• Journal of Korean society of Dental Hygiene
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• v.11 no.5
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• pp.791-799
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• 2011

Objectives : This study aimed at examining the aspects of utilization of the dental services in some regions and analyzing the related factors with a view to helping the old solve the dental problems and overcome the difficulties. Methods : This investigation was intended for 422 old people living in Jeon-ju city and Jang-su county from July 18, 2006 to August 25 by direct interviewing posing questions. The survey data sets were analyzed by chi-square, correlation, multiple regression and logistic regression. Results : 1. The average number of the existing teeth per an old person was 13.6 and the 28.8% of the old who didn't use denture called for dentures. 2. The annual coefficient of utilization in dental services for an old person was 52.3% and the annual average visits to dental clinics were 3.12 days while 38.6% of the old experienced illegal dental treatments. 3. The affecting factors on the dental utilization for treatment were as follows: family income, dental clinics available, the number of existing teeth, the days of dental trouble, the recognition of the prevention of the dental disease, the knowledge for the dental treatment and the oral health judged by himself. 4. The major variables influencing the utilization of dental services were spouse presence, form of family, income, having a regular dental care, denture presence and the experience of inconvenience in living. Conclusions : To conclude, the following suggestions could be made. First, It was necessary that enforcement practice of free dental prosthesis service and application to the national health insurance in old people's prosthetic therapy for government support because the economic factor was barrier to utilization of the dental services. Second, Dental clinic was required to the health center because availability of common dental services was big impact in utilization of the dental services.

• Journal of Society of Preventive Korean Medicine
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• v.14 no.2
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• pp.67-75
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• 2010

Objectives : Recently, the number of elderly people has been rapidly increasing in Korea, and it led to increase demands of Korean traditional medical services. However, there is a lack of information on Korean traditional service utilization. Thus, this study was intended to identify Korean traditional service utilization patterns such as acupuncture, moxibustion and cupping, since Korean traditional services were specially used in treating chronic diseases for elderly people. It is important to understand health services utilization for quality improvement of healthcare systems. Methods:We used data of 'Survey in Daegu' in 2008 and analyzed characteristics of disease structure and utilization patterns of health care service of 1,097 cases of participated citizens. Results : The proportion of the elderly people (>50 age) in total participators is 52.4%. Male to female ratio is 1:1.65 and most common age group was between 50 and 59 years old. 84.2% of participators were admitted at oriental health care facilities. In addition, the results showed that female were more used the service than man. The most common treated disease is musculoskeletal disorders in both male and female. Conclusions : Acupuncture, moxa and cupping are widely used to treat chronic degenerative diseases such as musculoskeletal disorders at oriental health care facilities. Elders and female prefer to be admitted at oriental health care facilities.

• Health Policy and Management
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• v.10 no.2
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• pp.103-119
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• 2000

This study is conducted to promote the activation of volunteer activities on the basic of the voluntaarry participation of local by investigating the utillzation of volunteers and analyzing this realted factors in the visiting health services of health centers. Subjects in this study were the whole 245 health centers. Data were collected from April, 12, 1999 to May, 31, 1999, and data for analyses were ones of 41 respondents, which answer " they utilize volunteers in visting health services". The summary of resulth was as follows : 1. In case that the type of health centers is one of county, in case that the number of staff in health center is over 80, in case that model business in not performed, in case that the degree of local financial independence is over 50%, and in case that the location of health centers in not good, there had more of volunteers in visiting health services. 2. 51.2% of analysing health centers answered that the utilization of volunteers has been done since 1998. 56.1% answered that they utillzed volunteers "over 4 hours" per person in a week. The average number of volunteers who was engaged at those visiting health services was 43.3. 3. Most of volinteers were housewives(73.2%). As for the action duration of volunteers. 68.8% answered " under 6 months". 4. As to the tasks of volunter activities, 75.6% were "home services" and 63.4% were "movable bath services". As for the tasks they intend to utilize, 90.2% answered " home services", 73.2% answered "movable health services". 5. Asked abount the purpose in utilizing volunteers, 75.6% answered "to induce the participation og local people". 65.9% answered "to provide various kinds of services". 66.7% provided some kind of education and training for volunteers. 6. Concerming evaluation of performance by volunteers, 90.2% answered " satisfactory". With reagards to the reason for that, 52.9% answered " volunteers can provide kinds of services". and 50.0% answered " volunteers can help local people to care their health". As for the obstacles to the utilization, 51.2% answered " the diffculty of recruitment for volunteers" and 43.9% answered "lack of budget and manpower needed for the utilization of volunteers".lty of recruitment for volunteers" and 43.9% answered "lack of budget and manpower needed for the utilization of volunteers".lunteers&".ot;.

