• Journal of Society of Preventive Korean Medicine
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• v.16 no.2
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• pp.83-94
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• 2012

Objectives : This study aimed to investigate the use and patterns of health care resources of local patients and to analyze the health seeking behaviors focusing on shopping around phenomenon. Methods : Questionnaires on the use of health institution were developed and administered to the residents in Yangsan city, Korea. We selected patients who were suffering from any diseases two months and over. Patients' health seeking behaviors were categorized, and the factors for selecting health institutions in each visiting stages were analyzed. Results : 139 local patients participated in the survey, and 130 completed questionnaires were analyzed. We found that there were sixty eight different types of medical utilization paths. The most frequent path was 'western clinics ${\rightarrow}$ Korean medicine hospitals or clinics ${\rightarrow}$ western clinics'. Only 6 patients started at Korean medicine, however, 16 patients(12.3%) finalized their treatment at Korean medicine hospitals or clinics. In most health seeking stages, patients tended to select health resources by their own decisions, and the geographic factor was the key reason to select health resources. Conclusions : Patients had not any stable forms to treat with their diseases, and we observed diversified patterns in the health seeking behaviors of patients, a typical shopping around phenomenon.

• Health Policy and Management
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• v.29 no.2
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• pp.160-171
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• 2019

Background: This study purposed to compare the difference on medical utilization and health expenditure of baby boomer generation by depression between gender. Methods: Korea Welfare Panel Survey 2016, provided by the Korea Institute for Health and Social Affairs, was used for the analysis. For the research, we used the two-part model, yes or no of use (part 1), and frequency of use (part 2) for medical utilization. The dependent variables are the whether or not to use of hospitalization services, outpatient services, length of stay, outpatient service visits, and health expenditure. And the independent variables are used as the predisposing (education, spouse presence), enabling (insurance type, private insurance, economic activity, income), and need (chronic disease, self-rated health, disability) factors in the Andersen behavior model. Depression was used as intervening variables. Structural equation model and multiple group analysis by gender were used. Results: There were differences in the medical care usage and cost between men and women in baby boomer. For men, mediating effects of depression were present at the hospitalization (yes/no), length of stay, and health expenditure. On the other hand, for women, the mediating effect of depression was found only at the outpatient visits. Specially, depression was working at the medical services by the different way between gender. The size of effect (multiple group analysis) was affected by significant differences between men and women. Conclusion: This study found that the mediating effect of depression is increased medical usage and health expenditure and the effect factors are different by gender. Therefore, it is necessary to establish a medical care policy considering the socio-economic characteristics of baby boomers.

• Journal of Digital Convergence
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• v.10 no.5
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• pp.289-299
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• 2012

The study was carried out to provide basic data of improving the accessibility of medical service through identifying the factors that make hospital injury inpatient in non-residential area not in their residential area in Gyeongsangnam-do. This study analyzed not only 8,225 cases of discharged patients with damages from 2008, provided by the Korea Centers for Disease Control and Prevention, but also using a census and a research data on the actual condition from health care system. This study conducted a frequency test, a chi-square test and a logistic regression In result, first, the centralization of medical utilization of patients with damages is apparent centrally the city area. Second, medical utilization of injury patients in non-residential areas were significantly higher local area compared to City area. To improve this, a policy that can not only provide medical centers and sickbed, but also improve the quality of local medical treatments for the localization of medical treatments, for the accessibility of medical services, government is demanded policy for patients with damages in local area.

• Health Policy and Management
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• v.10 no.2
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• pp.22-40
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• 2000

