• The Journal of the Korea Contents Association
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• v.21 no.3
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• pp.314-323
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• 2021

The purpose of this study is to analyze the status of medical service use of foreigners living in Korea by their nationality and types of national health insurance. As of 2018, 1,058,886 people were extracted from the qualification DB, excluding people whose insurance premium is missing. The data analysis showed that nearly 78% of foreigners with national health insurance used medical services and the countries with the largest number of users were China, Vietnam, and the United States. The total cost of treatment per capita was highest in the United States regardless of hospitalization and outpatient. The number of medical treatments per person, and the medical expenses of outpatients & inpatients services were highest among the regionally-insured and the length of stay per person was highest among the workers' dependents. Lastly, it was found that Chinese and regionally-insured received much more benefits than other groups compared to the premium they pay. After July 2019, foreign nationals residing in Korea for six months or longer are obligated to enroll in the national health insurance program. Since the latest data was in 2018, the result did not properly reflect the current situation, but it is meaningful that it made basic data for future comparative analysis.

• Women's Health Nursing
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• v.27 no.2
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• pp.128-140
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• 2021

Purpose: The purpose of this study was to develop a self-transcendence enhancement program and examine its effect on self-transcendence, spiritual well-being, and psychological well-being in elderly women who live alone. Methods: A self-transcendence enhancement program was developed through theory, literature review, and in-depth interviews. The theoretical framework came from the Psychoeducational Approach to Transcendence and Health intervention model based on Reed's middle-range theory of self-transcendence. The program consisted of multiple modalities in a structured, theory-based program lasting for eight weekly sessions. Using a single-group pretest-posttest design, the program was tested on a group of 40 elderly women aged 75 to 84 years living alone in Daejeon, Korea. Participants completed self-reported study questionnaires before and after the program at the elderly welfare center. Data were analyzed using SPSS version 24.0, with significance level set at .05. Paired t-test was used to compare mean differences before and after the program. Results: The mean age of the study participants was 79.1 years. After completing the program, the participants showed higher levels of self-transcendence (t=8.78, p<.001), overall spiritual well-being (t=8.30, p=.002), religious spiritual well-being (t=1.79, p=.040), existential spiritual well-being (t=6.75, p=.002), and positive affect (t=3.77, p=.001) than they did before the program. They also reported lower levels of depression (t=-7.59, p<.001) and negative affect (t=-6.15, p<.001). Conclusion: The self-transcendence enhancement program developed in this study may be effective for improving the level of self-transcendence in elderly women living alone and helping them to attain spiritual and psychological well-being.

• Journal of agricultural medicine and community health
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• v.37 no.2
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• pp.84-95
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• 2012

Background: In Korea, private health insurance has neglected to induce externality on national health insurance by moral hazard. Therefore, we conducted this study in order to explore the influence of private health insurance on unnecessary medical utilization among patients with cervical or lumbar sprain. Method: The study examined a population of 449 patients (admission, 384; out-patient; 85) diagnosed with simple cervical or lumbar sprain without neurological symptoms at 20 small hospitals or clinics in Gwangju and Jeollanam provinces from Jul. 1 to Aug. 31 2008. The data were collected using structured, self-administrated questionnaire which collected information such as whether or not the patient was admitted (as a dependent variable), whether or not they had private health insurance (as a independent variable), and covariates such as socio-demographic characteristics, the factors related to the sprain, and characteristics of the insurance provider. Results: From hierarchical multiple logistic regression analysis, it was found that the admission rate of patient with private health insurance was higher than that those without it (Odds ratio=3.31, 95% Confidence interval; 1.14-9.58), meaning that private health insurance was an independent factor influencing the admission of patients with these conditions. Other determinants of admission were patient age and physician referral. Conclusions: This study is the first empirical study to explore the influence of private health insurance on inducing moral hazard in admission services, specifically among patients with cervical or lumbar sprain. Regulation of benefits provided by private health insurance may be necessary, as the effect of this moral hazard may mean existence of externality.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.21 no.3
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• pp.243-252
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• 2014

Purpose: The purpose of this study was to investigate diabetic knowledge, self-care behaviors, and HbA1c of patients with diabetic mellitus in public hospitals. Methods: Participants were 287 adult patients who had been diagnosed with diabetes in two public hospitals in Seoul. Collected data were analyzed using t-test, ANOVA, Pearson's correlation with the SPSS (PASW) 21.0 program. Results: For general characteristics of the participants, there were significant differences in the level of diabetic knowledge according to age (F=11.28, p<.001), educational level (F=11.07, p<.001), type of health insurance (F=9.38, p<.001), and monthly income (t=-4.58, p<.001) and in the self-care behaviors according to age (F=8.61, p<.001) and in HbA1c according to age (F=6.72, p=.001). As for disease related characteristics of the participants, significant differences were found for self-care behaviors according to education about diabetes (t=3.90, p<.001) and in HbA1c according to education about diabetes (t=3.26, p=.001) and current diabetic therapy methods (F=13.51, p<.001). The study results showed that there was no correlation between diabetic knowledge and self-care behavior, or between self-care behavior and HbA1c. Conclusion: Results indicate that when developing preliminary data on nursing intervention education programs on diabetes, increasing diabetic knowledge and self-care behaviors would help to improve blood glucose levels.

