• Title/Summary/Keyword: Accessibility services

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The Application of Operations Research to Librarianship : Some Research Directions (운영연구(OR)의 도서관응용 -그 몇가지 잠재적응용분야에 대하여-)

  • Choi Sung Jin
    • Journal of the Korean Society for Library and Information Science
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    • v.4
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    • pp.43-71
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    • 1975
  • Operations research has developed rapidly since its origins in World War II. Practitioners of O. R. have contributed to almost every aspect of government and business. More recently, a number of operations researchers have turned their attention to library and information systems, and the author believes that significant research has resulted. It is the purpose of this essay to introduce the library audience to some of these accomplishments, to present some of the author's hypotheses on the subject of library management to which he belives O. R. has great potential, and to suggest some future research directions. Some problem areas in librianship where O. R. may play a part have been discussed and are summarized below. (1) Library location. It is usually necessary to make balance between accessibility and cost In location problems. Many mathematical methods are available for identifying the optimal locations once the balance between these two criteria has been decided. The major difficulties lie in relating cost to size and in taking future change into account when discriminating possible solutions. (2) Planning new facilities. Standard approaches to using mathematical models for simple investment decisions are well established. If the problem is one of choosing the most economical way of achieving a certain objective, one may compare th althenatives by using one of the discounted cash flow techniques. In other situations it may be necessary to use of cost-benefit approach. (3) Allocating library resources. In order to allocate the resources to best advantage the librarian needs to know how the effectiveness of the services he offers depends on the way he puts his resources. The O. R. approach to the problems is to construct a model representing effectiveness as a mathematical function of levels of different inputs(e.g., numbers of people in different jobs, acquisitions of different types, physical resources). (4) Long term planning. Resource allocation problems are generally concerned with up to one and a half years ahead. The longer term certainly offers both greater freedom of action and greater uncertainty. Thus it is difficult to generalize about long term planning problems. In other fields, however, O. R. has made a significant contribution to long range planning and it is likely to have one to make in librarianship as well. (5) Public relations. It is generally accepted that actual and potential users are too ignorant both of the range of library services provided and of how to make use of them. How should services be brought to the attention of potential users? The answer seems to lie in obtaining empirical evidence by controlled experiments in which a group of libraries participated. (6) Acquisition policy. In comparing alternative policies for acquisition of materials one needs to know the implications of each service which depends on the stock. Second is the relative importance to be ascribed to each service for each class of user. By reducing the level of the first, formal models will allow the librarian to concentrate his attention upon the value judgements which will be necessary for the second. (7) Loan policy. The approach to choosing between loan policies is much the same as the previous approach. (8) Manpower planning. For large library systems one should consider constructing models which will permit the skills necessary in the future with predictions of the skills that will be available, so as to allow informed decisions. (9) Management information system for libraries. A great deal of data can be available in libraries as a by-product of all recording activities. It is particularly tempting when procedures are computerized to make summary statistics available as a management information system. The values of information to particular decisions that may have to be taken future is best assessed in terms of a model of the relevant problem. (10) Management gaming. One of the most common uses of a management game is as a means of developing staff's to take decisions. The value of such exercises depends upon the validity of the computerized model. If the model were sufficiently simple to take the form of a mathematical equation, decision-makers would probably able to learn adequately from a graph. More complex situations require simulation models. (11) Diagnostics tools. Libraries are sufficiently complex systems that it would be useful to have available simple means of telling whether performance could be regarded as satisfactory which, if it could not, would also provide pointers to what was wrong. (12) Data banks. It would appear to be worth considering establishing a bank for certain types of data. It certain items on questionnaires were to take a standard form, a greater pool of data would de available for various analysis. (13) Effectiveness measures. The meaning of a library performance measure is not readily interpreted. Each measure must itself be assessed in relation to the corresponding measures for earlier periods of time and a standard measure that may be a corresponding measure in another library, the 'norm', the 'best practice', or user expectations.

