• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.15 no.11
• /
• pp.6746-6755
• /
• 2014

This study examined the effect of long-term care utilization on the health care utilization of Medicaid elderly. The subjects were 5,834 long-term care insurance with the level 1 Medicaid elders, who received either service or non-service. This study examined the impact of long-term care service on the probability of health care utilization and the costs of health care utilization. The total medical cost and inpatient day between 2009-2007 were significant factors affecting long-term care utilization (${\beta}=.29$, p< .001, ${\beta}=.33$, p< .001 ) and this variable explained 22.6% of the total medical cost and 22.4% of the inpatient day. The results showed that non-service in long-term care was associated with an increase in health care utilization. The current long-term care insurance system should place higher priority and more resource allocation on long-term care utilization to increase the efficiency of the insurance system.

• Korean Journal of Social Welfare
• /
• v.60 no.4
• /
• pp.231-251
• /
• 2008

Academic interest has been drastically increased for the health disparities due to socioeconomic factors. For those who have a chronic illness such as diabetes, various psychosocial barriers related to illness management might affect and aggravate this disparity. This study focused on illness management barriers experienced by people with diabetes, and examined the differences by their Medicaid beneficiary status. The between group differences in illness management barriers, family support and health status were examined as well as the association between illness management barriers and health status. The sample of this study consists of 144 community dwelling adults who have diabetes, recruited from an outpatient diabetes clinic and a community welfare center. Medicaid beneficiaries reported poorer health status, and experienced more illness management barriers compared to their counterparts. Statistically significant differences were observed in barriers due to mental health, financial status, and lack of support. The between group difference in health status remained significant after controlling for the effect of demographic characteristics and illness related factors. Social work practitioners working with this population should address these illness management barriers to reduce socioeconomic health disparity.

• Korean Journal of Social Welfare
• /
• v.57 no.2
• /
• pp.71-92
• /
• 2005

This study investigated social support, quality of life, and the impact of social support on quality of life among medicaid recipient with chronic illness such as hypertension, arthritis, diabetes, and stroke in Dec, 2003(N=221). Subjects were collected using stratified sampling by sex, age, diagnosis, and domicile on national data from National Health Insurance Corporation. Descriptive analysis and regression were performed. Results showed social support and quality of life was very low and social support was different in diagnosis and domicile, and social support, especially emotional support from family members, positively impacted on quality of life. The relationship of the two variables showed the differences in sex, diagnosis and domicile. This study will be used as theoretical bases for enhancing social support and quality of life among medicaid recipient with chronic illness.

• 대한예방의학회:학술대회논문집
• /
• 2001.10a
• /
• pp.180-181
• /
• 2001

• Journal of agricultural medicine and community health
• /
• v.16 no.2
• /
• pp.125-133
• /
• 1991

The medical insurance system has been adopted in rural areas in 1988. Since then, the utilization of medical care services has increased rapidly in rural areas. According to the various study on medical care utilization, the people in rural areas used more curative care services than urban areas. The purpose of this study was to analyze the utilization and expenses of medical care services in designated rural areas : Choonseong Gun, Kangwon Province ; and Soonchang Gun, Cheonbuk province in Korea. Medical care utilization of medical care beneficiaries showed slightly increase, while there was a decrease of 18% and more for the medicaid. Regarding selection of medical care institutions, medical care beneficiaries used more hospitals and clinics than health center networks, but the health center networks was used more by the medicaid. However, the hospitalized Soonchang health center was able to provide more curative care to the people than the other two health centers. More than 50% of the patients treated by hospitalized health center were residents of the place in which health center was located.

