• Journal of Preventive Medicine and Public Health
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• v.20 no.2 s.22
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• pp.287-300
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• 1987

Island regions suffer from a shortage of health care in part because they are less developed, they cover a widespread area relative to the population, and due to transportation barriers. The purpose of this study was to assess the level of illness and the magnitude of medical care utilization, and to investigate the determinants of utilization in these area. The data were collected by means of a household survey conducted from February 16 to 25, 1987 on S islands which were selected in consideration of the size of the population, the distance from the main land, and the distribution of health care facilities. The household response rate was 89.1% (491 of 551 households), and 1971 persons were surveyed. The major findings of this study are as follows: 1) The morbidity rate of the island inhabitants was 27.7% during the two weeks, and 25.5 chronic illnesses and 9.1 acute illnesses per 100 persons, were noted. Differences in the magnitude of illness were statistically significant by sex, age, education, and family size. 2) The magnitude of total ambulatory carl utilization was 16.8 visits per 100 persons during the two weeks, which was less than that of other regions; and differences in the magnitude of total ambulatory care were statistically significant by sex, age, education, occupation, and family size. 3) Unmet needs were classified as 56.0% in chronic illnesses and 19.6% in acute illnesses; and differences in unmet needs were statistically significant by sex, age, education, occupation, income, and family size. 4) Statistically significant determinants in medical care utilization included the frequency of acute illness and chronic illness, and income in total utilization; the frequency of chronic illness and acute illness, and medical care insurance in physician visits. 5) According to the results of the path analysis, need factors had the greatest effect on utilization, and predisposing factors had more indirect effects through enabling or need factors than direct effects.

• Journal of Preventive Medicine and Public Health
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• v.54 no.1
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• pp.81-84
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• 2021

The delivery of high-quality antenatal care is a perennial global concern for improving maternal and neonatal outcomes. Antenatal care is currently provided mainly on a one-to-one basis, but growing evidence has emerged to support the effectiveness of group antenatal care. Providing care in a small group gives expectant mothers the opportunity to have discussions with their peers about certain issues and concerns that are unique to them and to form a support system that will improve the quality and utilization of antenatal care services. The aim of this article is to promote group antenatal care as a means to increase utilization of healthcare.

• Journal of Preventive Medicine and Public Health
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• v.22 no.2 s.26
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• pp.236-241
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• 1989

The purpose of this study was to introduce the methodology of intervention analysis with time series data and to investigate the influence of the patient referral system on medical care utilization in Kangwha county. The data were obtained at the Kangwha Medical Inurance Society and we analysed the material based on the outpatient care fee. The results were as fellows: 1. The average outpatient care utilization in the hospital decreased by 41.7% due to the patient referral system. 2. The utilization of the health instituation increased by 278.8 persons per month due to the patient referral system. 3. The patient referral system did not influence the total outpatient are utilization. The methodology of intervention analysis, which detected the effect of intervention, will be helpful to the study of public health area.

• The Korean Journal of Health Service Management
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• v.9 no.4
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• pp.131-144
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• 2015

Objectives : This study investigated the health care utilization patterns and length of stay (LOS) determinants of fracture patients with workers' compensation insurance (WCI) and national health insurance (NHI). Methods : The discharge summary data of 4,394 WCI fracture patients were compared to 28,874 NHI patients. Health care utilization characteristics were compared with a logistic regression analysis, and the LOS determinants were identified with linear regression analysis. Results : The average LOS of the WCI fracture patients was 2.4 times higher than that of the NHI patients. WCI patients used more small or medium sized hospitals, and were more frequently admitted through the emergency room. Females, older patients and patients admitted through emergency room had a significant positive impact on LOS. Conclusions : Healthcare utilization by the WCI fracture patients may include medically unnecessary hospital stays. Therefore, policy makers need to respond appropriately to the inefficient use of health resources by WCI patients.

