• Health Policy and Management
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• v.25 no.4
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• pp.256-263
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• 2015

Background: Initial treatment of acute upper respiratory infection (AURI) should not include antibiotics because most AURIs are caused by virus. However, the prescription rate of antibiotics in Korea is higher than in any other countries. Inappropriate use of antibiotics in Korea accelerated the emergence of antibiotics resistance and increased the social and economic burden. The objective of this study was to investigate the factors related to antibiotics use for the AURI among children-adolescents and adults. Methods: This study analyzed the Health Insurance Review and Assessment Service-National Patient Sample data which was nationally representative sampling stratified by sex and age. Results: The influencing factors of antibiotics use for AURI are gender, age, types of medical security, primary disease, existence of concomitant disease, treatment seasons, first visit or revisit, indicated specialty, types of medical institution, and location of medical institution. Conclusion: The results showed health policy makers are required to place more efforts to resolve inappropriate antibiotics use. Especially they need to establish a health policy to reduce the gap between areas and specialties and recommend standardized clinical guidelines according to the subgroup code of AURI and the age group of patients.

• Health Policy and Management
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• v.29 no.4
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• pp.513-522
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• 2019

Background: South Korea operates a Medical Aid (MA) program targeting selected low-income individuals to ensure medical service delivery to the disadvantaged while enhancing self-sufficiency of work-capable beneficiaries. However, as reasons behind welfare exits are diverse and do not always infer poverty relief or the provision of appropriate levels of health care services, this study aimed to investigate the association between changes in MA status and health care utilization. Methods: This study used the 2006 to 2015 National Health Insurance claims data. The impact of changes in annual MA status on health care utilization (yearly number of outpatient visits, inpatient visits, length of stay, and emergency department [ED] visits) was investigated using the generalized estimating equation model. Results: In 117,943 adult subjects aged 20 to 64, compared to the 'MA to MA' group, the 'MA to MA exit' group showed general decreases in utilization (outpatient visits: β=-3.93, p<0.0001; hospital admissions: relative risk [RR], 0.87; 95% confidence interval [CI], 0.83-0.91; length of stay: β=-3.64, p<0.0001; ED visits: RR, 0.83; 95% CI, 0.77-0.90). Similar patterns were found in the 'MA exit to MA exit' group (outpatient visits: β=-5.72, p<0.0001; admissions: RR, 0.91; 95% CI, 0.87-0.94; length of stay: β=-5.87; p<0.0001; ED visits: RR, 0.81; 95% CI, 0.75-0.88). Likewise, in 74,747 older adult subjects aged 65 or above, the 'MA to MA exit' group showed reduced levels of utilization (outpatient visits: β=-1.51; p=0.0020), as well as the 'MA exit to MA exit' group (admissions: RR, 0.92; 95% CI, 0.89-0.95; length of stay: β, -5.45; p<0.0001; ED visits: RR, 0.90; 95% CI, 0.83-0.97). Conclusion: MA exit was associated with general decreases in health care utilization. Utilization patterns of individuals with experiences of receiving MA benefits should be monitored to promote the ideal use of health care services while preventing potential financial barriers present in accessing medical care.

• Journal of agricultural medicine and community health
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• v.49 no.3
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• pp.216-234
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• 2024

Background: Hapcheon-gun, Gyeongsangnam-do, is designated as an emergency medical vulnerable area, facing significant challenges in transporting and treating emergency patients. A detailed analysis of the regional emergency medical system is required to identify effective solutions. Methods: This study employed a mixed-methods approach, combining quantitative data from the National Emergency Medical Information System and emergency activity logs with qualitative data from focus group interviews involving 24 stakeholders, including medical staff, paramedics, civil servants, and local residents. Results: Quantitative findings indicated an aging population in Hapcheon-gun, with a growing number of elderly emergency room users. Despite the utilization of local emergency medical institutions, a lack of trust and preference for urban hospitals led even patients with mild conditions to seek care at higher-level facilities. Following the COVID-19 pandemic, transport distances and times for patients using 119 emergency services increased. Qualitative analysis identified several issues: limited capacity of local institutions, challenges in patient transport due to misaligned emergency medical zones, an increase in severely ill patients, and the absence of a coordinated emergency medical consultative body. Recommendations include strengthening local institutions through government support, realignment of emergency zones, legal reforms, the establishment of a continuous consultative body, and enhancing the capacity of medical staff, paramedics, and residents. Conclusion: Improving the emergency medical system in Hapcheon-gun will require targeted efforts in institutional strengthening, legal and administrative support, and capacity-building initiatives.

