• Journal of Korean Academy of Nursing
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• v.15 no.2
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• pp.5-15
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• 1985

This study was conducted for the purpose of fin-ding out the variance explaining the medical facilities utilization behavior, which is defined adaptation behavior Process by focal, contextual, residual stimuli in Roy's Adaptation Model. What kinds of characteristics can explain adaptation behavior in Roy's Model? And which is the relative importance of input variables? For this analysis, stepwise multiple regression and path analysis was used. The data come from the 1981 Baseline Household Interview Survey in remote rural area. The findings of the analysis can be summarized as follows: First, Total variance of independant variables for adaptation behavior, that is medical facilities utilization including clinic, drug store, health center, herb medicine was shown 16.2 percent. The most important variable which explain the dependent variable was the occurance of illness with the Ra of value 0.112. The illness symptom, living level, regular care source was shown important variables with relatively high the R²value and significant beta coefficient. Second, in the path analysis of variables which is selected important variables, the occurance of illness was shown variable which has the highest direct effect which 0.297 path coefficient. Also the education level of household was shown variable which has the highest indirect effect through living level and the occurance of illness in causal model. Third, This analysis suggests that the occurance of illness belonging focal stimuli are more influenced than others. To sum up, It is seem to the occurance of illness, illness symptom belonging focal stimuli have high explanation ability through direct effect, education level of household among contextual stimuli have explanation ability through indirect effect.

• Health Policy and Management
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• v.4 no.2
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• pp.58-76
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• 1994

In order to study factors affecting the use of the ambulatory physician services. Andersen's model for health utilization was modified by adding the health behavior component and examined with three different approaches. Three different approaches were the multiople regression model, logistic regression model, and LISREL model. For multiple regression, dependent variable was reported illness-related visits to a physician during past one year and independent variables are variaous variables measuring predisposing factor, enabling factor, need factor and health behavior. For the logistic regression, dependent variable was visit or no-visit to a physician during past one year and independent variables were same as the multiple regression analysis. For the LISREL, five endogenous variables of health utiliztion, predisposing factor, enabling factor, need factor, and health behavior and 20 exogeneous variables which measures five endogenous variables were used. According to the multiple regression analysis, chronic illness, health status, perceived health status of the need factor; residence, sex, age, marital status, education of the predisposing factor ; health insurance, usual source for medical care of enabling factor were the siginificant exploratory variables for the health utilization. Out of the logistic regression analysis, health status, chronic illness, residence, marital status, education, drinking, use of health aid were found to be significant exploratory variables. From LISREL, need factor affect utilization most following by predisposing factor, enabling factor and health behavior. For LISREL model, age, education, and residence for predisposing factor; health status, chronic illess, and perceived health status for need factor; medical insurance for enabling factor; and doing any kind of health behavior for the health behavior were found as the significant observed variables for each theoretical variables.

• Health Policy and Management
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• v.32 no.2
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• pp.205-215
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• 2022

Background: The purpose of this study is to identify the factors infecting the medical care utilization from a new perspective by newly classifying the categories of administrative districts using the urban decline index and medical vulnerability index as indicators. Methods: This study targeted 150,940 people who used medical services using the 2015 cohort database (DB), 2010-2015 urban regeneration analysis index DB, and 2014-2015 public health and medical statistics DB. The decline of the region was classified using the urban decline index typed using k-means clustering and the medical vulnerability index typed using the quantile score calculation. Regression analysis was performed 3 times with medical expenditure, length of stay, and the number of outpatient visits as dependent variables. Results: There were 37 stable region (47.4%), 29 health vulnerable region (37.2%), and 12 decline region (15.4%). The health vulnerable region had lower medical expenditure, fewer outpatient visits, and a higher length of stay than the stable region. The decline region was all higher than the stable region but had no significant effect. Conclusion: The factors that cause the health disparity between regions are not only factors related to individual health behavior but also environmental factors of the local community. Therefore, there is a need for a systematic alternative that properly considers the resources within the community and reflects the characteristics of the population.