• Journal of Preventive Medicine and Public Health
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• v.24 no.3 s.35
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• pp.328-338
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• 1991

To find out the state of illness, patterns of medical care utilization, and factors which determine medical care utilization for aged we surveyed 679 rural old persons who live in the Chungnam province from Jan. 10 1991 to Jan. 19. The major findings of this study were as follows : 1. The morbidity rate of chronic illness during last 3 months was 56.4% for all surveyed old persons ; 58.7% for female and 52.8% for male. 2. As expected, 80 years old or above group showed the highest morbidity rate, 60.2% and the 65-69 years age group was the lowest, 50.5%. 3. Old persons who are householder, whose family income is less than 290,000 won per month, and who receive benifits from the public medical assistance program had relative higher morbidity rate than other groups and the difference was statistically significant (p<0.05). 4. The most frequent chronic illness was musculoskeletal disease, 49.6% ; the disease from which the aged had suffered for the longest period was gastrointestinal, 11.6yrs : the cerebrovascular was the disease which inflicts the lowest level of physical ability. 5. 67.1% of 383 persons who were suffering from chronic illness were in need of medical care but unmet ; among the remaining 32.9% who utilized medical care, 19.2% utilized it in local clinics or hospital OPD and 15% in th health centers or subcenters. 6. Old person who are married, whose sons are householder and whose family income is 500,000 won or above per month showed relative higher utilization rate than other groups and the difference was statistically significant (p<0.05). 7. The most common reason why the aged did not utilize, in spite of, need medical care was economic problem, 35.4%. For the aged whose family income per month is 500,000 won or above, however the most common reason was tolerable symptom, 46.9% while persons who answered economic problem were 6.1% of them, the lowest frequency.

• Journal of Preventive Medicine and Public Health
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• v.23 no.3 s.31
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• pp.316-323
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• 1990

To analyze of determinants influencing the utilization of the rural health sub-centers (HSCs), 116 of 144 HSCs in Kyong Gi Do, were selected for this study. The self-administered questionnaire covering the environment and the characteristics of doctors working in the HSCs was sent to HSCs by mail. 105 questionnaires were returned of which 88 were completed and use in the study. The dependant variable was the total number of medical care visits to the HSCs from January 1, 1990 to March 31, 1990. Data was analyzed by multiple regression analysis. The results were as follows : First, the more time required to set from the HSCs to nearest hospital or clinic, the higher the utilization of the HSCs. Second, the more geographically accessible the HSCs was, the more utilization the HSCs. Third, the older of the HSCs doctors were, the more utilization of the HSCs. Fourth, the higher frequency of bus service from the HSCs to town, the more utilization of the HSCs. Fifth, the more time required from the HSCs to town, the more utilization of the HSCs. Therefore, the determinants influencing the utilization of the rural HSCs in Kyong-Gi Do, are mostly geographical accessibility of medical care.

• The Journal of the Korea Contents Association
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• v.17 no.5
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• pp.479-490
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• 2017

The objective of this study is to examine the association of social networks and medical care utilization of elderly living alone depending on self-rated health status, and also to measure the moderating effects of welfare services for elderly. To this purpose, the data which was collected from the 2014 National Survey on Elderly in Korea was analyzed by Chi-square test and Poisson regression. According to the results, social networks and elderly welfare services affected to medical care utilization of elderly living alone, only who aware of their self-rated health status as bad. With this group, the frequency of contact with family and participation in lifelong education had a significant effect on increasing medical care utilization. In contrast, the frequency of contact with neighbors and the participation in elderly employment program were significant to reduce the utilization of medical care. Furthermore, the moderating effects of elderly welfare services were also measured that formal social gathering has an effect of increasing the medical care utilization of elderly living alone by expansion of their social networks. Based on these results, this study consequently has an implication for suggesting expansion of elderly welfare services, which might be an alternative to social networks of elderly living alone, and also for seeking the direction of political intervention that helps health promotion and disease prevention through the research of medical care utilization.

