• Journal of Korean Academy of Nursing Administration
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• v.14 no.3
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• pp.229-240
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• 2008

Purpose: To develop the patient classification system based on the resource utilization for reimbursement of long-term care hospitals in Korea. Method: Health Insurance Review & Assessment Service (HIRA) conducted a survey in July 2006 that included 2,899 patients from 35 long-term care hospitals. To calculate resource utilization, we measured care time of direct care staff (physicians, nursing personnel, physical and occupational therapists, social workers). The survey of patient characteristics included ADL, cognitive and behavioral status, diseases and treatments. Major category criteria was developed by modified delphi method from 9 experts. Each category was divided into 2-3 groups by ADL using tree regression. Relative resource use was expressed as a case mix index (CMI) calculated as a proportion of mean resource use. Result: This patient classification system composed of 6 major categories (ultra high medical care, high medical care, medium medical care, behavioral problem, impaired cognition and reduced physical function) and 11 subgroups by ADL score. The differences of CMI between groups were statistically significant (p<.0001). Homogeneity of groups was examined by total coefficient of variation (CV) of CMI. The range of CV was 29.68-40.77%. Conclusions: This patient classification system is feasible for reimbursement of long-term care hospitals.

• Journal of Society of Preventive Korean Medicine
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• v.22 no.1
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• pp.1-14
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• 2018

Objectives : This study aimed to analyze the characteristics of uninsured herbal medicine(UHM) users and the economic and social barriers of UHM utilization. Methods : We used the Korea Health Panel Data, representative national survey on medical utilization and cost, provided by National Health Insurance Service and Korea Institiute of Health and Social Affairs. The frequency analysis was used to identify the characteristics of the respondents, and the cross-analysis (${\chi}^2-test$) was used to verify the relationship between their characteristics and the usage of UHM. In order to analyze the determinants of using the UHM considering the individual's characteristics, logistic regression analysis and multiple regression analysis were conducted for those who used the Korean medicine (KM) outpatient service in 2015. Results : The usage of UHM was significantly lower for those (1) who's age of 20 to 65; (2) who have the university or higher education degree; (3) who live in Jeju province, and (4) who bought the herbal medicine for other health related purposes. On the other hand, the usage of UHM for those (1) who have the first quintile of household income; (2) who have the chronic respiratory disease; (3) who have been taking the medicine for health promotion purpose for more than 3 months and (4) who have purchased the food which has health promotion function was significantly higher than others. The patients who have chronic musculoskeletal diseases accounted the most among the UHM users. Conclusions : There was the considerable inequality in the usage of UHM among household income groups, which provides policy rationale for UHM to be covered by national health insurance. To facilitate the coverage expansion, restrictive covering model can be considered for children and adolescents, or for patients with muskuloskeletal diseases who have the high demand for UHM.

• Korea Journal of Hospital Management
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• v.24 no.4
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• pp.43-56
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• 2019

Purpose: Importance of patient satisfaction related to patient-centeredness has been emphasized, and it is known to have effect on various health outcomes including health resource utilization. However, the effect of patient satisfaction has been discussed mostly in terms of hospital marketing in Korea. This study aims to examine the effect of patient satisfaction in patient-physician communication on healthcare utilization in a nationally representative adult population of South Korea. Method: Patient satisfaction with physician communication is assessed using 4 items in the 2011 Korea Health Panel Survey. Generalized linear regression analysis is conducted using 9,325 adults' healthcare utilization in 2012. Findings: Adjusting for the socio-demographic, economic factors, individual health status, health behaviors and healthcare utilization in 2011, more satisfied individuals, more likely to utilize the outpatient service, especially in clinical setting. Practical Implications: The study findings suggests that in context of South Korea healthcare system such as insufficient medical consultation time and the absence of health delivery system, patient satisfaction as a subjective healthcare quality indicator would have effect on the individual's outpatient visit. This study contributes to stimulate patient satisfaction research and discussion in South Korea to further explore its relationship with potential and various health related outcomes. Further implications of the study are discussed.

