• Health Policy and Management
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• v.33 no.3
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• pp.253-263
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• 2023

Background: The purpose of this study was to explore the relationship between the local extinction index and total medical service utilization. Methods: A fixed effects model in panel analysis was performed for the 228 administrative districts in Korea. The statistical yearbook on the usage of medical services by region and Korean Statistical Information Service data were used from 2010 to 2019 for analysis. Medical service utilization was represented by the number of visits day, the number of inpatient days, and medical charges. Control variables were selected by using an Anderson model. The local extinction index was calculated using resident registration population data. Results: Descriptive statistics showed that the number of areas at risk of extinction increased from 61 to 95 for the study years. In addition, the number of visits, the number of inpatient days, and medical charges all increased during the study years. After controlling for variables affecting medical service utilization and doing a panel fixed effects model, the result suggested that a one-step increase in the local extinction index was significantly associated with a 12.29% decrease in medical charges of inpatients, a 7.33% decrease in medical charge of outpatient, a 5.21% decrease in the number of inpatient day, and a 5.54% decrease in the number of visits day. Conclusion: This study showed that the higher the region's extinction risks, the higher the region's total medical service utilization. The results of this study suggested that there was a disparity in medical service utilization between areas at risk of extinction and areas not at risk of extinction, so measures should be taken to address this disparity.

• Health Policy and Management
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• v.3 no.2
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• pp.27-80
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• 1993

It is widely known that patients' utilization pattern for medical care facilities and the patientflow are influenced by multi-factors, such as demographic characteristics, structural characteristics of society, socio-psychological characteristics(value, attitude, norms, culture, health behavior, etc.), economic characteristics(income, medical price, relative price, physician induced demand, etc.), geographical accessibility, systematic characteristics(health care delivery system, payment methods for physician fees, form of health care security, etc.), and characteristics of medical facilities(reliability, quality of medical care, convenience, kindness, tec.). This study was conducted to research the mechanism of patient-flow according to changes of health care system(implementation of national health insurance, health care referral system and regionalization of health care utilization, etc.) and characteristics of medical facilities(ownership of hospital, characteristics of medical services, non-medical characteristics, etc.). In this study, the fact could be ascertained that the patient-flow had been influenced by changes of health care system and characteristics of medical facilities.

• Health Policy and Management
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• v.33 no.3
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• pp.264-272
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• 2023

Background: Private health insurance supplements the coverage of national health insurance in Korea. In this situation, the subject of the study is to identify the healthcare utilization of people with physical and mental illnesses according to private health insurance. Methods: This study used data from the Korea Health Panel Survey 2018. The study population consisted of 813 individuals with physical and mental illnesses (PMI). Multiple logistic regression analysis and binominal logistic regression analysis were conducted about the utilization of emergency, inpatient, and outpatient medical services of people with PMI depending on enrollment in private health insurance (PHI). Results: The results of this study indicated that individuals with PHI utilized emergency and outpatient medical services less frequently compared to those without PHI. Conversely, having PHI was associated with a higher utilization of inpatient medical services compared to not having PHI. Binomial logistic regression analysis revealed that individuals with PMI who had PHI exhibited a higher frequency of visits to emergency and outpatient medical services compared to those without PHI. However, the significance of this trend was not observed in the case of emergency medical services. On the other hand, individuals with PMI who had PHI showed a lower frequency of visits to inpatient medical services compared to those without PHI. Conclusion: In conclusion, there was a significant relationship between having PHI and the utilization of medical services in people with PMI. There is a need for a follow-up study considering the type of mental illnesses, length of stay, and health outcome of people with PMI depending on having PHI.

• Journal of Digital Convergence
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• v.16 no.11
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• pp.411-418
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• 2018

The purpose of this study was to estimate the current status and trends of healthcare utilization among people with ASD. Using National Health Insurance open database, from 2010 to 2017. We analyzed the treatment prevalence for people with ASD, the pattern of healthcare utilization, the difference in medical care utilization according to age, and the type and location of main medical institutions. The main results of the study are as follows: First, the medical utilization has been continuously increasing from 2010 to 2017. The total amount of medical utilization is increased by 50% in 2017 compared to 2010, and the treatment prevalence was estimated to be 79.1% in 2017 and medical uses for the next three years is also increasing. Second, the pattern of medical care utilization varied widely according to age, especially after 20 years of age. Third, the types of medical institutions that were mainly used were 45.6% in the medical clinic and 35.9% in Seoul. The results of this study can be used as a minimum reference point of evaluating the effectiveness of government policy on future autistic disorders. However, further studies are required to increase the prevalence of treatment for autistic patients and to find out the difference in medical use according to age.

• Journal of Preventive Medicine and Public Health
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• v.32 no.2
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• pp.206-214
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• 1999

