• The Korean Journal of Health Service Management
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• v.8 no.2
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• pp.89-100
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• 2014

The purpose of this study was to reveal association between medical service quality, consumer satisfaction, service value and customer loyalty. Medical service quality was composed of physical quality, personal quality, technical quality, procedural quality. We thought these factors affect to the consumer satisfaction, service value and customer loyalty. For this study, 221 dental patients in Busan and Ulsan are participated in this study. The data were analyzed with descriptive statistics, t-test, ANOVA, pearson's correlation coefficients, and stepwise multiple regression analysis with SPSS 18.0 program. In conclusion, we obtained the next results. First, the influencing factor in consumer satisfaction were physical quality(${\beta}$=.519), personal quality(${\beta}$=.262), procedural quality(${\beta}$=.110), adjusted $R^2$=.537. Second, the influencing factor in service value were physical quality(${\beta}$=.253), personal quality(${\beta}$=.251), technical quality(${\beta}$=.210), procedural quality(${\beta}$=.136), adjusted $R^2$=.401. Third, the influencing factor in customer loyalty were personal quality(${\beta}$=.343), physical quality(${\beta}$=.302), procedural quality(${\beta}$=.148), adjusted $R^2$=.398. As dental patients' desire to medical service quality becomes diversified, the analysis result is considered to help the future dental service management.

• Health Policy and Management
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• v.27 no.2
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• pp.139-148
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• 2017

Background: The purpose of this study is to investigate family caregivers' opinions about out-of-pocket payment for long-term care (LTC) facilities, and find the differences in the opinions for family caregivers of all different levels of income. Methods: We used the data of the study on out-of-pocket payment in national long-term care insurance, including 1,552 family caregivers with the elderly in long-term care facilities. Results: The average out-of-pocket payment per month was 511,635 Korean won and distributed from 230,750 to 1,365,570 Korean won. The amount of out-of-pocket payment might be affected by not co-payment but the cost of non-covered service. There were differences in them for family caregivers of all different levels of income. Opinions were surveyed about 5 issues. By levels of income, there were differences in their opinions about 3 issues, the financial burden on LTC, the necessity of reducing out-of-pocket payments, and to be willing to pay more for a high quality service. But there were not different opinions about the interruption of LTC service and staying with LTC facilities. Conclusion: These findings suggest that the range of out-of-pocket payment for LTC facility is wide and it can be a burden to lower income group. It should be to prepare the policies to ease the financial burden and support the appropriate LTC use.

• Health Policy and Management
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• v.31 no.3
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• pp.301-311
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• 2021

Background: This study purposed to analyze the relationship between the local extinction index and medical service uses of chronic diseases. The local extinction index is an indicator of the demographic structure and population aging of the region. Methods: The 2014-2018 statistics of National Health Insurance Corporation and Korean Statistical Information Service data were used for the analysis. First, descriptive statistics were used to analyze the general status of research variables. Second, a panel analysis was performed to analyze the relationship between the local extinction index and medical service uses of chronic diseases (hypertension, diabetes mellitus, periodontal disease, arthritis, mental health, epidemic disease, liver disease). Medical service uses were measured by the number of visits/inpatient days and medical charges of seven chronic diseases. Results: Panel analysis results showed that higher local extinction risks (meaning lower local extinction index) had a positive relationship with the number of visits/inpatient days and medical charges of chronic diseases. But the relationships were varied when the seven chronic diseases were analyzed separately. Conclusion: This study showed a significant relationship between the local demographic structure and medical service uses of chronic disease. Analyzing the local demographic structure will be an essential prerequisite step for implementing appropriate regional health care policies.

• The Korean Journal of Health Service Management
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• v.11 no.3
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• pp.51-64
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• 2017

Objectives : This study examined the effect of private health insurance on medical care utilization by subscription type. Methods : The data used were the six waves of the Korea Health Panel (2009-2014), and 16,187 persons were the subjects of the analysis. We performed a panel regression with a fixed effects model. Results : Indemnity private health insurance was positively related to the number of physician visits, number of admissions, and total length of stays. However, fixed-benefit private health insurance was not related to medical care utilization. Conclusions : The result of this study, which shows the difference by subscription type in the effect of private health insurance on medical care utilization, suggests that continuous monitoring of indemnity private health insurance is needed in the future.

• The Korean Journal of Health Service Management
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• v.7 no.1
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• pp.45-58
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• 2013

To study the factors related to self-efficacy and health promotion behavior of the late school-aged children, the questionnaire survey was conducted on 285 students from elementary schools in Daegu metropolitan city from September 3 to september 14, 2012. Correlation analysis showed that there was significantly normal correlation between self-efficacy and health promotion behavior of elementary school students and in correlation according to each sub-area, exercise area showed the highest correlation, followed by stress area, self-realization area, personal relations area, eating habits area, and responsibility for health area. It is considered that the level of health promotion behavior in the areas of low stress management and responsibility for health found in the results of the study will be able to be higher if schools and homes prepare so as to enhance the students' belief in health promotion behavior with mental stability by developing the programs for the improvement of eating habits in the group with low self-efficacy and especially, recognizing the necessity of stress management.

