• Health Policy and Management
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• v.21 no.1
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• pp.115-131
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• 2011

Several common issues are encountered by countries - Germany, Japan, and the United States - that adopted long-term care (LTC) system. First, the demand for LTC and its associated costs have steeply risen following the implementation of the LTC policy. Second, ensuring the quality of services have been difficult. Third, the coordination of services among providers and between LTC and medical care has been inadequate. Learning from their experience, we suggest ways to improve the LTC system in Korea. The basic approach aims for efficiency over equity in the system. This would require promoting provider competition and consumer choice. We propose several policy options according to the major stakeholders. For consumers, cash benefits at fixed rates and personal savings accounts are feasible options to self-contain the demand and cost of services. On the insurer's side, creating an environment of multiple insurers will engender competition, leading to cost savings and quality care. For providers, delivery of quality services through competition, cost-containment through capitated reimbursements, and coordination of services through integrated delivery system can be achieved. From the assessors' perspective, establishing an information system to monitor the activities of insurers and providers would be important, empowering consumers with information to choose cost-effective service providers. In summary, the suggested approach would provide cost-effective LTC services by guaranteeing consumer choice and promoting major stakeholder accountability. Further studies are needed to test the feasibility of this model in ensuring quality LTC in Korea.

• Journal of Korean society of Dental Hygiene
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• v.24 no.1
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• pp.17-26
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• 2024

Objectives: This study aimed to analyze the relationship between the socioeconomic status and oral health of adults. Methods: Data from the 7th Korea National Health and Nutrition Examination Survey (2016-2018) were analyzed, and 13,199 adults aged 19 years or older were selected as study subjects. Various oral health indicators were used to analyze the effect of socioeconomic status on oral health. Disparities in oral health according to socioeconomic status were analyzed using the complex sample chi-squared test and multiple logistic regression analysis. Results: A statistically significant difference was observed between income level, medical aid, and all oral health indicators, which indicated that the lower the income level, the lower the oral health level (p<0.001). Furthermore, all oral health indicators displayed statistically significant differences, with the exception of the prevalence of dental caries and education level. The lower the education level, the lower the oral health level (p<0.001). Therefore, the oral health level of adults presented significant differences according to different socioeconomic status indicators. Conclusions: To prevent oral health inequalities, the government and local governments need to intervene not only in the field of health care but also in the social determinants. Additionally, concerted efforts should be made to eliminate oral health disparities by improving policies and systems.

• Research in Community and Public Health Nursing
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• v.13 no.2
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• pp.272-279
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• 2002

Objectives: The purpose of this study was to analyze health service utilization, and its related factors in low income families who earned half of the average Korean household income. Methods: This was a cross-sectional descriptive survey study in which a nationwide randomization sampling technique was used. The data were collected from July 12 to August 7, 1999, and the total sample size was 5,819 individuals, belonging to 1.753 households. Results: 1) In the utilization of health services for the last 3months, the pharmacy was the type of service that was the most utilized (32.0%), and the health center was the one that was the least utilized (10.3%). About 29% (29.2%) of the respondents could not utilize the health service at all. and 19.8% of the respondents terminated their medical treatments half way to completion because of financial difficulty (89.4%). 2) Analysis of the data using logistic regression showed that living with spouse, level of education, occupation, and income had statistically significant effects on health service utilization. Conclusion: The parameters of health care policies are equity and efficacy for health status, and the health service utilization by low income families. The conclusive resolution for these is the improvement of public health centers for an increased utilization rate of their services.

• The Korean Journal of Health Service Management
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• v.11 no.1
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• pp.117-130
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• 2017

Objectives : In this study, 3,107 patients were used to evaluate the impact based on raw data of 2014 and the health status and medical expenses income quintile was collected and data was analyzed. Methods : Analysis method was the average comparison, ANOVA, subjected to a multiple logistic regression analysis, the statistical test was the t-test and the scheffe post verification. Results : Gender(p<.000), age(p<.000), marital status(p<.000) educational status (p<.000), easement(p<.000), medication(p<.000), subjective health status(p<.005) were analyzed. First quintile identified that the highest amount was spent in the Chungcheong region, the 2nd quintile showed that the highest output was in the Gyeongsang region. The 3rd and 4th quintiles indicated that the highest expenditure was in the Seoul metropolitan region. The 5th quintile showed that the Chungcheong was the highest once again and the Jeolla region was the lowest in terms of expediture. Conclusions : Future medical research on income will require the government's Big Data collection to create the primary basis for policy making in order to improve the efficiency, effectiveness and equity of medicine spending.

