• 간호행정학회지
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• 제11권4호
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• pp.401-414
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• 2005

Purpose: This study was to evaluate the utilization of health care service and to provide supportive data for health care policy making in one urban area in Korea. Method: This study tested the significance of public health service using the database of an university hospital and public health center from Feb. 2000 to Dec. 2004. Data were analyzed by multidimensional analysis and data mining technique and produced the information on the classification of utilization characteristics by main disease and the total cost of use and disease association with the users of the public health center. Results: The Results were as follows: 1) Top 10 diseases in the area accounted for 22.4% of total frequency for the most recent 5 years in university hospital, while 59.0% in public health center. 2) There were significant correlations between university hospital and public health center user's insurance type and place of residence: It showed higher use of public health center for free service beneficiaries residing in Seoul than residents in nearby or local area. The medical insurance types for hospital users were more various than those for public health center users. 3) The use of hospital for patients of hypertension, diabetes mellitus and hyperlipidemia was tended to concentrate in mostly autumn and winter since August 2000, while the cost of using public health center for those patients has been steadily reduced since July 2000. 4) As a result of cluster analysis, there were classified into three homogeneous groups according to the total cost of using public health service, age, and the frequency of use. 5) The association analysis on patients with chronic disease in public health center produced a detailed information on accompanying diseases related to the incidence rate of disease of high frequency due to aging, information on drug abuse and immune disease. Conclusion: The health care policy for local community should be evaluated continuously. And the policy to build an integrated data warehousing by public health indicator system and to enhance the faithfulness of data is required.

• 대한간호학회지
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• 제36권7호
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• pp.1193-1203
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• 2006

Purpose: The purpose of this study was to describe the current status of utilization and costs of home health nursing care by the levels of medical institutes in Korea. Method: A secondary analysis of existing data was used from the national electronic data information(EDI) of 148 home health agencies for 6 months from May to Oct 2005 in total. Result: The 148 agencies had multiple services in cerebral infaction, essential hypertension, sequoia of cerebrovascular disease, type 2 diabetes mellitus, etc.. The highest 10 rankings of 76 categories of home health nursing services were composed of 96.4% of the total services, such as simple treatment, inflammatory treatment, urethra & bladder irrigation, inserting indwelling catheter etc., in that order. The highest 20 rankings of 226 categories of home examination services were composed of 77.0% of the total home examination services. In addition, the average cost of home health care per visit was 46,088 Won (${\fallingdotseq}$ 48 $, 1 $=960 Won). The costs ranged from 74,523 Won (${\fallingdotseq}$78 $, loss of chronic kidney function, N18) to 32,270 Won (${\fallingdotseq}$34 $, other cerebrovascular diseases, 167). Conclusion: Results suggest that client characteristics of hospital based HHNC are not different from community based HHNC or visiting nursing services for elderly. The national results will contribute to baseline data used to establish a policy for the home health nursing care system and education.

• 농촌의학ㆍ지역보건
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• 제15권2호
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• pp.118-129
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• 1990

Socioeconomic status in this county progressed rapidly, this has brought about many changes in health care fields, namely, pattern of disease prevalence and morbidity, increase of the aged people, and also availability of health care in rural areas. According to the utilization study of medical care, it showed that the oriental medicine is used for the treatment of lasted chronic disease not the minor and common diseases which is quick in its effect. Particularly, in rural areas. prevalence of chronic disease is higher than that in urban areas. Although the health cafe need of the oriental medicine is high in rural areas, the distribution of manpower and facilities is lower than that in urban areas. Therefore the government has planned to implement the demonstration project for the oriental medicine at the designated 3 health centers in rural areas. The purpose of this study was to collect the utilization level of oriental medical care of the people in rural areas. To meet the purpose of this study, patient interview were applied. 790 patients visited to health center in project areas were selected and analyzed by experienced interviewers from 2 April to 21 April 1990. The major findings of this study were as follows ; 1) Of the 790 patients, 32.6 percent of the respondents had experience of using the oriental medicine. As for the utilization by age and sex. 54.8% of those was female and 70.7% was 40 years of age and more. 2) Reaction to the question of educational achievement showed that on schooling and primary school graduates accounted for 63.1%. 3) The most user of oriental medicine resides in country level, where the health center is located, and 80 percent of those users resides within 10Km. 4) More than 50% of the total was the chronic diseases which lingered for more than 3months. 5) 32.6 percent of the total cases used the oriental medicine. 61.2% among those was treated by oriental medical care hospital and 38.8% by oriental drug dispensaries etc. 6) The contont of oriental medical care varied ; 50.1% for prescription of herb drugs for treatment, 25.1% for health maintenance and 23.9% for acupuncture, moxibustion etc. 7) As for the motivation for using the oriental medicine. 56.6% of the respondents was for treatment of diseases and 27.9% wes for strengthening the physical weakness. 8) As for the effectiveness of the oriental medicine. 70.3% of the total cases satisfied with that treatment and 84.2% of the total cases will use the oriental medicine when is provided by health center.