• 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.

• Research in Community and Public Health Nursing
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• v.11 no.1
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• pp.37-66
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• 2000

Volunteers activities in Health Centers are strategically important for the efficient utilization of human resource and local people's health promotion in community. With these backgrounds. this study is conducted to examine significant factors in relation to demand and utilization of volunteers in Health Centers. and the factors are the characteristics of Health Centers. volunteer management factors and external environment factors. Subjects in this study were 245 Health Centers all chosen. Data were collected from April. 12. 1999 to May. 31. 1999. and the data for analyses were ones of 116 respondents. Then. the data coded and submitted to Fisher's exact test. NPAR1WAY ANOVA, Correlation analysis. multiple regression analysis, multiple logistic regression analysis with SAS program. The key results from this study can be epitomized as follows: 1. 43.1% of responding health centers answered that they 'utilize volunteers'. The average number of volunteers who were engaged in responding health centers was 43, out of which 7 were men and 36 were women. As for the adequacy of the number of the volunteers. 55.1% responded 'not enough' and 30.6% responded 'adequate'. The more the number of volunteers needed. the more the number of utilizing volunteers is. When asked about their views concerning the utilization of volunteers in Health Centers. 88.7% of all respondents answered in the affirmative. The accountable factor for the utilization of volunteers was the present utilization of volunteers. 2. Concerning the reasons for using volunteers. 'to induce local people's participation in health services' was the highest comprising 76% of the responding health centers. 3. Most of volunteers were housewives and independent enterprisers. The most type of volunteer activities was 'just simple labor'. 4. As for the action duration of volunteers. 69.4% answered 'under 6 months'. The factor was significant difference with the action duration of volunteers was 'to provide social meeting' in the middle of rewards for volunteers. 5. Asked about the problem in utilizing volunteers. 53.2% answered 'the difficulty of recruitment and education for volunteers'. and 42.6% answered 'lack of budget and manpower needed for the utilization of volunteers.' 6. Concerning the evaluation of the performance by volunteers. 88% answered 'satisfactory'. With regards to the reason for that. 29.3% answered 'volunteers can provide various kinds of services' 7. 88.7% of responding health centers answered that they will continuously or newly utilize volunteers in the future. 8. The main health program services which expect utilization of volunteers were visiting health services(63.2%). old people's health services (25.3%). These were not significant difference with any explanatory variable. 9. The average number of volunteer needed in responding health centers was 38. The more the average number of utilizing volunteers. the more the number of volunteers needed is. The more the degree of financial independence. the more the number of volunteers needed is. In conclusions. Health centers are necessary to promote their role of recruitment. education and training for volunteers. the development of volunteer activities programs.

• Health Policy and Management
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• v.17 no.1
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• pp.94-124
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• 2007

This paper critically reviews three decades of research on geographic variations. in health services utilization in the United States, thereby drawing policy and research implications for Korea. The recent renewed interest in variations research in the United States, precipitated by studies on regional variations in Medicare expenditures, stems mainly from the policy implication that a substantial amount of Medicare expenditures could be saved without compromising quality and access. From the research perspective, this policy implication was made tenable by integrating micro- and macro-level analysis of variations in health services utilization. Still, theoretical limitations inherent in the research pose great challenges to developing effective strategies at the health system level. Variations research in the United States can serve as a case study as to how health services research has responded to efficiency and quality issues in an ever expanding health system Considering the current health policy and research environment in Korea, the following implications can be drawn. Variations research will help formulate a national policy agenda for health care quality and also advance the framework of approaches to health policy issues. For such purposes, both relevant descriptive and hypothesis-testing studies are needed. Further advancement in variations research will require interdisciplinary explorations and methodological sophistication. To the extent that Korean health policies will strive to achieve complex goals, variations research will increasingly prove to be useful.

