• Journal of Preventive Medicine and Public Health
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• 제11권1호
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• pp.41-48
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• 1978

To examine the result of the government Medical Aid Program which began in January, 1977 as a part of social security policy implementation, all the medical records of the clients and official statistics in the year were analysed. The specific objectives this study pursues include the magnitudes and patterns of morbidity and utilization, and the characteristics of clients. One Korean rural area, Koje county was selected as the study area and subsequently all the clinics and hospitals assigned to work out the Aid Program are the subjects for the survey. A brief summary of the sutdy results as follows: a. The clients of Koje county are 6.4% of the total population in the area, more than the average percentage of the clients in Korea. It reflects on low level of economic status of the residents of the area. b. The population structure of the clients indicates that the large proportions of young and old age group are overwhelming, while the middle age group share very small portions. c. The utilization rates for primary care are 2.0 persons, 11.6 visits and 22.6 treatment days per 100 persons per months. Annual hospitalization is rated as 13.7 cases and 164 days per 1,000 persons, The utilization rates are slightly lower than those expected rates during planning period but eventually become higher than those of general population in rural Korea. d. The factors which influence the utilization rates are identified with client group (low income vs indigent), age and sex. e. The utilization pattern for primary care demonstrates seasonal variation similar to the pattern of general rural population in the low income group, but none in the indigent group. f. The most common diseases revealed at the primary care clinics are the acute respiratory infection (26.9%), acute gastritis (10.8%), skin and subcutaneous infection (6.8%). The cases of acute conditions are outnumbered than the cases of chronic condition. 8. The clinics, hospitals and other related health institutions are well cooperated in dealing health care services in their own capacities. Considering the above results Medical Aid Program generated satisfactory results at least in the utilization aspect.

• Journal of Preventive Medicine and Public Health
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• 제23권3호
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• pp.345-357
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• 1990

Accumulated data on medical care utilization among the insured in Korea Medical Insurance Corporation can explain the health status of the population. The purpose of this study was to analyze a change of the disease-mix and utilization pattern by controlling the size of the population enrollment. Major findings of the study are as follows : 1. The changes of inpatient disease-mix a. Utilization rate was 139.2% in 1988 against 1980. b. Disease groups higher than the average utilization rate included neoplasms, endocrine, nutritional and metabolic diseases and immunity disorders, mental disorders etc. Meanwhile, disease groups seen less often were infections and parasistic diseases, diseases of blood and bloodforming, diseases of the digestive system etc. c. Utilization rate was up 106.3% in 1988 compared to 1985, and diseases above that average level were ill-defined intestinal infections, chronic liver disease and cirrhosis, diabetes mellitus, essential hypertension, etc. d. The disease-mix by institution in 1988 compared to 1985 shows that chronic disorders rank high in general hospitals whereas opthalmologic, obstetric, and orthopedic diseases rank high in private clinics. 2. The changes of outpatient disease-mix a. Utilization rate was up 175.2% in 1988 compared to 1980. b. Disease groups higher than the average utilization rate included neoplasms, endocrine, nutritional and metabolic diseases and immunity disorders, mental disorders etc. And disease groups seen less often were infections and parasistic diseases, diseases of the respiratory system, diseases of the genitourinary system. etc. c. Utilization rate was up 104.0% in 1988 compared to 1985, and diseases above that average level were gastric ulcer, diseases of hard tissues of teeth, etc. And diseases seen below that average level were acute nasopharyngitis(common cold). acute upper respiratory infections of multiple or unspecified sites, etc. It was concluded that medical care utilization level was increased, and that, from 1980 to 1988, disease-mix shifted to the chronic disorders. Chronic disorders accounted for more medical care utilization in general hospitals.

