• Title/Summary/Keyword: patients' determinants

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Determinants of Mental Health Care Utilization in a Suicide High-risk Group With Suicidal Ideation

  • Kim, Hyun-Soo;Lee, Moo-Sik;Hong, Jee-Young
    • Journal of Preventive Medicine and Public Health
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    • v.49 no.1
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    • pp.69-78
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    • 2016
  • Objectives: The suicide rate in Korea is increasing every year, and is the highest among the Organization for Economic Cooperation and Development countries. Psychiatric patients in particular have a higher risk of suicide than other patients. This study was performed to evaluate determinants of mental health care utilization among individuals at high risk for suicide. Methods: Korea Health Panel data from 2009 to 2011 were used. Subjects were individuals at high risk of suicide who had suicidal ideation, a past history of psychiatric illness, or had utilized outpatient services for a psychiatric disorder associated with suicidal ideation within the past year. The chi-square test and hierarchical logistic regression were used to identify significant determinants of mental health care utilization. Results: The total number of subjects with complete data on the variables in our model was 989. Individuals suffering from three or more chronic diseases used mental health care more frequently. Mental health care utilization was higher in subjects who had middle or high levels of educational attainment, were receiving Medical Aid, or had a large family size. Conclusions: It is important to control risk factors in high-risk groups as part of suicide prevention strategies. The clinical approach, which includes community-based intervention, entails the management of reduction of suicidal risk. Our study identified demographic characteristics that have a significant impact on mental health care utilization and should be considered in the development of suicide prevention strategies. Further studies should examine the effect of mental health care utilization on reducing suicidal ideation.

Distribution and Determinants of Out-of-pocket Healthcare Expenditures in Bangladesh

  • Mahumud, Rashidul Alam;Sarker, Abdur Razzaque;Sultana, Marufa;Islam, Ziaul;Khan, Jahangir;Morton, Alec
    • Journal of Preventive Medicine and Public Health
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    • v.50 no.2
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    • pp.91-99
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    • 2017
  • Objectives: As in many low-income and middle-income countries, out-of-pocket (OOP) payments by patients or their families are a key healthcare financing mechanism in Bangladesh that leads to economic burdens for households. The objective of this study was to identify whether and to what extent socioeconomic, demographic, and behavioral factors of the population had an impact on OOP expenditures in Bangladesh. Methods: A total of 12 400 patients who had paid to receive any type of healthcare services within the previous 30 days were analyzed from the Bangladesh Household Income and Expenditure Survey data, 2010. We employed regression analysis for identify factors influencing OOP health expenditures using the ordinary least square method. Results: The mean total OOP healthcare expenditures was US dollar (USD) 27.66; while, the cost of medicines (USD 16.98) was the highest cost driver (61% of total OOP healthcare expenditure). In addition, this study identified age, sex, marital status, place of residence, and family wealth as significant factors associated with higher OOP healthcare expenditures. In contrary, unemployment and not receiving financial social benefits were inversely associated with OOP expenditures. Conclusions: The findings of this study can help decision-makers by clarifying the determinants of OOP, discussing the mechanisms driving these determinants, and there by underscoring the need to develop policy options for building stronger financial protection mechanisms. The government should consider devoting more resources to providing free or subsidized care. In parallel with government action, the development of other prudential and sustainable risk-pooling mechanisms may help attract enthusiastic subscribers to community-based health insurance schemes.

Satisfaction Determinants of Rehabilitation Care Group Inpatients in Rehabilitation Long-term Care Hospitals (재활요양병원의 재활군 환자의 만족도 요인에 관한 연구)

  • Kim, Jae-Seop;Chang, Yun-Jeong
    • The Korean Journal of Health Service Management
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    • v.10 no.4
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    • pp.61-73
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    • 2016
  • Objectives : The aim of this study was to investigate the satisfaction determinants of rehabilitation care group inpatients in rehabilitation long-term care hospitals. Methods : A survey was conducted with 262 patients from 6 rehabilitation long-term care hospitals located in Busan Kyungnam. Data were collected from June 2016 to July 2016 with a structured questionnaire and analyzed with SPSS 23.0. Results : The significant factors affecting the overall satisfaction score were disease group and 5 quality indices of medical services(Medical service quality, Rehabilitation services quality, Hospital reputation, External physical environment, and Internal physical environment). Additionally, the significant factors affecting intention to revisit were age, disease group, length of hospital stay and the 5 quality indices of medical services. Conclusions : The results of this study indicate that rehabilitation long-term care hospitals should try to improve the overall satisfaction of inpatients, especially focusing on the internal physical environment and the quality of the rehabilitation services and medical services, which will lead to a high level of intention for patients to revisit.