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Growth Environment Characteristics and Decline in Mt. Seunghak's Miscanthus sinensis Community (승학산 참억새군락의 생육환경 특성 및 쇠퇴에 관한 연구)

  • Park, Seul-Gi;Choi, Song-Hyun;Hong, Suk-Hwan;Lee, Sang-Cheol;Yu, Chan-Yeol
    • Journal of the Korean Institute of Landscape Architecture
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    • v.45 no.5
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    • pp.14-28
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    • 2017
  • Mt. Seunghak's Miscanthus sinensis community is not only a landscape resource in terms of cultural services within the Ecosystem Services but also a site that is visited by many mountaineers in autumn. As the current Miscanthus sinensis community has been experiencing a rapid decline due to Korean forest succession characteristics, ongoing artificial management is thought to be needed for landscape resource use. The purpose of this study was to determine growth environment characteristics and the cause of the rapid decline of the Miscanthus sinensis community in Mt. Seunghak, which is located inside a large city with a large scale and outstanding accessibility. As the Miscanthus sinensis community is the representative early vegetation that appears temporarily in dry, barren soil, the Miscanthus sinensis community in Korean forest succession tends to be unsustainable. As the current soil on Mt. Seunghak is inappropriately fertile for the Miscanthus sinensis community, other wetland woody plant communities are anticipated to succeed it. If Miscanthus sinensis community maintenance is needed for Miscanthus sinensis landscape scenery, various alternatives apart from overall Miscanthus sinensis community maintenance should be determined for cost-effective management. For example, while many byways toward the inside of the Miscanthus sinensis community have affected the Miscanthus sinensis community growth environment, the installation of wooden fences and ropes has been a control in approach. As a result of this positive effect, many byways toward the inside of Miscanthus sinensis community have been restored naturally. Through viewable range analysis, as good scenery sites on the observatory have a good viewable range on the main trail as well, if these scenery sites are intensively managed, effective Miscanthus sinensis ccommunity management will be done despite maintenance budget cutbacks. This study is expected to be used as a basic material regarding the alternatives for a sustained Miscanthus sinensis community and the possibility of cultivating other growth in poor soils of fallow fields and unused land.

Effects of Private Insurance on Medical Expenditure (민간의료보험 가입이 의료이용에 미치는 영향)

  • Yun, Hee Suk
    • KDI Journal of Economic Policy
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    • v.30 no.2
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    • pp.99-128
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    • 2008
  • Nearly all Koreans are insured through National Health Insurance(NHI). While NHI coverage is nearly universal, it is not complete. Coverage is largely limited to minimal level of hospital and physician expenses, and copayments are required in each case. As a result, Korea's public insurance system covers roughly 50% of overall individual health expenditures, and the remaining 50% consists of copayments for basic services, spending on services that are either not covered or poorly covered by the public system. In response to these gaps in the public system, 64% of the Korean population has supplemental private health insurance. Expansion of private health insurance raises negative externality issue. Like public financing schemes in other countries, the Korean system imposes cost-sharing on patients as a strategy for controlling utilization. Because most insurance policies reimburse patients for their out-of-pocket payments, supplemental insurance is likely to negate the impact of the policy, raising both total and public sector health spending. So far, most empirical analysis of supplemental health insurance to date has focused on the US Medigap programme. It is found that those with supplements apparently consume more health care. Two reasons for higher health care consumption by those with supplements suggest themselves. One is the moral hazard effect: by eliminating copayments and deductibles, supplements reduce the marginal price of care and induce additional consumption. The other explanation is that supplements are purchased by those who anticipate high health expenditures - adverse effect. The main issue addressed has been the separation of the moral hazard effect from the adverse selection one. The general conclusion is that the evidence on adverse selection based on observable variables is mixed. This article investigates the extent to which private supplementary insurance affect use of health care services by public health insurance enrollees, using Korean administrative data and private supplements related data collected through all relevant private insurance companies. I applied a multivariate two-part model to analyze the effects of various types of supplements on the likelihood and level of public health insurance spending and estimated marginal effects of supplements. Separate models were estimated for inpatients and outpatients in public insurance spending. The first part of the model estimated the likelihood of positive spending using probit regression, and the second part estimated the log of spending for those with positive spending. Use of a detailed information of individuals' public health insurance from administration data and of private insurance status from insurance companies made it possible to control for health status, the types of supplemental insurance owned by theses individuals, and other factors that explain spending variations across supplemental insurance categories in isolating the effects of supplemental insurance. Data from 2004 to 2006 were used, and this study found that private insurance increased the probability of a physician visit by less than 1 percent and a hospital admission by about 1 percent. However, supplemental insurance was not found to be associated with a bigger health care service utilization. Two-part models of health care utilization and expenditures showed that those without supplemental insurance had higher inpatient and outpatient expenditures than those with supplements, even after controlling for observable differences.