• Proceedings of the Korea Inteligent Information System Society Conference
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• 2001.06a
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• pp.293-304
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• 2001

frauds detection is a difficult problem, requiring huge computer resources and complicated search activities. researchers have struggled with the problem. Even though a flew research approaches have claimed that their solution is much bettor than others, research community has not found 'the best solution'well fitting every fraud. Because of the evolving nature of the frauds, a Revel and self-adapting method should be devised. In this research a new approach is suggested to solving frauds in insurance claims and credit card transaction. Based on evolutionary computing approach, the method is itself self-adjusting and evolving enough to generate a new set of decision-making rules. We believe that this new approach will provide a promising alternative to conventional ones, in terms of computation performance and classification accuracy.

• Journal of Preventive Medicine and Public Health
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• v.50 no.4
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• pp.240-250
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• 2017

Objectives: Subjective life expectancy (SLE) has been found to show a significant association with mortality. In this study, we aimed to investigate the major factors affecting SLE. We also examined whether any differences existed between SLE and actuarial life expectancy (LE) in Korea. Methods: A cross-sectional survey of 1000 individuals in Korea aged 20-59 was conducted. Participants were asked about SLE via a self-reported questionnaire. LE from the National Health Insurance database in Korea was used to evaluate differences between SLE and actuarial LE. Age-adjusted least-squares means, correlations, and regression analyses were used to test the relationship of SLE with four categories of predictors: demographic factors, socioeconomic factors, health behaviors, and psychosocial factors. Results: Among the 1000 participants, women (mean SLE, 83.43 years; 95% confidence interval, 82.41 to 84.46 years; 48% of the total sample) had an expected LE 1.59 years longer than that of men. The socioeconomic factors of household income and housing arrangements were related to SLE. Among the health behaviors, smoking status, alcohol status, and physical activity were associated with SLE. Among the psychosocial factors, stress, self-rated health, and social connectedness were related to SLE. SLE had a positive correlation with actuarial estimates (r=0.61, p<0.001). Gender, household income, history of smoking, and distress were related to the presence of a gap between SLE and actuarial LE. Conclusions: Demographic factors, socioeconomic factors, health behaviors, and psychosocial factors showed significant associations with SLE, in the expected directions. Further studies are needed to determine the reasons for these results.

• Women's Health Nursing
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• v.17 no.2
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• pp.137-147
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• 2011

Purpose: This study was done to examine mothers' acceptance and its influencing factors in daughters' human papillomavirus (HPV) vaccination to prevent cervical cancer. Methods: From July 20 to August 31, 2010, 220 mothers of unmarried daughters responded to self-administered questionnaires about their acceptance of HPV vaccination for their daughters and the optimal age for HPV vaccination. Descriptive statistics, univariate logistic and multiple logistic regression were used for data analysis with SPSS/WIN 12.0. Results: Mothers indicating their willingness to pay for their daughters to receive HPV vaccination accounted for 61.8%, and willingness with health insurance coverage, 84.5%. Mean optimal age for HPV vaccination was $19.78{\pm}3.96$) years. With self-payment the factor influencing mothers willingness was necessity of HPV vaccination (OR= 30.45, 95% CI=10.33~89.15). With health insurance coverage, income (OR=3.02, 95% CI: 1.19~7.62), necessity of HPV vaccination (OR=15.05, 95% CI=4.15~54.64), concern about HPV vaccine safety (OR=2.99, 95% CI=1.15~7.76), and experience of Pap test (OR=3.16, 95% CI=1.24~8.05) were factors influencing mothers willingness. Other influencing factors were optimal age for HPV vaccination, knowing about HPV (OR=7.66, 95% CI=2.19~26.82), and age of youngest daughter (OR=3.95, 95% CI=1.34~11.68). Conclusion: Financial support is anticipated for low income families in a primary approach to increase HPV vaccination. And focusing on earlier age and concerns about vaccination are necessary to gain mothers' acceptance.