• Korea Journal of Hospital Management
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• v.12 no.4
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• pp.1-21
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• 2007

The relaxation of the regulation in selection of medical institution allows patients to use their own judgement in choosing proper institution for their diseases. Since the change of the regulation, there should have been many changes in medical institution selection behavior. The analysis of the change in disease specific selection pattern is critical because there be an optimal selection criteria that ensure the efficient and effective utilization of medical resources. This study analysis the institution selection factors by comparing the choice among the cases of acute diseases, the cases of chronic diseases, inpatient services, outpatient services, and emergency medical service. The comparisons performed in terms of size, class and other characteristics of medical institutions. For the study the nationally surveyed database was used and the data were analyzed using logistic regression procedure. The results indicates that the primary care facilities were not properly utilized. This study speculates that the reason for the undesirable pattern of utilization is that the roles of primary care facilities in the healthcare delivery system was not clearly defined. Based on the results, the medical policy implications are discussed.

• Journal of dental hygiene science
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• v.9 no.5
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• pp.579-586
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• 2009

Prior to the start of the general oral examination, this study was performed using the theory of planned behavior to provide data that would help not only increase intention of industrial workers' dental care utilization after their dental examination, but develop the follow-up oral health programs. As the first research group, 608 workers were selected from the 1016 workers while excluding both 53 workers who were currently undergoing dental treatment and 355 workers who had an opportunity to visit the dental clinic over the previous six months. Among the general characteristics that would influence the 608 workers' intention to utilize the dental clinic within one (1) month, their financial state showed that the higher their financial abundance level, the stronger their intention to visit the dental clinic(p<0.01). It was shown that the attitude toward the dental care utilization related behavior and subjective norm except the perceived behavioral control among the TPB variables had a significant effect on their intention(p<0.01). Among TPB variables, attitude toward the dental care utilization and subjective norm except the perceived behavioral control, were significant correlation with behavioral intention(p<0.01). The structure model's R-square of the attitude toward the behavior, subjective norm and perceived behavioral control having and effect on the intention accounted for 21%. In order to encourage the workers to have positive thoughts about the attitude toward their dental care utilization and subjective norm, therefore, it is required to perform the continued oral health programs, in addi1ion to oral health experts' regular education.

• Journal of Korean Academy of Rural Health Nursing
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• v.18 no.2
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• pp.80-91
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• 2023

Purpose: The purpose of the study quantitatively investigates the experience of unmet healthcare service utilization by rural populations in vulnerable areas during the COVID-19 pandemic based on Andersen's behavior model. At the same time, this study attempts to describe the experiences of unmet healthcare service utilization among participants in vulnerable rural areas by analyzing qualitative contents through open-ended question. Methods: Data were collected from October to November 2022 using Qualtrix, a web-based survey platform. A total of 863 participants completed an online survey. Quantitative data were analyzed using 𝑥² test and logistic regression analysis. Qualitative data were analyzed using content analysis. Results: The factors affecting participants' unmet healthcare service utilization were type of residential area and underlying disease. The qualitative analysis identified; four categories and nine sub-categories. Conclusion: Based on these findings, it is necessary to develop a disaster nursing response model according to the type of residential areas and the number of people.

• Research in Community and Public Health Nursing
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• v.26 no.1
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• pp.11-17
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• 2015

Purpose: This study was to ascertain whether there are differences in health care utilization and expenditure for Type I Medical Aid Beneficiaries before and after applying Copayment. Methods: This study was one-group pretest posttest design study using secondary data analysis. Data for pretest group were collected from claims data of the Korea National Health Insurance Corporation and data for posttest group were collected through door to-door interviews using a structured questionnaire. A total of 1,364 subjects were sampled systematically from medical aid beneficiaries who had applied for copayment during the period from December 12, 2007 to September 25, 2008. Results: There was no negative effect of copayment on accessibility to medical services, medication adherence (p=.94), and quality of life (p=.25). Some of the subjects' health behaviors even increased preferably after applying for copayment including flu prevention (p<.001), health care examination (p=.035), and cancer screening (p=.002). However, significant suppressive effects of copayment were found on outpatient hospital visiting days (p<.001) and outpatient medical expenditure (p<.001). Conclusion: Copayment does not seem to be a great influencing factor on beneficiaries' accessibility to medical services and their health behavior even though it has suppressive effects on outpatients' use of health care.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.7
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• pp.443-452
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• 2018

