• Korean Journal of Health Education and Promotion
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• v.22 no.1
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• pp.147-160
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• 2005

The purpose of this study is to identify the nature of the patient service quality of health center, and based on that, to examine the relationship of health center visitor's perceived quality and overall satisfaction. Data were collected on the basis of 'the 3rd Regional Health Care Planning' operated by Rural Health Care Service Technology Aid Task-force Team(RHCSTAT), Ministry of Health and Welfare. Basically, the Manual of 3rd Regional Health Care Planning is composed of structure, process, and outcome measurement indicators. Of these indicators, 21 patient satisfaction questions as outcome indicators are used in this study. The samples are 3,530 patients who visited 80 health centers all of the nation. First, the reliability and validity of patient service quality items was evaluated. Second, the descriptive statistics of health service quality are calculated. Third, through the T-test and ANOVA, the differences of patient satisfaction by responder's general characteristics are compared. In final, to explore the relationship of service quality and overall satisfaction, multiple regression analysis was used. This study shows firstly, the dimension of patient service quality was categorized into 3 dimensions, that is, facilities and environment, staff kindness, and access convenience. Secondly, the reliability and validity of patient service quality items was satisfied. Thirdly, the mean score of staff kindness factors are high in contrast to the facilities and environment. And in regard to the overall satisfaction, the mean score is more higher in Daegu region, County type health center, male group, and upper 65 age group than comparison groups. Lastly, as a result of multiple regression analysis, the effect of patient's perceived service quality, especially, appropriateness of billing time(Beta=0.190) and of reservation time(Beta=0.132) are statistically significant(P<0.01). In conclusion, to satisfy the health need of community people and improve the service quality of the health center, the efforts for the access convenience might be needed. Additionally, the enlargement on health center space and supply of new medical equipment is urgent for the patient satisfaction.

• Health Policy and Management
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• v.17 no.2
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• pp.33-51
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• 2007

The disabled population is a vulnerable group, having very complex medical conditions, but little is known about differences in the level of access by type of disability. This study was performed to investigate the differences of health care utilization by the type of disability. The database was constructed from registry of the disabled and health insurance and medical aid claims data submitted to the Korea Health Insurance Cooperation during in the year 2003. The disability classified three groups according to the Disabled Welfare Act; physically disability with external dysfunction, physically disability with organic disease, and mentally disability. There were huge differences in health care utilization by the type of disability. For the inpatient care, those with a mental disability were more likely to utilize health care services in terms of average visit number of medical facilities and visit days per case, but the treatment amount per case was the highest in physically disabled with organic disease. For the outpatient care, those who the physically disabled with organic disease were more likely to utilize health care services in terms of average visit number of medical facilities, treatment amount per case, and the treatment days per case. Also, those who physically disabled with organic disease were more likely to utilize general hospital for both inpatient and outpatient care, and spent more out-of-pocket expenditure. As the number of persons with disabilities rises, the need to consider new approaches to protecting their health grows increasingly. Especially, Korean health care system should be refined to be more responsive to the needs of the type of disability.

• Health Policy and Management
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• v.6 no.1
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• pp.110-143
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• 1996

The purpose of this study is to assess the extent of inequality in health outcomes and the distribution of health services according to health need under National Health Insurance System in Korea. For the empirical analysis, data were collected through an interview survey during one month of October, 1994. Interview were conducted with a total of 10, 875 of the employees and the self-employed selected through cluster, systematic sampling. The major findings of this research are as follows: 1. The analysis of the differentials in morbidity rates by socio-economic group showed that health inequality in the pro-higher groups existed in all self-reported morbidity indicators. 2. The findings of the conventional use measures showed that the lower socio-economic groups had more ambulatory and inpatient services than the higher groups. In contrast to the level of the medical care utilization, however, the higher socio-economic groups were more likely to use the high-quality source of care in terms of their treatment place compared to the lower groups. 3. By using the need-based use measures, the results were different from each use-disability ration indicator. Using the use-disability ration measured by physician visits per 100 restricted-activity days in the population, it was found that there was no evidence favoring the higher socio-economic groups. In contrast, the use-disability ration based on physician visits per a chronic patient in one year displayed that there was remarkable relative difference by income group as well as the evidence of the pro-higher income groups. 4. The results of logistic regression analysis and two-stage estimation method indicated that although the utilization is significantly affected by type and duration of insurance coverage, the use or nonuse of service and the volume of physician care consumed is determined by health need and demographic characteristics rater than economic status. In sum, these findings suggest that physician service is equitably distributed according to health need under national health insurance system in Korea. As there were some evidences of inequality including the differential in physician visits of chronic patients by income group, however, the government should strengthen the activities to guarantee the equity of health services utilization.