• Health Policy and Management
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• v.1 no.1
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• pp.19-26
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• 1991

Demographic variables have a great deal of impact on the utilization of health services. In this paper, the use of segmented polinomials is shown to be superior to the simple use of dummy variables and simple polinomials in explaining differences in health care utilization with respect to sex and age differences.

• Journal of Society of Preventive Korean Medicine
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• v.3 no.2
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• pp.1-23
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• 1999

The purpose of this paper is to survey the current status of service utilization in oriental medicine, to identify the determinants of consumers' decision in the service utilization, and then suggest policy implications for promoting the consumers' utilization. A multiple regression model was adopted to analyze the factors that influence consumer's decision in purchasing the oriental medical services. Data used in this research relied on National Survey Data conducted by Korea Institute of Health and Social Affairs, and sampling survey. The results could be summarized as follows.: 1. the number of visits to oriental medical institutions has shown an overall increase during the last decade since the inception of health insurance for oriental medical services. It still, however, revealed a relatively iow figure to western medical services. 2. the main factors, after controlling demographic variables, that determine consumers' selection between oriental medical services and western medical services are considered to be price, belief in effectiveness of services, waiting time for service. Implications for policy recommendation include 1. to reduce a barrier to service utilization by discounting dramatically the price of herb medicine, which is believed to be crucial in expanding market share, 2. to encourage consumer's belief in clinical effectiveness through a specialization in competitive services compared with wertern medicine, 3. to keep the affirmative image among consumers alive through an active participation of oriental medical doctors in community activities, 4 to change the health care system in favor of oriental medicine in the long run.

• Research in Community and Public Health Nursing
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• v.13 no.2
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• pp.272-279
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• 2002

Objectives: The purpose of this study was to analyze health service utilization, and its related factors in low income families who earned half of the average Korean household income. Methods: This was a cross-sectional descriptive survey study in which a nationwide randomization sampling technique was used. The data were collected from July 12 to August 7, 1999, and the total sample size was 5,819 individuals, belonging to 1.753 households. Results: 1) In the utilization of health services for the last 3months, the pharmacy was the type of service that was the most utilized (32.0%), and the health center was the one that was the least utilized (10.3%). About 29% (29.2%) of the respondents could not utilize the health service at all. and 19.8% of the respondents terminated their medical treatments half way to completion because of financial difficulty (89.4%). 2) Analysis of the data using logistic regression showed that living with spouse, level of education, occupation, and income had statistically significant effects on health service utilization. Conclusion: The parameters of health care policies are equity and efficacy for health status, and the health service utilization by low income families. The conclusive resolution for these is the improvement of public health centers for an increased utilization rate of their services.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.13
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• pp.5265-5270
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• 2014

Background: In Korea, the National Health Insurance program has initiated various copayment policies over a decade in order to alleviate patient financial burden. This study investigated healthcare spending and utilization in the last 12 months of life among patients who died with lung cancer by various copayment policy windows. Materials and Methods: We performed a retrospective cohort study using nationwide lung cancer health insurance claims data from 2002 to 2012. We used descriptive and multivariate methods to compare spending measured by total costs, payer costs, copayments, and utilization (measured by length of stay or outpatient days). Using 1,4417,380 individual health insurance claims (inpatients: 673,122, outpatients: 744,258), we obtained aggregated healthcare spending and utilization of 155,273 individual patient (131,494 inpatient and 103,855 outpatient) records. Results: National spending and utilization is growing, with a significant portion of inpatient healthcare spending and utilization occurring during the end-of-life period. Specifically, inpatients were more likely to have more spending and utilization as they got close to death. As coverage expanded, copayments decreased, but overall costs increased due to increased utilization. The trends were the same in both inpatient and outpatient services. Multivariate analysis confirmed the associations. Conclusions: We found evidence of the higher end of life healthcare spending and utilizations in lung cancer patients occurring as coverage expanded. The practice pattern within a hospital might be influenced by coverage policies. Health policy makers should consider initiating various health policies since these influence the long-term outcomes of service performance and overall healthcare spending and utilization.