• 보건의료산업학회지
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• 제6권1호
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• pp.77-86
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• 2012

Objective of the study represents experiences of medical utilization of Psychiatric Outpatients. This research draws on information obtained from the 2008 National-wide sampling study of the Korean Healthcare Panel(KHP) conducted. The results of our study suggest the significance of variables such as the gender(p<.001) in the social demographical characteristics, the medical security type(p<.016), medical institution utilization(p<.012) treatment type(p<.004) in the utilization factors. In the case of medical utilization cost, the financial support factor(p<.018) showed a significant relationship. Depending on the particularities of gender, medical security type, financial support, medical institution utilization, treatment type were determined through a multiple logistics regression analysis. Gender showed that, among Psychiatric outpatient age of 30-59 level was 5.358 times and 60 years and older, their the second medical examination level was 4.490 times higher than Psychiatric outpatients under the age of 29. Health insurance type showed for the others medical allowance was 6.712 times higher than job health insurance and the other treatment was 0.395 times lower than drug treatment. Psychiatric outpatients utilization are rooted in the thoughts and factor levels of the Psychiatric patients and must be understood from the Psychiatric outpatients's perspective. The point is not only to gauge the patients research during Psychiatric medical utilization. The important of social community mental healthcare services levels goes beyond the goal of enhancing healthcare.

• 보건행정학회지
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• 제31권4호
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• pp.508-517
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• 2021

Background: After the first case of coronavirus disease 2019 (COVID-19) in January 2020, Korea has experienced three waves in 2020. This study aimed to analyze changes in health care utilization according to the period of the 1st to 3rd waves of the COVID-19 pandemic. Methods: We analyzed 3,354,469,401 national health insurance claims from 59,104 medical facilities between 2017 and 2020. Observed-to-expected ratios (O:E ratio) with data from 2017 to 2019 as expected values and data from 2020 as observed values were obtained to analyze changes in medical utilization. T-test was used to test whether the difference of observed and expected values was statistically significant. Results: In 2020, the O:E ratio was 0.894, indicating a decrease in health care utilization overall during the pandemic. The O:E ratio of the 1st wave was 0.832, which was lower than those of the second (0.886) and third (0.873) waves. Health care utilization decreased relatively more among outpatient, women, children and adolescents, and health insurance patients. And health care utilization decreased more in small medical facilities and in Daegu and Gyeongbuk during the first wave. During the pandemic, the O:E ratios of respiratory diseases were 0.486-0.694, while chronic diseases and mental diseases were more than 1.0. Conclusion: Health care utilization decreased during the COVID-19 pandemic overall, and there were differences by COVID-19 waves, and by the characteristics of patients and medical facilities. It is necessary to understand the cause of changes in health care utilization in order to cope with the prolonged COVID-19 pandemic.

• 보건행정학회지
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• 제33권3호
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• pp.325-337
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• 2023

Background: While there are many studies estimating the effects of private health insurance on various types of health care utilization, few have examined how such effects change in conjunction with important policy reforms in national health insurance (NHI). This study examined how the effect of private health insurance (supplemental and fixed cash benefit) on high-cost outpatient imaging test utilization changed following the expansion of magnetic resonance imaging (MRI) coverage in 2018, which is a key example of the NHI benefit expansion policy in recent years. Methods: Data from the 2017 and 2019 Korea Health Panel Survey, which contained information about healthcare utilization before and after the expansion of MRI coverage in 2018, were used. The incremental effect of private health insurance on high-cost outpatient imaging test utilization for each period were quantified and compared, with special attention given to the type of private health insurance. Results: While people with supplemental private health insurance were more likely to use high-cost outpatient imaging tests than those without, both before and after the expansion of MRI coverage, the incremental effect increased from 1.6% points in 2017 to 2.5% points in 2019. Conclusion: Benefit expansion in NHI does not necessarily reduce disparities in the use of health care between private health insurance subscribers and non-subscribers. The results of our study also suggest that the path through which private health insurance affects healthcare utilization may not be limited to the price mechanism alone but can be more complex.

• 농촌의학ㆍ지역보건
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• 제16권2호
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• pp.125-133
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• 1991

The medical insurance system has been adopted in rural areas in 1988. Since then, the utilization of medical care services has increased rapidly in rural areas. According to the various study on medical care utilization, the people in rural areas used more curative care services than urban areas. The purpose of this study was to analyze the utilization and expenses of medical care services in designated rural areas : Choonseong Gun, Kangwon Province ; and Soonchang Gun, Cheonbuk province in Korea. Medical care utilization of medical care beneficiaries showed slightly increase, while there was a decrease of 18% and more for the medicaid. Regarding selection of medical care institutions, medical care beneficiaries used more hospitals and clinics than health center networks, but the health center networks was used more by the medicaid. However, the hospitalized Soonchang health center was able to provide more curative care to the people than the other two health centers. More than 50% of the patients treated by hospitalized health center were residents of the place in which health center was located.

