• Health Policy and Management
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• v.9 no.2
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• pp.40-54
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• 1999

The purpose of this study is to compare the health service utilization patterns between up and myun and to find the determinants of utilization. For this purpose. this study used different versions of utilization rates. such as crude utilization rates. utilization rates adjusted for population composition. and age-sex adjusted utilization rates. Data used in this analysis were the Community Health Interview Survey which was conducted by interviewing 741 households from August 31 to September 11, 1998 in HongCheon-Gun. KangWon-Do. The major findings of the analysis are summarized as follows: 1. There was a statistically significant difference in the level of health service utilization between up and myun. Depending upon the unit of analysis employed (those who were interviewed vs those who were sick). the difference between up and myun was reversed. 2. Determinants of health service utilization are analyzed using logistic regression. The result showed that predisposing factor influenced health service utilization in rural areas, while the enabling factor didn't.

• Journal of Society of Preventive Korean Medicine
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• v.19 no.3
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• pp.57-66
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• 2015

Objective : Private health insurance coverage in Korean medicine has been reduced since October 2009 for preventing unnecessary utilization. The aim of this study is to identify how private health insurance coverage reduction affects on the Korean medicine utilization. Method : We analyzed the Korea Health Panel data from 2008 to 2012. Panel negative binominal regression model was used to analyze the relationship between private health insurance coverage reduction and utilization of outpatient service. Panel tobit regression analysis was used to identify the relationship between private health insurance coverage reduction and health expenditure of outpatient service. Results : Private health insurance coverage reduction significantly dropped both utilization and health expenditure of outpatient service by 9%, 9.22% respectively. In addition, therapeutic utilization significantly decreased up to 10%. Conclusion : Private health insurance coverage reduction seems to have an effect to reduce both utilization and the health expenditure of Korean medicine outpatient service. This effect was more noticeable in the therapeutic utilization. Thus, more elaborate policy will be needed to prevent unnecessary utilization of Korean medicine.

• 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.

• Korea Journal of Hospital Management
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• v.18 no.4
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• pp.78-96
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• 2013

The purpose of this study is to analyze the emergency health care utilization using status according to income class. The target was the 2011 data out Korea Health Panel's raw data. 2011 data composed of total 17,035 people from total 5,741 households. This study set total 1,101 adults over full-20-years old having used an emergency health care utilization as its analysis target. In order to find out the number of emergency health care utilization use according to income class and the influential factors on emergency health care utilization cost, this study conducted the multiple regression analysis. And in order to more accurately analyze the emergency health care utilization use status depending on the income class and the features of emergency health care utilization use status, this study developed Models. As the result, this study found following findings. First, as the income class was lower, the gender was male, the age was lower, and the user has spouse, the user was not a business owner or a paid worker, the user is a house owner, the emergency medical facility type was a clinic, the means of transportation was others rather than 119 ambulance, the reason visiting emergency medical facility was belonged to others rather than accidents or poisoning, then the number of emergency was increased. Second, as the user was in higher income class, received the health insurance benefits, the using medical facility was general hospital, used 119 ambulance more often, stay days in emergency was shorter, then health care utilization cost was increased. In this study investigating the data out of Korea Health Panel, it was found that while the number of emergency health care utilization use was increased in the lower income class, but the emergency health care utilization cost was increased for higher income class. It is considered that this finding was caused from the facts that lower income class was more often exposed to dangers for physical health, so the number of emergency health care utilization use was increased, but their health care utilization cost was decreased because of their economic burdens against various examinations and their difficulties to pay such costs, comparing to that of higher income class. Therefore, in order to solve unequal problem of emergency health care utilization use between lower and higher income classs, it is required to set suitable solutions like the disease prevention effort by facilitating national health check-up programs, the enhancement of public health services in quantity and quality, the emergency health care utilization securing policy at using medical facilities, the promotional, educational activities about emergency health care utilization delivery system, the enhanced accessibility of emergency health care utilizations and emergency medical facilities.

• Journal of Preventive Medicine and Public Health
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• v.50 no.1
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• pp.29-37
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• 2017

Objectives: The accurate measurement of geographic patterns of health care utilization is a prerequisite for the study of geographic variations in health care utilization. While several measures have been developed to measure how accurately geographic units reflect the health care utilization patterns of residents, they have been only applied to hospitalization and need further evaluation. This study aimed to evaluate geographic indices describing health care utilization. Methods: We measured the utilization rate and four health care utilization indices (localization index, outflow index, inflow index, and net patient flow) for eight major procedures (coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, surgery after hip fracture, knee replacement surgery, caesarean sections, hysterectomy, computed tomography scans, and magnetic resonance imaging scans) according to three levels of geographic units in Korea. Data were obtained from the National Health Insurance database in Korea. We evaluated the associations among the health care utilization indices and the utilization rates. Results: In higher-level geographic units, the localization index tended to be high, while the inflow index and outflow index were lower. The indices showed different patterns depending on the procedure. A strong negative correlation between the localization index and the outflow index was observed for all procedures. Net patient flow showed a moderate positive correlation with the localization index and the inflow index. Conclusions: Health care utilization indices can be used as a proxy to describe the utilization pattern of a procedure in a geographic unit.

