• 한국노년학
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• v.40 no.4
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• pp.707-727
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• 2020

This study aims to empirically analyze the role that perception of the probability of lonely death among the elderly people living alone plays in the relationship between perceived social support and preference for institutional care based on Andersen's expanded Behavioral Model (2002). The subjects (n=676) of this study were the elderly people living alone, extracted from the "2018 Seoul Aging Survey." With "perceived social support" as an independent variable, "preference for institutional care" as a dependent variable, and "perception of the probability of lonely death" as a mediator variable, we conducted a Binary Logistic Regression to follow the three steps of analyzing mediation effect, as suggested by Baron and Kenny (1986). The results showed that perceived social support has a negative effect on the preference for institutional care and perception of the probability of lonely death among the elderly people living alone; at the same time, perception of the probability of lonely death was found to have a positive effect on their preference for institutional care. Lastly, perception of the probability of lonely death was found to partially mediate the effect of perceived social support among the elderly people living alone in terms of their preference for institutional care. Based on these findings, the practical implications of this study can be summarized as follows. First, various programs and support should be provided to the elderly people living alone in order to enhance the level of perceived social support, a factor that has been confirmed to increase preference for institutional care among the elderly people living alone. Second, as the perception of the probability of lonely death was confirmed to be a psychosocial factor of the preference for institutional care, we need to promote education and support for older people living alone to prepare them for lonely death. These efforts are expected to form a foundations for implementing a community-based integrated care system, "Aging in Place," which is the policy direction required for older people care.

• The Journal of the Korea Contents Association
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• v.16 no.2
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• pp.211-220
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• 2016

It is very common to produce fairytales, folktales, or fables into animations. If they often transform existing works into animations, we may have to examine how they change the original to communicate with the audience and also how they change the original's subject matter or theme to create meaning. The purpose of this study is to consider how the original's meaning and value were changed as Hans Christian Andersen's fairy tale, "The Snow Queen", was converted into an animation, , and also how it influenced the work itself. To attain the goal, this author is going to comparatively analyze the two works' narratives, actants, and semiotic squares by using A.J. Greimas' semiology. According to the findings, although "The Snow Queen" expresses the desire to go back to happy days in the past, it is not a simple return to the past but a stepwise process to become mature mentally as well as religiously. Meanwhile, intends to generate past-oriented meaning expressing the desire to return what is abnormal in the present to what was normal in the past and resolve the individual and religious aspects of "The Snow Queen" in a social and popular way.

• Health Policy and Management
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• v.9 no.1
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• pp.110-138
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• 1999

This study intended to understand the factors influencing the utilization of charged retirement home services for the elderly by stage of discision making. At the same time the purpose of the study is also to present the results of this study as data for the expectation of the demand. The subject of this study was non-utilizer (635 persons) and utilizer (62 persons) of charged retirement home services over the age of sixty. Non-utilizer was selected by random sampling in urban and rural area, and utilizer was investigated by census survey in the three charged retirement home. The research method was interview survey by questionaire. The questionaire was composed of 59 items, 25 variables, 5 components. The research model was to add Andersen's Prediction Model. The components were predisposing component, enabling component, need component, actualizing component, psychologic component. The results of this study were as follows. 1)In the stage of recognizing the residence problem, the recognizer were 76.7% (487 persons) of all the non-utilizer. The factors of influencing were property (B=-4.1E-05), solidarity with children (B=-.1070), house satisfaction (B=-.2517), need of charged retirement home (B=.2614). 2)In the stage of selecting an altenative as utilizing of charged retirement home services, the selecter were 41.1% (261 persons) of all the non-utilizer. The factors of influencing were perception of charged retirement home (B=.2790), need of charged retirement home (B=.2971). 3)In the stage of decion-making, the decider were 29.6% (188 persons) of all the non-utilizer. The factor of influencing was need of charged retirement home (B=.3570). 4)In the stage of the actualization, the factors of influencing were charge ability of utilization (B=.1025), significant others (B=.1868). The upper results were implemented by using the statistical methods of frequency, t-test, $$\chi$^{2}$-test, multiple logistic regression ( and P 〈 .05 ).

