• Journal of the Korean association of regional geographers
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• v.18 no.2
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• pp.203-216
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• 2012

The aim of the research is to lead to suggestions on public health policy, to suggest the direction of accessibility to public health services in rural area through analyzing various health programs and health service system, health care facilities. Nepal's public health policy needs improvement in the quality of the health services as well as accessibility to the services to improve population quality.

• Health Policy and Management
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• v.27 no.3
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• pp.229-240
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• 2017

Background: This study purposed to analyze the spatial accessibility of women in childbearing age to the healthcare organizations (HCOs) providing delivery services in Gangwon-do. Methods: Network analysis was applied to assess the spatial accessibility based on the travel time and road travel distance. Travel time and travel distance were measured between the location of HCOs and the centroid of the smallest administrative areas, eup, myeon, and dong in Gangwon-do. Korean Transport Database Center provided road network GIS (Geographic Information System) Database in 2015 and it was used to build the network dataset. Two types of network analysis, service area analysis and origin-destination (OD)-cost matrix analysis, applied to the created network dataset. Service area analysis defined all-accessible areas that are within a specified time, and OD-cost matrix analysis measured the least-cost paths from the HCOs to the centroids. The visualization of the number of the HCOs and the number of women in childbearing age on the Ganwon-do map and network analysis were performed with ArcGIS ver. 10.0 (ESRI, Redlands, CA, USA). Results: Twenty HCOs were providing delivery services in Gangwon-do in 2016. Over 50% of the women in childbearing age were aged more than 35 years. Service area analysis found that 89.56% of Gangwon-do area took less than 60 minutes to reach any types of HCOs. For tertiary hospitals, about 74.37% of Gangwon-do area took more than 60 minutes. Except Wonju-si and Hoengseong-gun, other regions took more than 60 minutes to reach the tertiary hospital. Especially, Goseong-gun, Donghae-si, Samcheok-si, Sokcho-si, Yanggu-gun, Cheorwon-gun, and Taebaek-si took more than 100 minutes to the tertiary hospital. Conclusion: This study provided that the accessibility toward the tertiary hospital was limited and it may cause problems in high-risk delivery patients such as over 35 years. Health policy makers will need to handle the obstetric accessibility issues in Gangwon-do.

• Journal of Korean Society of Rural Planning
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• v.22 no.1
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• pp.93-100
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• 2016

Land price can be affected by convenience or psychological repulsion like PIMFY (Please In My Front Yard) or NIMBY (Not In My Back Yard) for various facilities. Services related to public establishment, welfare, medical attention, and amenities in rural areas are comparatively poorer than those in urban areas. The purpose of this study is to estimate the implications of the accessibility to community facilities in rural areas for land prices using a hedonic price model. The accessibility to facilities is estimated by real road distances and the land prices are applied for four types of land usages: field, rice paddy, building lots, and village halls. Community facilities are classified from public and community services view: education, safety, culture, transport, environment, health care, and finance. The results show that the accessibility to health care and transport can positively affect land prices and the accessibility to environment (waste facilities and junkyard) and unpleasant services (funeral hall and charnel house) can negatively affect land prices. Especially, the accessibility to hospital is the most positive influential factor for all types of land usages.

• Journal of Korean Academy of Oral Health
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• v.42 no.4
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• pp.167-174
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• 2018

Objectives: The aim of this study was to analyze the accessibility of dental care services among individuals with precarious employment in South Korea. Methods: We used the $9^{th}$ wave of the Korean Health Panel data (2015) and included 7,736 wage and non-wage earners in our study. We determined precariousness in the labor market as a combination of employment relationship and job income, and categorized individuals based on this into the following four groups: Group A comprising those who report job and income security, Group B comprising those who experience job insecurity alone, Group C comprising those who report a stable job but low income, and Group D comprising those who experience both job and income insecurity. Accessibility to dental care services was determined by experience of unmet dental care needs and unmet dental care needs caused primarily by financial burden. Logistic regression analyses were used to assess the effect of precarious work on access to dental care services. Results: Individuals with job insecurity (Group B; OR=1.445; 95% CI=1.22-1.70) and both job and income insecurity (Group D; OR=1.899; 95% CI=1.61-2.24) were more likely to have unmet needs than the comparison group. Both groups B and D were also 2.048 (95% CI=1.57-2.66) times and 4.435 (95% CI =3.46-5.68) times more likely, respectively, to have unmet dental care needs caused by financial burden. Education status, health insurance, and health status were all also effective factors influencing unmet dental care needs. Conclusions: Unstable employment and low income resulted in diminished access to dental care services. Therefore, governments should consider health policy solutions to reduce barriers preventing individuals with employment and income instability from accessing adequate dental care.