• Journal of agricultural medicine and community health
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• v.25 no.2
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• pp.413-425
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• 2000

The purpose of this study was to compare the health services information need between urban area and rural area in Sooncheon City. For accomplishing this purpose, we selected 1,060 adults randomly, 744 urban residents and 314 rural residents were surveyed from 1st, December to 31st, December in 1999. Compared the difference between two areas by cross tabulation, and chi-square test were used. The results of this study are as follows: 1. There were statistically difference in sociodemographic characteristics between urban residents and rural residents, such as age, education, job, income, and insurance payment(p<0.001). 2. According to the health utilization behavior, types of health facility, satisfaction of medical cost, and satisfaction of medical results were statistically different between the two areas(p<0.001). Also utilization of the health service center, and accessibility were statistically different between urban and rural areas(p<0.001). 3. Experiencing the health service information, type of health service information, methods of information, effectiveness, and satisfaction were statistically different between the two areas(p<0.001). 4. And experience of using computer, and internet and preference of method of health service information were statistically different between urban and rural areas. Therefore, the construction of health information system should be carefully reviewed by community health service centers and they should consider the different residents information needs, and accessibility and convenience of community residents.

• Korean Journal of Clinical Pharmacy
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• v.28 no.2
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• pp.117-123
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• 2018

Background: Prostatitis, one of the most common diseases of the prostate, is a complex disease with various clinical features. This study aims to analyze the utilization and prescribing patterns of antibiotics in Korean patients with prostatitis between 2008 and 2015. Methods: We used the National Health Insurance Database complied from the Health Insurance Review and Assessment Service (HIRA). The outcomes included the number of claims, number of patients, medical cost, and length of stay for each year. In addition, the prescribing patterns of antibiotics, including fluoroquinolone, and low-dose use of ciprofloxacin and levofloxacin were investigated. Results: The total number of patients and medical cost increased by 9.5% and 51.7% from 2008 to 2015, respectively. Most prostatitis patients were classified as chronic prostatitis patients. The prescribing proportion of antibiotics for chronic prostatitis outpatients decreased from 71.0% to 66.9% from 2008 to 2015, and fluoroquinolone accounted for more than half of the total antibiotics. Over 80% of prescription of levofloxacin and ciprofloxacin was identified to be for low-dose use. Conclusion: Most of the patients with prostatitis experienced pain relief and condition improvement after antibiotic treatment; however, chronic prostatitis and chronic pelvic pain syndrome recur easily. Therefore, active disease management and further studies are needed to enhance our understanding of effective treatment for prostatitis.

• Journal of Preventive Medicine and Public Health
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• v.23 no.3 s.31
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• pp.316-323
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• 1990

To analyze of determinants influencing the utilization of the rural health sub-centers (HSCs), 116 of 144 HSCs in Kyong Gi Do, were selected for this study. The self-administered questionnaire covering the environment and the characteristics of doctors working in the HSCs was sent to HSCs by mail. 105 questionnaires were returned of which 88 were completed and use in the study. The dependant variable was the total number of medical care visits to the HSCs from January 1, 1990 to March 31, 1990. Data was analyzed by multiple regression analysis. The results were as follows : First, the more time required to set from the HSCs to nearest hospital or clinic, the higher the utilization of the HSCs. Second, the more geographically accessible the HSCs was, the more utilization the HSCs. Third, the older of the HSCs doctors were, the more utilization of the HSCs. Fourth, the higher frequency of bus service from the HSCs to town, the more utilization of the HSCs. Fifth, the more time required from the HSCs to town, the more utilization of the HSCs. Therefore, the determinants influencing the utilization of the rural HSCs in Kyong-Gi Do, are mostly geographical accessibility of medical care.

