results indicate that to improve the HRQoL of Medicaid beneficiaries it is important to develop nursing intervention programs that focus on psychological health and health behavior and to give consideration to differences in gender and region.

• Journal of Korean Public Health Nursing
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• v.26 no.2
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• pp.289-302
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• 2012

Purpose: The purpose of this study was to compare the effectiveness of case management in elderly medicaid beneficiaries according to geographic location. Methods: Data were collected from 23,633 elderly medicaid beneficiaries assigned from over users of medicaid. We used the need assessment tool developed by the government, which consists of 19 items with four subscales. Results: Among elderly medicaid beneficiaries, statistically significant differences in effectiveness of case management were observed for quality of life, self-care competency, medical care utility, and support system. Differences in case management effectiveness were higher in urban areas than in metropolitan or rural areas. Conclusion: The differentiated and tailored intervention model based on characteristics of participants, resource distribution, and geographic location may be needed for effective case management for elderly medicaid beneficiaries.

• Research in Community and Public Health Nursing
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• v.23 no.4
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• pp.438-445
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• 2012

Purpose: Medical Aid Beneficiaries were surveyed to identify differences in health behaviors, adherence to drug regimen, and quality of life between those people in the Designated Doctor System and those who are not. Methods: A total of 1,327 study subjects were separated into three groups: those in the Designated Doctor System for 2 years, those in for 1 year, and those not in the system. Results: After the introduction of the Designated Doctor System, 55.8% and 67.9%, respectively, of the subjects in the Designated Doctor System complained of inconvenience in relation to hospital use and the patient referral process. Also, the rate of emergency room use or hospitalization guided by the Designated Doctor System was only 8.7% and 6.5%, respectively. There were no significant differences in health behaviors and adherence to drug regimens between those in the Designated Doctor System and those who are not. Conclusion: This study was carried out early in the introduction of the system. Therefore, it is necessary to monitor the positive and negative effects of the Designated Doctor System for a full reflection of its impact.