An Empirical Study on The Relationships of Service Quality, Customer Satisfaction and Its Influencing Variables in Medical Service area (의료서비스의 품질 및 고객만족 관련 변수들의 관계에 관한 실증적 연구)

  • Cho, Hyun-Joo
    • Korea Journal of Hospital Management
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    • v.4 no.1
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    • pp.171-189
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    • 1999
  • This study aims to investigate the determinants of service quality and the relationships of service quality, customer satisfaction, word of mouth and subsequent purchase intention of medical service. SERVQUAL, an instrument developed by the marketing area, is offered as a possible measure of medical service quality. SERVQUAL measures service dimension of tangibles, reliability, responsiveness, assurance and empathy. The questionnaire method is used in this study. A survey is conducted on patients who are randomly selected. The questionnaire are sent to 300 patients and 208 are available. The objectives of this study were: 1) to find out the influence of determinants of service quality on medical service. 2) to investigate the relationship of medical service quality and customer satisfaction. 3) to analyze the relationship of customer satisfaction and favorable word of mouth, ubsequent purchase intention 4) to find out the gap perceived service quality between secondary and tertiary hospital. The results of this study are summarized as follows: 1) Reliability, responsiveness and assurance have a positive impact on the medical service quality. 2) Medical service quality has a positive impact on the customer satisfaction. 3) Customer satisfaction has a positive impact on the favorable word of mouth and subsequent purchase intention. 4) There is no gap between secondary and tertiary hospital of perceived service quality.

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The Determinants of the Long-term Influence of Violence: Focus on Hospital Nurses (폭력의 장기적 영향 결정요인: 병원간호사를 중심으로)

  • Lee, Sun-Ok;Kim, Moon-Jeong
    • The Korean Journal of Health Service Management
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    • v.10 no.1
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    • pp.93-104
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    • 2016
  • Objectives : The purpose of this study was to identify the determinants of the long-term influence of violence on hospital nurses. Methods : Three-hundred hospital nurses were recruited in B city, South Korea. They were asked to complete a questionnaire, and 282 data- sets were included in the multiple regression analysis. Results : Subjects experienced more episodes of verbal violence than that of physical threats or physical violence. Assailants tended to be patients and their caretakers rather than internal customers. Nurses who had religion, worked in a surgical ward, and a 3-6 year career perceived a high level of violent experiences compared to their counterparts. The determinants of the long-term influence of violence were physical violence (t=-2.705, p=.007), emotion-focused coping (t=3.049, p=.003), and emotional response (t=3.611, p<.001). The model was statistically significant explaining 13.0% of the variance (F=14.981, p<.001). Conclusions : Nurse managers should help nurses who are victims of hospital violence by teaching them not to depend on emotion-focused coping and by alleviating their emotional response to violence.

A Study on WOM and Determinants of Hospital Choice (구전(WOM)활동과 의료기관 선택요인 : - 피부과와 산부인과의 20~30대 여성고객 중심으로 -)

  • Shin, Young-Hee;Suh, Chang-Jin
    • Korea Journal of Hospital Management
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    • v.16 no.2
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    • pp.31-52
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    • 2011
  • The cutthroat competition of the market for the medical services caused changes and developments of hospital management from the traditional provider-oriented management to a consumer-oriented management toward the customer. And the popularization of on-line community through the growth and spread of internet technology is developed into an important exploration activity to provide various medical information to patient(or customer) who wishes a high-quality medical services. This is an on-line Word-of-Mouth(WOM). It is a kind of information exploration that is performed by customers before choosing the hospital with off-line word-of-mouth. In this study, we develop our research model to verify the causal relationships among on/off-line WOM, key determinants of hospital choice and the customer's will to make use of the hospitals, and total effect of these variables. We adopt a component-based PSL method for an empirical analysis of the patients experienced dermatology or obstetrics gynecology. Finally, we understand the characteristics of the various medical services and draw new and significant strategic previews.