• Journal of dental hygiene science
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• v.15 no.1
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• pp.67-76
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• 2015

This study aims to determine the factors affecting the dental service utilization of adults. The subjects in this study were 455 adults, whom a survey was conducted form May 7 to June 7, 2013. Statistical verification conducted through PASW Statistics was 18.0. The difference in the distribution of independent variables related with the dental service utilization was verified with chi-square test. Relevant factors were determined using Hierarchical logistic regression analysis. Model I is predisposing factor, Model II is predisposing factor and enabling factor. Model III is predisposing, enabling, need factor. Andersen model factor which infuences dental service utilization of adults resulted that use dental floss (OR, 2.32; CI, 1.39~3.86), use electric toothbrush (OR, 2.98; CI, 1.0~8.89), use interdental brush (OR, 2.55; CI, 1.36~4.78), self-efficacy (OR, 0.68; CI, 0.48~0.96), barriers (OR, 1.45; CI, 1.04~2.04). Predisposing factor and need factor were found to be determinants for dental service utilization in adult.

• Journal of Digital Convergence
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• v.13 no.8
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• pp.345-356
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• 2015

Health service quality is increasingly emphasized, and primary care service is no exception in this. This study identified patients' perception of quality considering convergence factors associated with increased utilization among patients over the age of 65 using community health centers. A total of 307 respondents were included in the analysis. The results showed that positive perceptions on facility and environment, patient-centered care, technical knowledge and skills of physicians, and emotional support with nurses and non-medical workers were statistically and significantly associated with higher utilization. In order to increase utilization of primary care service at community health centers, they need to manage and improve these factors.

• Korean Journal of Health Education and Promotion
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• v.31 no.3
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• pp.27-37
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• 2014

Objectives: This study aims to identify the factors associated with regular medical services utilization of chronic disease patients. Methods: The research selected 4,489 adults aged over 30, diagnosed with hypertension, diabetes, hyperlipidemia, hypercholesterolemia, from the Korea health panel. We analyzed states of regular medical service utilization using descriptive statistics. Multiple regression analysis was used to examine the main factors associated with regular medical services utilization in chronic disease patients. Results: In terms of socio-demographic factors, gender, age, marital status, education level, employment, household income and disability were significantly different between hypertension, diabetes, hyperlipidemia and hypercholesterolemia. Among health status and behavioral factors, number of chronic diseases, subjective health status, smoking, high risk drinking, regular meals, physical activity, obesity were significantly different. From the multiple logistic regression analysis, age, number of chronic diseases, obesity, type of chronic diseases were associated with regular medical services utilization. Conclusions: It is necessary to develop effective health education programs and individualized approach to improve continuous management in chronic diseases patients.

• Korean Journal of Clinical Pharmacy
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• v.22 no.4
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• pp.291-303
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• 2012

As respiratory tract infections (RTI) account for about 60% of all antibiotic prescriptions in outpatient care setting, there are significant concerns about emerging resistance that are largely due to the excessive or inappropriate use of antibacterial agents for viral respiratory infections. This study was aimed to develop retrospective drug utilization review (DUR) program of antibiotics for RTIs using Delphi methods. Retrospective DUR criteria of antibiotics for RTIs were identified based on clinical practice guidelines and opinion of experts. Expert panel members were clinical doctors and pharmacists and Delphi method was applied by survey on 16 members of panels. The claim data from Korean Health Insurance Review & Assessment (HIRA) were used to examine trends in outpatient antibiotic prescription between Janunary to December of 2008. As results, Quality index for RTI was assessed for the claim type, antibiotics use of quantity, duration, number and cost. Antibiotic prescription rate for RTIs, Defined Daily Dose (DDD), and duration of antibiotics use were more recognized as significant quality index by experts' opinion. Use of first line agents suggested by guidelines was low and duration of antibiotics use was shorter compared to the recommendations. Antibiotics were over prescribed for RITs. However, dose and duration of antibiotics were under-used.