• Quality Improvement in Health Care
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• v.26 no.2
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• pp.95-103
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• 2020

Purpose: This study was to examine whether a health care model that provides comprehensive medical services based on population groups to members of the medical cooperative is applicable as a policy alternative in terms of medical use and cost. Methods: Data were derived from National Health Insurance claim data in 2019. We compared the medical volume and expenses of patients who visited social cooperative-type medical clinics with other patients, control group who visited other clinics in a local area. Results: The average number of visit days was 25.3 days in social cooperative-type medical clinics, more than 24.2 days in the control group (p=.004). However, the average medical cost per visit was KRW 46 thousand in social cooperative-type medical clinics, which was significantly lower than KRW 51 thousand in the control group (p<.001), and the total medical cost was also KRW 16.1 billion in social cooperative-type medical clinics and KRW 16.9 billion in the control group. Conclusion: We identified that a population-based health care model might change patients' behaviors to health care services and decrease total medical cost. Further population based experiment is needed to develop alternative healthcare model.

• Health Policy and Management
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• v.33 no.1
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• pp.55-64
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• 2023

Background: Despite the various activities of the regional public hospitals, discussions are being made as to whether or not to continue due to the issue of financial deficit. Therefore, the main factors affecting the fiscal deficit were analyzed with 10-year data. Methods: This study is a panel analysis that analyzed the characteristics of 34 regional public hospitals and influencing factors on medical benefits for 10 years from 2010 to 2019. First, we analyze the determinants of medically vulnerable areas set by the government, analyze the trend of medical profit per 100 beds and medical profit rate from 2010 to 2019, and identify the factors that affect them. Results: Differences in medical profit per 100 beds and medical profit-to-medical profit rate were caused by market share representing regional characteristics, and both indicators improved as the number of outpatients increased. The important influencing variables are the number of doctors and nurses, and both indicators improve when there are specialists, but medical benefits decrease as the number of doctors increases when judged by the number of people per 100 beds. In addition, the number of nurses per 100 beds does not contribute to medical profit and has a negative effect on the medical profit ratio. Conclusion: As only regional characteristics were taken into account for medically vulnerable areas, operational characteristics need to be considered. The greatest impact on the finances of local medical centers is the proper staffing of doctors and nurses, and their efficient arrangement is the most important factor in financial stability.

• Health Policy and Management
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• v.21 no.2
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• pp.263-278
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• 2011

As the competition among hospitals become intensified, hospital management is required to carry out more effective marketing and positioning of the hospital. Successful positioning of a hospital requires the knowledge about how the concrete attributes inherent in the medical service associated with the customer values that customers seek eventually in the medical service. Thus, it is required for hospital management to understand which hospital attributes should be emphasized in order to improve the customer values. The hierarchical structure of service attributes can provide valuable information about effective positioning and advertising. To obtain such knowledge, we employed the order analysis technique as an objective means-end chain method. Order analysis is useful for identifying the causal structure among attributes. Thus, we can examine the underlying causal relationship and eventually the vertical structure of hospital selection attributes. For this study, we conducted a survey to obtain 370 responses for the analysis. The result suggests that hospital management had better increase the scale of hospital, improve the services of health care providers, and modernize the hospital facilities and equipments so as to enhance customer values and eventually to lead them to recommend the hospital to others. Our findings would provide the valuable information for hospital management to develop the more effective hospital positioning and marketing strategies.

• Health Policy and Management
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• v.22 no.4
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• pp.497-521
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• 2012

Objectives This study aimed to investigate the effect of social capital, health risk behavior and health status on medical care utilization by the elderly. The data and Research method Data were obtained from the 4th wave survey of the Korea Welfare Panel Study. 4,087 household members aged 65 years and over were subject to analysis. Descriptive statistics are used to describe the basic features of the data in a study. we performed a structural equation modeling(SEM) analysis to evaluate the effect of social capital and mediating effect of health risk behavior and health status. Results Results showed that factors related to medical care utilization of the elderly were different depending on types of service (inpatient and outpatient service) except health status. Age, higher social capital, more health-risk behavior and poorer health status were associated with increased use of inpatient service. Social capital was found to have a positive direct effect on it. Also, social capital had an indirect effect on reducing use of inpatient services by improving health status. On the other hand, lower age and higher household income tended to increase use of outpatient service, while higher social capital and higher health status were inversely related. Social capital had a direct effect and an indirect effect on reducing use of outpatient service and, at that time, health status played a mediating role. Conclusions Social capital may contribute to improve health status and indirectly reduce medical care utilization of the elderly by enhancing their health status. These results provide evidence that more policy and strategy considerations should be needed for the elderly to strengthen their social capital in order to enhance their levels of health and more efficient utilization of medical care.

• Research in Community and Public Health Nursing
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• v.16 no.1
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• pp.5-12
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• 2005

Purpose: This study was conducted to examine the effect of visiting nursing of the visiting nursing services based on the district management system on the subjects of stroke patients. Method: A nonequivalent control group pretest-posttest design was applied to 50 stroke patients (31 from the experimental group, 19 from the control group). To evaluate the effects of visiting nursing services. health status(SF-36) and activity daily living(ADL/IADL) were measured from June 2003 to November 2004. Result: Health condition and the activities of daily living (ADL/IADL) of the subjects who received visiting nursing service were shown to be improved. Conclusion: Visiting health service model based on the district management system in public health center is considered to be an effective measure of visiting nursing services in large cities.