• Journal of Preventive Medicine and Public Health
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• 제50권1호
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• pp.29-37
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• 2017

Objectives: The accurate measurement of geographic patterns of health care utilization is a prerequisite for the study of geographic variations in health care utilization. While several measures have been developed to measure how accurately geographic units reflect the health care utilization patterns of residents, they have been only applied to hospitalization and need further evaluation. This study aimed to evaluate geographic indices describing health care utilization. Methods: We measured the utilization rate and four health care utilization indices (localization index, outflow index, inflow index, and net patient flow) for eight major procedures (coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, surgery after hip fracture, knee replacement surgery, caesarean sections, hysterectomy, computed tomography scans, and magnetic resonance imaging scans) according to three levels of geographic units in Korea. Data were obtained from the National Health Insurance database in Korea. We evaluated the associations among the health care utilization indices and the utilization rates. Results: In higher-level geographic units, the localization index tended to be high, while the inflow index and outflow index were lower. The indices showed different patterns depending on the procedure. A strong negative correlation between the localization index and the outflow index was observed for all procedures. Net patient flow showed a moderate positive correlation with the localization index and the inflow index. Conclusions: Health care utilization indices can be used as a proxy to describe the utilization pattern of a procedure in a geographic unit.

• 한국도서관정보학회지
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• 제36권2호
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• pp.327-348
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• 2005

본 연구의 목적은 서지정보검색시스템의 색인 정의의 중요성을 강조하고 최적 색인의 기초 자료를 마련하기 위함이다. 이를 위해 서지마크 데이터베이스로부터 색인 태그 정의 및 정규화를 통한 색인어추출이론에 대해 고찰하고, 이론에 따라 생성된 색인어의 검색 활용도를 분석하였다. 실험은 서지 2,200,488건에서 생성된 색인어 29,219,853건을 텍스트형 색인과 코드형 색인으로 나누어 이용자 왱 검색 로그에 나타난 색인 항목과 비교하여 어떤 색인 정의가 얼마나 활용되는가를 분석하였다. 결과에 따르면 서명, 저자, 출판사, 주제와 같은 텍스트형 색인어는 높은 검색 활용도를 보인 반면에 코드형 색인어는 검색 활용도가 낮아 검색에 활용되지 않는 불필요한 색인 정의들은 과감하게 제거하여 색인 정의를 최적화해야 함을 제안하였다.

• 보건행정학회지
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• 제29권3호
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• pp.288-302
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• 2019

Background: The one-person households (OPH) are rapidly increasing and vulnerable to socioeconomic and health problems. Because it is predicted to be inequitable to health care utilization, we would like to find out about the equity of health care utilization of the OPH by comparison with the multi-person households (MPH). Methods: This study followed the theoretical framework of Wagstaff and van Doorslaer (2000), O'Donnell and his colleagues (2008), where the horizontal inequity index is the difference between the concentration indices of actual health care utilization and health care needs. This study employed the 9th Korea Health Panel survey, and a total of 10,807 cases were analyzed. Health care needs were measured by age, sex, subjective health status, chronic disease count, Charlson's Comorbidity Index, limitation of activities, and disability. Results: Compared with the MPH, there were pro-poor inequities in hospitalization, emergency utilization, hospitalization out-of-pocket payments, and pro-rich inequities in outpatient out-of-pocket payments for the OPH. The decomposition of the concentration index revealed that chronic disease count made the largest contribution to socioeconomic inequality in outpatient utilization. Age, health insurance, economic activities, and subjective health status also proved more important contributors to inequality. The variables contributing to the hospitalization and emergency utilization inequity were age, education, Charlson's Comorbidity Index, marital status, and income. Conclusion: Because the OPH was more vulnerable to health problems than the MPH and there were pro-poor inequities in medical utilization, hospitalization, and emergency costs, it is necessary to develop a policy that can correct and improve the portion of high contribution to medical utilization of the OPH.