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우리나라 농촌지역의 출산조절행태 및 출산조절행위의 결정요인 분석

  • Chung, Kyung-Hee;Han, Seung-Hyun;Bang, Sook
    • Korea journal of population studies
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    • v.11 no.2
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    • pp.33-53
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    • 1988
  • This study aimed at developing a desirable family planning policy and strategy by examining the current status of family planning practice in rural Korea and by indentifying the crucial factors which affect fertility control behavior. For this purpose, an analytical study was conducted, using the survey data collected in July 1985, on an interview basis, on 1, 440 married women living in the Soyi, Wonnam and Maingdong townships of Eumseong County(in North Chungcheong Province). This study population has the typical characteristics of rural areas, and the results of the analysis can be summarized as follows: 1. In regard to the demographic characteristics of the study population : their average age at marriage was 23.7, they had an average of 2.6 children( 1.3 boys, 1.3 girls) :10% experienced the death of their child (ren) :14% had spontaneous abortion(s) :4% weathered stillbirth(s) :35% went through induced abortion (s) : and 5.5% were currently pregnant. The average of their ideal numbers of children was 2.2, while 44% felt that they must have a son. 2. Looking at the contact rate with medical & health institutions, over the past 1 year, the visit rate to health subcenters was 43.7%, while 26.9% visited the (county) health center :59.6% had been to private clinics : and 41.5% went to the Soonchunhyang - Eumsung hospital : thus showing a relatively high rate of accessibility. 3. The utilization rate of family planning services was 76.5%, with tubectomy being the most prominent method at 52.3%, while the informants were health workers in 54.2% of the acceptors. Of the 8.4% who discontinued the use of contraceptive methods, only 26% did so due to want for pregnancy, natural infertility (meno - pause), or other reasons, while the remaining 74% stopped usage on account of side effects, failure in the methods themselves, and inconvenience of use, thus pointing to a situation where the proper choice of family planning methods have not yet been made. It can be noted that there is a strong motivation for early birth stopping as 35.3% practice family planning even with only one child, of which 38.3% have had sterilization operations. According to results of a multiple regression analysis, among the variables affecting contraception usage the most significant variable was the number of sons. 4. 34.8% experienced induced abortions. It was shown as a result of multiple regression analysis that the number of children and attitudes toward induced abortions extensively affected their frequency of abortions conducted. 5. In the regard to the relation between family planning and induced abortions, 33.7% of the women used both, while 52.0% of them used only the former(family planning), with only 1.4 % utilizing solely the latter(abortion), and 12.9% totally abstaining from fertility regulation : again, the discriminant analysis indicated that the choice of family planning and/or induced abortion was determined by the number of children and attitudes toward induced abortion. In view of the above mentioned results, the following are some comments and suggestions concerning problems related to the current family planning policies, in Korea : 1. It is difficult to expect a further quantitative expansion in family planning program operations, as there has been an excessive supply of target-oriented sterilization operations on women. From a maternal and child health care point of view, it will be desirable to have a diversification of service points in the future where family planning methods may be properly chosen, so that choices of methods which suit the mothers' characteristics and tastes may be made by the individuals themselves by strengthening their quality of family planning information services. 2. Along with the strengthening of the qualitative improvement of family planning services policies must be implemented to effectively promote the moral (ethical) deterrents to induced abortions and to preference for sons. From a maternal care standpoint, the social permissive norm toward induced abortion must be modified, and the bias towards son must be analyzed as the women with more daughters have a lower rate of family planning acceptance. Such changes in attitudes, however, can not be hoped to be accomplished with ad hoc policies, but will only be possible when an enhancement of the women's status(within the society) is brought about in a long - term perspective.

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How to Implement Quality Pediatric Palliative Care Services in South Korea: Lessons from Other Countries (한국 소아청소년 완화의료의 발전 방안 제언: 국외 제공체계의 시사점을 중심으로)