• Health Policy and Management
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• v.33 no.3
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• pp.370-375
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• 2023

The responsibility to ensure the health rights of detainees, particularly their medical rights, fundamentally lies with the state in all nations. However, in the correctional facilities of the Republic of Korea, these rights are currently not adequately safeguarded. Numerous detainees express dissatisfaction with the medical services provided and show a preference for voluntary external treatment. However, barriers such as prolonged application processes for external treatment and the requirement for detainees to cover their medical expenses present significant challenges. Therefore, the National Human Rights Commission of Korea has advocated for an increased medical budget in correctional facilities and a bolstered professional medical workforce to improve the medical care of detainees. Recommendations for improvements include: (1) establishing dedicated correctional hospitals for detainees, (2) setting up specialized correctional wards, (3) collaborating with military hospitals, (4) launching mobile medical buses for diverse specialties, (5) enhancing collaboration with public and private medical institutions, (6) increasing compensation for partnering external medical institutions, (7) improving the working conditions of medical officers, (8) safeguarding the defense rights of medical staff, (9) improving the working conditions of public health doctors from the Ministry of Justice in correctional facilities, and (10) pre-assigning public health specialists and military doctors to correctional facilities. By implementing these measures, it is anticipated that the quality of medical services in the Republic of Korea's correctional facilities will improve, reducing the demand for external treatments among detainees and ensuring their health and medical rights are realistically upheld.

• Health Policy and Management
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• v.14 no.3
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• pp.1-19
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• 2004

The purposes of this study were to investigate factors of the Obstetrics & Gynecology healthcare consumers' selection of hospitals by lifestyle segmentation and to propose managerial suggestions in health care marketing. Out of total 400 Questionnaires, 351 were considered to be valid for final analysis. The Questionnaire consisted of 81 Questions. 11 demographic Questions, 15 factors for selecting hospitals, 55 lifestyle. The collected data were analyzed with SPSS/pc+ Version 10.0. The subjects were divided into four groups in terms of their lifestyles: 'health active group', 'health conscious group', 'health indifferent group', 'health inactive group'. The analysis of factors related to the selection of hospitals shows that there were four factors: 'accessability', 'medical trust', 'cost and convenience', 'facilities'. Conclusion: As a results of this study, 4 types of healthcare consumers' lifestyle were defined. Each life style has specific characteristics. 'Health active group' pursue 'accessability', 'medical trust', 'cost and convenience' and Health conscious group' depended on 'medical trust', 'cost and convenience'. and 'facilities'. 'Health indifferent group' didn't show any special interest in the selection of hospitals and that 'Health inactive group' relied on 'medical trust', and 'facilities'.

• Health Policy and Management
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• v.22 no.1
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• pp.65-84
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• 2012

Because of the rising healthcare costs, there is a growing need for developing efficiency indicators for medical resources use and measuring efficiency of healthcare providers and healthcare systems using them. In this study, we aimed to develop efficiency indicators for medical resources use by means of Delphi technique. We systematically reviewed the existing measures of medical resource use. Thirty nine indicators were selected as a candidates across the six domains: medical personnel, medical equipment, medical facilities, ethical management, resource efficiency, and drug use. To develop efficiency indicators with professional consensus, a 2-round Delphi survey was conducted among 29 professional experts. The following indicators were selected based on the Delphi survey results: adjusted number of the patient per day and level of the nurse number medical personnel in medical personnel domain; the number of the scan a professional physician and the quality of the scan in medical equipment domain; bed utilization rate in medical facility domain; drug price reported pharmaceutical price by medical institutions, medical fee billing transparency, and medical care appropriateness in ethical management domain; costliness index in resource efficiency domain; and utilization of high cost drug and items per prescription in drug use domain. The efficiency indicators could provide valid information about efficiency of healthcare providers and healthcare systems with respect to their resources use and facilitate policies to improve their efficiency.

