• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.1
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• pp.162-170
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• 1998

The purpose of this study is to provide framework for understanding children's dental utilization. In this paper Andersen-Newman's model is applied to the use of dental visits. This model consists of predisposing, enabling, and need components that describe a person's decision to use dental health services. One thousand, nine hundred seven children and their mothers were selected for the study. The children were fourth grade to sixth grade in elementary schools in Iksan city, Korea. Models are operationalized using stepwise multiple regression analysis and path analysis. The number of independent variables used in the analysis was 39 in total, ie 32 predisposing components, 6 enabling components, and 1 need component. Children's Dental utilization was measured based on the number of visits. The data collected by means of a questionnaire survey. In this study, the amount of variance by the model was 25 percent. Predisposing factors had the greatest effect on utilization. Number of restricted activity days caused by oral disease, having a regular dental care, and susceptibility on oral disease of children were found to have significant major effects on dental utilization of children. Mother's dental visits was most important factor affecting dental utilization of children.

• Korea Journal of Hospital Management
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• v.6 no.3
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• pp.148-166
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• 2001

The purpose of this study is to classify elderly patient in long-term care facilities using RUG(Resource Utilization Group)-III. It is designed by measuring patient medical characteristics and medical staff time. Elderly patients are classified into 7 categories by clinical(medical and behavioral) hierarchical typology of patients. Through the tertiary split, all 44 groups are formulated. This classification is explained by each patient resource(staff time) utilization level which is called CMI(Case-Mix Index). Major findings are as follows; 1. The objects in this study were classified into 35 groups out of 44 groups. The most frequent category is clinical complex category(CCC; 38.9%). And extensive service category(ESC; 18.8%), reduced physical function category(RPC; 13.1%), special rehabilitation category(SRC; 12.8%), and impaired cognitive category(ICC; 0.00%) are followed. 2. The mean of total CMI was $1.02{\pm}0.36$, ranging from 0.68 to 1.44(1 vs 2.12). The mean of CMI of SRC is only 1.17 which should be the highest. The means of ESC and see are equally 1.20. The means of CMI of CCI, ICC, BPC, and RPC were 0.90, 0.75, 0.83 and 0.96, respectively. 3. The validity of this classification was tested. Trend-test using Regression Analysis was done in the secondary split level. SCC, CCC, ICC, and RPC which covered 68.4% of this research objects showed linear trend of CMI in interim classification. This results were statistically significant. 4. In clinical hierarchy, the trend were showed linearity. But the multiple comparison of categories using Scheffe-test showed that SRC, ESC and see had same level of CMI means and CCC and ICC, too. This results were statistically significant. Classifying elderly patients with RUG-III, the results showed partly linear trend in clinical hierarchy and in interim classification in conclusion. But, in clinical hierarchy, it was failed to show the consistent order of CMI. It can be explained by two reasons. One is that this research subjects were overlapped in each clinical hierarchy group. And the other is that the some of the characteristics for clinical hierarchy is not appropriate for them. For the further study, it needs to have proper sample size and to modify RUG-III to K-RUG to consider our.. medical environment.

• Journal of Preventive Medicine and Public Health
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• v.28 no.2 s.50
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• pp.325-333
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• 1995

Laparoscopic cholecystectomy was introduced into Korea in 1990 and has been rapidly replacing open cholecystectomy when the indications were met. In this study a medical utilization and technology was assessed on the selected hospitalized patients with cholelithiasis who underwent open or laparoscopic cholecystectomy from April 1, 1991 to March 31, 1994. The results are as follows. Despite the low reimbursement rate by the health insurance, the number of laparoscopic cases have been steadily increased. The post-operative days before health insurance coverage were significantly shortened from 8.4 days to 4.6 days. The preoperative days before health insurance coverage were significantly shorted from 8.4 days to 4.0 days. The total length-of-stays in the hospital were also significantly shortened from 15.2 days to 10.7 and 9.8 days in laparoscopic cholecystectomy. The laparoscopic cholecystectomy showed low expenses in all aspects expect the average hospital charges per day. For the hospital to have cost containment, it is more effective if length-of-stay is shorter because of high daily inpatient hospital charge. The laparoscopic cholecystectomy also showed shortened anesthesia time and operation time compared with open cholecystectomy that were statistically significant. The mean anesthesia and operation time for open cholecystectomy were 113.2 and 90.2 minutes but those of laparoscopic cholecystectomy were 105.7 and 68.6 minutes. According to this study the laparoscopic cholecystectomy has reduced the medical expenditure and we recommend this procedure over open cholecystectomy. The further discussion on the different morbidity rate between two types of procedure is essential in providing quality medical care, and to educate specialist.