  • Kim, Cho Hee;Kim, Min Sun;Shin, Hee Young;Song, In Gyu;Moon, Yi Ji
    • Journal of Hospice and Palliative Care
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    • v.22 no.3
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    • pp.105-116
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    • 2019
  • Purpose: Pediatric palliative care (PPC) is emphasized as standard care for children with life-limiting conditions to improve the quality of life. In Korea, a government-funded pilot program was launched only in July 2018. Given that, this study examined various PPC delivery models in other countries to refine the PPC model in Korea. Methods: Target countries were selected based on the level of PPC provided there: the United Kingdom, the United States, Japan, and Singapore. Relevant literature, websites, and consultations from specialists were analyzed by the integrative review method. Literature search was conducted in PubMed, Google, and Google Scholar, focusing publications since 1990, and on-site visits were conducted to ensure reliability. Analysis was performed on each country's process to develop its PPC scheme, policy, funding model, target population, delivery system, and quality assurance. Results: In the United Kingdom, community-based free-standing facilities work closely with primary care and exchange advice and referrals with specialized PPC consult teams of children's hospitals. In the United States, hospital-based specialized PPC consult teams set up networks with hospice agencies and home healthcare agencies and provide PPC by designating care coordinators. In Japan, palliative care is provided through several services such as palliative care for cancer patients, home care for technology-dependent patients, other support services for children with disabilities and/or chronic conditions. In Singapore, a home-based PPC association plays a pivotal role in providing PPC by taking advantage of geographic accessibility and cooperating with tertiary hospitals. Conclusion: It is warranted to identify unmet needs and establish an appropriate PPD model to provide need-based individualized care and optimize PPC in South Korea.

A Study on the Evaluating Standards On-Line Service for Archives (기록관의 온라인 서비스 향상을 위한 웹사이트 평가기준설계에 관한 연구)

  • Lee, Yoon-Ju
    • The Korean Journal of Archival Studies
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    • no.16
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    • pp.147-200
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    • 2007
  • Archives provide users with easier and more convenient access to and use of archival data through their Internet websites. Now, archival websites function not only as a tool of information provision or marketing, or as a gateway of Internet-based materials, but also as cyber space for all services of archives, providing users with information and knowledge and direct accessibility to the services in the archives. At present, Korean archives are proceeding with establishing websites or upgrading existing websites, and the use rates and reliability of web services by users are becoming higher. However, although there have been various studies for the evaluation of general websites, few are found with regard to the evaluation of archival websites. It is necessary for archival websites that provide information service to users of every stripe to make more efforts and have more interest in user-centered convenience, right to know, and information provision-centered service. Accordingly, needless to say, it is necessary to study evaluation criteria of websites so that high quality archival websites can be established. With this background, this study establishes evaluation criteria for archival websites, which are appropriate to their objectives and functions and directly evaluates archives, presenting ways to establish and redevelop archival websites. More detailed purposes are as follows: First, analyzes existing theories of evaluation through reviews on previous literature and elicits evaluation criteria for websites, which are appropriate to archives; Second, based on the elicited evaluation criteria for archival websites, examines the current state of domestic archival websites through analytic evaluation; and Third, presents ways to improve archival websites that may be helpful in establishing or improving them in the future. The expectancy effects of this study are as follows: First, it will be helpful when one wishes to identify the current state of archival websites and to improve or redevelop existing websites, or to develop online service through website; Second, it will function as a checklist when a developer who is to establish an archival website wishes to develop evaluation criteria; and Third, it may be used as an inspection tool when an archives contracts out the establishment of its website.

A Plan to Improve Consumer Satisfaction and Reliability of Opticians by Analyzing Consumers' Spectacles Purchasing Behavior (소비자의 안경 구매 행태 분석을 통한 만족도 및 신뢰도의 향상 방안)

  • Park, Jee-Hyun;Lee, Eun-Hee;Koo, Eun-Hye;Kim, Hee-A;Song, Da-Hye;Hyun, Jin-Hee;Kim, Hyojin
    • Journal of Korean Ophthalmic Optics Society
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    • v.15 no.1
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    • pp.1-7
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    • 2010
  • Purpose: To plan and improve consumers' satisfaction by analyzing consumers' purchasing behavior of spectacles. Also this will show the need of improvement in reliance of an optician. Methods: A total of 307 people (10 to 60 years) participated in individual questionnaires. Questionnaires comprised of general characteristic of surveyed people, purchasing spectacles behavior, satisfaction after purchasing spectacles, reliability of optician, and improvement points of optician. Results: Most important points in selecting the product were the design and the price of the spectacles. 142 people (46.3%) replied "average" and 140 people (45.6%) replied "satisfying" out of maximum point of satisfaction level which was 5 points. 72.3% of people have regularly visiting optical shop due to the high accessibility, after-sales care, and courteous optician. On the contrary, 27.7% replied "never visit same optician shop again" because of the low accessibility, minimal range of products, and high price. Data showed that people had high re liability about the opticians' knowledge of product, and their technique of eye refraction. Data revealed that people did not show high satisfaction about opticians' knowledge of ophthalmology, and price of products. Most important improvement points were accurate spectacle prescription by Opticians rating 42% of reply. Factors most considered during spectacle selection among the 10 to 20 age group were design by 34.8% and price by 10.1%. Among the 40 to 50 age group, most considered factors were design by 14% and spectacle frame material by 10.1%. Conclusions: Satisfaction rate of purchasing spectacles for the total participant group was 4.2 average grades. Reliability of opticians' eye refraction result and prescription was 50.5%. However consumers wanted to obtain more accurate eye refraction result and prescription with more comprehensive explanations. Also, consumers wanted opticians to be sensitive and have appreciative eye in select spectacles for customers, and to offer precise spectacle dispensing services and courteous after-sales care.