• Safety and Health at Work
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• v.11 no.3
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• pp.291-300
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• 2020

Background: The study aimed to determine the association of individual cognitive ability in late midlife with labor market participation among older workers. Methods: This prospective cohort study estimates the risk of long-term sickness absence, disability pension, early retirement, and unemployment from scores on the Intelligenz-Struktur-Test 2000R by combining data from 5076 workers from the Copenhagen Aging and Midlife Biobank with a register on social transfer payments. Analyses were stepwise adjusted for age, gender, physical and psychosocial work environment, health behaviors, occupational social class, education, and chronic diseases. Results: In the fully adjusted model, low cognitive ability (≥1 standard deviation below the mean for each gender) and high cognitive ability (≥1 standard deviation above the mean for each gender) were not associated with risk of any of the four labor market outcomes. Conclusion: Individual cognitive ability in late midlife was not associated with risk of long-term sickness absence, disability pension, early retirement, and unemployment in the fully adjusted model. Thus, no direct effect of individual cognitive ability in late midlife was observed on the risk of permanently or temporarily leaving the labor market.

• Journal of Ecology and Environment
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• v.43 no.2
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• pp.202-211
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• 2019

Oceanic islands are biologically important for their unique assemblages of species and high levels of endemism and are sensitive to environmental change because of their isolation and small species source pools. Habitat destruction caused by human landscape development is generally accepted as the main cause of extinction on islands, with exotic species invasion a secondary cause of extinction, especially on tropical islands. However, secondary impacts of human development (e.g., general degradation through resource use and exotic species introduction) are understudied on temperate islands. To determine secondary impacts of human development on the understory vegetation community, 90 field sites on Ulleung Island, South Korea, were sampled during the summer of 2016. Understory vegetation was chosen as it is a proxy for ecosystem health. Diversity and percent cover of introduced, native, and endemic species were tested against proximity to developed areas and trail usage using a model selection approach. Diversity was also tested against percent cover of three naturalized species commonly found in survey plots. The main finding was that distance to development, distance to town, and trail usage have limited negative impacts on the understory vegetation community within best-supported models predicting native and introduced cover and diversity. However, endemic species cover was significantly lower on high usage trails. While there are no apparent locally invasive plant species on the island at the time of this study, percent cover of Robinia pseudoacacia, a naturalized tree species, negatively correlated with plot diversity. These findings indicate that forests on Ulleung Island are not experiencing a noticeable invasion of understory vegetation, and conservation efforts can be best spent preventing future invasions.

• Health Policy and Management
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• v.10 no.3
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• pp.1-18
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• 2000

This study was conducted to find medical care utilization pattern and to examine the affecting factors on medical facilities utilization using Andersen's medical care service behavioral model. Three hundreds and five public officials with detected disease through the health examination in 1998 were surveyed using self-administered questionnaire. And 230 data were available and analyzed. The results of this study were summarized as follows: Among variables of predisposing factors, knowledge for disease, confidence about periodic health examination program in health insurance, and the attitude toward medical utilization in the usual showed significant relations with the medical utilization. Other variables were not related with the medical utilization. Variables of enabling factors did not show significant relations with the medical utilization. Recognition of family members for detected disease had significant relations with the medical utilization. Among variables of need factors, absence caused by detected disease was significantly related with the medical utilization. The number of non-occupational diseases detected, but untreated people were 75(32.6%) of total subjects, mainly because detected diseases seemed insignificant to them. With multiple logistic regression analysis, the significant variables having an effect on the medical facilities utilization were 'knowledge for disease', 'attitude toward medical utilization in the usual', 'recognition of family members for detected disease' and 'experience of absence caused by detected disease'. On considerations of above findings, counselling for detected disease and its treatment, health education for individuals and program for family support promotion are needed for health management of public officials with diseases detected in health examination.

• 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.