• Journal of Korean Academy of Nursing
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• v.26 no.2
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• pp.345-358
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• 1996

All human health behavior is deeply rooted one's beliefs or value system usually encompassed within the culture in which they live. The Taegyo, based on Oriental folk medicine, is defined as the behavior and self care of pregnant women administered for herself and her fetus(unborn child). Taegyo is believed to be desirable, effective, and healthy behavior by most of Korean pregnant women. It is essential in our contemporary culture, to ascertain what the components of Taegyo are and to integrate them into current, western nursing care, particularly in the area of prenatal care. 910 Korean women were the subjects of this study, who were in a gestation period of pregnancy between 10 weeks to three months postpartum. The subjects were selected by clustered smpling from 10 representative cities in Korea. Data was collected from February 10 to March 30 1995 by a constructed Questionnaire which consisted of 95 items. The questionnaire was developed through three steps such as content analysis, calculation of content validity index, and pretest. Data was analyzed by descriptive statistics and rotated matrix factor analysis with pc-SAS. The mean age of the subjects was 28.9 years : 36.5％ of them were employed and the mean income per month was about 2000 dollars. The component of Taegyo was clustered into five factors such as fetus psychological stability(equity), fetus personality development, maternal-fetal interaction, fetus intellectual development and physical health promotion. The variance of each factor were 23.7％, 8.3％, 4. 7％, 4.1％, and 3.3％ respectively in that order. The Eigen value of each factor was 13.03, 4.57, 2.60, 2.23, and l.83 respectively. It was found that the Taegyo is an unique and holistic self care behavior of Korean pregnant women. Therefore it has been concluded that this study has broadened the understandability of the implications the Taegyo. It is suggested that further studies on the effects of the Taegyo are needed to provide a scientific basis for professional maternity nursing.

• Korea Journal of Hospital Management
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• v.14 no.1
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• pp.36-61
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• 2009

This study focused on finding the variation of medical service utilization, paths of medical service utilization and medical payments of the patients died by cerebrovascular diseases. For this study, data of the one-year episodes of the health insurance subscribers died in 2004 were selected. The frequency of medical visits, the lengths of stays, the days of outpatient visits, the total period of medical services and the total medical payments were compared by the characteristics of the suppliers and utilizers. This study is useful in reviewing the equity of medical service utilization because it analyzed variance in utilization by episodes. In oder to collect accurate data of the patients died by cerebrovascular diseases in 2004 the 2004 reimbursement data of all medical institutions were matched to the data of funeral fee payment by the National Health Insurance Corporation from January 2004 to May 2005. The major results of the study are as follows. The variation of medical service utilization of cerebrovascular diseases was influenced by supplier factors suppliers, such as types and locations of medical institutions and user factors such as sex and age. It was suspected that the reimbursement by fee-for-service contributed to the variation quite a lot, but we could not compare the variation between the different reimbursement systems in Korea. On the basis of analyzing results this study suggests that the factors of suppliers and utilizers should be reviewed to reduce the under use and over use expressed by variations of medical service. The processes of care, effective communication and management system should be investigated for the equity of medical service utilization and also. alternative medical services would be recommended to reduce the high medical payment. Additionally to find other causes of variation further in depth study controling the severity of diseases, socio-economic status of the users and the system factors is required.

• Health Policy and Management
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• v.7 no.1
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• pp.73-99
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• 1997

This study was carried out by using questionnaires with 126 insurance societies from Sept. 30, 1995 to Oct. 18, 1995. The primary data collected bythe survey have been significantly supplemented by secondary data obtained from sources such as health insurance statistical year books and internal data in the Ministry of Health and Wolfare. Major findings were summarized as follows: Two financial coordinating programs have significantly improved financial status of regional health insurance societies: the catastrophic program for high cost medical care that was initiated in 1991 and the program for hospitalization cost of the aged in 1995. Another finding is that there existed ambiguity and inconsistency of equity index that had been used by stabilization programs and its side effects could not be ignored. Regression analyses were made to identify factors that affect financial transfers. Inde pendent variables in the regression include utilization frequency, dependancy ration, insurance contribution per insured and medical expense per insured. All these variables were statistically significant in the equations of applying distribution rate (distribution/contribution) and transfer rate (transfer/contribution) as dependent variables. Policy suggestions for the catastrophic program for high cost medical care are modifying the definition of catastrophic case and setting the maximum amount of subsidies for each society based on distribution rates. To solve the problems of the financial coordinating program for the aged, we could consider reimbursing more than 50% of the copayment incurred by the aged 65 or more and determining the maximum amount of outpatient copayment at 10,000 Won per day or per visit for the elderly. More fundamental improvement could be made by amending the Welfare Benefit Act to establish and expand medical and welfare facilities for the elderly.

