• Journal of The Korea Institute of Healthcare Architecture
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• v.18 no.4
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• pp.39-51
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• 2012

Purpose: Hospitals for patients and their guardians can, from the concept of healing, be removed from just gaining profits, but suggest a future-oriented direction for the hospital. Accordingly, there have been studies related to the selection of hospitals, but most were related to preference and satisfaction, and only recently did research from the concept of tradeoffs of factors for selection began to grow rapidly. Methods: From this context, this study evaluates the level of importance for factors of selecting hospitals using the analytical hierarchy process, and identifies the correlation with users, gender, age group, and outpatient features in order to identify the difference of awareness among different groups for selecting hospitals. In the factors for selection 26 factors in six categories were set through studies of preceding research, and after surveying 144 people, the following results were attained. Results: 1) The overall analysis results were found in the order of medical level, medical service, and fame, and low for facilities, which is similar to the cases of preceding studies. 2) For user analysis, it was similar between patients and guardians, but there was a slight difference in awareness among nurses, who are also medical service providers. Nurses showed relatively high level of importance in direct factors such as medical technologies and medical services, while guardians of patients showed higher importance in indirect factors such as facility environments and convenience. 3) Women showed higher assessments of importance levels in environmental factors, while men in physical factors. 4) The older the age group, the lower level importance there was on medical level, while the importance on fame reduced the further the commute to the hospital was.

• Health Policy and Management
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• v.21 no.3
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• pp.397-413
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• 2011

Purpose: The purpose of this study is to examine the relationship between the income level and the healthcare utilization by health insurance type in all cancer patients in year 2005. Methods: The target population was cancer patients with health insurance who used healthcare as a diagnosis code (C00-C97) from January 1 to December 31 of 2005. The Korea Central Cancer Registry Center's Cancer Patient Registry Data, the list of cancer patients of the National Health Insurance Corporation, and the claim data of the Health Insurance Review & Assessment Service were used. The I was the wealthiest, followed by II, III, IV. The V was the poorest in this study. For the analysis, the $x^2$-test, ANOVA (and Kruskal-Wallis test), and regression were used. Results: Outpatient and hospitalization medical expenses, and outpatient visit days of cancer patients with self-employed health insurance were highest in I (p<.001, respectively), and the hospitalization days were the highest in II (p<.001, respectively). Outpatient and hospitalization medical expenses, and outpatient visit and hospitalization days of cancer patients with occupational health insurance were the highest in I (p<.001, respectively). Outpatient and hospitalization medical expenses, and outpatient visit and hospitalization days in cancer patients were higher in I compared to V, and higher in II and III, IV compared to V (p<.001, respectively). Conclusion: Supporting plan for cancer patients' outpatient healthcare utilization are necessary. Moreover, we should make specialized strategy for low income cancer patients with self-employed health insurance when we develop quality improvement policy for inpatient service.

• Quality Improvement in Health Care
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• v.5 no.2
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• pp.176-189
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• 1998

This study was conducted to evaluate the subjective ideas about the determinants of quality in ambulatory care unit among outpatients and medical staff of a university hospital, and to compare the differences of the ideas, between patients themselves and hospital staff. A self-administered questionnaire survey was conducted covering 799 outpatients and 190 hospital staff in March, 1998. The questionnaire included general characteristics and 26 determinants of ambulatory care quality. The following are summaries of the findings: 1. Both of outpatients and hospital staff perceived, "Physician's knowledge" as the most important determinant of medical care quality. 2. In respect of 7 determinants related to physician's knowledge and skill, both outpatients and hospital staff perceived "physician's knowledge and skill" as important determinants. The scores of determinants such as, "Not doing unnecessary examinations", and "Assignment of adequate number of patients and duty schedule for the physician" were significantly different between outpatients and hospital staff. 3. In respect of 4 determinants related to doctor-patient relationship, both outpatients and hospital staff perceived "attention to patient's complaints" as the most important determinant. The scores related to the determinants such as "kindness of physician" and "explanation of treatment outcome" were significantly different between outpatients and hospital staff. 4. Among the amenities related determinants, "Modern facilities and equipments" were perceived as the most important determinant in both group. 5. In respect of 8 determinants related to non-financial accommodation, outpatients perceived, "Waiting hours for treatment" as the most important determinant, and hospital staff perceived, "Kindness of hospital staff". 6. In respect of 4 determinants related to financial accommodation, outpatients perceived, "Fare account of medical cost" as the most important determinant, and hospital staff perceived, "Increasing reimbursements". Further comprehensive research should be made on the evaluation of perceptions of medical care quality, both of outpatient and inpatient care, among patients and hospital staff. So good quality in medical care will be achieved based on clients' needs.

