• 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.

• Research in Community and Public Health Nursing
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• v.12 no.3
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• pp.589-599
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• 2001

The purpose of this study was to analyze the relation amongst health status, health care costs. health service utilization among the low income elderly who were 60 years of age or older, earning a half of the average Korean family income. The cross-sectional descriptive survey research we conducted used families randomly sampled nationwide. The data were collected from July 12 to August 7, 1999 and the total sample was 1.259 household members (421 households). These were the major findings. 1. As for the health status. 72.4% of respondents fell ill in the last 1 month; 54% of respondents had chronic disease. 2. As for the health care cost. the cost of hospitalization and the medical treatment were 1.069,000 won and 226.000won. respectively. 59.3% of respondents experienced a burden from the monthly health care expenses. 3. As for the health service utilization for the last 3months. 28.5% of respondents didn't utilize the health service. In addition, 22.2% of respondents gave up a medical treatment because of economic situation (88.8%). 4. The statistically significant determinants of health service utilization are old age, female, living with a spouse, unemployed state, medicare, and more days sick. 5. It is shown conclusively that equity and efficacy of the health care policy are to be considered for lower income older adult.

• Journal of Korean Academy of Nursing Administration
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• v.17 no.2
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• pp.180-188
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• 2011

Purpose: This study was done to evaluate the operating status of community-based home health center for revitalization of the centers. Method: In this study performance data including organization plan and service utilization plan were evaluated according process theory. Target of evaluation was the community-based home health care center. Results: The vulnerable part of the organization was the information system and financial resources. The home health center introduced PDA (Personal Digital Assistants) in 2005, however home health care nurses did not make full use of it. This service received full support from Seoul city and local government and there were no other sources of income. The vulnerable part of service utilization was service expansion and standardization due to vulnerability of organizational aspects. Conclusions: The home health care center provides high quality services to underprivileged people. In the future, these services should be provided with equity for continuous health care for this population.

• Journal of Preventive Medicine and Public Health
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• v.31 no.3 s.62
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• pp.460-470
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• 1998

By expanding health insurance, customers will carry a smaller burden of medical costs. As a result, the number of visits to a physician increase and this result in the improvement of medical accessibility. But medical care utilization may be changed not only by insurance status but also by socio-demographic factor, economic status and other factors. The question thus remains, at which level of accessibility and what price of medical care service in health insurance will the customer and the medical care service be satisfied. The price of medical care service ls comprised of the customer's out-of-pocket money and the costs not covered by health insurance. If the price of medical care services in health insurance are appropriate, medical care utilization should not differ because of the difference in income status or the acuteness of illness. But If the price is not adequate, low income groups will receive relatively low medical care utilization, particularly in the case of chronic disease. The purpose of this study is to evaluate the differences in medical care utilization among the various income groups and those with varying acuteness of illness. The major hypotheses to test in this study are : (i) whether there are differences in medical care utilization among different income groups exist, (ii) whether differences in medical care utilization among different income groups exist with the hospital type. (iii) whether differences in medical care utilization among different income groups exist with the acuteness of illness and with age. The data was collected from the JongRo District Health Insurance Society in Seoul. A total of 118,336 persons were selected as the final sample for this study. The major findings of this study were as follows; 1. The volume of ambulatory utilization among users was statistically significant by income level. 2. Among different income groups, the volume of ambulatory utilization was statistically significant by the acuteness of illness. 3. Higher income groups with chronic diseases had a greater volume of ambulatory utilization than other groups.

• The Korean Journal of Health Service Management
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• v.10 no.4
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• pp.97-107
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• 2016

Objectives : This study aims to : (i) characterize and differentiate between two different periods of baby boomers, (ii) study the utilization of their health care services, and (iii) establish effective ways of providing better health service utilization and preventive policy strategies for upcoming and older generations. Methods : A multiple regression analysis using descriptive statistics, frequency analysis, and dummy variables was utilized to access the presence of correlations between socio-demographic factors and health care service utilization. Results : Medical insurance type, marital status, and chronic disease were factors that influenced health care service utilization. Furthermore, the factors that influenced individual medical expenses were cohabitation, inpatient days, and chronic disease. Conclusions : Primary findings and exploratory statistics revealed that there were strong correlations and interaction among some of the predictor variables. Because of the chronologically limited nature of the sample data set gathered in 2012, it would be helpful to continue to develop or research related constructs that may capture relationships more effectively among extended populations.

• Journal of Korean Public Health Nursing
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• v.24 no.2
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• pp.182-196
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• 2010

Purpose: This study examined potential determinants of gender differences in utilization of health care services among Korean adults. Methods: The study population was 21,647 adults ${\geq}$25-years-of-age who had responded to a health interview survey conducted as part of the 2005 National Health and Nutrition Surveys. Relative gender differences in the use of each health service were assessed using chi-square test and sex ratios. The contribution of potential factors of sex differences in the use of health services was evaluated by comparing the odds ratio and sex ratio before and after adjustment for such variables. Results & Conclusions: More females had visited a physician and been admitted to hospital, but hospitalization time was longer for males. Adjustment for poor self-rated health, number of chronic disease and limit of full term for ADL led to a reduction in the odds ratio of females compared to males for health service utilization. However, adjustment for socioeconomic factors (household income, education, occupation, and health insurance) magnified the gender difference concerning length of hospitalization. Factors that explain gender-related differences in utilization of health care services are concluded to be different health needs and socioeconomic status.