The purpose of the study was to discuss amrketing strategy for oriental hospital, by making a comparative analysis of how hospital user satifaction was affected by hospi시 choice motivation between oriental hospital users and western hospital. The data usel in this study was the Korea Isititute of oriental medicine(1999)'s study on utilization of oriental medical care. And and interview was hold with outpatients who visited around march to April, 1999, at each an oriental hospital and a westen hospital in Seoul and in Wonju city, Kongwon province. The collected data were analyzed by SPSS program. The factor analysis of hospital choice motivation was made by figuring out facor's mean value, and T-test and ANOVA were employed to find out what difference was made by sociodmographic charcteristics to the factors. Also, the multiple regression analysis was carried out to examine what gave an impact on hospital user satisfaction. The findings of this study were as follows; First as a result of making a factor analysis against hospital choice motivation to find out what kind of differenc there was between oriental hospital user motivation and western hospital and person factors. Among them, the hospital charcteristics, preception, personal and person factors. Among them, the hospital charcteristics appered to have the biggest effect of hospital choice motivation. Second, as a result of making comparison between oriental oriental hospital user satisfaction and werterm hospital user satisfaction, there was a singificant between their satisfaction at treatment time, kindness and relative kiness aginst the pther hospital. The oriental level combining 6 items. The geneal satisfaction level combining 6itmes tured out to have reliability of chronbach $\alpha$=0.7126. As a result of examining how mech the general satifaction level depended on sociodemographic characteristics, ther was found be significantly affected by age, marital status, educational background or hospital type. Those who a spouse or a lower educational background or the oriental hospital users got better score. Third, the multiple regression analysis was made to find out what factors affected western and oriental hospital user satisfaction, As a result, the waiting time, experience of other medical facilities and hospital characteristic variable were identified as a key factor on which westerm hospital user satisfaction depended. In conclusion, the oriental hhspital user expressed more staisfaction than the weshren hospital users. Then the characteristic factor played a singificant role in user satisfaction, which included hospital facilities, kindness of herb doctor and employees, or hospital reputation of credibility. in order to raise hospital user datisfaction, it seemed necessary to pay more attention to hospital characteristic factor rather than to perception factor.

• Journal of Hospice and Palliative Care
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• v.2 no.2
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• pp.109-113
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• 1999

Purpose : Because we don't have inappropriate health care system for the terminal cancer patients, there were abnormal behavior patterns of health care utilization. So, There were needs to develop the comprehensive care for terminal cancer patients. Increased attention is being paid to the futility of life-sustaining treatment and high cost of management of terminal cancer patients Materials and Methods : This study was performed on cancer patients, registered in 1996 Central Cancer Registry, who were as insured person of Korea Medical Insurance and died from January 1997 to June 1998. We studied the day of medical care and medical expenses of 151 cancer patients evaluable. Results : The mean day of inpatient care was 39 days, and the mean days of outpatient care was 14 days in study subjects. Mean expenses per day of medical care, day of inpatient, and day of outpatients care were 85,392 won, 105,908 won, and 40,173 won. 95% of medical expenses is paid to the general hospital, and 85% of medical expenses was paid for inpatient care. About half of all medical expenses in th last 6 months were incurred in the last 60 days of life, and about 30 percent were incurred in the last 30 days. Expenses of outpatients care increased between 6 month and 3 months, after which they decreased. Expenses of inpatients care increased during all last 6months Conclusion : The distribution or medical expenses during the last 6 months in our study is similar to the distribution of American Medicare costs. We need to study medical expenses during the last year of life with large scale and details in order to develop the plan about the management of terminal cancer patient.

• The Journal of the Korea Contents Association
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• v.12 no.7
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• pp.295-305
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• 2012

This study analyzes actual conditions of private health insurance empirically by using the decision to join Korea Health Panel data. First, the study investigates how sociodemographic factors influence joining the private health insurance. Next, the relationship between the private health insurance membership and the frequency of medical service utilization is analyzed. The main results of these analyses can be summarized as follows: the socially vulnerable are less likely to join private health insurance relative to the middle and upper classes. The frequency of medical service utilization of private insurance members is relatively higher. This fact contains the possibility that the middle and upper classes are able to receive more medical services through private health insurance membership, while the socially vulnerable have difficulty with obtaining medical services in spite of much need. Therefore, policies are needed which manage the private health insurance more effectively and secure the publicity of health service socially.

• Health Policy and Management
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• v.20 no.1
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• pp.19-36
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• 2010