• The Journal of Korean Medicine
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• v.35 no.1
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• pp.75-87
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• 2014

Objectives: This study aimed to analyze the utilization of Korean medical clinics by sex. Methods: Data was based on reports about usage and consumption of Korean medicine in 2011 by the Ministry of Health and Welfare and Korea Institute for Health and Social Affairs. 171 Korean medical hospitals and more than 300 Korean medical clinics were selected after 2 rounds of extraction, from the 12,250 Korean medical institutions throughout the country. The investigation was carried out between August 25 and September 30, 2011. The study group was composed of 290 men and 813 women; Korean medical institutions including clinics and hospitals were mainly used for their health care. Results: 1. For sociodemographic distribution, sex, marital status, education level, occupation status, and income level showed statistically significant differences. 2. Females had a lower subjective health status than did males. Muscle injury, hwa-byung, gastric disorder, lumbago, common cold, weight loss, and herbal tonics showed differences in prevalence rates between the sexes. 3. Arthritis, muscle injury, gastric disorder, ankle sprain, herbal tonics, and stroke showed differences in usage rates between the sexes. Likewise, major treatment methods had differences between the sexes. 4. There were no statistically significant differences between the sexes concerning acupuncture. Conclusions: Females were lower than males in several aspects of income and education level and occupation status. Males had a higher subjective health status than did females. Differences by sex of treatment methods and prevalence rates of several diseases existed.

• Journal of Preventive Medicine and Public Health
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• v.41 no.4
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• pp.279-286
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• 2008

Objectives: This study was performed to provide the basic data for establishing countermeasures for preventing injury by analyzing the incidence rates, the risk factors, the characteristics of the injury and the utilization of medical care for mild injury that lasted for two weeks. Methods: We examined the injury survey data among the National Health and Nutrition Survey data. The definition of mild injury that lasted for two weeks was that the injury that caused pain at least once a day for two weeks or the injury for which the usual daily activity of the injured person was severely affected. We used statistical analysis methods such as chi-square test and multiple logistic regression analysis. Results: The incidence rate of injury that lasted for two weeks was 4.7 per 1,000 persons. On the multiple logistic regression, the children and adolescents (OR=3.80, 95%CI=1.63-8.84) had higher rates of injuries than the adults, and the middle and high school (OR=0.51, 95%CI=0.31-0.85) and college(OR=0.34, 95%CI=0.17-0.68) students had lower rates of injuries than the elementary school students. The unemployed (OR=0.39, 95%CI=0.20-0.73) and others (OR=0.38, 95%CI=0.21-0,70) had lower rates of injuries than the blue collar workers. The major causes of injuries were found to be falling and slipping, and the most prevalent place of occurrence was near or at home. Conclusions: A prevention program needs to be developed and continuous education must be offered to the children, adolescents and blue collar workers.

• Korea Journal of Hospital Management
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• v.9 no.2
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• pp.102-127
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• 2004

The objective of this study is to analyze a current trend of and relating factors on profitability of the Korean Public Corporation Medical Centers(KPCMCs, hereinafter, hospitals) in Korea. There are 34 hospitals in Korea as of 2004. Among these hospitals some are red ink hospitals, others are black inks in terms of profitability. Data were collected by Korea Health Industry Development Institute(KHIDI) Statistics for Hospital Management 2000-2002 and Ministry of Health and Welfare(MOHW) financial data of public hospitals which was planned to coordinate public health care services roadmap in the long run. The samples are 32 hospitals. Profitability was measured in the aspect of profit rate with normal profit to total assets, and normal profit to gross revenues as dependent variables in respective. Independent variables were classified by general factors, i.e., location, intern/resident training, period of opening, number of beds, and managerial factors(current ratio, fixed ratio, liability to total assets, total assets turnover, personnel costs, materials cost, administrative cost), and finally factors related to patient treatment(average length of stay, bed occupancy rate, admission ratio of outpatients). The methods of analysis are correlation and multiple regression analysis. This study shows firstly, a lot of hospitals are optimal current ratio. Hospitals in upper 100% current ratio are 81.2%. And the personnel cost in total costs are high. Secondly, the trend of normal profit to gross revenues of hospitals are deteriorating gradually. And lastly, as a result of multiple regression analysis, the factors had on significant effect on normal profit to total assets are fixed ratio(+), liability to total assets(-), bed occupancy rate(+), admissions of outpatients(+), etc. And the factors had on significant effect on normal profit to gross revenues are current ration(+), fixed ratio(+), personnel cost(-), administrative expenses(-), admissions of outpatients(+), etc. In conclusion, to improve the profitability of hospitals, the efforts to reduce personnel cost and average length of stay might be needed. And also beds utilization rate need to be increased.