• The Journal of Korean Society for School & Community Health Education
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• v.12 no.1
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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.

• Health Policy and Management
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• v.30 no.1
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• pp.82-91
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• 2020

Background: This study investigates the influence factors of medical service variations using medical charge and the length of stay (LOS) for urinary incontinence surgery and uterine polypectomy. Methods: The National Health Insurance claims data and Medical Resource Report by the Health Insurance Review & Assessment Service in 2016 were used. Frequency analysis, one-way analysis of variance, and Bonferroni post-hoc tests were executed for each surgery. A multilevel analysis was executed to assess the factors to the medical charge and LOS for each surgery in patient, doctor, and hospital level. Results: Fifty-two point eight percent of urinary incontinence surgery and 87.1% of uterine polypectomy were distributed in general and tertiary hospitals. Among three levels, the patient level variation was 61.5% or 77.2% in medical charge and 93.9% or 96.3% in LOS, respectively. The doctor level variation was 29.6% or 22.6% in medical charge and 0.6% or 0.0% in LOS, respectively. The institution level variation was 8.9% or 0.2% in medical charge and 5.5% or 3.7% in LOS, respectively. Number of other disease and organizational type were main factors that affected the charge and LOS for urinary incontinence surgery and uterine polypectomy. Conclusion: Medical service variations of the urinary incontinence surgery and uterine polypectomy were the largest for the patient level, followed by doctor level for the medical charge, and the institution level for the LOS.

• Health Policy and Management
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• v.22 no.4
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• pp.497-521
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• 2012

Objectives This study aimed to investigate the effect of social capital, health risk behavior and health status on medical care utilization by the elderly. The data and Research method Data were obtained from the 4th wave survey of the Korea Welfare Panel Study. 4,087 household members aged 65 years and over were subject to analysis. Descriptive statistics are used to describe the basic features of the data in a study. we performed a structural equation modeling(SEM) analysis to evaluate the effect of social capital and mediating effect of health risk behavior and health status. Results Results showed that factors related to medical care utilization of the elderly were different depending on types of service (inpatient and outpatient service) except health status. Age, higher social capital, more health-risk behavior and poorer health status were associated with increased use of inpatient service. Social capital was found to have a positive direct effect on it. Also, social capital had an indirect effect on reducing use of inpatient services by improving health status. On the other hand, lower age and higher household income tended to increase use of outpatient service, while higher social capital and higher health status were inversely related. Social capital had a direct effect and an indirect effect on reducing use of outpatient service and, at that time, health status played a mediating role. Conclusions Social capital may contribute to improve health status and indirectly reduce medical care utilization of the elderly by enhancing their health status. These results provide evidence that more policy and strategy considerations should be needed for the elderly to strengthen their social capital in order to enhance their levels of health and more efficient utilization of medical care.