Fee for long-term care insurance in Korea are determined in proportion to resources utilized according to severity rather than based on categorization of beneficiaries in consideration of the characteristics of resource utilization. This adoption is based on the assumption that as beneficiaries of long-term care insurance, characteristically, demands social services rather than needs medical treatments, the characteristics of beneficiaries and the quality of utilized resources are comparatively homogenous. Therefore, the proposition is that the size of resource consumed by beneficiaries in the same grade is identical. However, even in the same grade, the level of utilized resources is different depending on the characteristic of beneficiaries. In this regard, this study is to examine whether there are differences in the volumes of utilized resources depending on the characteristics of beneficiaries even in the same grade. We analyzed time study data for 2003, 2005, 2006 which conducted by the Korea Institute for Health and Social Affairs. To look at differences in the volumes of utilized resources, we identified characteristics of beneficiaries that influence utilized resource volumes and categorized services provided by facilities into the rehabilitation treatment category, the problematic behavior category, and the physical malfunction category. Then, we examined each service in consideration of service difficulty levels and wage weights. The result of examination showed that differences in utilized resource volumes exist in all three grades depending on the characteristics of beneficiaries. Especially, in the first grade with a high level of seriousness, utilized resource volumes were different for those three service categories and the problematic behaviour category considered dementia was found to consume the largest volume of resources. Moreover, there was the inversion phenomenon of utilized resources volumes between the grades. This result indicates that utilized resource volumes are different even in the same grade depending on the characteristics of beneficiaries and it is required to consider case-mix for reflection of the volumes of utilized resources depending on the characteristics of beneficiaries.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.8
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• pp.3500-3512
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• 2012

The purpose of this study is to conduct a comparative analysis of health behaviors, health status, and health care utilization by the homeland of the internationally married women immigrants living in Korea. The subjects of this study were 171 married women immigrants who are registered at 7 multicultural centers in Chungbuk province. The study was conducted from September 2010 to November 2010 by surveying them with structured questionnaires translated in 7 different languages. In health behaviors the results indicated that there were statistically significant differences in high intensity exercise, walking, weight control, and the number of times having breakfast per week depending on the subject's homeland. In health status, there were statistically significant differences in low back pain incidence and obesity rate by the subject's homeland. In health care utilization, the subjects revealed statistically significant differences in utilizing health screening, in selecting primary medical institutes, and in the reasons for avoiding medical institutes depending on the subject's homeland. Health promotion policies that take the results of this research into account would provide suitable health care services for internationally married migrant women.

• Journal of Society of Preventive Korean Medicine
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• v.22 no.2
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• pp.25-32
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• 2018

Objectives : This study was conducted to investigate the frequent diseases among the people who had been treated by collaborative treatment of Korean medicine and Western medicine, and to compare their medical use behaviors before and after the collaborative first-stage pilot project between Korean medicine and Western medicine. Methods : 4,467 patients were identified as the patients who are participated in the collaborative first-stage pilot project between Korean medicine and Western medicine during the period between July 15, 2016 and March 31 2017. We used 28,480 records of Korean national health insurance claim data from January 1 2016 to March 31 2017 to analyzed present condition of cooperative medical usage. Also we conducted a paired t test to compare the percentage of collaborative treatment days before and after the pilot project period. Results : We found that the most frequent diseases treated in the pilot project were the diseases of musculoskeletal and nervous system and then 10 major diseases such as H, K, J, C (D), N, L, E, A, H and F disease codes in order. Also it was confirmed that 14 major and 53 medium diseases are included from more than 90% of total patients. As a result of high frequency of medical treatment in Western medicine or Korean medicine is "administration of Korean medicine", which is same as before and within the pilot project. The ratio of utilizing both Western and Korean medical care for the same disease on the same day by both general patients and patients in KCD-7 disease code group C, G, I, M and S had been increased significantly. Conclusions : The pilot project might change the behavior of utilizing the medical care service by increasing the ratio of collaborative treatment of Western medicine and Korean medicine for the same disease on the same day.

• Journal of Korean Academy of Rural Health Nursing
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• v.1 no.1
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• pp.11-20
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• 2006

Purpose: To compare of health inequalities between rural and urban areas in term of health status, health behaviors and medical care utilization by using national-wide data. Method: The data came from the 2000 and 2005 census data, 2004 death certification statistics and 2001 national health and nutrition survey. The health indicators used in this study were mortality, perceived health status, health related behaviors, morbidity, accidents and suicides, mental health-related factors, health care accessibility. Korean rural areas have been experiencing a rapid aging process and there are demographic differences between rural and urban populations. Thus, both of crude rates and age-adjusted rates were compared. Result: Although the degrees decreased after adjustment for age, health inequalities between areas still existed. The people who lived in rural areas suffer from higher mortality, morbidity and unhealthy behavior compared to people in urban areas. Especially, regional health inequalities for women were significant. Health care accessibility in rural areas was also lower and medical indirect costs for rural residents were higher than those of urban residents. Conclusion: To reduce health inequalities between geographical areas, political efforts to tackle health inequalities in the rural areas are required.