• Health Policy and Management
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• v.31 no.2
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• pp.197-206
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• 2021

Background: The purpose of this study was to identify factors affecting unmet healthcare needs due to physical accessibility by residential area by utilizing the Korea Community Health Survey (KCHS). Methods: Andersen's medical service behavioral model was applied to analyze the enabling factors, predisposing factors, and needs factors of unmet healthcare needs focusing on residential areas. This study used data from the KCHS (2017-2019, n=440,792). We used multivariate survey logistic regression analysis in order to identify affecting factors. Sub-group analysis was conducted in order to evaluate the effects of residential areas. Results: Some participants (2,621, 0.59%) had experienced unmet healthcare needs due to physical accessibility and 2,047 subjects (78.1%) of them lived in rural areas. Multivariate survey logistic regressions revealed that experience of unmet healthcare needs due to physical accessibility increased when people lived in rural areas (odds ratio [OR], 3.95; 95% confidence interval, 3.46-4.51). Conclusion: This study showed that despite the development of transportation and efforts to alleviate medical inequality, residents in rural areas may still have higher experience of unmet healthcare needs due to physical accessibility compared to the metropolitan city regardless of any other sub-group differences (OR range, 1.90-6.31). This study suggested that government and policymakers should identify the causes of the experience of unmet healthcare needs due to physical accessibility and should develop policies to alleviate those healthcare disparities.

• Health Policy and Management
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• v.30 no.3
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• pp.399-408
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• 2020

Background: The purpose of this study was to examine the impact of the regional characteristics on the accessibility of emergency care and the impact of emergency medical accessibility on the patients' prognosis and the emergency medical expenditure. Methods: This study used the 13th beta version 1.6 annual data of Korea Health Panel and the statistics from the Korean Statistical Information Service. The sample included 8,119 patients who visited the emergency centers between year 2013 and 2017. The arrival time, which indicated medical access, was used as dependent variable for multi-level analysis. For ordinal logistic regression and multiple regression, the arrival time was used as independent variable while patients' prognosis and emergency medical expenditure were used as dependent variables. Results: The results for the multi-level analysis in both the individual and regional variables showed that as the number of emergency medical institutions per 100 km² area increased, the time required to reach emergency centers significantly decreased. Ordinal logistic regression and multiple regression results showed that as the arrival time increased, the patients' prognosis significantly worsened and the emergency medical expenses significantly increased. Conclusion: In conclusion, the access to emergency care was affected by regional characteristics and affected patient outcomes and emergency medical expenditure.

• Korean Journal of Occupational Health Nursing
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• v.12 no.2
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• pp.110-122
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• 2003

Purpose: The purpose of this study is to make a systemic assessment on the level of self-efficacy, social support, and accessibility to medical services, health status, health promoting behaviors, and the quality of life of workers in small scale enterprises. RECEDE model developed by Green and Kreuter for the purpose of a comprehensive assessment research was used. Method: The number of subjects was 199 workers in small scale enterprises at Youngdeungpo-gu and Sungdonggu, Seoul. Data were collected between October and December, 200 through a self-reported questionnaire. And data were analyzed by descriptive statistics, t-test, and F-test. Result: 1. The level of quality of life was 3.08, and general health status was 2.75. There was no significant difference by sex, age, marital status, job, and perceived health status. 2. The level of health promotion life style was 2.09. There was no significant difference by sex, age, marital status, and job. But there was significant difference by perceived health status. 3. The level of self-efficacy, social support and accessibility to medical services were 3.04, 2.85, and 1.45. Conclusion: The results of this study suggest that it is necessary to develop the systematic health promotion programs that can strengthen self-efficacy and health status, and supplement social support and accessibility to medical services, and to encourage health promoting behavior in order to improve quality of life for workers in small scale enterprise.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.10 no.1
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• pp.5-14
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• 2003