• Health Policy and Management
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• v.6 no.1
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• pp.110-143
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• 1996

The purpose of this study is to assess the extent of inequality in health outcomes and the distribution of health services according to health need under National Health Insurance System in Korea. For the empirical analysis, data were collected through an interview survey during one month of October, 1994. Interview were conducted with a total of 10, 875 of the employees and the self-employed selected through cluster, systematic sampling. The major findings of this research are as follows: 1. The analysis of the differentials in morbidity rates by socio-economic group showed that health inequality in the pro-higher groups existed in all self-reported morbidity indicators. 2. The findings of the conventional use measures showed that the lower socio-economic groups had more ambulatory and inpatient services than the higher groups. In contrast to the level of the medical care utilization, however, the higher socio-economic groups were more likely to use the high-quality source of care in terms of their treatment place compared to the lower groups. 3. By using the need-based use measures, the results were different from each use-disability ration indicator. Using the use-disability ration measured by physician visits per 100 restricted-activity days in the population, it was found that there was no evidence favoring the higher socio-economic groups. In contrast, the use-disability ration based on physician visits per a chronic patient in one year displayed that there was remarkable relative difference by income group as well as the evidence of the pro-higher income groups. 4. The results of logistic regression analysis and two-stage estimation method indicated that although the utilization is significantly affected by type and duration of insurance coverage, the use or nonuse of service and the volume of physician care consumed is determined by health need and demographic characteristics rater than economic status. In sum, these findings suggest that physician service is equitably distributed according to health need under national health insurance system in Korea. As there were some evidences of inequality including the differential in physician visits of chronic patients by income group, however, the government should strengthen the activities to guarantee the equity of health services utilization.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.4
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• pp.2726-2736
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• 2015

This study aimed to investigate the determinants of patients satisfaction and intent to revisit oriental medical hospitals. The level of overall patient satisfaction was used as an intervening variable and the level of intent to revisit was used as a dependent variable. The sample used in this study consisted of 578 patients from 3 oriental medical hospitals located in Chungnam Province. Data were collected from October 2014 to December 2014 with a structured and self-administrated questionnaire and analysed using path analysis. The results of the study indicate that oriental medical hospitals should make an effort to improve the overall satisfaction of patients, in the case of outpatient, especially focusing on the doctors' service and medical procedure, and in the case of inpatient, especially focusing on the facilities convenience, medical price and hospital ward life which will lead to high level of intent to revisit of patients.

• Korea Journal of Hospital Management
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• v.25 no.3
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• pp.29-37
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• 2020

Purposes: The purpose of this study was to identify the factors related to the long-stay hospitalization of dementia patients aged 65 years or older who had received inpatient care at geriatric hospitals according to the minute facility characteristics and patient features. Methodology: This study was conducted on 317,353 cases of 1,512 geriatric hospitals using the Health Insurance Review and Assessment Service dataset. The data collected were processed using the SAS Enterprise Guide 4.3 for descriptive statistics, the chi-square test, and the binary logistic regression analysis. Findings: As a result of the study, in the facility characteristics of geriatric hospitals, the long-stay hospitalization of the aged with dementia were found to be related to the type of facility establishment, the number of hospital beds, the number of medical specialists, the number of nursing personnel, and the number of geriatric hospitals by region and province. In the personal features of patients, the long-stay hospitalization was found to be associated with the gender, age, insurance, and the patient classification groups. Practical Implication: Considering the results of this study, it seems that securing the sufficient medical personnel in a geriatric facility, providing the good quality medical services, and preparing the appropriate discharge plan can reduce the unnecessary long-stay hospitalization and spend the medical expenses for the older patients.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.11
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• pp.4968-4979
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• 2011