• Journal of Preventive Medicine and Public Health
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• 제31권4호
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• pp.814-827
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• 1998

In this study we analyzed the insurance claims data to investigate the medical care utilization pattern of tuberculosis patients in private sector. We selected the claims of principal or secondary diagnosis with tuberculosis from claims database of National federation of Medical Insurance, from December 1995 to November 1996. Both spell-based analysis and person-based analysis were carried out. In spell-based analysis, type and location of treatment facilities, distribution of diagnoses, number of outpatient/inpatient treatments were analyzed. Additionally in person-based analysis, number of tuberculosis patients, demographic characteristics, number of treatments per person, frequency and pattern of change in source of care were analyzed. The results were as follows 1. The number of treatments with tuberculosis was 863,641 from 1 December 1995 to 30 November 1996. The number of patients was 313.964. 2. Most of tuberculosis patients in private sector were treated in general hospital (45.8%) and clinics(42.2%) 3. About 77.7% of tuberculosis patients who were treated more than two times did not change the source of care. 18,9% of tuberculosis patients changed source of care only once. Even when we limited tuberculosis patient to those who were treated more than five times and whose treatment period were longer than six months, 94.7% of patients did not change source of care at all, or changed treatment facility only once. 4. The probability of change in source of rare was higher in pulmonary tuberculosis, in twenties, and in rural area respectively than other tuberculosis. In conclusion, healer shopping of tuberculosis patients was not serious as expected. However special attention is needed to pulmonary tuberculosis in twenties and rural area.

• 보건교육건강증진학회지
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• 제18권1호
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• pp.139-149
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• 2001

With the increasing number of women involved in social activities, beauty industry has flourished. More women than ever before are concerned about make-up, hair care, skin care, and weight control, etc. With the success and commercialization of beauty industry, unconfirmed beauty care services have been introduced in the market. However, the health hazard from diverse beauty care services has not been systematically addressed. This study has the following two purposes: 1) to examine the utilization pattern of diverse beauty care services; and 2) to examine the health hazard from beauty care services. For this study, two major universities located in Seoul area were selected. While 450 female college students were selected from one women's university, the other 450 were from mixed university. Using survey questionnaire, we interviewed with 900 female college students. The results are as follows: As for the beauty care patterns, makeup accounted for 78.6％, Skin care 49.5％, weight/body control 32.0％, hair care 81.5％, and cosmetic operation 14.9％, indicating significant high rates of makeup(x2=9.215, p=0.002) and hair care(x2=4.435, p=0.035) at both mixed and women's universities. The health hazard was measured using four questions. The past studies have not paid special attention to the methodological issue of how to ask health hazard. Depending on how to ask health hazard, the percentage of respondents reporting health problems varied. When the respondents were asked whether or not they had suffered health problems for a short period, over 60％ of respondents reported health problems; when they were asked in other ways-1) whether or not they had suffered health problems for a long period, 2) whether or not they had suffered whole body problems, 3) whether or not they had permanent traces on skin due to beauty care activities-, the percentage of respondents reporting health problems dropped substantially to less than 10％, This finding indicates the importance of ‘words’ used in questions. The relationships between health problems and utilization of beauty care services were examined, using χ2 test or t test. We found that there was a significant relationship between health problem and beauty care.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 1995년도 제47차 추계 학술대회 연제집
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• pp.167-168
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• 1995

• 대한치과교정학회지
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• 제48권4호
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• pp.216-223
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• 2018

Objective: This study is performed to investigate the trend of health care (HC) utilization among cleft lip and/or palate (CL/P) during 2007-2016 by using data from the Korean National Health Insurance Service (KNHIS). Methods: The KNHIS data were reorganized to count a specific patient only once for a specific year. Cleft type (cleft lip [CL], cleft palate [CP], and cleft lip and palate [CLP]), sex, and age at HC utilization were investigated. The study period was divided into the first half (2007-2011) and the last half (2012-2016). The utilization number and rate per 1,000 population were calculated for the total population and for new-born patients. Independent t-test and one-way analysis of variance were used for statistical analyses. Results: The total CL/P population (n = 48,707) comprised 19.2% CLP, 35.5% CL, and 45.3% CP (CLP < CL < CP; p < 0.001). Their HC utilization rate increased from 0.066 in 2007 to 0.118 in 2016. The new-born patient population (n = 7,617) comprised 18.6% CLP, 30.4% CL, and 51.0% CP (CLP < CL < CP; p < 0.001). Their HC utilization rate increased from 1.12 in 2007 to 1.74 in 2016. An examination of the utilization number and rate among new-born patients revealed CP exhibited a female-dominant pattern (all p < 0.01), while CL and CLP exhibited a male-dominant pattern (all p < 0.01). However, utilization number showed no difference by sex and cleft type between 2007-2011 and 2012-2016. Conclusions: These results might serve as a guideline for HC utilization among patients with CL/P.