Objectives: This study was carried out to identify relation of health care utilization due to skin disease(ICD-10, L00-L99) and characteristics(sex, age, exposure status, type of industry, size of enterprise) of workers. Methods: We made new database composed of 30,536 workers' health examination results in one specific health examination institute in Inchon and data of medical insurance utilization due to skin disease in 4 medical insurance associations for enterprise from January, 1995 to December, 1997 And we analyzed determinants of health care utilization due to skin disease of workers. Results: Among 30,536 study subjects, 8,837(28.9%) workers and 4,181 (13.7%) workers utilized medical insurance due to total skin disease(ICD-10, L00-L99) and contact dermatitis(ICD-10, L23-L25), respectively. Female workers(p<.001), workers exposed to organic solvents(p<.05), workers if manufacturing industries(p<.05, p<.01, respectively) and in large scale enterprises(p<.001) utilized more medical insurance due to total skin disease and contact dermatitis than male workers, workers not exposed to organic solvents, workers in non-manufacturing industries and small scale enterprises. With multiple logistic regression analysis, significant explanatory variables affecting workers' medical utilization due to total skin disease and dermatitis and eczema(ICD-10, L20-L30) in total workers were sex, age, specific chemicals and size of enterprises. And age, type of industries, organic solvents, specific chemicals and size of enterprises were significant explanatory variables related to medical insurance utilization due to dermatitis and eczema and contact dermatitis in male workers. Conclusion: From the above results, we found that workers exposed to organic solvents utilized more medical insurance due to skin disease than workers not exposed to. And, comparing to workers in large scale enterprises, workers in small scale enterprises may have unmet medical care utilization due to skin disease. Therefore we have to establish counterplan to manage occupational skin disease of high risk group(organic solvent exposure group) and to satisfy unmet medical care utilization of workers in small scale enterprises.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.11
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• pp.7463-7473
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• 2015

This study aims to analyze the effect of long-term care utilization on health care utilization of the national health insurance elderly. This study is a secondary data analysis of the long-term care insurance data that comprised of total 21,213 long-term care insurance with the level 1 elders who received either service or non-service. This study evaluated the impact of long-term care service on the probability of health care utilization experience and costs of health care utilization. The total medical cost, geriatric hospital's medical cost, inpatient day and geriatric hospital's inpatient day by 2007-2009 were significant factor influencing the long-term care utilization. This study suggests long term care system should proper medical service linkage system. The current long-term care insurance system should more resource allocation on long-term care utilization to increase the efficiency of insurance system.

• The Korean Journal of Health Service Management
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• v.10 no.4
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• pp.97-107
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• 2016

Objectives : This study aims to : (i) characterize and differentiate between two different periods of baby boomers, (ii) study the utilization of their health care services, and (iii) establish effective ways of providing better health service utilization and preventive policy strategies for upcoming and older generations. Methods : A multiple regression analysis using descriptive statistics, frequency analysis, and dummy variables was utilized to access the presence of correlations between socio-demographic factors and health care service utilization. Results : Medical insurance type, marital status, and chronic disease were factors that influenced health care service utilization. Furthermore, the factors that influenced individual medical expenses were cohabitation, inpatient days, and chronic disease. Conclusions : Primary findings and exploratory statistics revealed that there were strong correlations and interaction among some of the predictor variables. Because of the chronologically limited nature of the sample data set gathered in 2012, it would be helpful to continue to develop or research related constructs that may capture relationships more effectively among extended populations.

• The Korean Journal of Health Service Management
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• v.11 no.3
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• pp.51-64
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• 2017

Objectives : This study examined the effect of private health insurance on medical care utilization by subscription type. Methods : The data used were the six waves of the Korea Health Panel (2009-2014), and 16,187 persons were the subjects of the analysis. We performed a panel regression with a fixed effects model. Results : Indemnity private health insurance was positively related to the number of physician visits, number of admissions, and total length of stays. However, fixed-benefit private health insurance was not related to medical care utilization. Conclusions : The result of this study, which shows the difference by subscription type in the effect of private health insurance on medical care utilization, suggests that continuous monitoring of indemnity private health insurance is needed in the future.

• The Korean Journal of Health Service Management
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• v.13 no.4
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• pp.179-190
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• 2019

Objectives: This study aimed to investigate the mediating effects of health promotion behaviors on the correlation between self-perceived health and medical care utilization among older adults. Methods: This study used data from a. Data were analyzed with frequency analysis, descriptive statistics, Pearson's correlation coefficient, and hierarchical multiple regression. Mediation analysis was performed according to the Sobel test. Results: The self-perceived health and some health promotion behaviors in older adults had a statistically significant effect on medical care utilization. Only the nutritional management of health promotion behaviors had a mediating effect on the relation between the self-perceived health and medical care utilization of older adults. Conclusions: The nutritional management of older adults was confirmed as an important factor to health promotion and prevention. This study was meaningful in that it identified the political directions for establishing health care policy for the older adults.

• Korean Journal of Occupational Health Nursing
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• v.19 no.2
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• pp.170-179
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• 2010

Purpose: It was to identify the relationship with the health beliefs, self-efficacy and medical care utilization in nurses in order to provide basic data for program development to actively help nurses' health practice. Methods: The subjects were 360 hospital nurses in P city, K Province. Instruments were health belief developed by Walker, Sechrist & Pender (1987), self-efficacy by Sherer, Maddux & Mercandante(1982), and medical care utilization by Korean National Health & Nutrition Examination Survey(2006). The data were analyzed as descriptive statistics, Chi-square, t-test, and ANOVA using SPSS 11.5. Results: There were significant differences in medical care utilization depending on age(p=.008), marital status(p=.019), education level(p=.005), types of work(p=.017), nursing units(p=.018), and period of work(p=.001). Use of outpatient clinic was significantly different depending on perceived susceptibility(F=2.463, p=.045). Nurses who consulted to doctor in other hospital had higher perceived severity(F=2.759, p=.028). Nurses who used complementary medicine had higher perceived barrier(F=2.278, p=.047). The score of self-efficacy was significantly different in medical care service frequency (F=3.030, p=.018) and to whom their health problems consulted(F=3.092, p=.010). Conclusion: Medical service utilization was different depending on the demographic characteristics, perceived susceptibility, severity, and barrier, and self efficacy. It is needed to give health promotion program considering these factors for nurses.