• Perspectives in Nursing Science
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• 제10권1호
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• pp.52-64
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• 2013

Purpose: The purpose of this study was to explore the utilization of health care of patients with lung cancer in Korea and identify determinants of these patients' health care utilization. Methods: This was a descriptive analytical study. The national medical fees claims data of patients with lung cancer were used. Using SPSS Statistics 20, the ${\chi}^2$-test and logistic regression were performed to determine the factors influencing health care utilization. Results: There were significant differences by sex, age, disease type, stage, comorbidity index, region of institutions, and type of institutions in the utilization of surgical procedures; by age, disease type, stage, comorbidity index, region of institutions, and type of institutions in the utilization of chemotherapy; and by age, stage, comorbidity index, region of institutions, and type of institutions in the utilization of radiotherapy. Conclusion: The findings of this study suggest that democratic and clinical characteristics of patients as well as institutional characteristics affect health care utilization of patients with lung cancer. Additional research is needed to determine the factors influencing health care utilization of patients with lung cancer.

• 보건행정학회지
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• 제27권4호
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• pp.304-314
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• 2017

Background: This study aimed to analyze effects of postpartum care services to women after birth, identify the factors affecting their use, and examine the extent of income-related inequality in the postpartum care services utilization and expenditures using Korean Health Panel data between 2010 and 2013. Methods: The panel data of the year 2010-2013 of the 247 women after birth were used. First, EuroQoL-5D was used to evaluate the effects of postpartum care service to women's quality of life. Second, multinominal logistic regression analysis was used to identify determinants of the use of the postpartum care services. Finally, concentration index and HIwv (horizontal equity) index were used to find that the concentration index for the inequality in the use of postpartum care services showed negative sign, which implied pro-rich. Results: The estimation results showed that utilization of the postpartum services has a positive effect on women after birth. Also age, area of residence, and number of household members turn out to be the factors of using postpartum services. And there are inequality in the use of postpartum care services whose HIwv index showed positive sign, which implied pro-rich. Conclusion: Therefore, the government's policy of the postpartum care service is necessary to be expanded and diversified considering the personal characteristics and equity of the women after birth.

• 한국학교ㆍ지역보건교육학회지
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• 제12권1호
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• pp.35-44
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• 2011

Objectives: The purpose of this study were to measure the effect of factors analyse the associated by the oral health behaviors and dental health services utilization factors of dental caries in the middle-school student's and then to provide basic material of preventive oral health and oral health education program. Methods: This subject of study consists of 342 middle schools each 1,2,3 grade Daegu city. The data were collected from July 2 to 30, 2009. by way of the self-reported questionnaire. The data materials are analyzed by demographic characteristics, oral health behaviors and dental health services utilization of frequency analysis, demographic characteristics of dental caries and oral health behaviors and dental health services utilization of one-way ANOVA analysis. Results: Brushing twice a day, which was the higher 69.3%, Students were trained received oral health education. Girls than boys dental caries teeth(DT) index (p<0.05), dental filling teeth(FT) index(p<0.00), dental experience caries teeth(DMFT) index(p<0.00) was higher than all three variables was a statistically significant. Oral health behavior of brushing twice a day 'once' dental caries teeth(DT) index was the highest, there was statistically significant difference (p<0.01), oral health education students experience a higher dental caries teeth(DT) index(p=0.36). dental health services utilization of preventive dental visits last one year when they did not have dental caries teeth(DT) index was higher (p=0.076) Conclusions: Oral health promotion is considered to adolescent as part of the oral health clinics school for elementary school students in the focus to middle school students and enhance.

• Tuberculosis and Respiratory Diseases
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• 제81권2호
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• pp.116-122
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• 2018

