This study investigated population characteristics that influencing treatment service use of people who are voluntarily using drug dependency treatment services by using logistic and hierarchical regression analysis. The research model of the current study was driven by the framework of the 'the Behavioral Model of Health Services Use(the Andersen model)' that has been broadly applied to study on health behavior. This study used data from a sample group of 80 adults by using purposive sampling. This study found that some predisposing factors, enabling factors and need factors have direct effects on service use. In detail, individuals who graduated from high school use drug dependency treatment utilities more than those who did not. Further, individuals who were given more support from family, peers, or others, use the treatment utilities more frequently and were more willing to use the utilities continuously. Furthermore, the greater the perceived need felt by the dependent, the greater the tendency to enter hospitals or shelters. The important implications of this study for social work practice and social policy can be summarized as follows: first, this study supports the idea that intervention for drug dependents in Korea should be focused on environment resources rather than population characteristics; and government must support drug dependent treatment systems; the present study was the first to investigate Korean drug dependents through taking a more positive view, as well as the first to apply 'the Behavioral Model of Health Services Use', and as such represents an example of how studies could be productively conducted in the future. Despite these implications, there remain some limitations in this study. These include the following: limitation in generalizability of the results; the cross-sectional nature of the study design; survey research through the questionnaire method; using foreign scales; and the difficulty of classifying treatment settings.
Background: This paper describes the relationship and effect of health examination on personal medical cost by identifying the difference of the cost for medical care in physician visit between the population without and with health examination. Methods: After classifying into three cohorts in which, independent variables were designed according to the Andersen's behavioral model, the association of personal medical cost for medical care and prescription drugs which is dependent variable was analyzed by t-test and Mann-Whitney test for description and gamma regression model for inference. Results: In personal average medical cost, the population with health examination paid significantly more than without health examination, 11.6% more in cohort 2008, 26.6% more in cohort 2009, and 48.0% more in combined cohort. The odds ratio on medical expenditure of outpatients with health examination was 1.067, 1.126, 1.398 significantly in cohort 2008, 2009, and combined cohort respectively, comparing to the group without health examination. In independent variables, that is female, the elderly, never married, non-working, non-metropolitan, the higher family income, the smaller family size, people with disability, the people with chronic disease, and people with health examination have significantly being paid more tendency showing positive association with medical cost. Conclusion: This result showed that medical expenditure in physician visit has been increased after taking a health examination. Therefore reasonable limitation of getting preventive medical service is suggested to avoid medical shopping around and reduce being repeated health examination by unifying control to find out easily the clinical results from various medical facilities.
The purpose of this study was to examine the factors influencing the decision to get implant treatment at dental clinic. The subjects in this study were 321 patients at dental hospitals and clinics. Andersen model in which predisposing variables, enabling variables and need variables were suggested as independent variables was used. The implant decision making was selected as a dependent variable in the model. Using logistic regression analysis, we found statistically significant effects of three independent variables: 1) class, 2) satisfaction with the facility; 3) familiarity with others received implant treatment. Those with the middle or high class background were more likely to take implant treatment. Those who were satisfied with clinic facility were more likely to take implant treatment. Those who were familiar with others received implant treatment were more likely to take implant treatment. This result implies the importance of opinion of others were received the same treatment. Hence viral marketing effort is required even in dental care field.
The purpose of this study is to learn about the decision factors affecting utilization of elderly welfare center of the elderly living in Gimpo city. The reason of the study is that the elderly welfare center as a provider of general welfare services could not only thinking about the state policy but also need to consider about the inherent role and function of the elderly. Especially for these elders living in rural areas, although the number of elderly welfare centers of the whole country has greatly increased in last 10 years, the effect and function of the facility are almost the same and they are still lack of leisure activities. This issue become a serious problem nowadays. For the above reasons, this article conducts a social survey of 360 elderly people over the age of 65 who lives in the Gimpo city which is a rural-urban type city. The research method is to examine the relationship between the predisposing factors, enabling factors and need factors of Andersen's behavior model with binary logistic regression analysis and the decision tree analysis. The result of binary logistic regression shows the most of factors of Andersen's model is significant. The factors of age, gender, education level in predisposing factors; monthly income in enabling factors and the reserve for old life, the preparation of economic activity for old life in need factors are significant. Then the result of decision tree analysis shows the interaction between factors; when the education level in predisposing factors is higher, the possibility of using of elderly welfare center becomes bigger. Also as the level of healthy promoting preparation in the need factors gets lower, the possibility of using of elderly welfare center still becomes bigger. Although differences were found in the interpretation of the results of regression analysis and decision tree analysis, the results of this study can still provide support for the necessity of elderly welfare centers providing integrated welfare services.
Objectives: The purpose of the study is to investigate the oral health and oral health beliefs in industrial workers and to analyze the influencing factors on dental health care utilization. Methods: The subjects were 280 adults from 16 to 64 years old in Seoul and Gyeonggi from June 20 to July 31, 2014, A self-reported questionnaire was completed after receiving informed consent. The independent variables consisted of predisposing, enabling, and need factors. The predisposing factors included gender, age, residence area, number of family. The enabling variables included monthly income, education, occupation, type of employment. The need factors included subjective oral health recognition and oral health belief model. These three variables had a direct and indirect influence on dental clinic use. The types of occupation were classified into desk duties, merchandizing and service duties technology and others by KSCO-6. Results: The relating factors to dental health care utilization were sex, oral health beliefs perceived benefits, perceived barriers, and self-efficacy. Female tended to have the higher oral health beliefs perceived benefits, perceived barriers(p<0.01), self-efficacy(p<0.05). Conclusions: Those who received frequent oral examination and health instruction tended to have a favorable impact on maintenance of oral health status and improvement in quality of life.
