• Journal of Korean Public Health Nursing
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• v.13 no.2
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• pp.12-25
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• 1999

This study examines individual determinants of hospital days in community-dwelling elders by estimating a linear structural equation model based upon Andersen's behavioral model. Data were collected through a national survey of elders in Korea in 1994. The subjects for this secondary data analysis were 1687 non-institutionalized elders aged 60 years or older. Except for the effect of age and gender on family help. the predisposing components had direct effects on the enabling components. Of the effects of the enabling components. family help had a direct effect on self-evaluated health; economic status had a direct effect on chronic disease and self-evaluated health; and access had a direct effect on chronic disease. functional health status and self-evaluated health. Of the enabling components. residence and family help directly affected hospital days. Self-evaluated health revealed the greatest direct effect on hospital days followed by functional health. Overall. the effects of the predisposing components and the enabling components on hospital days were not prominent. Since the model explained only $4\%$ of the variance in hospital days. the magnitude of the effect of the need components cannot be judged in terms of equity of distribution of health services. In particular. the effect of family help in the model reveals the importance of family support in health management of elders. The implications of these analyses for improving the proposed model of hospital days were discussed.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.7
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• pp.3505-3510
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• 2016

Cervical cancer is a major public health problem in Thailand, being ranked second only to breast cancer. Thai women have been reported to have a low rate of cervical cancer screening (27.7% of the 80% goal of WHO). We therefore aimed to apply the social marketing theory and health belief model in promoting cervical cancer screening in Kanthararom District, Sisaket Province. A total of 92 from 974 targeted women aged 30-60 years were randomly divided into two groups. The experimental group underwent application of social marketing theory and a health belief model program promoting cervical cancer screening while the control group received normal services. Two research tools were used: (1) application of social marketing theory and health belief model program and (2) questionnaire used to evaluate perceptions of cervical cancer. Descriptive and inferential statistics including paired sample t-test and independent t-test were used to analyze the data. After the program had been used, the mean score of perception of cervical cancer of experimental group was at a higher level (${\bar{x}}=4.09$; S.D.=0.30), than in the control group (${\bar{x}}=3.82$; S.D.=0.20) with statistical significance (p<0.001). This research demonstrated an appropriate communication process in behavioral modification to prevent cervical cancer. It can be recommended that this program featuring social marketing and the health belief model be used to promote cervical cancer screening in targeted women and it can be promoted as a guideline for other health services, especially in health promotion and disease prevention.

• Journal of the Korea Convergence Society
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• v.11 no.3
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• pp.341-349
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• 2020

The purpose of this study was conducted to explain the intention of use of IoT (internet of things) healthcare service for elderly using TAM (Technology Acceptance Model). The exogenous variables were professional support, personalization, interaction, and convenience, The endogenous variables were usefulness and intention. Data were collected from 220 elderly residents aged 65 over in welfare center and were analyzed using structural equation modeling using AMOS 25.0. The result of this study showed that professional support and personalization did not significantly difference perceived usefulness, and there were significant differences interaction, and convenience. Futhermore, perceived usefulness influence intention of use of IoT healthcare service for elderly. IoT health care service for elderly is affected by perceived usefulness. This study systematically verified the elderly's intention of using IoT-based smart healthcare services. The result of this study would be able to be used as basic data for preparing strategies to enhance their intention to use the services.

• Journal of Preventive Medicine and Public Health
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• v.50 no.5
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• pp.303-310
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• 2017

Objectives: The aim of this study was to evaluate socioeconomic inequalities in the prevalence of dental caries among an urban population. Methods: This study was conducted among 2000 people 15-40 years of age living in Kurdistan, Iran in 2015. Using a questionnaire, data were collected by 4 trained dental students. The dependent variable was the decayed, missing, and filled teeth (DMF) index. Using principal component analysis, the socioeconomic status (SES) of families was determined based on their household assets. Inequality was measured using the concentration index; in addition, the Oaxaca analytical method was used to determine the contribution of various determinants to the observed inequality. Results: The concentration index for poor scores on the DMF index was -0.32 (95% confidence interval [CI], -0.40 to -0.36); thus, poor DMF indices had a greater concentration in groups with a low SES (p<0.001). Decomposition analysis showed that the mean prevalence of a poor DMF index was 43.7% (95% CI, 40.4 to 46.9%) in the least privileged group and 14.4% (95% CI, 9.5 to 9.2%) in the most privileged group. It was found that 85.8% of the gap observed between these groups was due to differences in sex, parents' education, and the district of residence. A poor DMF index was less prevalent among people with higher SES than among those with lower SES (odds ratio, 0.31; 95% CI, 0.19 to 0.52). Conclusions: An alarming degree of SES inequality in oral health status was found in the studied community. Hence, it is suggested that inequalities in oral health status be reduced via adopting appropriate policies such as the delivery of oral health services to poorer groups and covering such services in insurance programs.