The purpose of this study was to investigate the effects of Socioeconomic factors on medical information resources when medical consumer choose inpatient or outpatient services. The target population was 12,249 people aged above 19 in Chungcheongbuk-do. The sample was accrued for the period of 3 months in 2008 by face to face interview of direct visiting from systematic sampling method. There was a significant difference in the use of personal informer and public informer by sex(p<0.001). There was a significant difference in the use of experimental and professional informer by living area(p<0.001). In conclusion, the results suggest that there is relationship between medical information resource and socioeconomic factors of medical consumer.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.34 no.2
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• pp.21-37
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• 2021

Objectives : Allergic rhinitis(AR) is a common chronic disease that accounts for 10-40% of the world's population. This study aims to analyze the status of claims, prevalence, and medical utilization of allergic rhinitis patients using representative patients sample data. Methods : This study used the National Patients Sample(HIRA-NPS) of the Health Insurance Review and Assessment Service for 7 years(2010-2016). And we defined AR patients as all statements including J30 or a subcategory of J30 as the main disease, using the Korean Standard Classification of Diseases(KCD-7). The trend of AR patients by year was divided into Western medicine(WM) and Korean medicine(KM), and analyzed by subgroup analysis such as inpatient/outpatient, gender, age, insurance type, and care institution. Results : Patients with AR were mainly claimed for first sub diagnosis in WM and major diagnosis in KM, and the number of claims increased about 1.3 times and 1.4 times compared to 2010 in WM and KM, respectively. In addition, the total annual medical expenses in 2016 increased 1.3 times and 1.7 times compared to 2010, respectively. Conclusions : Both WM and KM are showing a steadily increasing trend in medical use due to allergic rhinitis. Further research is needed by considering genetic and environmental factors and individual characteristics, and linking with additional data.

• Health Policy and Management
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• v.34 no.1
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• pp.94-102
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• 2024

Background: There is controversy surrounding the claim that current nursing workforce policies exacerbate the geographic imbalance of nurses in Korea, but very few studies have confirmed this assertion. Therefore, this study aimed to identify factors influencing the distribution of nurses at the regional level, including variables related to nursing workforce policies. Methods: This study analyzed the distribution of 225,462 practicing nurses across 250 regions in Korea as of 2020. National statistics were collected for these 250 regions, and regression analysis was conducted. Results: Factors influencing the distribution of practicing nurses included the number of annual inpatient days, integrated nursing care service beds, public healthcare institutions, tertiary hospitals, and general hospitals. Additionally, the number of nursing graduates and healthcare institutions with nurse staffing grade 1 and 2 had an impact on nurse distribution in non-capital regions. Conclusion: To prevent exacerbating the geographic imbalance of nurses, careful decisions should be made regarding the expansion of integrated nursing care service beds. Furthermore, it is necessary to increase the number of nursing students in non-capital regions and prioritize the improvement of wages and working conditions for nurses in those areas.

• Journal of the Korean Data and Information Science Society
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• v.25 no.1
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• pp.37-52
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• 2014

The aim of this study was to understand home hospice care status and problem in Korea, and ultimately to develop the home hospice standard. This study was conducted as a part of a study on the institutionalization of the home hospice in Korea. A focus group interview with representatives of seven home hospice agency where have provided home hospice service for years was conducted. All of the participants agreed to the essential components for home hospice service including 24 hour on call service, multidisciplinary team visiting, and periodical team meeting. Visiting frequency was 1-3 times per week mostly by nurses. And they agreed requisitely to fulfill an office for home visiting nurses, storage space, and home visiting bags. The obstacles of providing home hospice were 1) no reimbursement system, 2) difficulties to change medication at home, 3) lack of inpatient beds for symptom control. Standardization of home hospice is critical to improve service quality and to develop reimbursement system. The findings of this study could be used as a basic data to develop home hospice standards and guidelines.