• 지역사회간호학회지
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• 제26권3호
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• pp.278-291
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• 2015

Purpose: This study was conducted to examine differences in health care utilization and related costs between before and after the introduction of the designated doctor system, and to find out factors making the differences. Methods: Data were collected from 200 medical aid beneficiaries having one or more chronic diseases, registered in the designated doctor system during the year of 2012, and the relationship between the use of health services and claimed medical expenses was analyzed through paired t-test and multiple regression analysis using the SPSS 18.0 program. Results: There was a decrease in the number of total benefit days and the number of outpatient and medication days, but some cases showed an increase after the designation of medical institution. In general, hospital stay increased after the introduction of the system. However, the number of medical institutions utilized was reduced in most cases after designation. Conversely, medical expenses increased in most cases after the designation of medical institution. Conclusion: These results suggest that a detailed scheme to designate medical institutions should be made in consideration of the seriousness of illness and classification of medical institutions not only for the beneficiaries' enhanced health but for the effective management of medical aid fund.

• 보건행정학회지
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• 제32권2호
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• pp.205-215
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• 2022

Background: The purpose of this study is to identify the factors infecting the medical care utilization from a new perspective by newly classifying the categories of administrative districts using the urban decline index and medical vulnerability index as indicators. Methods: This study targeted 150,940 people who used medical services using the 2015 cohort database (DB), 2010-2015 urban regeneration analysis index DB, and 2014-2015 public health and medical statistics DB. The decline of the region was classified using the urban decline index typed using k-means clustering and the medical vulnerability index typed using the quantile score calculation. Regression analysis was performed 3 times with medical expenditure, length of stay, and the number of outpatient visits as dependent variables. Results: There were 37 stable region (47.4%), 29 health vulnerable region (37.2%), and 12 decline region (15.4%). The health vulnerable region had lower medical expenditure, fewer outpatient visits, and a higher length of stay than the stable region. The decline region was all higher than the stable region but had no significant effect. Conclusion: The factors that cause the health disparity between regions are not only factors related to individual health behavior but also environmental factors of the local community. Therefore, there is a need for a systematic alternative that properly considers the resources within the community and reflects the characteristics of the population.

• 한국보건간호학회지
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• 제17권1호
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• pp.26-34
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• 2003

The purpose of this study was to analyze the activities of Community Health Nurse Practitionses using the Community Health Post Information System(CHPIS). The information system that have been introduced in 1994 and used by 400 Community Health Posts(CHPs) since 1997, which is about $20\%$ of the total CHPs nationwide. Twenty-five CHPs from two provinces participated in the analysis. Seventy-two percent of the CHPs among the participating CHPs started using the system since 1996. The degree of utilization of the information system was classified into three groups (i. e., high. medium, and low). The results revealed that only $48\%$ utilized the system with high level. The areas of analysis of the information system included characteristics of community residents, environmental attributes, and job analysis of Community Health Nurse Practitioners(CHNPs). The study results indicated that primary health care and drug demand and supply system showed the highest level of satisfaction in utilizing the information system by CHNPs.