• Journal of muscle and joint health
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• v.28 no.2
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• pp.152-160
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• 2021

Purpose: This study, using the International Classification for Nursing Practice, aimed to identify the phenomenon of family nursing care, and the factors affecting it, for high-risk and frail older persons who have a significant need for home healthcare services. Methods: This study was conducted using secondary data collected by students who interviewed 93 healthcare subjects in a health center. The data was used to analyze the general characteristics, health-related characteristics, and confirmed problems of family nursing phenomena of the subjects. Independant t-test, Pearson correlation coefficient, and multiple linear regression were used for the data analysis. Results: The mean age of the subjects was 82.4±6.3 years. The most common problem of the family nursing phenomenon were unhealthy lifestyle, disturbance in family communication, and lack of family interaction in the community. People with greater family nursing phenomenon problems reported a higher degree of frailty and depression, lower quality of life and self-rated health. The factors that influence the family nursing phenomenon of frail older persons are the problems of mobility and hearing. Conclusion: Physical and psychological problems associated with aging can cause not only personal, but family functional problems as well. Therefore, a comprehensive family-oriented support program is required.

• Health Policy and Management
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• v.17 no.3
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• pp.68-86
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• 2007

This study was performed to explore the effect of customer satisfaction and switching barriers on customer royalties in medical services. 900 households, 1% sample were randomly selected from K city located in Kangwon province. Interview survey was performed with structured questionnaire for the entire people, 923 persons who experienced medical service utilization during one year before survey on time, september, 2002. In comparison of switching barriers by sociodemographic characteristics, lower income group and lower educated group showed the higher level of recognition level on availability of changing the service provider significantly. In terms of economic loss as one of switching barriers, the group of over aged 61, the lower income group and the lower educated group felt higher than other groups. Also, the time loss of switching barrier was recognized in 41-60 aged group and employee in service industry highly. For the perceived risk factor as another switching barrier, the high educated group showed the higher recognition level in performance risk and felt higher social risk than other groups. In analysis of customer satisfaction and loyalty levels by switching barrier components, the lower level of availability of changing the service provider and the higher level of recognition for economic and time loss, they showed the higher satisfaction and loyalty levels. In final step, multiple regression analysis showed the positive relationship between customer satisfaction, switching barrier and customer loyalties. Besides, the moderating effect of switching barrier in relationship between customer satisfaction and loyalties was significant and this results suggests that the influence of customer satisfaction to customer loyalties might be weakened in high level of recognition for switching barrier. In conclusion, perceived risk of economic and time loss as switching barrier is an important factor and should be considered in planning of marketing strategy carefully in terms of defensive marketing.

• Korea Journal of Hospital Management
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• v.21 no.2
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• pp.37-49
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• 2016

The purpose of this study is to investigate the level of competition between Public Health Centers (PHCs) and private clinics (PCs) by examining the number of patients that used PHCs vs. PCs, estimating the total amount of revenue generated from outpatient services at both PHCs and PCs, thereby analyzing the financial impacts on PCs derived from the PHCs. We utilized 2011 National Inpatient Sample data (NIS). Using the 20 table containing general information on each individual claims, we integrate it with the 40 table which contains all the diagnostic codes for each claim. Then, we disaggregate the bundled claims into the original individual claims. Overall, 3.1% of outpatient visits are made at PHCs while the rest was made at the PCs (96.9%). Among the total claim costs of 6.34 billion USD (as of 2011), PHCs occupy 2.0% (124 million USD), and 98.0% are contributed to PCs (6.21 billion USD). The estimated economic losses of PCs due to PHCs are summarized as follow; the maximum potential loss is estimated at 198 million USD in total and 7,099 USD per clinic when we include all patient types; the minimum loss is estimated at 71 million USD in total and 2,540 USD per clinic where Medical Aid recipients and the elderly (aged 65 and over) are excluded. Our results confirm the potential economic effect on PCs due to PHCs providing outpatient services. PCs and PHCs are the most important players providing primary care in Korea. Unnecessary competition between PCs and PHCs is not desirable. Health authorities should carefully examine the healthcare services currently provided by PHCs and their impacts on PCs.