• Journal of Preventive Medicine and Public Health
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• v.42 no.3
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• pp.177-182
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• 2009

Objectives : Both organized and opportunistic screening programs have been widely used in Korea. This paper examined the determinants of the use of opportunistic screening programs in Korea. Methods : The subjects were a national stratified random sample of 10,254 people aged 45 or older from the first wave of the Korean Longitudinal Study of Ageing in 2006. A logit model was used to examine the determinants of the use of opportunistic screening programs in terms of the demographic and socioeconomic characteristics, the type of health insurance and the health status. Results : Thirteen point seven percent of the individuals received opportunistic screening programs within 2 years from the time the survey was conducted in 2006. The individuals who graduated from college or who had even more education were 3.0 times more likely to use opportunistic screening programs compared with the individuals who were illiterate. The individuals who resided in urban areas and who had religious beliefs were more likely to receive opportunistic screening programs compared with their counterparts. Those who were in the first quartile for the total household assets were 2.6 times more likely to use opportunistic screening programs than those who were in the fourth quartile for the total household assets. Privately insured people were 1.6 times more likely to use opportunistic screening programs than those who were not insured. Finally, the individuals who self-assessed their health status as worst were 2.1 times more likely to use opportunistic screening programs compared individuals who self-assessed their health status as best. Conclusions : This study suggests that opportunistic screening programs can be an indicator for whether or not an individual is among the advantaged group in terms of their socioeconomic characteristics and type of health insurance.

• Nutrition Research and Practice
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• v.15 no.6
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• pp.789-797
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• 2021

BACKGROUD/OBJECTIVES: Registered dietitian nutritionists (RDN) are providers of medical nutrition therapy (MNT) to address health and chronic disease. Traditionally, RDNs have provided care in healthcare facilities including hospitals and private care facilities. The purpose of this study was to determine how RDN individualized MNT in the home impacted nutrition, physical activity, and food security. SUBJECTS/METHODS: This is a secondary data analysis. The mean age of the participants (n = 1,007) was 51.6 years old with a mean body mass index (BMI) of 34.1 kg/m². Individualized MNT visits were delivered by an RDN in the home setting from January to December 2019. Participants were referred by healthcare professionals or self-referred. Participants had MNT benefits covered by their health insurance plan (43.3% Medicaid; 39.8% private insurance; 7.9% Medicare, 9% other). Health outcomes related to nutrition care were measured. Outcomes included self-reported consumption of nutrition factors and physical activity. Our secondary outcome focused on food security. The changes in weight, BMI, physical activity, and nutrition factors were analyzed by a linear regression model or linear mixed model, adjusting for age, sex, baseline value, and number of appointments. Food security was summarized in a 2 by 2 contingency table. RESULTS: Baseline values had significantly negative impacts for all changes and number of appointments was significant in the changes for weight and BMI. Increases in physical activity were significant for both female and male participants, 10.4 and 12.6 minutes per day, respectively, while the changes in weight and BMI were not. Regarding dietary factors, the consumption total servings per day of vegetables (0.13) and water (3.35) significantly increased, while the consumption of total servings of whole grain (-0.27), fruit (-0.32), dairy (-0.80) and fish (-0.81) significantly decreased. About 24% (of overall population) and 45% (of Medicaid population) reported improvements in food security. CONCLUSIONS: This study found that home visits were a useful setting for MNT delivered by RDNs. There is a strong need for individualized counseling to meet the participants' needs and personal goals.

• Journal of Preventive Medicine and Public Health
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• v.46 no.5
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• pp.213-225
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• 2013

Objectives: The aim of this study was to evaluate the association between Agent Orange exposure and self-reported diseases in Korean Vietnam veterans. Methods: A postal survey of 114 562 Vietnam veterans was conducted. The perceived exposure to Agent Orange was assessed by a 6-item questionnaire. Two proximity-based Agent Orange exposure indices were constructed using division/brigade-level and battalion/ company-level unit information. Adjusted odds ratios (ORs) for age and other confounders were calculated using a logistic regression model. Results: The prevalence of all self-reported diseases showed monotonically increasing trends as the levels of perceived self-reported exposure increased. The ORs for colon cancer (OR, 1.13), leukemia (OR, 1.56), hypertension (OR, 1.03), peripheral vasculopathy (OR, 1.07), enterocolitis (OR, 1.07), peripheral neuropathy (OR, 1.07), multiple nerve palsy (OR, 1.14), multiple sclerosis (OR, 1.24), skin diseases (OR, 1.05), psychotic diseases (OR, 1.07) and lipidemia (OR, 1.05) were significantly elevated for the high exposure group in the division/brigade-level proximity-based exposure analysis, compared to the low exposure group. The ORs for cerebral infarction (OR, 1.08), chronic bronchitis (OR, 1.05), multiple nerve palsy (OR, 1.07), multiple sclerosis (OR, 1.16), skin diseases (OR, 1.05), and lipidemia (OR, 1.05) were significantly elevated for the high exposure group in the battalion/company-level analysis. Conclusions: Korean Vietnam veterans with high exposure to Agent Orange experienced a higher prevalence of several self-reported chronic diseases compared to those with low exposure by proximity-based exposure assessment. The strong positive associations between perceived self-reported exposure and all self-reported diseases should be evaluated with discretion because the likelihood of reporting diseases was directly related to the perceived intensity of Agent Orange exposure.