The purpose of this study was to investigate the utilization behavior of medical services according to the characteristics of socioeconomic status (SES) and prevalence by using the 6th National Health and Nutrition Survey data for adults over 25 years old. Frequency and technical statistical analysis, ANOVA, ${\chi}^2$-test, and regression analysis were performed using SPSS 23.0. The results were as follows: more female than male, 65 years old and over, high school graduate, and unemployed and income quintiles were similar. The SES score considering education level, function, and income quintiles was the highest at 7-8, and most of the respondents felt moderate about their subjective health condition. The mean number of prevalence was $1.07{\pm}1.497$, the mean utilization of outpatient services was $0.50{\pm}0.045$, and the mean number of inpatient services use was $0.12{\pm}0.454$. Depending on general characteristics, there was a significant difference between subjects with prevalence and subjective health conditions. Higher age was associated with lower education, skill level, income, and SES score, and average prevalence was associated with poor subjective health conditions. More serious prevalence was associated with greater utilization of inpatient services. More chronic prevalence was associated with utilization of outpatient services. In other words, higher SES score was associated with lower overall use of medical services. Lower SES score was associated with higher use of medical services. In conclusion, we must develop appropriate health education programs that can prevent diseases in groups with low socioeconomic characteristics. There is the need to construct and implement a community-based appropriate health service system so that proper medical services can be used.

• Health Policy and Management
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• v.20 no.3
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• pp.138-156
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• 2010

Objective : The purpose of this study is 1) to understand the information-searching behavior of health care consumers ; 2) to examine the relationship between the information-searching behavior of health-care consumers and regulatory variables such as socioeconomic factors, characteristics of medical utilization, and perceived risks ; and 3) to determine the factors that affect consumer satisfaction, especially with respect to information-searching behavior. Method : The data for this study were collected from 838 respondents in five university hospital located in three areas?Seoul, Gyeonggi province, and Chungchong province. As the first step of the study, we conducted a preliminary survey from September 23?26, 2008. At the second step, we conducted a survey on the effect of information-searching behavior on those individuals who had visited. Furthermore, personal interviews were conducted through a face-to-face survey between September 30 and October 17, 2008. Results : The major research findings that were obtained from the study were as follows : First, the age, educational level, and residential district were associated with information source utilization. Second, the level of information searching effort and quality of service had a significant effect on consumer satisfaction. Conclusion : These results show that it is essential for marketers to have in-depth knowledge about the young and educated people who actively search for information and about those who are in the prime of their life and rely on word-of-mouth communication from personal and experi in-al informers. Therefore, marketers should develop different marketing strategies to meet the needs of such consumers.

• Journal of Preventive Medicine and Public Health
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• v.47 no.6
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• pp.327-335
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• 2014

Objectives: Several epidemiological studies on medical care utilization prior to suicide have considered the motivation of suicide, but focused on the influence of physical illnesses. Medical care expenditure in suicide completers with non-illness-related causes has not been investigated. Methods: Suicides motivated by non-illness-related factors were identified using the investigator's note from the National Police Agency, which was then linked to the Health Insurance Review and Assessment data. We investigated the medical care expenditures of cases one year prior to committing suicide and conducted a case-control study using conditional logistic regression analysis after adjusting for age, gender, area of residence, and socioeconomic status. Results: Among the 4515 suicides motivated by non-illness-related causes, medical care expenditures increased in only the last 3 months prior to suicide in the adolescent group. In the younger group, the proportion of total medical expenditure for external injuries was higher than that in the older groups. Conditional logistic regression analysis showed significant associations with being a suicide completer and having a rural residence, low socioeconomic status, and high medical care expenditure. After stratification into the four age groups, a significant positive association with medical care expenditures and being a suicide completer was found in the adolescent and young adult groups, but no significant results were found in the elderly groups for both men and women. Conclusions: Younger adults who committed suicide motivated by non-illness-related causes had a higher proportion of external injuries and more medical care expenditures than their controls did. This reinforces the notion that suicide prevention strategies for young people with suicidal risk factors are needed.