• Health Policy and Management
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• v.17 no.3
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• pp.68-86
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• 2007

This study was performed to explore the effect of customer satisfaction and switching barriers on customer royalties in medical services. 900 households, 1% sample were randomly selected from K city located in Kangwon province. Interview survey was performed with structured questionnaire for the entire people, 923 persons who experienced medical service utilization during one year before survey on time, september, 2002. In comparison of switching barriers by sociodemographic characteristics, lower income group and lower educated group showed the higher level of recognition level on availability of changing the service provider significantly. In terms of economic loss as one of switching barriers, the group of over aged 61, the lower income group and the lower educated group felt higher than other groups. Also, the time loss of switching barrier was recognized in 41-60 aged group and employee in service industry highly. For the perceived risk factor as another switching barrier, the high educated group showed the higher recognition level in performance risk and felt higher social risk than other groups. In analysis of customer satisfaction and loyalty levels by switching barrier components, the lower level of availability of changing the service provider and the higher level of recognition for economic and time loss, they showed the higher satisfaction and loyalty levels. In final step, multiple regression analysis showed the positive relationship between customer satisfaction, switching barrier and customer loyalties. Besides, the moderating effect of switching barrier in relationship between customer satisfaction and loyalties was significant and this results suggests that the influence of customer satisfaction to customer loyalties might be weakened in high level of recognition for switching barrier. In conclusion, perceived risk of economic and time loss as switching barrier is an important factor and should be considered in planning of marketing strategy carefully in terms of defensive marketing.

• The Korean Journal of Health Service Management
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• v.7 no.1
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• pp.21-34
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• 2013

Hospitals in Korea are enforcing a quality control over 119Emergency Medical Services to increase the survival rate of Out of Hospital Cardiac arrest patients. This study is to analyze the factors that effect the survival rate of Out of hospital Cardiac arrest patients by comparing the results of before and after the quality control enforcement. Cardiac arrest patients can be assorted into pre-decision group and decision group. The study analyzed the survival factors which was based on the adequate use of 119 BLS and ACLS usage rates, response time of 119EMS, qualification of ambulance worker, number of EMS team members, and adequate use of AED according to ECG diagnosis. The analyzation was done over total 1,233 of Cardiac arrest patients from January 1, 2010 to December 31, 2011 After the enforcement of the quality control, the usage of Vital sign check and BLS showed a big difference. Especially, as the usage of ECG showed a significant difference, Shockable rhythm, which is the most important to Cardiac arrest patients, also showed a significant difference. After the enforcement of quality control, the performance of ACLS showed a significant difference in IV. The study showed 119 ambulance workers provided better service in Vital sign and BLS and ACLS after the enforcement of quality control. It is considered a 119 ambulance service effects the survival rate of Cardiac arrest patients. Therefore, it can increase the survival rate and it is necessary to continue a quality control.

• Journal of the Korea Convergence Society
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• v.10 no.9
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• pp.343-349
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• 2019

This study used data from the 3rd and 11th year of the Korean Welfare Panel to evaluate the effects of the Long-Term Care Insurance(LTCI) system on the consumption and expenditure of LTCI users' households. The study consisted of program group using LTCI and control group not using. Chi-square and t-test were used for the characteristic differences among the groups, and the difference of consumption expenditure was identified by multiple regression analysis. As a result, LTCI had a statistically significant effect on the health care costs of LTCI users' households, resulting in an increase in health care costs(${\beta}=3.06$). However, there was no statistically significant effect on the total cost of living, basic cost, education cost, and recreation/entertainment cost. Therefore, in order to show the effect of LTC system, we should try to reduce of self-pay and improve the contents and quality of the service of the LTC system.

• Journal of the Health Care and Life Science
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• v.8 no.2
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• pp.127-133
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• 2020

While only the experts could create the contents in the existing VR contents business, in the proposed "Untact Social VR Video-Based Tour Scheduling", the GUI (Graphic User Interface) allows anyone to easily and quickly share the information taken through VR camera after creating. It is intended to serve as a variety of SNS-based media by developing a structure that can be shared in html format after creating with the GUI menus. In particular, it is applied to companies that operate the SNS-type publicity projects including experience facilities and viewing facilities, and the various SNS-type publicity businesses that create the VR contents. Communication is clear compared to the existing homepage-based information delivery method, and It aims to provide universality that anyone can easily edit in an environment where only experts can edit VR video contents of.