• Journal of Preventive Medicine and Public Health
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• v.49 no.4
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• pp.230-239
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• 2016

Objectives: We aimed to evaluate the effect of geographic units of analysis on measuring geographic variation in medical services utilization. For this purpose, we compared geographic variations in the rates of eight major procedures in administrative units (districts) and new areal units organized based on the actual health care use of the population in Korea. Methods: To compare geographic variation in geographic units of analysis, we calculated the age-sex standardized rates of eight major procedures (coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, surgery after hip fracture, knee-replacement surgery, caesarean section, hysterectomy, computed tomography scan, and magnetic resonance imaging scan) from the National Health Insurance database in Korea for the 2013 period. Using the coefficient of variation, the extremal quotient, and the systematic component of variation, we measured geographic variation for these eight procedures in districts and new areal units. Results: Compared with districts, new areal units showed a reduction in geographic variation. Extremal quotients and inter-decile ratios for the eight procedures were lower in new areal units. While the coefficient of variation was lower for most procedures in new areal units, the pattern of change of the systematic component of variation between districts and new areal units differed among procedures. Conclusions: Geographic variation in medical service utilization could vary according to the geographic unit of analysis. To determine how geographic characteristics such as population size and number of geographic units affect geographic variation, further studies are needed.

• Health Policy and Management
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• v.23 no.2
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• pp.145-151
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• 2013

Background: The objective of this study was to explore patient family's evaluation of emergency department (ED) service satisfaction and to compare these with ED staff perception of patient family's evaluation. Methods: Based on two surveys of the National Emergency Medical Center: the 2008 National Survey for Recognition and Satisfaction towards Emergency Medical Services and the 2008 Opinion Survey of Emergency Medical Service Providers, satisfaction gaps among physicians, nurses, and patient family were evaluated by Kruskal-Wallis tests and Wilcoxon-Mann-Whitney tests. Furthermore, the factors associated with satisfaction of emergency medical service were identified by ordinal logistic regression models. Results: There were statistically significant gaps among physicians, nurses, and patient family in overall satisfaction with ED visit, length of stay in ED, enough explanation, physicians/nurses kindness, and ED facilities. Age and income in the patient family model, the number of beds in hospital, job satisfaction and year of service in the physicians model, and the number of beds in hospital, job satisfaction and the number of patients per duty hour in the nurses model were statistically significant factors associated with evaluation/ perception of ED service satisfaction. Conclusion: Patient satisfaction is an important indicator of the quality of care and service delivery in the ED. To improve and understand satisfaction in ED service, a dyadic view of the evaluation of service quality and satisfaction-that is, from the perspectives of both the patient and the emergency medical service providers-should be concerned.

• Health Policy and Management
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• v.30 no.1
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• pp.62-71
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• 2020

Background: The purpose of this study is to analyze the current status and factors of elderly patients' hospitalization for hip replacement, knee replacement, and general spine surgery. Methods: National health insurance data in 2018 was provided by the National Health Insurance Service. We used multiple regression to analyze factors associated with the medical utilization of hip replacement, knee replacement, and general spine surgery in elderly patients over 65 years old. The dependent variables are the length of stay and total health expenditure. The independent variables are the demographic-social factors (sex, age, region, insurance type, income level) and surgery-related factors (institution type, location of the hospital, surgery classification). Results: The most common factor affecting surgery was the location of medical institutions. Compared with the medical institutions located in metropolitan, the length of stay in rural medical institutions was higher and total health expenditure was lower. The lower quartile of income, the higher the length of stay and total health expenditure. In addition, the variables of age, type of health insurance, and type of medical institution were statistically significant. Conclusion: In this study, we confirmed the effect of sociodemographic factors and medical institution factors on the Healthcare Utilization of spinal and joint surgery.

• Korea Journal of Hospital Management
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• v.12 no.2
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• pp.112-132
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• 2007

The purpose of this study was to basically review of the China Medical Industry. China affiliate World Trade Organization(WTO) in 2001. In accordance with the provisions of WTO, China have to open the medical industry from 2003. To do this, the contents of this article is China medical industry, investment circumstance of capital, medical market-open plan of outbound-base, and national medical market policy in now and future.