Background: Chronic obstructive pulmonary disease (COPD) is a serious chronic condition with a global impact. Symptoms of COPD include progressive dyspnea, breathlessness, cough, and sputum production, which have a considerable impact on the lives of patients. In addition to the human cost of living with COPD and the resulting death, COPD entails a huge economic burden on the Chinese population, with patients spending up to one-third of the average family income on COPD management in some regions is clinically beneficial to adopt preventable measures via prudent COPD care utilization, monetary costs, and hospitalizations. Methods: Toward this end, this study compared the relative effectiveness of six indices in predicting patient healthcare utilization, cost of care, and patient health outcome. The six assessment systems evaluated included the three multidimensional Body mass index, Obstruction, Dyspnea, Exercise capacity index, Dyspnea, Obstruction, Smoking, Exacerbation (DOSE) index, and COPD Assessment Test index, or the unidimensional measures that best predict the future of patient healthcare utilization, cost of care, and patient health outcome among Chinese COPD patients. Results: Multiple linear regression models were created for each healthcare utilization, cost, and outcome including a single COPD index and the same group of demographic variables for each of the outcomes. Conclusion: We conclude that the DOSE index facilitates the prediction of patient healthcare utilization, disease expenditure, and negative clinical outcomes. Our study indicates that the DOSE index has a potential role beyond clinical predictions.

• 보건행정학회지
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• 제13권3호
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• pp.104-128
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• 2003

Equity in health care has taken priority in the Korean government's policy agenda after the government-led national health insurance achieved universal coverage in 1989 along with the final inclusion of the self-employed as beneficiary. The purpose of this study is to examine the extent to which there exists difference or inequality in the utilization of health care, especially cancer inpatient services among income classes. We analysed the utilization of cancer inpatient services of residents in Jeju Island for a year of 2000, using the national health insurance data for qualification of beneficiaries and utilization of health care. The independent variable are 10 income classes based on the national health insurance fee imposed on each household for a year of 2000. The dependent variables of this study are an amount of cancer inpatient health care utilization measured by cancer admission days and cancer treatment costs. Also, cancer inpatient health care utilization is analysed by three categories divided into utilization in medical care institutions (1) within Jeju Island, (2) outside Jeju Island, and (3) all within and outside Jeju Island. We measured concentration index of cancer inpatient health care utilization. This analysis showed negative concentration index within Jeju Island and positive outside Jeju Island, and positive in all within and outside Jeju Island. This results suggest inequality against the relatively poor income groups in utilization of cancer inpatient health care services. Especially, inequity of cancer inpatient health care would be more serious in Jeju Island of Korea, considering that lower income groups reportedly have higher incidence rates in most of cancer and thus use more health services.

• 한국식품조리과학회지
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• 제11권5호
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• pp.552-556
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• 1995

The rheological properties of Korean white gruel at various concentrations (4-7%) and temperatures (30-60$^{\circ}C$) were investigated. The rheological behavior of Korean white gruel was evaluated by Herschel-Bulkley equation and showed typical Bingham psedoplastic behavior with yield stress. Flow behavior index was increased at over 5％ of rice content. Consistency index was increased by the increase of concentration of rice. But, measuring temperature was not effected in the flow behavior index and consistency index. Yield stress was increased by the incerase of concentration of rice and the decrease of measuring temperature. The activation energy of flow of Korean gruel increased from 7.646 to 32.949${\times}$10/Sup 6/ J/Kg$.$ mole by increasing concentration from 4％ to 7％. As the temperature increased from 30$^{\circ}C$ to 60$^{\circ}C$, B-value decresed from 1.214 to 0.947 Flow behavior index and consistency index was reduced during storage.

• 보건행정학회지
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• 제17권3호
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• pp.26-49
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• 2007

The purpose of this study is to analyze the equity of health care utilization by income groups in terms of both quantity and quality of care, which is measured by expenditure, type of care, and type of health care institutions. Equity in health care utilization is measured by HIwv index, based on the survey of 1,480 Gwangju-Jeonnam residents. Health care utilization in terms of the probability and quantity of outpatient and inpatient care show equitable or pro-poor inequitable distribution, whereas the distribution of health care expenditure, which can account for the quality of care, is pro-rich inequitable, implying that the better off tend to use more expensive medical care. In terms of the types of care, simple visits for basic care show equitable distribution, whereas the distribution of the utilization of traditional tonic medicine, comprehensive health examination, CT, MRI, and ultrasound is pro-rich inequitable. Utilization of general hospitals and traditional health institutions show pro-rich inequitable distribution, hospitals and dental care institutions equitable, and physician clinics and public health centers pro-poor inequitable.