• Journal of Korean Academy of Nursing Administration
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• v.14 no.3
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• pp.229-240
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• 2008

Purpose: To develop the patient classification system based on the resource utilization for reimbursement of long-term care hospitals in Korea. Method: Health Insurance Review & Assessment Service (HIRA) conducted a survey in July 2006 that included 2,899 patients from 35 long-term care hospitals. To calculate resource utilization, we measured care time of direct care staff (physicians, nursing personnel, physical and occupational therapists, social workers). The survey of patient characteristics included ADL, cognitive and behavioral status, diseases and treatments. Major category criteria was developed by modified delphi method from 9 experts. Each category was divided into 2-3 groups by ADL using tree regression. Relative resource use was expressed as a case mix index (CMI) calculated as a proportion of mean resource use. Result: This patient classification system composed of 6 major categories (ultra high medical care, high medical care, medium medical care, behavioral problem, impaired cognition and reduced physical function) and 11 subgroups by ADL score. The differences of CMI between groups were statistically significant (p<.0001). Homogeneity of groups was examined by total coefficient of variation (CV) of CMI. The range of CV was 29.68-40.77%. Conclusions: This patient classification system is feasible for reimbursement of long-term care hospitals.

• Journal of Preventive Medicine and Public Health
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• v.40 no.4
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• pp.329-335
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• 2007

Objectives : To identify the effects of supplemental private health insurance on health care utilization and expenditure under the mandatory National Health Insurance(NHI) system in Korea. Methods : The data were collected by the National Cancer Center in Korea. Cancer patients who were newly diagnosed with stomach (ICD code, C16), lung(C33-C34), liver (C22), colorectal cancer(C18-C20) or breast(C50) cancer were included as study subjects. Data were gathered using a structured questionnaire from face-to-face interviews, the hospital Order Communication System (OCS) and medical records. Clinical, socio-demographic and private health insurance related factors were also gathered. The differences of health care utilization and expenditure were compared between those who have private health insurance and those who do not using t-test and multivariable regression analysis. Results : Individuals with private health insurance spent larger inpatient costs than those without, but no differences were found in utilization in other service such as hospital admissions, hospital days and physician visits. Conclusions : We found that private health insurance exerts a significant effect on the health care expenditure in inpatient service. These study results can provide a rational basis to plan a national health policy regarding private health insurance. Further studies are needed to investigate the impacts of private health insurance on cancer patients' outcomes and survival rates.

• Journal of agricultural medicine and community health
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• v.19 no.2
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• pp.97-106
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• 1994

In order to estimate the utilization pattern of a rural health subcenter, and to identify the recognition for it among the inhabitants in Kogsung district, a questionnaire survey was carried out for objects of 708 population. The results observed were as follows; 1. The annual utilization rate of a rural health subcenter for a basic health service unit was 27.5 per 100 persons, and annual mean visiting times was 1.43 times. 2. The most frequent disease by, annual health subcenter utilization illness was respiratory disease(26.5%), and the next was musculoskeletal disease(23.9%), gastrointestinal disease(15.9%) by order. 3. Favorite reasons for community health subcenter utilization were lower medical cost(23.4%), near distance from living place(20.7%) and lower disease severity(19.5%) by order. But disfavorite reasons for it were non effective treatment(26.2%), insufficient equipment(25.4%) and absence of specialist(17.4%) by order. 4. Insufficient items about community health subcenter utilization were restriction of treatment limit(47.1%), lower reliance(22.4%) and not punctral(21.8%) by order. 5. The results of logistic regression analysis suggested that statistically significant factors in health subcenter utilization were age, educational level and the nearest medical facility class. 6. There was no difference between recognition for a community health subcenter's work and actual utilizing service, and desirable works for it were disease preventing service, disease control of elderly and sanitation control by order. These results suggested that to increase the utilization of rural health subcenter and to promote the accessibility of rural residents to primary health care, there must be considered public relation about health subcenter, expansion of health equipment and recognition about access time.