• The Journal of the Society of Korean Medicine Diagnostics
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• v.18 no.1
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• pp.25-31
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• 2014

Objective This study aims to understand the actual utilization of the oriental rehabilitation medicine center of the initial interdisciplinary medical care at the National Rehabilitation Center and to arrange proper development plans for more effective interdisciplinary medical services for future activation of interdisciplinary medical care. Method: The interdisciplinary patient status, composition of patient care, and major disease-related status were studied and analyzed for oriental rehabilitation medication relating to interdisciplinary medical care at the National Rehabilitation Center. Furthermore, the interdisciplinary status and its operating conditions were evaluated to devise a development plan for the National Rehabilitation Center. Results: As a result of the analysis of oriental rehabilitation medical care diagnosing status utilization at the National Rehabilitation Center regarding interdisciplinary medical care, the ratio of the number of those receiving interdisciplinary oriental rehabilitation medical care was less than half of the total receiving interdisciplinary care. As the major disease status from the patients of interdisciplinary care, stroke patients covered the large majority, and musculoskeletal pain patients covered the majority of outpatients. The establishment of additional oriental medication departments and assigning of interdisciplinary coordinators were presented as the goals of a development plan for the manpower and structural side of interdisciplinary medical care at the National Rehabilitation Center. On the institutional and systematic side, improvement in the interdisciplinary hierarchy and interdisciplinary model development based on the number of patients per disease was proposed. In addition, operation on ward bedding and construction of interdisciplinary EMR medical care is necessary on the medical and administration service side. Conclusion: To understand the actual utilization and to arrange development plans aimed at constructing a safe and effective interdisciplinary hierarchy for interdisciplinary medical care at the National Rehabilitation Center, patient-centered care needs to be implemented.

• The Korean Journal of Health Service Management
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• v.10 no.1
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• pp.39-51
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• 2016

Objectives : This study investigated the health care utilization patterns of workers' compensation insurance(WCI) pneumoconiosis patients with excessively long hospital stays. Methods : The discharge summary data of 3,094 WCI pneumoconiosis patients were analyzed. The study sample was divided into 3 groups based on the length of stay(LOS). Health care utilization patterns were compared among the groups with logistic regression analysis, and the LOS determinants were identified with linear regression analysis. Results : The average LOS of the 222 long stay group patients was 1,448 days. Patients in this group tended to use private general hospitals, were admitted through the emergency room and discharged without the consent of a doctor. Conclusions : Many of the long LOS patients will maintain their inpatient status for the rest of their lives. For quality of life and efficient use of health care resources, policy makers need to establish a policy that enables patients to receive outpatient care in appropriate living conditions outside the hospital.

• The Korean Journal of Health Service Management
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• v.9 no.3
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• pp.115-126
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• 2015

Objectives : This research was performed to investigate the characteristics and determination factors of health care policy satisfaction and welfare recognition for health insurance & health care financing. Methods : The utilized data were 4,174 cases who responded to a welfare recognition survey in the 8th wave of the Korea Welfare Panel Study (2013). The statistical methodology used in this study is the multiple regression model. Results : The significant affecting factors of health care policy satisfaction were age, education, household income, welfare attitudes, and health status. Medical utilization & private medical insurance were not related to health care policy satisfaction. The affecting factors of health insurance reinforcement were age, health status, welfare attitudes. The affecting factors of health care financing expansion were age, economic activity type, medical utilization, welfare attitudes. The affecting factors of welfare attitudes were age, economic activity type, household income, health insurance, and health status. Conclusions : Health care policy satisfaction, health insurance reinforcement, and health care financing expansion were all affected by age and welfare attitude; but this was not the case for private health insurance. This study recommended that the Korean government provide active planning for reinforcement of health insurance and publicity of the health care system in order to accord with the prospects of people.

• Korean Institute of Interior Design Journal
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• v.19 no.6
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• pp.224-232
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• 2010

This paper aims to identify the characteristics and the current situation of the architectural characteristics, children's characters using facilities, and status of management and utilization by surveying 'Day Service for Children' in Tokyo-do. First, About the status of management and utilization, 'Day Service for Children' is operated by a local government, NPO corporate group and social welfare corporate. There are not big differences of the care program or running hours depending on operating principals but there are differences depending on staff organization, number of children and space constitution. Also, infants ratio at 'Day Service for Children' is high for the purpose of detecting disability early and supporting their development early. They have diverse disabilities but developmental disabilities' ratios high and most children are using both this facility and normal nursery centers together. Samples for proper child care based on status of space constitutions were installing lock, raising door knobs and using softer floor materials which are for children's safety. For the problem of space utilization, most comments were about lack of space which is not enough for teaching and training materials. Therefore, as an example, observation rooms for parents and teachers were sometimes used as storages and it changes teachers' moving direction, staying area and behavior zone. The programs of 'Day Service for Children' are divided to group teaching and private one. It will be the best if they have separate spaces such as group class room, private class room and play room. When they were operated by NPO corporate group or Social welfare corporate, there are many cases that their space was not properly zoned for each activity.