• Journal of Korean Society of Rural Planning
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• v.25 no.1
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• pp.67-74
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• 2019

This study is to identify the heat vulnerability area as represented by heat risk factors which could be attributable to heat-related deaths. The heat risk factors were temperature, Older Adults(OA), Economic Disadvantage(ED), Accessibility of Medical Services(AMS), The population Single Person Households(SPH). The factors are follow as; the temperature means to the number of days for decades average daily maximum temperature above $31^{\circ}C$, the Older Adults means to population ages 65 and above, furthermore, the Economic Disadvantage means to the population of Basic Livelihood Security Recipients(BLSR), the Accessibility of Medical Services(AMS) means to 5 minutes away from emergency medical services. The results of the analysis are showed that the top-level of temperature vulnerability areas is Dong, the top-level of vulnerability OA areas is Eup, the top-level of AMS vulnerability is Eup. Moreover, the top-level of vulnerability ED area appears in the Eup and Dong. The result of analysing relative importance to each element, most of the Eup were vulnerable to heat. Since, there are many vulnerable groups such as Economic Disadvantage, Older Adults in the Eup. We can be figured out estimated the number of heat-related deaths was high in the Eup and Dong by the data of emergency activation in the Chungcheongnam-do Fire Department. Therefore, the result of this study could be reasonable.

• Quality Improvement in Health Care
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• v.19 no.2
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• pp.80-88
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• 2013

Objectives: With the increase in the number of people who are marginalized in receiving medical services, the role of Seoul National University Hospital as a public hospital is being emphasized. However, many patients are either experiencing delays in receiving medical services or simply being left out as a result of the inaccessibility to the department of social work on part of both the patients and the medical staff. Methods: In order to increase consultation from other departments and the accessibility to the department of social work for the socially marginalized group through early consultation from other departments, the following steps were taken. First, an orientation program for novice medical residents led by clinical social worker was introduced/implemented. Second, posters and brochures on various financial aids programs were produced and distributed. Third, a system of early screening was built/constructed, and once a week rounds and early screening meeting were executed/carried out. Result: The department of social work's rate of consultation from other departments increased by 4.4% compared to last year, while it showed 61% increase for those wards that had an early screening meeting. In addition, the average time of consultation from other departments was reduced by 3.1 days, securing sufficient amount of time for clinical social work services, both in terms of quality and quantity. Conclusion: It is believed that the various promotional activities, along with the strengthening of accessibility to clinical social work services and early consultation on part of social disadvantaged/marginalized group, would undoubtedly help provide quality services to patients and increase their level of satisfaction. In this way, the wards can effectively reduce the number of unnecessary hospital stay days while the hospital can prevent the accumulation of outstanding bills/fees as well as contribute to the publicness of hospitals. The promotion of clinical social work programs in various ways are crucial to ensuring the satisfaction of patients and hospital staff.

• Health Policy and Management
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• v.30 no.3
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• pp.399-408
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• 2020

Background: The purpose of this study was to examine the impact of the regional characteristics on the accessibility of emergency care and the impact of emergency medical accessibility on the patients' prognosis and the emergency medical expenditure. Methods: This study used the 13th beta version 1.6 annual data of Korea Health Panel and the statistics from the Korean Statistical Information Service. The sample included 8,119 patients who visited the emergency centers between year 2013 and 2017. The arrival time, which indicated medical access, was used as dependent variable for multi-level analysis. For ordinal logistic regression and multiple regression, the arrival time was used as independent variable while patients' prognosis and emergency medical expenditure were used as dependent variables. Results: The results for the multi-level analysis in both the individual and regional variables showed that as the number of emergency medical institutions per 100 km² area increased, the time required to reach emergency centers significantly decreased. Ordinal logistic regression and multiple regression results showed that as the arrival time increased, the patients' prognosis significantly worsened and the emergency medical expenses significantly increased. Conclusion: In conclusion, the access to emergency care was affected by regional characteristics and affected patient outcomes and emergency medical expenditure.

