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.
Journal of Agricultural Extension & Community Development
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v.15
no.3
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pp.461-497
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2008
The objective of the study was to evaluate the impact of the Call System of agricultural extension services in Korea. The respondents were satisfied on the speedy solution (74.5%), consultation (88.4%), and accessibility (79.7%) of the call system. However, satisfaction of farmers on in-depth consultation was higher (74.3%) than the satisfaction rated by the public servants of RDA (48.9%). Both groups replied positively (70.4%) on the need for expansion of the call system. The analyses of the results leads to a conclusion that there is a need to increase marketing on the importance of RDA's Call System to customers of agricultural extension and to improve accessibility through expansion of the system in other areas. These could solve the decreasing number of extension professionals and improve the quality and efficiency of extension services. These analyses may be useful as bases for a nationwide Call System that connects the center with other districts and for planning a renovation of information-oriented agricultural extension services. The issue that needs improvement is to abandon the grounds of agricultural technology information provider and respond to the customers' needs efficiently by building an established Call System which can minimize the side effect of the trends of reforming and downsizing the organization. It is needed to develop a unified management Call System of agricultural technology information that could provide real-time information, and database the results simultaneously for use as feedback to the Rural Development Programs. Related laws and policies need to be improved to establish a nationwide information network that maximizes the current network in agricultural regions to spread information, to provide institutional support, and to encourage development of training system and research and development by concerned institutes.
Several detailed aspects of medical care services during one year (Aug 1, $1982{\sim}$July 31, 1983) were compared between two community health sub-centers; one (A) was served by a local clinician, the other (B) by a trainee of preventive medicine. The results were analysed as follows: 1. Total spells of medical services during the same period in 'A' sub-center was 4,087 and that in 'B' 2,347. Medicaid visitors in 'A' was 1,051 (25.7% of the total), that in 'B' was 250 (10.7%). Significant difference was observed. 2. Average number of visits for the same case in 'A' was 2.0, that in 'B' was 1.4. Average duration of service by day for the same case in 'A' was 3.9, that in 'B' 3.0. 3. Average cost of service for a case in 'A' was 6,770 won, that in 'B' 4,230 won. 4. Difference in age distribution of visitors in the two sub-centers was insignificant. $0{\sim}9$ year group was 38.5% of the total. Difference in distribution by sex (between two sub-centers) was minimal. Male utilisers more than female by ca. 10%. 5. Concerning distribution of visitors by month, utilisation in July, August and September was the highest; the sum of them was 32.7% of the total in 'A' and 32.9% in 'B'. 6. Distribution by diagnoses in 'A' in decreasing order of frequency was Respiratory system diseases (26.1%), Digestive system diseases (23.0%), Diseases of skin and subcutaneous tissue (17.4%), Accidents and poisoning (11.5%) and Diseases of musculoskeletal system and connective tissue (5.4%). That in 'B' was Respiratory system diseases (39.0%), Digestive system diseases (23.0%), Diseases of skin and subcutaneous tissue (14.2%), Accidents and poisoning (10.9%) and Infection and parasitic diseases (9.1%). 7. The 10 most frequent diagnoses comprised 68.5% of the total in 'A' and 65.5% in 'B' 8. Utilisation by accessibility to each sub-center was studied. It is shown that the nearer the distance or the easier the accessibility, the more visits to services. The distinct pattern is manifested in the utilisation in 'A'-Myun.
Park, Hee-Jung;Lee, Jun Hyup;Park, Sujin;Kim, Tae-Il
Journal of Periodontal and Implant Science
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v.48
no.1
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pp.3-11
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2018
Purpose: This study utilized a strong quasi-experimental design to test the hypothesis that the implementation of a policy to expand dental care services resulted in an increase in the usage of dental outpatient services. Methods: A total of 45,650,000 subjects with diagnoses of gingivitis or advanced periodontitis who received dental scaling were selected and examined, utilizing National Health Insurance claims data from July 2010 through November 2015. We performed a segmented regression analysis of the interrupted time-series to analyze the time-series trend in dental costs before and after the policy implementation, and assessed immediate changes in dental costs. Results: After the policy change was implemented, a statistically significant 18% increase occurred in the observed total dental cost per patient, after adjustment for age, sex, and residence area. In addition, the dental costs of outpatient gingivitis treatment increased immediately by almost 47%, compared with a 15% increase in treatment costs for advanced periodontitis outpatients. This policy effect appears to be sustainable. Conclusions: The introduction of the new policy positively impacted the immediate and long-term outpatient utilization of dental scaling treatment in South Korea. While the policy was intended to entice patients to prevent periodontal disease, thus benefiting the insurance system, our results showed that the policy also increased treatment accessibility for potential periodontal disease patients and may improve long-term periodontal health in the South Korean population.