An Empirical Study on the Influencing Factors of Perceived Job Performance in the Context of Enterprise Mobile Applications (업무성과에 영향을 주는 업무용 모바일 어플리케이션의 주요 요인에 관한 연구)

  • Chung, Sunghun;Kim, Kimin
    • Asia pacific journal of information systems
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    • v.24 no.1
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    • pp.31-50
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    • 2014
  • The ubiquitous accessibility of information through mobile devices has led to an increased mobility of workers from their fixed workplaces. Market researchers estimate that by 2016, 350 million workers will be using their smartphones for business purposes, and the use of smartphones will offer new business benefits. Enterprises are now adopting mobile technologies for numerous applications to increase their operational efficiency, improve their responsiveness and competitiveness, and cultivate their innovativeness. For these reasons, various organizational aspects concerning "mobile work" have received a great deal of recent attention. Moreover, many CIOs plan to allocate a considerable amount of their budgets mobile work environments. In particular, with the consumerization of information technology, enterprise mobile applications (EMA) have played a significant role in the explosive growth of mobile computing in the workplace, and even in improving sales for firms in this field. EMA can be defined as mobile technologies and role-based applications, as companies design them for specific roles and functions in organizations. Technically, EMA can be defined as business enterprise systems, including critical business functions that enable users to access enterprise systems via wireless mobile devices, such as smartphones or tablets. Specifically, EMA enables employees to have greater access to real-time information, and provides them with simple features and functionalities that are easy for them to complete specific tasks. While the impact of EMA on organizational workers' productivity has been given considerable attention in various literatures, relatively little research effort has been made to examine how EMA actually lead to users' job performance. In particular, we have a limited understanding of what the key antecedents are of such an EMA usage outcome. In this paper, we focus on employees' perceived job performance as the outcome of EMA use, which indicates the successful role of EMA with regard to employees' tasks. Thus, to develop a deeper understanding of the relationship among EMA, its environment, and employees' perceived job performance, we develop a comprehensive model that considers the perceived-fit between EMA and employees' tasks, satisfaction on EMA, and the organizational environment. With this model, we try to examine EMA to explain how job performance through EMA is revealed from both the task-technology fit for EMA and satisfaction on EMA, while also considering the antecedent factors for these constructs. The objectives of this study are to address the following research questions: (1) How can employees successfully manage EMA in order to enhance their perceived job performance? (2) What internal and/or external factors are important antecedents in increasing EMA users' satisfaction on MES and task-technology fit for EMA? (3) What are the impacts of organizational (e.g. organizational agility), and task-related antecedents (e.g., task mobility) on task-technology fit for EMA? (4) What are the impacts of internal (e.g., self-efficacy) and external antecedents (e.g., system reputation) for the habitual use of EMA? Based on a survey from 254 actual employees who use EMA in their workplace across industries, our results indicate that task-technology fit for EMA and satisfaction on EMA are positively associated with job performance. We also identify task mobility, organizational agility, and system accessibility that are found to be positively associated with task-technology fit for EMA. Further, we find that external factor, such as the reputation of EMA, and internal factor, such as self-efficacy for EMA that are found to be positively associated with the satisfaction of EMA. The present findings enable researchers and practitioners to understand the role of EMA, which facilitates organizational workers' efficient work processes, as well as the importance of task-technology fit for EMA. Our model provides a new set of antecedents and consequence variables for a TAM involving mobile applications. The research model also provides empirical evidence that EMA are important mobile services that positively influence individuals' performance. Our findings suggest that perceived organizational agility and task mobility do have a significant influence on task-technology fit for EMA usage through positive beliefs about EMA, that self-efficacy and system reputation can also influence individuals' satisfaction on EMA, and that these factors are important contingent factors for the impact of system satisfaction and perceived job performance. Our findings can help managers gauge the impact of EMA in terms of its contribution to job performance. Our results provide an explanation as to why many firms have recently adopted EMA for efficient business processes and productivity support. Our findings additionally suggest that the cognitive fit between task and technology can be an important requirement for the productivity support of EMA. Further, our study findings can help managers in formulating their strategies and building organizational culture that can affect employees perceived job performance. Managers, thus, can tailor their dependence on EMA as high or low, depending on their task's characteristics, to maximize the job performance in the workplace. Overall, this study strengthens our knowledge regarding the impact of mobile applications in organizational contexts, technology acceptance and the role of task characteristics. To conclude, we hope that our research inspires future studies exploring digital productivity in the workplace and/or taking the role of EMA into account for employee job performance.

