Background: This study aims to empirically compare and evaluate the current status of medical accessibility and health inequality between people with disabilities and without. We calculated the ACSC hospitalization rate, which is a medical accessibility index, for hypertension, a major risk factor for cardiovascular disease that accounts for more than 20% of deaths among people with disabilities using the 2016 National Health Insurance Big Data. Methods: The subjects of the study were a total of 601,520, including 64,018 people with disabilities and 537,501 people without. Logistic regression was performed to analyze the differences in hypertension hospitalization rates adjusted for demographic and sociological characteristics and disease characteristics using SAS 9.4 program. Results: Before adjusting for the characteristics, the hypertension hospitalization rate of people with disabilities was 1.55%, and the people without disabilities were 0.49%. After adjusting, it was found that people with disabilities were 2.11 times higher than people without disabilities, and it was statistically significant. Conclusion: The preventable hospitalization rate of people with disabilities is higher than that of people without, suggesting that the disabled have problems with access to medical care and health inequality. Therefore, the government's policy improvement is required to close the medical gap for the disabled.

Purposes: This study was to investigate intention to exercise the patient's right of self-determination on adopting the non-benefit medical services and was to identify factors associated with intention to self-determined decision. Methodology: A total of 1,000 adult respondents aged 20 to 65 years were recruited using stratified random sampling and surveyed by online. Multivariate logistic regression analysis was performed to identify factors associated with intention to self-determined decision using SAS 9.4(SAS Institute Inc. Cary, NC, USA). Findings: 61.9% of total participants(n=592) had intention to exercise patient's right of self-determination on adopting the non-benefit medical services. Significant differences were observed in the exercise of self-determination in relation to prior explanation and opportunity for self-determination. Practical Implications: This study suggested that explanation duty of provider might influence on increasing intention to exercise the patient's right of self-determination. Considering appropriate use of non-benefit services, it is important to enhance explanation duty of provider.

Purposes: This study purposed to evaluate the effect of a value incentive program(VIP) on the in-hospital mortality of acute stroke. Methodology: Study period was from January 2010 to December 2018. This study included 63 hospitals for acute hemorrhagic stroke that the mortality rate per month was more than one during study period. Independent variables were time variables and hospital characteristics such as hospital type, district and bed number. Interrupted time series analysis was applied to analyze the data. Findings: In case of general hospitals, the in-hospital mortality rate per month for acute hemorrhagic stroke tends to be increased by 0.03% in overall study periods but decreased by 0.32% after the implementation of the policy. On the other hand, tertiary hospital changes are not statistically meaningful. Conclusion: This study provides evidences how the VIP was effective in improving quality of acute hemorrhagic stroke care. General hospitals showed higher policy effect compare to that of tertiary hospitals.

Purposes: This study aims to investigate the changes in the length of stay and medical expenses by the impact of the admission decided by patients or their family. Methodology: The analysis was conducted using data from elder patients aged 65 or older who have used admission services more than once from year 6(2012) to year 12(2017) of the Korean Medical Panel Data(KOWEPS). The statistical analysis was performed through the Chi-square test, mean difference analysis, and generalized estimation equation analysis. Findings: Compared to the patients who used admission services decided by doctors, those who used admission services decided by patients or their family had a longer length of stay and a lower daily medical expense. Practical Implications: Inappropriate admission decided by patients or their family can increase the risk of hospital-acquired infections, impairing the health of elderly patients, and has a negative impact on the efficiency of health resources. Therefore, it is necessary to prevent and properly manage inappropriate admission decided by patients or their family

Background: Avoidable mortality rate has been widely used as an indicator of the quality of health care and the degree of inequality in health levels. The purpose of this study was to identify the factors affecting the avoidable mortality rate in the region. Methods: The data was MDIS(Microdata Integrated Service) Causes of Death Statistics, and the analysis period was from 2010 to 2019. Panel analysis was performed to identify the influencing factors on the avoidable mortality rate. Findings: Result showed that the current smoking rate had a significant positive effects on the avoidable mortality rate of both men and women. And the smoking cessation trial rate, low salt diet rate, weight control trial rate, annual vaccination rate had a significant negative effect. In the social environment, the divorce rate had a significant positive effect. In the economy environment, financial independence and social welfare budget rate had a significant negative effect. In the physical environment, the factory area rate had a significant positive effect. Practical Implication: Practical implication in order to lower the local avoidable mortality rate, various social determinants of health as well as health care resources should be considered together.