• Journal of Families and Better Life
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• v.20 no.3
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• pp.1-12
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• 2002

This study was conducted to examine the relationship between socio-familial characteristics and health status in early stage of elderly life. In this study, a total of 252 Korean males and females aged 55 to 74 were interviewed to obtain information on various socio-familial characteristics such as age, gender, residence, marital status, education, religion, distance with children, household size, and living arrangements. They were also examined for self-perceived depression and diagnosed health problems. The analysis of the results show that marital status, gender, and living arrangement were major characteristics differentiating health status; widowed women living apart from their children are at lower level for most items of hea1th status such as emotional, circulatory, respiratory, digestive, and muscle and skeletal function. Based on this analysis, suggestions are made for efficient health management. First, widowed females living without children are encouraged to participate in regular health promotion programs in self-organized groups. Second, usual welfare service programs need to be segregated for each age group, so that relatively young elderly are not frustrated from being treated together with extremely frail older elderly. Third, low education group living in rural area are offered preventive medical services for muscular and skeletal related health problems.

• Journal of Korean Critical Care Nursing
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• v.7 no.1
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• pp.24-32
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• 2014

Purpose: The purpose of this study was to examine the effects of discharge planning on patient satisfaction, the readmission rate and preparedness for discharge in the elderly admitted to the emergency room (ER) for pulmonary disease. Methods: A quasi-experimental intervention study design was used. Older adults with pulmonary health problems in the ER in one general hospital were randomly allocated to either an experimental (n=21, 74.2 years) or control group (n=19, 70.7 years). The experimental group participated in a discharge planning program by a geriatric nurse practitioner. Data were collected from medical records, physical measurements and structured questionnaires including information on demographics, patient satisfaction, readmission, and preparedness for discharge. Results: Participants in the experimental group had significantly better outcomes with regard to patient satisfaction with nursing services (p=.003) and preparedness for discharge (p=.034). However, there was no significant effect on the readmission rate (p=.392) Conclusion: The results suggested that a discharge planning program could bolster nursing service satisfaction and preparedness for discharge in older patients admitted to the ER for pulmonary health problems. To clarify the effects of discharge planning on older patients admitted to the ER, a larger sample population, better instruments for various measures, a new manual on discharge planning and frequent follow-up will be necessary.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.8
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• pp.3753-3756
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• 2014

Background: Cervical cancer is relatively common in Thai women, but the proportion of females receiving Pap smear screening is still low. Objective: The purpose of this cross-sectional study was to study factors related to cervical cancer screening uptake by Hmong hilltribe women in Lomkao District, Phetchabun Province. Materials and Methods: Interview data were collected from 547 of these women aged 30-60 years living in the study area and analyzed using multiple logistic regression. Results: The results showed that 64.9% of the study sample had received screening, and that 47.2% had attended due to a cervical screening campaign. The most common reason given for not receiving screening was lack of time (21.4%). The factors found to be positively associated with uptake (p value <0.05) were as follows: number of years of school attendance (OR=1.56, 95%CI:1.02-2.38), animistic religious beliefs (OR=0.55, 95%CI:0.33-0.91), a previous pregnancy (OR=6.20, 95%CI:1.36-28.35), receipt of information about cervical cancer screening (OR=2.25, 95%CI:1.35-3.76), and perceived risk of developing cervical cancer (OR=1.83, 95%CI:1.25-2.67). Conclusions: To promote the uptake of cervical screening, Hmong hilltribe women need to know more about cervical cancer and cervical cancer screening, and access to screening services should be provided in conjunction with existing everyday services, such as family planning and routine blood pressure monitoring or diabetes services.