• 지역사회간호학회지
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• 제30권4호
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• pp.484-493
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• 2019

Purpose: The purpose of this study was to examine the effect of health literacy and self-care performance on health care utilization of medicaid elderly. Methods: A total of 203 medicaid elderly over 65 and living in B-metropolitan city were interviewed. Data were analyzed with descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients and Hierarchical Multiple regression. Results: The average score of the health literacy was 7.88±2.84 out of 12. The average score of self-care was 3.26±0.77 points on the 5 point scale. The frequency of health care utilization by the subjects was 6.65±5.25 a month. The health literacy and self-care performance showed a statistically significant positive correlation. The health literacy and self-care performance showed a statistically significant negative correlation with health care utilization. The factors affecting health care utilization of the subjects were self-care performance, health literacy, and religion, and the explanatory power was 25%. Conclusion: The results indicate that the self-care performance, health literacy, religion are significant factors of health care utilization in medicaid elderly. Therefore, it is necessary to develop strategies to improve their self-care performance and health literacy for reasonable health care utilization. Also, it is necessary to provide the elderly with correct information about medical use from accessible religious institutions, senior community center, and welfare centers.

• 보건행정학회지
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• 제2권1호
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• pp.147-166
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• 1992

The purpose of this study is to analyze the effects of the health center hospital on the health service utilization pattern of the rural population in a county. Two field studies had been conducted in Yonchon County, Kyunggi Province, on February 1989 and on August 1991 before and after the establishment of the Yonchon health center hospital. This study revealed that Yonchon health center hospital occupied 7.3% of total outpatient visits and 16.8% of hospitalization of the county population and the self-sufficient rate of the outpatient visit and hospitalization of Yonchon County between two field studies increased by 1.7% and 20.9% each. Yonchon health center hospital contributed to the growth of the public health sector but it weakened the role of health sub-centers. For the efficient health service utilization of the population in that County, more investment to health center hospital would be needed and the primary health activities of the health subcenter should be enforced.

• 한국병원경영학회지
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• 제24권4호
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• pp.43-56
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• 2019

Purpose: Importance of patient satisfaction related to patient-centeredness has been emphasized, and it is known to have effect on various health outcomes including health resource utilization. However, the effect of patient satisfaction has been discussed mostly in terms of hospital marketing in Korea. This study aims to examine the effect of patient satisfaction in patient-physician communication on healthcare utilization in a nationally representative adult population of South Korea. Method: Patient satisfaction with physician communication is assessed using 4 items in the 2011 Korea Health Panel Survey. Generalized linear regression analysis is conducted using 9,325 adults' healthcare utilization in 2012. Findings: Adjusting for the socio-demographic, economic factors, individual health status, health behaviors and healthcare utilization in 2011, more satisfied individuals, more likely to utilize the outpatient service, especially in clinical setting. Practical Implications: The study findings suggests that in context of South Korea healthcare system such as insufficient medical consultation time and the absence of health delivery system, patient satisfaction as a subjective healthcare quality indicator would have effect on the individual's outpatient visit. This study contributes to stimulate patient satisfaction research and discussion in South Korea to further explore its relationship with potential and various health related outcomes. Further implications of the study are discussed.

• 보건의료산업학회지
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• 제10권4호
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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.

• 보건의료산업학회지
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• 제13권4호
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• pp.179-190
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• 2019

Objectives: This study aimed to investigate the mediating effects of health promotion behaviors on the correlation between self-perceived health and medical care utilization among older adults. Methods: This study used data from a. Data were analyzed with frequency analysis, descriptive statistics, Pearson's correlation coefficient, and hierarchical multiple regression. Mediation analysis was performed according to the Sobel test. Results: The self-perceived health and some health promotion behaviors in older adults had a statistically significant effect on medical care utilization. Only the nutritional management of health promotion behaviors had a mediating effect on the relation between the self-perceived health and medical care utilization of older adults. Conclusions: The nutritional management of older adults was confirmed as an important factor to health promotion and prevention. This study was meaningful in that it identified the political directions for establishing health care policy for the older adults.

• Asian Pacific Journal of Cancer Prevention
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• 제15권13호
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• pp.5265-5270
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• 2014

Background: In Korea, the National Health Insurance program has initiated various copayment policies over a decade in order to alleviate patient financial burden. This study investigated healthcare spending and utilization in the last 12 months of life among patients who died with lung cancer by various copayment policy windows. Materials and Methods: We performed a retrospective cohort study using nationwide lung cancer health insurance claims data from 2002 to 2012. We used descriptive and multivariate methods to compare spending measured by total costs, payer costs, copayments, and utilization (measured by length of stay or outpatient days). Using 1,4417,380 individual health insurance claims (inpatients: 673,122, outpatients: 744,258), we obtained aggregated healthcare spending and utilization of 155,273 individual patient (131,494 inpatient and 103,855 outpatient) records. Results: National spending and utilization is growing, with a significant portion of inpatient healthcare spending and utilization occurring during the end-of-life period. Specifically, inpatients were more likely to have more spending and utilization as they got close to death. As coverage expanded, copayments decreased, but overall costs increased due to increased utilization. The trends were the same in both inpatient and outpatient services. Multivariate analysis confirmed the associations. Conclusions: We found evidence of the higher end of life healthcare spending and utilizations in lung cancer patients occurring as coverage expanded. The practice pattern within a hospital might be influenced by coverage policies. Health policy makers should consider initiating various health policies since these influence the long-term outcomes of service performance and overall healthcare spending and utilization.