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http://dx.doi.org/10.5953/JMJH.2021.28.2.161

An Exploratory Study of Healthcare Utilization Process among Patients with Multimorbidity  

Yu, Soo-Young (Department of Nursing Science, Jeonju University)
You, Myoung Soon (Graduate School of Public Health, Seoul National University)
Publication Information
Journal of muscle and joint health / v.28, no.2, 2021 , pp. 161-173 More about this Journal
Abstract
Purpose: This study examined: 1) what it meant for patients to have multimorbidity 2) how they manage their illness using health care facilities, and 3) what contextual backgrounds exist regarding the health care system. Methods: This qualitative research obtained individual in-depth interviews from 22 patients. Participants were selected by purposive sampling among those who saw physicians more often than the national average from the 2013 medical-claim data. The transcribed data were analyzed using Ground theory. Results: Multimorbidity patients suffered from "chain-like serial symptoms" and "pain without a breakthrough". They expressed themselves as "indeed patients among patients", "my body is a general hospital", and "an incompletely normal person". There was a demand to resolve the anxiety arising from the situation in which the body keeps getting sicker without showing any signs of recovery. In a state of reduced social support and a lack of trust in the doctor, their desire to be healed led them to receive a temporary relief through dependence on medical institutions. Conclusion: This research recognized the desire of multimorbidity patients to seek temporary relief through dependence on medical institutions. A more patient-centered directed care plan, specific to the needs of the patients with multimorbidity is required.
Keywords
Multimorbidity; Patient acceptance of health care; Qualitative research;
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1 Korea Institute for Health and Social Affairs. (2013). A study on effective chronic disease management plan (Issue Brief No. 2013-31-19). Sejong. Retrieved from March 17, 2021, https://www.kihasa.re.kr/publish/report/view?type=research&seq=27593
2 O'Brien, R., Wyke, S., Guthrie, B., Watt, G., & Mercer, S. (2011). An 'endless struggle': A qualitative study of general practitioners' and practice nurses' experiences of managing multi-morbidity in socio-economically deprived areas of Scotland. Chronic Illness, 7(1), 45-59. https://doi.org/10.1177/1742395310382461   DOI
3 Cho, B. H. (2015). Sociology of disease and medicine (2nd ed.). Seoul: Jipmundang.
4 Duguay, C., Gallagher, F., & Fortin, M. (2014). The experience of adults with multimorbidity: A qualitative study. Journal of Comorbidity, 4(1), 11-21. https://doi.org/10.15256/joc.2014.4.31   DOI
5 Hujala, A., Rijken, M., Laulainen, S., Taskinen, H., & Rissanen, S. (2014). People with multimorbidity: Forgotten outsiders or dynamic self-managers? Journal of Health Organization and Management, 28(5), 696-712. https://doi.org/10.1108/JHOM-10-2013-0221   DOI
6 Jung, Y. H. (2013). Analysis of multimorbidity in the elderly: Focusing on outpatient use. Health Wellfare Issue & Focus, 196, 1-8.
7 Kim, C. H., Hwang, I., & Yoo, W. S. (2014). The common patterns of multimorbidity and its impact on healthcare cost in Korea. Health Policy and Management, 24(3), 219-227. https://doi.org/10.4332/KJHPA.2014.24.3.219   DOI
8 Korea Institute for Health and Social Affairs. (2019, December) A report on the Korea health panel survey of 2017 (Issue Brief No. 2019-43-01). Sejong. Retrieved from March 17, 2021, from http://repository.kihasa.re.kr/handle/201002/34640
9 Korea Institute for Health and Social Affairs. (2020, December). A report on the Korea health panel survey of 2018 (Issue Brief No. 2020-33). Sejong. Retrieved from March 17, 2021, from http://repository.kihasa.re.kr/handle/201002/37343
10 Bae, J. Y. (2014). The study on the relationship between the burden of medical expenditures and health-related quality of life among the elderly with chronic diseases. Journal of Social Science, 25(4), 109-129. https://doi.org/10.16881/jss.2014.10.25.4.109   DOI
11 Wallace, E., Salisbury, C., Guthrie, B., Lewis, C., Fahey, T., & Smith, S. M. (2015). Managing patients with multimorbidity in primary care. British Medical Journal, 350, h176. https://doi.org/10.1136/bmj.h176   DOI
12 Squires, A., & Dorsen, C. (2018). Qualitative research in nursing and health professions regulation. Journal of Nursing Regulation, 9(3), 15-26. https://doi.org/10.1016/S2155-8256(18)30150-9   DOI
13 Strauss, A., & Corbin, J. (1994). Grounded theory methodology: An overview. In N. K. Denzin & Y. S. Lincoln, Handbook of qualitative research (pp. 273~285). Thousand Oaks, CA, US: Sage Publications, Inc.
14 van den Akker, M., Buntinx, F., Metsemakers, J. F., Roos, S., & Knottnerus, J. A. (1998). Multimorbidity in general practice: Prevalence, incidence, and determinants of co-occurring chronic and recurrent diseases. Journal of Clinical Epidemiology, 51 (5), 367-375. https://doi.org/10.1016/s0895-4356(97)00306-5   DOI
15 Glaser, B. G., & Strauss, A. L. (2017). Discovery of grounded theory: Strategies for qualitative research. New York: Routledge.
16 National Health Insurance Service Health Insurance Policy. (2011). Method of inducing appropriate medical use of health insurance enrollee (Issue Brief No. 11-8). Seoul. Retrieved from March 17, 2021, from http://lhttp://lib.nhis.or.kr/search/detail/CATXAZ000000002497
17 Lee, J., & Choi, M. (2018). The relationship between physicians' patient-centered communication and the quality of life of patients with chronic diseases: Focusing on mediating effect of health behavior. Health and Social Welfare Review, 38(3), 279-302. https://doi.org/10.15709/hswr.2018.38.3.279   DOI
18 Lee, S. (2018). Industrialized medicine, commercialized health and marxism. Marxism21, 15(2), 40-66. https://doi.org/10.26587/marx.15.2.201805.002   DOI
19 Miller, W. R. (2010). Qualitative research findings as evidence: Utility in nursing practice. Clinical Nurse Specialist, 24(4), 191-193. https://doi.org/10.1097/NUR.0b013e3181e36087   DOI
20 Moser, A., & Korstjens, I. (2018). Series: Practical guidance to qualitative research. Part 3: Sampling, data collection and analysis. European Journal of General Practice, 24(1), 9-18. https://doi.org/10.1080/13814788.2017.1375091   DOI
21 Organization for Economic Co-operation and Development. (2019). Health statistical data: health care utilization. Retrieved from March 17, 2021, from https://stats.oecd.org/Index.aspx?DataSetCode=HEALTH_PROC