A Study on the Variables Affecting the Intention to Use Healing Agriculture (치유농업 이용의도에 영향을 미치는 변인 고찰)

  • Kim, Ok Ja;Ha, Kyu Soo
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.13 no.4
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    • pp.59-72
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    • 2018
  • The purpose of this study is to investigate the factors affecting the intention to use healing farming by setting aged readiness, rural healing supply condition, and rural healing service as independent variables. This study has been started based on the idea that it is necessary to provide healing service through healing agriculture to the rapidly increasing elderly people and urban people who need mental rest. Therefore, the purpose of this study is to find out the various factors influencing intention to use healing agriculture through empirical analysis. Second, we want to examine whether the variables influenced the intention to use more. Third, based on the results of these tests, we suggest the policy for activation of healing agriculture by examining the factors necessary for the promotion of physical and mental health of the elderly in the aging society and the revitalization of healing agriculture for the mental healing of the urban people. For this study, a questionnaire survey was conducted for men and women over 30 years old, and the final 356 copies were analyzed. The validity of the research hypothesis was verified by linear regression analysis. The results of the analysis are as follows. First, the physical preparation, emotional preparation, and economic preparation of aged care preparations were found to have a significant effect on intention to use. Second, natural landscape, accessibility, and stability of rural healing supply conditions were found to have a significant effect on intention to use. But economics and expertise were dismissed. Third, crop cultivation, animal medication and healing facilities of rural healing service were proved to have significant influence on intention to use. In order to increase the utilization of healing agriculture, it is necessary for the consumer to be well prepared for aging. In rural healing supply conditions, accessibility and safety should be provided for healing facilities in rural healing services.And to increase the intention to use it.

Effects of Regional Medical Insurance on Utilization of Medical Care in Urban Population (지역의료보험 실시전후 도시 일부주민의 의료이용양상 비교 - 소득 계층별 의료필요충족도와 주민 만족도를 중심으로 -)

  • Kim, Seok-Beom;Kang, Pock-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.1 s.45
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    • pp.117-134
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    • 1994
  • The effects of regional medical insurance on utilization of medical care in urban population was examined in this study. The data was collected in a 2-year follow-up household survey conducted at Taegu city before and after implementation of the regional medical insurance. The study population was divided into 2 groups. Cohort I was the uninsured in 1989 and cohort II was the insured in 1989. After the coverage of medical insurance, physician visit rate per 1,000 population, use-disability ratio and use-restricted activity ratio in cohort I were increased compared to cohort II in both of acute and chronically ill people. The use-disability ratio and use-restricted activity ratio of the insured poor were lower than those of the insured nonpoor in both of cohort I and cohort II. The major reasons for pharmacy use were accessibility and affordability before the coverage of medical insurance in cohort I, however, after the coverage of medical insurance, the important reason was accessibility rather than affordability. In logistic regression analysis of physician visit, the significant independent variables were acute illness episode (+), chronic illness episode (+) and income (+) in both of cohort I and cohort II. In cohort I, after the coverage of medical insurance, more people replied that the medical cost of hospital and clinic was reasonable. The people who covered by the regional medical insurance were more dissatisfied with the imposed premium than those who covered by other types of medical insurance in both of cohort I and cohort II. More people in cohort II than cohort I were dissatisfied with the services from hospitals and clinics after implementation of the regional medical insurance. In conclusion. after the coverage of medical insurance, the gap between the poor and the nonpoor still exists in terms of medical care utilization.

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