• Korea Journal of Hospital Management
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• v.4 no.2
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• pp.85-105
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• 1999

The main purpose of this article is to analyze the managerial performance of small and medium-size hospitals that are specialized in certain areas of medical services. Data of 189 hospitals were obtained from the data file of Korea Institute of Health Services Management The items include general characteristics of the hospitals, fianancial reports, and utilization records. Degree of specialization is measured by concentration(Herfindahl) index, and the sample hospitals are accordingly classified into specialized and unspecialized groups, by means of cluster analysis. These groups are compared in terms of various measures of managerial performance, which include several profitability indices such as operating margin, return on assets(ROA), and return on equity(ROE). To examine the relationship between specialization and managerial performance, we estimate the regression model, where the profitability indices are used as the dependent variables and the concentration index as the independent variable, controlling for the hospital characteristics such as size, type and location. Also, we perform 'Du Pont' analysis, to investigate the basic elements that can explain the differences in profitability between specialized and unspecialized hospitals. Major findings are as follows: 1. Managerial performance is better for the specilized hospitals than the unspecilized, in all aspects of profitability(operating margin, ROA, ROE). 2. Regression analysis suggests that there is a positive, statistically significant relationship beween the degree of specialization(i.e. concentration) and hospital profitability. 3. Main reason for the higher profitability of specialized hospitals lies in lower expenses rather than higher revenue. 4. In particular, personnel and material expenses are significantly smaller for the specialized hospitals, and this result seems to stem from the efficiency of operating fewer lines of business.(some kind of 'economies of scale') 5. Specialized hospitals also have fewer employees compared with the unspecialized, especially in administrative departments, which implies their efficient personnel management.

• Women's Health Nursing
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• v.3 no.1
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• pp.39-50
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• 1997

To examine the effects of an educational program with a purpose of reducing symptoms and ailments of women's premenstrual syndrome on the basis of the Self-care theory of Orem, a stimulation was carried out by using pre-and post-design of non-equity control group after choosing both an experimental group of 62 persons and a control group of 62 persons among 497 industrial women. This study was conducted from June 20, 1996 to September 30, 1996. Meantime, an education was provided for the experimental group of 62 persons for 8 weeks but no education for the control group of 62 persons. Study matters are general and obstetric characteristics, knowledge and self-care behavior and premenstrual syndrome from questionnaires with 497 industrial women, pre and post questionnaires with the control group of 62 persons and the questionnaires collected before and after providing an education for the experimental group of 62 persons, these matters were used as research data for this study and analyzed by means of the SAS program. As a result, it was shown that the scores of 497 industrial women's knowledge by age were the highest 26.36 for 20 to 29 year old women, then 25.58 for 30 to 39 year old women and 25.74 for less 19 year old women. The performance scores of their self-care behavior by age were the highest 39.17 for 30 to 39 year old women, 35.72 for 20 to 29 year old women and 32.85 for less 19 year old women, which means that the older the women are, the higher the performance degree is(p<0.01). And the scores of their premenstrual syndrome by age were 2.80 for less 19 year old women, 2.18 for 20 to 29 year old women and 2.00 for 30 to 39 year old women. Women in their teens and twenties showed more serious symptoms and ailments of premenstrual syndrome than women in their thirties(p<0.01). For the experimental group of 62 persons who received the educational program, both the knowledge of premenstrual syndrome and the degree of self-care behavior were remarkably improved(p<0.01), respectively and the symptoms and ailments of premenstrual syndrome were also remarkably reduced(p<0.01), while the control group showed no change in the knowledge, self-care behavior, and symptoms and ailments of premenstrual syndrome. The above results demonstrated that educational program based on the Self-care theory of Orem is an effective intervention to reduce the symptoms and ailments of premenstrual syndrome. The effects of the study can be generalized by extending the application in which various age groups and professional and social environments are considered together with a research to evaluate the long-term effects of this educational program. Accordingly, it is expected that it can possible not only to provide help for the women by actually applying the program to practical areas for improvement of women's health but also to suggest plans to activate it as one of health education areas.

• The Korean Journal of Health Service Management
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• v.8 no.3
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• pp.13-25
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• 2014

This research was performed to investigate the characteristics and determination factors on tertiary hospital inpatients. The used data was the four waves of Korea Health Panel(2008, 2009, 2010, 2011), and the number of subjects was 4,430 cases of tertiary and general hospital admission. The statistical methodology used in the study is the logistic regression model. The significant affecting factors in utilizing tertiary hospital admission were gender, marital status, education, household income, residence region and ICD-10 classification. Man, graduating college/university, married, high-income were socio-economic affecting factors in tertiary hospital admission. Medical need factor of ICD-10 classification and residence region of inpatients was also significant affecting factors in tertiary hospital admission. The 81.4% of inpatients at tertiary hospital had chronic disease and the 12.9% of inpatients readmitted, the 68.2% had a selecting doctor and the only 26.7% of inpatients reinforced by private medical insurance. This study recommended the Korean government to provide proper rule for tertiary hospital admission in order to improve the equity and efficiency of health care system.