• Tuberculosis and Respiratory Diseases
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• 제70권4호
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• pp.307-314
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• 2011

Background: Chronic obstructive pulmonary disease (COPD) is a major cause of death and disability worldwide and one of the most prevalent diseases in Korea. We examined trends and risk factors of health care utilization for COPD in Korea. Methods: We retrospectively analyzed the database of Patient Surveys from 1990 through 2008, which were nationwide surveys of health services utilization through outpatient department (OPD) visits and hospitalization. Physician-diagnosed COPD patients whose ages were 45 years and older were included. Results: OPD visits and hospitalization of COPD patients between 1990 and 2008 were estimated to be 68,552 and 17,774 persons, respectively. Trends in OPD visits and hospitalization for COPD significantly increased from 1990 through 2008 (p=0.019, p=0.001, respectively). The increment rate for OPD visits was 2.0 fold over those years; for hospitalization it was 3.3 fold. Risk factors for OPD visits for COPD were male gender (odd ration [OR], 1.41; 95% confidence interval [CI], 1.39~1.43), those aged 65 years and older (OR, 1.50; 95% CI, 1.47~1.53), residential area other than a metropolis (OR, 1.08; 95% CI, 1.07~1.010) and access to a physician's office (OR, 1.17; 95% CI, 1.14~1.21). Risk factors for hospitalization were male gender (OR, 2.15; 95% CI, 2.07~2.23), those aged 65 year and older (OR, 2.86; 95% CI, 2.72~3.00), residential area other than a metropolis (OR, 1.98; 95% CI, 1.90~2.07) and access to a hospital (OR, 2.88; 95% CI, 2.59~3.22) (p<0.001, both). Conclusion: Health care utilization for COPD subjects increased from 1990 to 2008. Risk factors for the utilization were male gender, older age, and residential area other than a metropolis.

• 아동학회지
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• 제30권6호
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• pp.281-295
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• 2009

Representative services of the afterschool in Korea are After-Schools of the Ministry of Education, Science and Technology, Community Child Centers, After-school Child Care, and Youth After-school Academy of the Ministry of Health, Welfare and Family. Each service is distinguished with its own founded laws, subject children, specialists, principle management agent, a number of participants, and more. Research issues of afterschool are development of new afterschool programs, evaluatjon of the effectiveness of the afterschool, establishment of policies related to cooperative efforts among the different services of the afterschool, obtainment of legal status, and enhancement of the credential of its personnels. To guarantee the quality of the Afterschool and improve personnels' working conditions, various means are to be implemented. In regard to programatic and policy issues, the afterschool is needed to establish a system for training the afterschool coordinators and of its accreditation and to develop more child-centered afterschool programs. Also, it is needed to legislate fundamental law and consolidate communication system among the services of the Afterschool in pursue of their effective utilization and actual expansion.

• 한국학교ㆍ지역보건교육학회지
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• 제13권3호
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• pp.101-112
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• 2012

Background & Objective: Oral health care in adolescent is important for oral health of adult life. The aim of this study was to investigate knowledge and attitude on oral health among high school students. Method: A questionnaire survey was conducted in April, 2010 for students of two high schools located in Yangsan, Gyeongsangnam-Do, Korea and final data from 458 students was analyzed. Results: The study subjects were well known about toothbrushing but not on scaling, oral care products, and fluorine. They had positive attitude toward toothbrushing, regular oral health examination, and smoking and drinking control but assumed negative attitude to scaling and utilization of fluorine. A total of 51.1% of the study subjects has participated in oral health education and they had higher level of knowledge and attitude on oral health. There was a significant difference in knowledge and attitude on oral health according to the interest level in oral health and also in knowledge on oral health according to self-rate oral health status. According to utilization of oral health product and scaling knowledge and attitude level on oral health were different significantly. Conclusions: Knowledge and attitude of adolescent are necessary to be improved and changed in some topics of oral health through oral health education.

• Journal of Preventive Medicine and Public Health
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• 제22권1호
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• pp.162-168
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• 1989

This study was conducted to analyse attitudes to a new health care system in a rural community. The specific purpose of this thesis was to classify attitudes to the patient referral system in Kangwha county, and to identify factors affecting the attitudes. Sampling was done by a multi-stage stratified cluster sampling method from the population. The data were collected in Kangwha county through a structured interview survey for two weeks in June, 1957. Attitudes to the patient referral system were classified into four types based upon answers to questions about awareness of the system, the recognition for the necessity of the system, and opinions on the improvement of the system. The four types of attitudes were active acceptance(10.2%), partial acceptance (27.2%), refusal(35.8%), and indifference(26.7%). The respondent's age, educational level, age of head of household, medical insurance fee, the number of ill family members, and the percentage of medical utilization by the family were the variables which affected the attitudes. The medical insurance fee, respondent's age, age of head of household, and the percentage of medical utilization by the family were the statistically significant discriminant factors of the four types of attitudes.