• Health Policy and Management
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• v.33 no.4
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• pp.389-399
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• 2023

Background: The purpose of this study is to analyze the factors affecting the unmet healthcare needs of older people with chronic diseases in Korea and provide a basic research report to strengthen their access to medical care. Methods: In the 2020 older people survey data, 8,182 older people aged 65 or older who were diagnosed with one or more chronic diseases were the final subjects of the study. According to Andersen's behavioral model used in unmet healthcare needs, independent variables were composed of predisposing factors, possible factors, and necessary factors, and whether or not unmet healthcare needs was set as dependent variable. Results: Of the older people with chronic diseases, 1.6% experienced unmet healthcare needs, of which 55.9% experienced unmet healthcare needs for reasons related to economic burden, 31.6% physical constraints, and 12.5% time constraints. As a result of the analysis, older people with chronic diseases were more likely to experience unmet healthcare needs if they were relatively low in age, low in education level, no spouse, low in household income, poor subjective health, complex chronic diseases, and functional restrictions. However, by major reasons for experiencing unmet healthcare needs, living in rural areas were more likely to experience unmet healthcare needs due to physical constraints, and those who participated in economic activities and who had were more likely to experience unmet healthcare needs due to time burden. These results were not derived when only unmet healthcare needs was set as the dependent variable. Conclusion: This study emphasizes the need for an approach by cause of unmet medical occurrence by suggesting that there are differences in influencing factors by reason for experiencing unmet healthcare needs.

• Industry Promotion Research
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• v.7 no.2
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• pp.43-49
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• 2022

This study aims to study Esping-Anderson's theory of welfare state system, develop a model of welfare state suitable for Korea's situation, and apply it to reality. In this research method, basic research and analysis of ideology is used, focusing on Esping-Anderson's welfare state system theory, and applying it appropriately to the Korean situation. Studies on the model of the welfare state have been studied after the classification of complementary and institutional models asserted by Willensky and Lebo in 1965. In addition, Esping-Andersen asserts three things as a model of the welfare state according to ideology. First, the role of the market is central to the liberal welfare system that best fits the image of classical capitalism, and individualistic solidarity through the market. The role of the state or family, which can be a hindrance, is actually marginalized. In addition, in order to maximize individualistic solidarity through the market, de-commodification in the national domain tends to be minimized. Second, the conservative welfare system has a strong familistic element, so the source of social solidarity is the family, and the state plays a role of supporting and supplementing the characteristics of this family. In the conservative system, de-commodification appears to be high among household heads, or the welfare system takes on a corporatist and nationalistic form, it can be said that these characteristics are reflected. Third, in the social democratic welfare system, the source of social solidarity is the state. Therefore, the role of the state is large, the state has a high possibility of decommodification, and it has the characteristics of substitutes for the family and the market through universalist intervention. This study applies Esping-Anderson's three welfare state models to study a model suitable for the Korean situation. In conclusion, Esping-Anderson's three welfare state models can be classified into a market-oriented model based on a liberal welfare system, a status-oriented model based on a conservative corporatist welfare system, and a solidarity-oriented model based on a social-democratic welfare system, presented a compromise between liberalism and conservatism as a Korean model.

• Health Policy and Management
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• v.33 no.1
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• pp.3-18
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• 2023

Background: A chronic disease management program including patient education, recall and remind service, and reduction of out-of-pocket payment was implemented in Korea through a chronic care model. This study aimed to assess the effect of a community-based intervention program for improving medication adherence of patients with diabetes mellitus in rural areas of Korea. Methods: We applied a non-equivalent control group design using Korean National Health Insurance Big Data. Hongcheon County has been continuously adopting this program since 2012 as an intervention region. Hoengseong County did not adopt such program. It was used as a control region. Subjects were a cohort of patients with diabetes mellitus aged more than 65 years but less than 85 years among residents for 11 years from 2010 to 2020. After 1:1 matching, there were 368 subjects in the intervention region and 368 in the control region. Indirect indicators were analyzed using the difference-in-difference regression according to Andersen's medical use model. Results: The increasing percent point of diabetic patients who continuously received insurance benefits for more than 240 days from 2010 to 2014 and from 2010 to 2020 were 2.6%p and 2.7%p in the intervention region and 3.0%p and 3.9%p in the control region, respectively. The number of dispensations per prescription of diabetic patient in the intervention region increased by approximately 4.61% by month compared to that in the control region. Conclusion: The intervention program encouraged older people with diabetes mellitus to receive continuous care for overcoming the rule of halves in the community. More research is needed to determine whether further improvement in the continuity of comprehensive care can prevent the progression of cardiovascular diseases.