• Health Policy and Management
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• v.31 no.2
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• pp.197-206
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• 2021

Background: The purpose of this study was to identify factors affecting unmet healthcare needs due to physical accessibility by residential area by utilizing the Korea Community Health Survey (KCHS). Methods: Andersen's medical service behavioral model was applied to analyze the enabling factors, predisposing factors, and needs factors of unmet healthcare needs focusing on residential areas. This study used data from the KCHS (2017-2019, n=440,792). We used multivariate survey logistic regression analysis in order to identify affecting factors. Sub-group analysis was conducted in order to evaluate the effects of residential areas. Results: Some participants (2,621, 0.59%) had experienced unmet healthcare needs due to physical accessibility and 2,047 subjects (78.1%) of them lived in rural areas. Multivariate survey logistic regressions revealed that experience of unmet healthcare needs due to physical accessibility increased when people lived in rural areas (odds ratio [OR], 3.95; 95% confidence interval, 3.46-4.51). Conclusion: This study showed that despite the development of transportation and efforts to alleviate medical inequality, residents in rural areas may still have higher experience of unmet healthcare needs due to physical accessibility compared to the metropolitan city regardless of any other sub-group differences (OR range, 1.90-6.31). This study suggested that government and policymakers should identify the causes of the experience of unmet healthcare needs due to physical accessibility and should develop policies to alleviate those healthcare disparities.

• Journal of Korean Society of Rural Planning
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• v.22 no.1
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• pp.93-100
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• 2016

Land price can be affected by convenience or psychological repulsion like PIMFY (Please In My Front Yard) or NIMBY (Not In My Back Yard) for various facilities. Services related to public establishment, welfare, medical attention, and amenities in rural areas are comparatively poorer than those in urban areas. The purpose of this study is to estimate the implications of the accessibility to community facilities in rural areas for land prices using a hedonic price model. The accessibility to facilities is estimated by real road distances and the land prices are applied for four types of land usages: field, rice paddy, building lots, and village halls. Community facilities are classified from public and community services view: education, safety, culture, transport, environment, health care, and finance. The results show that the accessibility to health care and transport can positively affect land prices and the accessibility to environment (waste facilities and junkyard) and unpleasant services (funeral hall and charnel house) can negatively affect land prices. Especially, the accessibility to hospital is the most positive influential factor for all types of land usages.

• Journal of Korean Society for Geospatial Information Science
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• v.22 no.3
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• pp.107-112
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• 2014

In keeping with the increasing demand for medical services in accordance with the economic development, the use of oriental medicine is on the rise year by year. In particular, it is a tendency that the elderly over age 65 prefer the oriental medicine to the western medicine in Korea. Under the circumstance, changing into an aging society, the importance of oriental medical services has been growing. In this regard, this study evaluated the quality of medical services by conducting the density analysis and the accessibility analysis of oriental medical clinic targeting Jinju, which is one of local small and medium-sized cities. The study results reveal that oriental medical hospitals accounted for 27% of the entire medical facilities in Jinju, and there was an imbalance in the quality of the oriental medical services according to districts(called dong) because oriental medical hospitals were mainly concentrated in the central commercial areas. In particular, in terms of the analysis on the accessibility of an aging population over age 65 to the oriental medical hospitals, over 50% of the whole districts (dongs) in Jinju were blind spots in medical services, showing a very vulnerable condition. Accordingly, it is judged that systematic measures for improvement in support of the oriental medical services in local small and medium-sized cities should be provided in Korea when we consider the characteristics of Korea where an aging population is rapidly increasing.