Journal of the Korean Data and Information Science Society
/
v.14
no.3
/
pp.561-570
/
2003
We propose a nonparametric test procedure for checking the proportionality assumption between hazard functions using a functional equation. Because of the involvement of censoring distribution function, we consider the large sample case only and obtain the asymptotic normality of the proposeed test statistic. Then we discuss the rationale of the use of the functional equation, give some examples and compare the performances with Andersen's procedure by computing powers through simulations.
Kim, Min-Young;Park, Jong-Ku;Koh, Sang-Baek;Kim, Chun-Bae
Journal of Preventive Medicine and Public Health
/
v.43
no.6
/
pp.513-522
/
2010
Objectives: The purpose of this study was to define the association between the medical utilization of osteoarthritis patient and its related factors. Methods: We used the 2005 Korean National Health and Nutrition Survey data and we enrolled 2833 participants who were forty or older and who were diagnosed as having osteoarthritis by a doctor within 1 year and who had suffered from osteoarthritis for more than 3 months. The Andersen behavioral model was used as the analytic framework, and the variables were categorized into predisposing, enabling, and need factors. To determine the influence of each variable on the medical utilization of osteoarthritis patient, we applied hierarchical logistic regression analysis with two stages: the first stage included the predisposing and enabling factors and the second stage included the need factors. Results: On the hierarchical logistic analysis, the variables of personal income, the type of medical security, the duration of arthritis related symptoms within 1 month, the subjective health status and the duration of osteoarthritis showed a statistically significant association with medical utilization in men. And the variables of age, limitation activity due to osteoarthritis, arthritis related symptoms within 1 month, and the subjective health status had a statistically significant association with medical utilization in women. Conclusions: The patients who tend to receive less care are those who suffer less from symptoms of osteoarthritis, those who are within the initial phase, or those with a low-level severity of osteoarthritis. It is necessary to encourage patients to receive the treatment in the initial phase.
Salih, Alaaddin M;Alfaki, Musab M;Alam-Elhuda, Dafallah M;Nouradyem, Momin M
Asian Pacific Journal of Cancer Prevention
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v.17
no.4
/
pp.2105-2110
/
2016
Purpose: A multicenter, observational, cross-sectional study was conducted to assess factors delaying presentation of breast cancer cases. Materials and Methods: Data were collected from a pair of highly specialized referral centers, both located in the center of the Sudanese capital, Khartoum. For a total of 153 eligible respondents, durations of delay, clinicodemographic factors and reasons of referral were collected from our respondents through self-administered questionnaires. Logistic regression analysis and ANOVA were used to test the relation between periods of delay and different factors. Odd ratios (OR's) and their correspondent Confidence intervals (95% CI's). Delay periods were studied with Andersen's model. Results: The average duration of delay in our study was 11.9 (${\pm}11.2$) months. Only a quarter of our patients presented early within the first 3 months after onset of their symptoms. About 47.7% arrived later during the course of the first year, while it took beyond that for the last 27% to come. A prior diagnosis of BC was the only predictor of early presentation (for 3-12 months OR=9.6 (p<0.00), 95% CI 9.55-9.75; for >12 months OR=9.3 (p<0.00), 95% CI 9.33-9.33). Out of the 12 different reasons for delay given by our respondents, none showed a significant difference between patients presenting early or late. Financial incapacity (17.5%), ignorance about BC (14.3), and misinterpreting symptoms (12.7%) were the top three whys of delay. Conclusions: Our findings support existence of a non-uniform pattern of delay among Sudanese BC patients. Changing currently adopted awareness elevating strategies into much more inclusive approaches is strongly recommended.
Journal of The Korean Society of Integrative Medicine
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v.11
no.2
/
pp.87-99
/
2023
Purpose : This study intended to provide essential data for developing measures for the stable settlement and expansion of the life-sustaining treatment decision system by identifying the effects on preparing advanced directives. Methods : The effects on preparing advance directives of older people were identified based on Andersen's behavioral model, using the 2020 Korean national survey on elderly. Data were statistically analyzed with SPSS Statistics ver 25.0 and the significance level (α) was set to .05. Results : For factors that influence the preparation of advance directives, the predisposing factor was .769 times less for women than men (p=.026). By age, it was 1.410 times higher (p=.006) for people in their 70s compared to people in their 60s and 1.675 times higher (p=.003) for those in their 80s. By the level of education, it was 1.617 times higher (p=.026) for those who have elementary school education compared to those who have no education, 1.596 times higher (p=.048) for those who have a middle school education, 2.313 times higher (p<.001) for those who have a high school education, and 3.827 times higher (p<.001) for those who have a college education. By religion, it was 1.328 times higher (p=.008) for those who have faith compared to those who do not. For possible factors, it was 2.325 times higher (p=.003) for those who spend 100,000 won or more on healthcare (monthly average) compared to those who do not spend. For necessary factors, it was 1.439 times higher (p=.041) for those with the chronic disease compared to those without. Conclusion : It is deemed a measure that can increase the preparation of advance directives, considering the characteristics of each cause, for the stable settlement of the life-sustaining treatment decision system.
Graphical and numerical methods for checking the assumption of proportional hazards of Cox model for censored survival data are discussed. The strenths and weaknessess of several goodness of fit tests for the propotional hazards for the two-sample problem are evaluated with Monte Carlo simulations, and the tests of Schoenfeld (1980), Andersen (1982), Wei (1984), and Gill and Schumacher (1987) are considered. The goodness of fit methods are illustrated with the survival data of patients who had chronic liver disease and had been treated with the endoscopy injection sclerotheraphy. Two other examples of data known to have nonpropotional hazards are also used in the illustration.
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