• 농촌의학ㆍ지역보건
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• 제28권2호
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• pp.87-105
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• 2003

2002년도 군위군 내 30세 이상 저소득주민을 대상으로 건강검진을 실시한 결과 유소견자로 판정된 263명에 대하여 설문지를 이용하여 추후의료기관 이용여부와 관련요인을 조사 분석하였다. 대상자의 추후의료기관 이용률은 51.0%이었으며, 미이용률은 49.0%이었다. 단순분석결과, 추후의료기관 이용률은 소인성 요인에 있어서는 남자의 경우, 건강관심도가 높은 경우, 질병이 오는 이유가 팔자나 운명적이지 않다는 경우, 검진이 건강에 도움이 된다는 경우, 검진결과를 통보 받을 당시 느낌이 걱정된다는 경우가 의료기관 이용률이 높았다(P<0.05). 가능성 요인에서는 의료보장형태가 의료급여인 경우, 과거 2년간 건강검진 경험이 있는 경우, 단골의료기관이 있는 경우, 검진결과를 인지하는 가족이 있는 경우에 추후의료기관 이용률이 높았다(P<0.05). 필요성 요인에서는 검진결과를 본인이 인지한 경우, 판정결과가 건강에 심각하다는 경우, 검진결과를 통보받는 방법이 우편과 전화통보를 받은 경우, 검진결과에 대한 가족반응이 있는 경우, 보건지도가 있는 경우가 추후의료기관 이용률이 유의하게 높았다(P<0.01). 의료기관 이용여부를 종속변수로 하고 단순분석에서 유의한 관련이 있는 변수를 독립변수로 한 다중 로지스틱 회귀분석 결과, 판정결과를 받을 당시 느낌이 걱정이 된 경우, 의료보장형태가 의료급여의 경우 (P<0.05), 과거 2년간 검진경험이 있는 경우(P<0.05), 검진결과에 대한 가족의 반응이 있는 경우(P<0.01)가 의료기관을 더 이용하였다. 추후 의료기관을 이용한 방문시점은 통보 후 8-15일이 가장 높았고 그 다음이 16-30일 순이었다. 재검결과 당초와 같은 질환이 69.4%, 정상이 23.1%, 당초와 다른 질환이 7.5%이였으며, 정밀검사 후 치료유형에서는 규칙적 치료가 39.6%로 가장 높았으며, 치료하지 않은 경우가 34.4%, 치료중단이 11.8%이었다. 추후의료기관을 이용하지 않은 이유는 가벼운 질환인 것 같아서가 32.4%로 가장 높았으며, 일 때문에 시간이 없어서, 결과가 정상이라서, 이전부터 알고 있는 질병으로 치료 중이어서 순이었다. 이상의 결과, 저소득층의 건강검진 실시 후 의료이용 제고와 사후관리를 위해서는 국가와 검진기관, 보건기관, 가족 등이 연대가 되어야 하겠다. 국가에서는 차상위계층의 의료이용문제점을 해결하여 의료이용의 형평성과 효율성을 높이도록 하여야 하며, 검진기관과 보건기관에서는 건강검진 전에 검진의 필요성, 의의, 올바른 수검지도를 실시하고, 건강검진 통보 시에는 유소견자에 대해서는 방문 등을 통하여 추후관리를 하는 것이 의료기관 이용률을 높일 수 있을 것이다. 그리고 건강검진 결과에 대한 올바른 해석, 의료이용의 필요성, 해당 질환에 대한 정보에 대해 본인 뿐만 아니라 가족을 포함한 보건지도가 있어야 하겠다.

• 약학회지
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• 제47권4호
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• pp.244-251
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• 2003