• The Korean Journal of Emergency Medical Services
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• v.25 no.2
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• pp.19-38
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• 2021

Purpose: This study aimed to investigate the relationship between emergency medical service accessibility in different regions and the sudden death rate in elderly patients with ischemic heart disease using data analysis techniques and suggest improvements in regional emergency medical services. Methods: The study collected data from the NEDIS database and Statistics Korea. Data on a total of 75,867 patients aged ≥65 years were reviewed among patients with ischemic heart disease who visited emergency medical institutions in 2018. Frequency analysis, chi-square test, multiple logistic regression analysis, and simple logistic regression analysis were performed using SPSS PC Window 25.0. Results: With an emergency medical resource per 100km², there was a concomitant reduction in the risk of death. There was a decrease in the death rate by 0.967, 0.970, 0.997, and 0.391 times with the increase in the presence of a fire department, an ambulance, a paramedic, and a regional medical center, respectively. Furthermore, a decrement in the death rate was witnessed 0.844, 0.825, and 0.975 times with the initiation of a local emergency medical center, a local emergency medical institution, and an angiography device, respectively(p <.001). Conclusion: To improve the accessibility of emergency medical services, the population and geometric area of the region should be considered essential factors when deploying emergency medical resources.

• Journal of Digital Convergence
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• v.12 no.3
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• pp.289-297
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• 2014

This study is meaningful by offering basic data that is able to enhance satisfaction with the use of medical services by the qualified recipients of medical aid and to promote health consistently while looking into their satisfaction with the use of medical services, using independent variables for the period after the introduction of the selected medical center system. The study period from August 16, 2013 was 23 August, In conclusion, with a view to enhancing satisfaction with the use of medical services by qualified recipients of medical aid after the execution of the selected medical center system, it is most important to identify with greater sufficiency and accuracy the effect of medical services by qualified recipients of medical services and any unsatisfied desire for medical services. Also, in pursuit of the use of appropriate medical services, there is a need to prepare active cooperation between medical centers and various political alternatives of the government for the effective discovery of accessibility to medical services, overcome inefficiencies in administrative procedures, establish a reasonable medical service delivery system with the guarantee of appropriate medical treatment, and improve health management.

• Journal of Korean Society for Geospatial Information Science
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• v.23 no.3
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• pp.49-55
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• 2015

Current medical delivery system in Korea has been distinguished into three types; primary medical facilities, secondary facilities, and tertiary facilities since 1989. This system prevents the waste of medical resources along with the maintenance of balance according to the medical treatment subjects. However, it is inevitable that the imbalance of the medical services among regions has been generated due to the concentration of the medical facilities on large cities. In this regard, this study attempted to evaluate the quality of the primary medical services, emphasizing accessibility and convenience targeting Jinju city, a small and medium-sized city, based on the distribution characteristics of the space. The study results show that cohesion index about the spatial distribution of the primary care facilities was 0~0.25. It conducted a correlation analysis between the location of the hospitals and users, based on the study results. Finally, it is demonstrated the correlation between the location of the hospitals and users tended to be low, while, the cohesion of the Oriental medicine clinics was high in other treatment subjects, and the accessibility to the Oriental medicine clinics was the highest because most Oriental medicine clinics were distributed to the places where users were many. However, on account that the locations of the medical facilities and users were varied in other treatment subjects except for the Oriental medicine clinics, problems were generated in terms of the accessibility. Therefore, it is judged that the preparation of the measures to improve the selection of lots in consideration of users, who use the primary medical services, is required.

• Research in Community and Public Health Nursing
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• v.26 no.1
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• pp.11-17
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• 2015

Purpose: This study was to ascertain whether there are differences in health care utilization and expenditure for Type I Medical Aid Beneficiaries before and after applying Copayment. Methods: This study was one-group pretest posttest design study using secondary data analysis. Data for pretest group were collected from claims data of the Korea National Health Insurance Corporation and data for posttest group were collected through door to-door interviews using a structured questionnaire. A total of 1,364 subjects were sampled systematically from medical aid beneficiaries who had applied for copayment during the period from December 12, 2007 to September 25, 2008. Results: There was no negative effect of copayment on accessibility to medical services, medication adherence (p=.94), and quality of life (p=.25). Some of the subjects' health behaviors even increased preferably after applying for copayment including flu prevention (p<.001), health care examination (p=.035), and cancer screening (p=.002). However, significant suppressive effects of copayment were found on outpatient hospital visiting days (p<.001) and outpatient medical expenditure (p<.001). Conclusion: Copayment does not seem to be a great influencing factor on beneficiaries' accessibility to medical services and their health behavior even though it has suppressive effects on outpatients' use of health care.