• Journal of Society of Preventive Korean Medicine
• /
• v.2 no.1
• /
• pp.231-242
• /
• 1998

• Journal of Preventive Medicine and Public Health
• /
• v.38 no.1
• /
• pp.93-100
• /
• 2005

Background : Cancer is the leading cause of death and one of the largest burdens of disease in Korea. In 1996, the Ten year Plan for Cancer Control was formulated and the government then adopted the plan as a national policy. As part of this plan, the National Cancer Screening Program (NCSP) for Medicaid recipients was formulated, and the government adapted this in 1999. For low-income beneficiaries of the National Health Insurance Corporation (NHIC), the screening program has been in place since 2002. In 2002, the target cancers of NCSP were stomach, breast and cervical cancer. This study was conducted to examine the relationships between the participation rate, the abnormal screening rate and the socio-demographic factors associated with participation in the screening program. Methods : To analyze the participation rate and abnormal rate for the NCSP, we used the 2002 NCSP records. The information on the socio-demographic factors was available from the database of the beneficiaries in the NHIC and Medicaid. Results : The participation rate of the Medicaid beneficiaries for the stomach, breast and cervical cancer screening were 9.2%, 15.5% and 15.0%, respectively, and 11.3% and 12.5%, except cervical cancer which wasn't be included in the NCSP, for the beneficiaries of the NHIC. The abnormal rate of stomach, breast and cervical cancer screening were 25.7%, 11.2% and 21.0%, respectively, for the beneficiaries of Medicaid and 42.6% and 19.4% for the beneficiaries of the NHIC. On the multiple logistic regression analysis, gender, age and place of residence were significantly associated with participation rates of the NCSP. For stomach cancer, women participated in the NCSP more than men. The participation rate was higher among people in their fifties and sixties than for those people in their forties and those people over seventy years in age. For the breast and cervical cancer, people in their fifties were more likely to participate in the NCSP than people in their forties and people over sixty. For the place of residence, people in the rural areas participated more than those people in any other places. Conclusions : The above results show that the participation rate and abnormal rate were significantly associated with the socio-demographic factors. To improve the participation rate for the NCSP, more attention should be given to the underserved groups.

• The Korean Nurse
• /
• v.32 no.1
• /
• pp.95-110
• /
• 1993

The purpose of this study was to describe the populat.ion of a Medicare/Medicaid home healt.h agency in Galveston, identify their specific needs and assess their satisfaction with the services pro-vided to them. The data obtained will be used to improve home health services in the Galveston agency.

• Communications for Statistical Applications and Methods
• /
• v.25 no.2
• /
• pp.173-184
• /
• 2018

In medical or public health research, it is common to encounter clustered or longitudinal count data that exhibit excess zeros. For example, health care utilization data often have a multi-modal distribution with excess zeroes as well as a multilevel structure where patients are nested within physicians and hospitals. To analyze this type of data, zero-inflated count models with mixed effects have been developed where a count response variable is assumed to be distributed as a mixture of a Poisson or negative binomial and a distribution with a point mass of zeros that include random effects. However, no study has considered a situation where data are also censored due to the finite nature of the observation period or follow-up. In this paper, we present a weighted version of zero-inflated Poisson model with random effects accounting for variable individual follow-up times. We suggested two different types of weight function. The performance of the proposed model is evaluated and compared to a standard zero-inflated mixed model through simulation studies. This approach is then applied to Medicaid data analysis.

• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.2 no.1
• /
• pp.17-30
• /
• 2006

Federal disability law has evolved from several laws geared to protect people with disabilities since the late 1960s and early 1970s. When U.S. Congress passed the Americans with Disabilities Act (ADA) in 1990, no federal statute prohibited the majority of employers, program administrators, owners and managers of places of public accommodation and others from discriminating against people with disabilities. Toward the ends to assure equality of opportunity, full participation, independent living, and economic self-sufficiency for individuals with the disabilities, the ADA pursues three major strategies: Title I addresses inequality in employment, Title II, inequality in public services, and Title III, inequality in services and accommodations offered by private entities. The purposes of the study were to analyze the impact of the ADA on health care for persons with disabilities and to review the ongoing health policy reforms at the federal and state governments. Essential remedies that the ADA contemplates are based on two principles, simple discrimination and reasonable accommodation, which significantly improved access to quality care, especially long-term care, by persons with disabilities. However, the ongoing Medicaid policy reforms to control rising health care costs in the U.S. could threaten the access to care by persons with disabilities in optional groups and to optional care services by persons with disabilities in mandatory groups.