• The Korean Journal of Health Service Management
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• v.8 no.3
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• pp.49-61
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• 2014

Due to the rapid population's aging, the life span's expansion and social & cultural characteristics, the standards of age classes in senescence are changed. Thus, this study aimed to identify the influential factors on health care utilization in the elderly by age class, and targeted 2,937 adults in their ages over 55 years old from the Korea Health Panel's 2009 Yearly Integrated Data. This study investigated the target health care utilization in the elderly in relation with the gender, the education level, the health-care insurance type, the income, the current job state, the chronic disease. In order to analyze the influential factors on health care utilization in the elderly, the multiple linear regression analysis was conducted to the data. As the results from this study, Concerning the influential factors on the health care utilization, the income, the subjective health state, the chronic disease and the regularly meals for the young-old influenced. Concerning the influential factors on the health care utilization, the subjective health state for the old. Concerning the influential factors on the health care utilization, the subjective health state, the income for the older-old influenced. Concerning the influential factors on the health care utilization, the education level, the spouse, the economic activity and the drinking oldest-old influenced. Therefore, it will need to provide systemic health-care & medical services, to develop health-care & medical programs and the health-care & medical policies and to execute them according to the age classes in senescence.

• Health Policy and Management
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• v.13 no.1
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• pp.69-97
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• 2003

This study focuses on the determinants of the community health service utilization. Theories suggest seven models for community health service utilization, which are divided largely into two groups such as Health Service Supply Model and Health Service Demand Model: Supply Model includes Medical Implements Model, Personnel and Budget Model, Management System Model, Staffs' Behavior Model, Service Quality Model; Demand Model includes Area Model and Clients' Characteristics Model. This paper tests how the above models influence on the community health service utilization. After interviewing some administrative staffs of the Community Health Service Center at Pusan, questionnaires were made and mailed to the staffs of 198 Korean Community Health Service Center as a universe, among which from 98 centers we got response. Analyzing the data from the questionnaires, we found "the number of personnels in the health service center" and "demands for medical service" as important variables to affect the utilization of the community health service center. These two variables are typical factors representing Supply Model and Demand Model each. However, the variables selected from Management System Model, Administrative Behavior Model, Service Quality Model and Area model are not significant in a statistical sense. The paper suggests that to recruit the personnels, especially nurses, and to make out the demands of the clients for health service be the precedent conditions to increase the utilization of the Community Health Service Centers in Korea.ce Centers in Korea.

• Health Policy and Management
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• v.29 no.3
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• pp.288-302
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• 2019

Background: The one-person households (OPH) are rapidly increasing and vulnerable to socioeconomic and health problems. Because it is predicted to be inequitable to health care utilization, we would like to find out about the equity of health care utilization of the OPH by comparison with the multi-person households (MPH). Methods: This study followed the theoretical framework of Wagstaff and van Doorslaer (2000), O'Donnell and his colleagues (2008), where the horizontal inequity index is the difference between the concentration indices of actual health care utilization and health care needs. This study employed the 9th Korea Health Panel survey, and a total of 10,807 cases were analyzed. Health care needs were measured by age, sex, subjective health status, chronic disease count, Charlson's Comorbidity Index, limitation of activities, and disability. Results: Compared with the MPH, there were pro-poor inequities in hospitalization, emergency utilization, hospitalization out-of-pocket payments, and pro-rich inequities in outpatient out-of-pocket payments for the OPH. The decomposition of the concentration index revealed that chronic disease count made the largest contribution to socioeconomic inequality in outpatient utilization. Age, health insurance, economic activities, and subjective health status also proved more important contributors to inequality. The variables contributing to the hospitalization and emergency utilization inequity were age, education, Charlson's Comorbidity Index, marital status, and income. Conclusion: Because the OPH was more vulnerable to health problems than the MPH and there were pro-poor inequities in medical utilization, hospitalization, and emergency costs, it is necessary to develop a policy that can correct and improve the portion of high contribution to medical utilization of the OPH.

• Health Policy and Management
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• v.17 no.3
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• pp.26-49
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• 2007

The purpose of this study is to analyze the equity of health care utilization by income groups in terms of both quantity and quality of care, which is measured by expenditure, type of care, and type of health care institutions. Equity in health care utilization is measured by HIwv index, based on the survey of 1,480 Gwangju-Jeonnam residents. Health care utilization in terms of the probability and quantity of outpatient and inpatient care show equitable or pro-poor inequitable distribution, whereas the distribution of health care expenditure, which can account for the quality of care, is pro-rich inequitable, implying that the better off tend to use more expensive medical care. In terms of the types of care, simple visits for basic care show equitable distribution, whereas the distribution of the utilization of traditional tonic medicine, comprehensive health examination, CT, MRI, and ultrasound is pro-rich inequitable. Utilization of general hospitals and traditional health institutions show pro-rich inequitable distribution, hospitals and dental care institutions equitable, and physician clinics and public health centers pro-poor inequitable.

• Health Policy and Management
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• v.13 no.3
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• pp.104-128
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• 2003

Equity in health care has taken priority in the Korean government's policy agenda after the government-led national health insurance achieved universal coverage in 1989 along with the final inclusion of the self-employed as beneficiary. The purpose of this study is to examine the extent to which there exists difference or inequality in the utilization of health care, especially cancer inpatient services among income classes. We analysed the utilization of cancer inpatient services of residents in Jeju Island for a year of 2000, using the national health insurance data for qualification of beneficiaries and utilization of health care. The independent variable are 10 income classes based on the national health insurance fee imposed on each household for a year of 2000. The dependent variables of this study are an amount of cancer inpatient health care utilization measured by cancer admission days and cancer treatment costs. Also, cancer inpatient health care utilization is analysed by three categories divided into utilization in medical care institutions (1) within Jeju Island, (2) outside Jeju Island, and (3) all within and outside Jeju Island. We measured concentration index of cancer inpatient health care utilization. This analysis showed negative concentration index within Jeju Island and positive outside Jeju Island, and positive in all within and outside Jeju Island. This results suggest inequality against the relatively poor income groups in utilization of cancer inpatient health care services. Especially, inequity of cancer inpatient health care would be more serious in Jeju Island of Korea, considering that lower income groups reportedly have higher incidence rates in most of cancer and thus use more health services.