• Quality Improvement in Health Care
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• v.2 no.1
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• pp.58-67
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• 1995

Background: This paper describes an effort to provide baseline informations for appropriate utilization of emergency room in a tertiary hospital. Methods: Authors have evaluated that the admissions in the emergency room were medically necessary by objective criteria, Appropriateness Evaluation Protocol(AEP), for one month in a tertiary hospital. Data were analysed by chi-square test and multiple logistic regression to exmaine statistical significances at the level of 0.05. Results: The prevalence of inappropriate decisions for admission was found to be 47.8%(154/322). Whether the physician decided the patient to admit or not was affected by type of services, number of departments involved, patients' medical condition, route of visit, and a day of the week visited. Level of appropriateness of admission is significantly related to patients' age, type of services, and a day of the week visited. Conclusion: We found that substantial proportion of admissions through emergency room are medically unnecessary and that non-medical factors are related to physician's for admission decisions and level of appropriateness of admission. This suggests that policy measures be required to relieve the overcrowding problem and to reduce non-emergent utilization of emergency room in a tertiary hospital.

• Journal of Digital Convergence
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• v.15 no.7
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• pp.259-269
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• 2017

This study analyzed medical aid case management effects based on the number of access by visits, phone calls, letters, internal investigation, resource links, and requests, in medical aid case management business that is carried out to improve the quality of life of medical care beneficiaries and reduce financial cost. Secondary analysis study using data of 564 high-risk group in the medical aid case management and their healthcare utilization data. Letters had positive correlations with the scores of all case management domains. The higher visits was, the lower the score of self-health care ability was, and the higher the number of phone calls was, the higher the score for reasonable medical use was. While there was no significant difference in medical cost according to aid management by interventions, the higher visits and resource links were, the lower the subjects' total number of payment days was. There is a difference in the various areas of the quality of health -related life and medical use depending on case management by intervention method and its number. It is necessary to carry out the efficient number of access to case management by intervention method.

• The Journal of the Korea Contents Association
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• v.14 no.8
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• pp.156-171
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• 2014

The purpose of this exploratory study is to examine if the application of smart technology(ST) would assist adjustment to the nursing home facilities in the elderly. Since there is not much previous research on this subject, we generated survey questionnaires on our own. Data were collected from the survey of 127 employees at 6 nursing homes including geriatric care workers, social workers and nurses who provide direct as well as indirect care services. Results showed that the utilization of ST would benefit the areas of family relationship support, health support, leisure support, and physical environment adjustment. As for physical environment adjustment, study participants reported that ST would help elders familiarize employees and find directions for specific space the most. As for health support, ST would be best utilized as a security sensor and program alarm system. As for support for family relationship, ST was expected to be utilized as looking at family pictures and playing with self pictures/videos. As for leisure support, ST was expected to assist elders to listen to music and watch movies/TV. These results were different according to the characteristics of the participants and the smartifacts. These results of the study will show the direction for more in-depth studies on application of smart technology for the elderly in the future.

• Journal of Preventive Medicine and Public Health
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• v.37 no.3
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• pp.260-266
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• 2004

Objectives : To assess the impacts of implementing case payment system (CPS) to Medical Aid (MA) hemodialysis patients on the frequencies and expenditure of dialysis. Methods : Fifty-eight clinics and 35 tertiary care hospitals were identified as having a minimum of 10 hemodialysis patients for each of the MA and Medical Insurance (MI) programs, who received hemodialysis from the same dialysis facilities for both periods of July 2001 and July 2002. From these facilities, a total of 2,167 MA and 2,928 MI patients were identified as the study subjects. Using electronic claims data, the changes in the total number of monthly treatments and charges for outpatient hemodialysis treatments for each patient after the introduction of the CPS were compared between the MA and MI patients. Multiple regression analyses were performed to examine the independent impact of the CPS on the utilization and expenditure of dialysis treatments among the MA patients. Results : There was a significant decrease in the total charges for the hemodialysis treatments of the MA patients, 3.4% (p<0.05), whereas a significant increase was observed for the MI patients, 2.5% (p<0.05). For both the MA and MI patients, the frequency of the monthly hemodialysis treatments were significantly increased, 5.5 (from 12.1 to 12.7) and 7.8% (from 11.6 to 12.5), for the MA and MI patients, respectively. However, a multivariate regression analysis showed no significant difference in the changes in the total number of monthly hemodialysis treatments between the MA and MI patients after implementation of the CPS. Another regression model, regressing on the changes in the monthly claims of dialysis treatments, showed a significant negative coefficient for the MA ((=-70725, p<0.05). Conclusion : The significant decrease in the total charges for hemodialysis treatments among MA as compared to MI patients suggests that there was a cost reduction in the MA program following the introduction of the CPS.