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.
Objectives: This study explored the community food environmental factors affecting food purchasing using a qualitative research methodology for the elderly as well as the various food environments under their socioeconomic diversity. Methods: For the qualitative data collection, this study interviewed 20 elderly people aged 65 years or more, who participated in a public health program or lunch services operated by the senior welfare center in Seoul. Five dimensions, such as availability, physical accessibility, affordability, acceptability, and accommodation suggested in previous studies, were used to identify the community food environmental factors. Results: The elderly participants showed overall similarities to the concepts derived from existing studies on the five dimensions of food accessibility environment. In addition, other important food accessibility environmental factors that were not present in previous studies, such as acceptability for a product of domestic origin, delivery service to home, and small-packaged food sales, were derived. On the other hand, the concept of some subjects differed depending on the household income and specifically for the physical accessibility concept. This showed that the close distance factor from a grocery store at home might not apply to older adults in low-income households in Korea. Conclusions: This study found that five dimensions of the food environment suggested by previous studies could also be applied to vulnerable older adults in Korea. On the other hand, the socioeconomic characteristics of individuals and households would affect the perspectives of their local food environments differently. The findings of this study could help in the development of tools for evaluating the community food environment.
Objectives : This study examined the health policy researchers' needs and their accessibility towards health insurance claim datasets according to their academic capacity. Methods : An online questionnaire to capture relevant proxy variables for academic needs, accessibility, and research capacity was constructed based on previous studies. The survey was delivered to active health policy researchers through three major scholarly associations in South Korea. Seven-hundred and one scholars responded while the survey as open for 12 days (starting on December 20th, 2010). Descriptive statistics and logistic regression analysis were carried out. Results : Regardless of the definition for operational needs, the prevalent needs of survey respondents were not met with the current provision of claim data. Greater research capacity was shown to be correlated with increased demand for claim data along with a positive correlation between attempts to obtain claim datasets and research capacity. A greater research capacity, however, was not necessarily correlated with better accessibility to the claim data. Conclusions : The substantial unmet need for claim data among the healthcare policy research community calls for establishing proactive institutions which could systematically prepare and make available public datasets and provide call-in services to facilitate proper handling of data.
Park, Young-Yong;Park, Ju-Hyun;Park, Yu-Hyun;Lee, Kwang-Soo
The Korean Journal of Health Service Management
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v.13
no.1
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pp.15-30
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2019
Objectives: This study aimed to analyze people's accessibility to medical institutions providing national gastric cancer screening services in Gangwon-do using a geographic information system(GIS). Methods: To assess the spatial accessibility, network analysis was applied. Two types of network analysis-Service area analysis and origin-destination cost matrix(OD-cost matrix)-were applied to create network dataset. Results: The results of the analysis of the service area revealed that it took more than 60 minutes each to reach tertiary hospitals and general hospitals from 74.4% and 9.6% of Gangwon-do areas, respectively. Similarly, it took more than 60 minutes each to reach hospitals and clinics from 4.2% and 3.4% of Gangwon-do areas, respectively. The results of the OD-cost revealed that there were large regional variations in distance and time taken to reach the medical institutions. Conclusions: there were regional variations of spatial accessibility between Si and Gun in Gangwon-do.
The development of information and communication technology affects people's life in social, cultural, and economic aspects. When this happens in public sector, it gives way more benefits than in private sector because of its high accessibility by public. Among the technological public services in Korea, call center service which provides administrative services by telephone and internet had been spotlighted as a new type of communication between people in demand and public service provider. Public call center service is expected to be continuously diffused in years due to its accessibility and convenience for public users. This study analyzes diffusion pattern of public call center service in Korea using Bass model and tries to suggest appropriate diffusion strategies. For practical cases, three most popular public call centers in Korea are analyzed in light of diffusion pattern and operating strategies. Our analyses identify that public call centers in Korea are facing continuous diffusion in two years and there exist certain strategies to efficiently expedite the diffusion.
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.
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