Recently, there has been an increasing need for long-term care and comprehensive health care services in community settings. The Ministry of Health and Welfare introduced the Hospital-Based Home Nursing Care Program in 2000. Before this initiative, there was a Home Nursing Demonstration Center, affiliated with the Seoul Nurse Association, had offered home nursing services with the financial support from the local government. since 1993, the Center's nursing staff has been engaged in a general hospital in an effort to provide home nursing care services within Korea's health care system. The purpose of this study was to analyze and identify characteristics of community-based home nursing care supplied by a community-based home nursing team engaged in a general hospital. Also. visit nursing care services provided by public health centers were evaluated in terms of accessibility and supply versus demand, to enhance the accessibility of low-income patients living in Seoul to home nursing care services. Data were collected from home nursing insurance reimbursement claims submitted by the community-based home nursing care team from March 1 to October 30 in 2001 and a questionnaire survey on home-visit nursing services of 25 public health centers in Seoul. The subjects consisted of 197 patients and 12 public health centers. The result were as follows. First, medical institution's community-based home nursing care program was better in technical quality than health-center-based home-visit nursing care. In addition. the pattern of the subject patients was similar to that of hospital-based home nursing care program. Second, there was a high demand for community-based home nursing care while only a small number of home-visiting nurses served at public health centers in Seoul. As a result, many patients could not receive adequate care. Finally, we suggest that community-based home nursing care program should be introduced in the national health system to meet the at-home care needs of severely ill low-income patients. Furthermore, to better utilize home nursing and visit-nursing care resources and offer continued care for patients in community settings, an efficient referral network should be built among related institutions. This would require improvement of reimbursement system and amendment of the law related to health insurance system and community-based home nursing care services.

• Korea Journal of Hospital Management
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• v.23 no.2
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• pp.28-41
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• 2018

Purpose: This study purposed to analyze the spatial accessibility of mental health institutions in Ganwon-Do using Geographic Information System and to suggest policy implications. Methodology: Network analysis was applied to assess the spatial accessibility of mental health institutions in Gangwon-Do. To perform the network analysis, network data set was built using administrative district map, road network, address of mental health institutions in Gangwon-Do. After building network data set, Two network analysis methods, 1) Service area analysis, 2) Origin Destination cost matrix were applied. Service area analysis calculated accessive areas that were within specified time. And using Origin Destination cost matrix, travel time and road travel distance were calculated between centroids of Eup, Myeon, Dong and the nearest mental health institutions. Result: After the service area analysis, it is estimated that 19.63% of the total areas in Gangwon-Do takes more than 60 minutes to get to clinic institutions. For hospital institutions, 23.08% of the total areas takes more than 60 minutes to get there. And 59.96% of Gangwon-do takes more than 30 minutes to get to general hospitals. The result of Origin-Destination cost matrix showed that most Eup Myeon Dong in Gangwon-Do was connected to the institutions in Wonju-si, Chuncheon-si, Gangneung-si. And it showed that there were large regional variation in time and distance to reach the institutions. Implication: Results showed that there were regional variations of spatial accessibility to the mental health institutions in Gangwon-Do. To solve this problem, Several policy interventions could be applied such as mental health resources allocation plan, telemedicine, providing more closely coordinated services between mental health institutions and community mental health centers to enhance the accessibility.

• Quality Improvement in Health Care
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• v.19 no.2
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• pp.80-88
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• 2013

Objectives: With the increase in the number of people who are marginalized in receiving medical services, the role of Seoul National University Hospital as a public hospital is being emphasized. However, many patients are either experiencing delays in receiving medical services or simply being left out as a result of the inaccessibility to the department of social work on part of both the patients and the medical staff. Methods: In order to increase consultation from other departments and the accessibility to the department of social work for the socially marginalized group through early consultation from other departments, the following steps were taken. First, an orientation program for novice medical residents led by clinical social worker was introduced/implemented. Second, posters and brochures on various financial aids programs were produced and distributed. Third, a system of early screening was built/constructed, and once a week rounds and early screening meeting were executed/carried out. Result: The department of social work's rate of consultation from other departments increased by 4.4% compared to last year, while it showed 61% increase for those wards that had an early screening meeting. In addition, the average time of consultation from other departments was reduced by 3.1 days, securing sufficient amount of time for clinical social work services, both in terms of quality and quantity. Conclusion: It is believed that the various promotional activities, along with the strengthening of accessibility to clinical social work services and early consultation on part of social disadvantaged/marginalized group, would undoubtedly help provide quality services to patients and increase their level of satisfaction. In this way, the wards can effectively reduce the number of unnecessary hospital stay days while the hospital can prevent the accumulation of outstanding bills/fees as well as contribute to the publicness of hospitals. The promotion of clinical social work programs in various ways are crucial to ensuring the satisfaction of patients and hospital staff.