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Erythrocyte Sedimentation Rate: Its Determinants and Relationship with Risk Factors Involved in Ischemic Stroke

  • Kaur, Kirandeep;Kaur, Amandeep;Kaur, Anupam
    • Korean Journal of Clinical Laboratory Science
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    • v.54 no.1
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    • pp.1-8
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    • 2022
  • Erythrocyte sedimentation rate (ESR) evaluation is a useful tool for monitoring disease activity in various inflammatory and non-inflammatory conditions. ESR is known to be influenced by a multitude of confounding factors. The present study aimed to assess the possible determinants of the ESR and its relationship with various risk factors involved in ischemic stroke. ESR and other hematological and biochemical parameters were investigated in 163 ischemic stroke patients (107 males and 56 females) selected based on imaging techniques including magnetic resonance imaging (MRI) or computed tomography (CT) scans. Statistical analysis was performed using the SPSS 16.0 software. Linear regression analysis showed a significant inverse relationship of hemoglobin (Hb) and hematocrit or packed cell volume (PCV) (P<0.001 for females; P<0.01 for males) with the ESR. It was observed that the red blood cell (RBC) count was not strongly correlated with the ESR (P<0.05 for both males and females). It was also observed that sex significantly affected the variables determining the ESR levels, whereas age had no effect. Gender differences were also observed with respect to Hb, RBC, PCV, mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and ESR. The possible determinants of higher ESR levels in ischemic stroke may be sex, Hb, hematocrit, and RBC count, but the role of other clinical and laboratory parameters cannot be underestimated.

Determinants of Patient Satisfaction -Allergic Rhinitis Patients Treated with Laser Therapy- (비염 레이저 치료환자의 만족도)

  • Jin, Ki-Nam;Chung, Woo-Kyung;Jang, Seung-Yon
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.2 s.57
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    • pp.402-412
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    • 1997
  • The purpose of this study is to examine the factors influencing the allergic rhinitis patients' satisfaction with laser surgery. The data were collected by telephone interviews with 211 patients who visited I university hospital. The statistical methods used for the analysis were factor analysis, reliability test, and hierarchical multiple regression. We find that satisfaction level is a function of not only the surgery outcome but also the socio-psychological experience during treatment. With the improvement in nasal allergic condition, patients were more likely to be satisfied with medical services. And patients who had positive experience with physicians and facilities reported higher satisfaction level. While the surgery outcome explained 68% of the variation of satisfaction level, socio-psychological experience explained 23% of it. This result clearly shows that physicians need to pay attention to the socio-psychological aspect as well as the technical aspect of medical services.

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Determinants of Length of Hospital Stay by Insured and Non-insured Patients (의료보험환자와 일반환자의 재원기간에 관련되는 요인분석)

  • Yu, Seung-Hum;Lee, Tae-Yong;Oh, Dae-Kyu
    • Journal of Preventive Medicine and Public Health
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    • v.16 no.1
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    • pp.157-162
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    • 1983
  • In order to determine the factors affecting the length of stay by pay status, a total of 961 in-patients medical records with appendectomy. cholecystectomy and Cesarean section discharged from the January 1979 to December 1981 from the University hospital were reviewed. Average length of stay showed no statistically significant difference by year between the insured and the non-insured patients, however multiple diagnoses and surgical complication were significantly different from single diagnosis and non-complicated cases. Surgical complication explained the length of stay mostly, and physician in discharge, multiple diagnoses, and accommodation in order for insured patients. Surgical complication, admission route, physician in charge and age in order explained the length of stay for non-insured patients.

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Potential Predictors of Sensitivity to Pemetrexed as First-line Chemotherapy for Patients with Advanced Non-Squamous NSCLCs

  • Lu, Yan-Yan;Huang, Xin-En;Xu, Lin;Liu, De-Gan;Cao, Jie;Wu, Xue-Yan;Liu, Jin;Xiang, Jin
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.2005-2008
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    • 2013
  • Background: Pemetrexed (PEM) is effective in first-line treatment for patients with non-squamous non-small cell lung cancer (NSCLC). However there are currently no definitive determinants to certify which patients could benefit from PEM. To improve the efficacy of PEM combined with platinum as first-line therapy for advanced non-squamous NSCLC, we conducted this retrospective study to detect potential determinants of this regimen. Methods: We recruited 109 patients with advanced non-squamous NSCLC who received PEM with a platinum as first-line therapy from June 2006 to February 2013 in Jiangsu Cancer Hospital. Multiple variables (age, sex, smoking, degree of cell differentiation, hemoglobin, platinum drugs combined, positions of metastasis) were selected. Logistic regression analysis was used to analyse relationships between these variables and tumor response. Result: In univariate analysis, we found that age and platinum significantly influenced the results of PEM therapy (P<0.05). In multivariable analysis, no factors were independently significant. Conclusion: Our analysis did not suggest that the age, sex, metastasis of liver or other organs, hemoglobin, smoking history and pathological differentiation are associated with the response of PEM. We should conduct further analyses with larger sample size to reconfirm this issue.