Asthma is a chronic inflammatory disease of the airway and the prevalence rate is increasing. As the burden of asthma to the society is significant due to the increasing hospital admissions and emergency visits, National Heart, Lung and Blood Institute (NHLBI, USA) and World Health Organization (WHO) have developed comprehensive guidelines to help clinicians and patients make appropriate decisions about asthma care. The aim of study was to analyze the pattern of asthma prescriptions based on the national asthma guidelines for the patients visiting primary health care providers. Prescription data for asthma were obtained from the Korean National Health Insurance claims database of January 2002. Ten percent of the primary health care providers were sampled based on their specialty areas, and 20％ of the claim cases were randomly chosen. Study results showed that prescription rate for oral beta-2 agonists was 44.3％, and that for oral theophylline was 46.9％. Oral steroids were prescribed for the 28.2％ of the claims. Utilization of inhalers was low for both bronchodilators (20.3％, beta-2 agonists inhalers), and steroids (8.4％ steroids inhalers). Bronchodilators were more preferred to the longterm anti-inflammatory controllers among the primary health care providers. Prescription rate for antibiotics was 46.0％ for asthmatic patients. Also gastrointestinal drugs were prescribed for 59.0％, antitussives 65.3％, antihistamines 25.3％ and analgesics 29.4％, respectively. This study presented that the prescribing pattern of the primary health care providers for the asthma was quite different from the national and international guidelines. More efforts need to be made to reduce the gap between the present pattern of asthma prescription and the guidelines.

• Journal of Preventive Medicine and Public Health
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• 제46권3호
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• pp.147-154
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• 2013

Objectives: Many epidemiological studies have suggested that a variety of medical illnesses are associated with suicide. Investigating the time-varying pattern of medical care utilization prior to death in suicides motivated by physical illnesses would be helpful for developing suicide prevention programs for patients with physical illnesses. Methods: Suicides motivated by physical illnesses were identified by the investigator's note from the National Police Agency, which was linked to the data from the Health Insurance Review and Assessment. We investigated the time-varying patterns of medical care utilization during 1 year prior to suicide using repeated-measures data analysis after adjustment for age, gender, area of residence, and socioeconomic status. Results: Among 1994 suicides for physical illness, 1893 (94.9%) suicides contacted any medical care services and 445 (22.3%) suicides contacted mental health care during 1 year prior to suicide. The number of medical care visits and individual medical expenditures increased as the date of suicide approached (p<0.001). The number of medical care visits for psychiatric disorders prior to suicide significantly increased only in 40- to 64-year-old men (p=0.002), women <40 years old (p=0.011) and women 40 to 64 years old (p= 0.021) after adjustment for residence, socioeconomic status, and morbidity. Conclusions: Most of the suicides motivated by physical illnesses contacted medical care during 1 year prior to suicide, but many of them did not undergo psychiatric evaluation. This underscores the need for programs to provide psychosocial support to patients with physical illnesses.

• 농촌의학ㆍ지역보건
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• 제15권2호
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• pp.118-129
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• 1990

Socioeconomic status in this county progressed rapidly, this has brought about many changes in health care fields, namely, pattern of disease prevalence and morbidity, increase of the aged people, and also availability of health care in rural areas. According to the utilization study of medical care, it showed that the oriental medicine is used for the treatment of lasted chronic disease not the minor and common diseases which is quick in its effect. Particularly, in rural areas. prevalence of chronic disease is higher than that in urban areas. Although the health cafe need of the oriental medicine is high in rural areas, the distribution of manpower and facilities is lower than that in urban areas. Therefore the government has planned to implement the demonstration project for the oriental medicine at the designated 3 health centers in rural areas. The purpose of this study was to collect the utilization level of oriental medical care of the people in rural areas. To meet the purpose of this study, patient interview were applied. 790 patients visited to health center in project areas were selected and analyzed by experienced interviewers from 2 April to 21 April 1990. The major findings of this study were as follows ; 1) Of the 790 patients, 32.6 percent of the respondents had experience of using the oriental medicine. As for the utilization by age and sex. 54.8% of those was female and 70.7% was 40 years of age and more. 2) Reaction to the question of educational achievement showed that on schooling and primary school graduates accounted for 63.1%. 3) The most user of oriental medicine resides in country level, where the health center is located, and 80 percent of those users resides within 10Km. 4) More than 50% of the total was the chronic diseases which lingered for more than 3months. 5) 32.6 percent of the total cases used the oriental medicine. 61.2% among those was treated by oriental medical care hospital and 38.8% by oriental drug dispensaries etc. 6) The contont of oriental medical care varied ; 50.1% for prescription of herb drugs for treatment, 25.1% for health maintenance and 23.9% for acupuncture, moxibustion etc. 7) As for the motivation for using the oriental medicine. 56.6% of the respondents was for treatment of diseases and 27.9% wes for strengthening the physical weakness. 8) As for the effectiveness of the oriental medicine. 70.3% of the total cases satisfied with that treatment and 84.2% of the total cases will use the oriental medicine when is provided by health center.