• The Journal of Korean Society for School & Community Health Education
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• v.12 no.1
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• pp.35-44
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• 2011

Objectives: The purpose of this study were to measure the effect of factors analyse the associated by the oral health behaviors and dental health services utilization factors of dental caries in the middle-school student's and then to provide basic material of preventive oral health and oral health education program. Methods: This subject of study consists of 342 middle schools each 1,2,3 grade Daegu city. The data were collected from July 2 to 30, 2009. by way of the self-reported questionnaire. The data materials are analyzed by demographic characteristics, oral health behaviors and dental health services utilization of frequency analysis, demographic characteristics of dental caries and oral health behaviors and dental health services utilization of one-way ANOVA analysis. Results: Brushing twice a day, which was the higher 69.3%, Students were trained received oral health education. Girls than boys dental caries teeth(DT) index (p<0.05), dental filling teeth(FT) index(p<0.00), dental experience caries teeth(DMFT) index(p<0.00) was higher than all three variables was a statistically significant. Oral health behavior of brushing twice a day 'once' dental caries teeth(DT) index was the highest, there was statistically significant difference (p<0.01), oral health education students experience a higher dental caries teeth(DT) index(p=0.36). dental health services utilization of preventive dental visits last one year when they did not have dental caries teeth(DT) index was higher (p=0.076) Conclusions: Oral health promotion is considered to adolescent as part of the oral health clinics school for elementary school students in the focus to middle school students and enhance.

• Health Policy and Management
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• v.21 no.3
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• pp.349-364
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• 2011

Objectives : The purpose of this study was to evaluate the relationship between new-building of rural public health centers and the outpatient medical utilization. Methods : The study subjects were 141 public health centers in rural area. The data were collected from 1995 to 2001, medical utilization and local population, healthcare resources, and economic characteristics were included. In order to evaluate new-building effects, we performed paired t-tests and multivariate regression analyses. Results : The following variables are significant affecting the medical utilization of rural public health centers: urban side location of public health centers(p<0.05), pre- and post-IMF economic crisis(p<0.001), number of medical aid recipients(p<0.01), number of private clinics(p<0.05), workers of public health centers(p<0.001), financial independent level of local governments(p<0.001). In contrast, the existence of new-building and number of the aged 65 and over were not significant variables. Conclusions : We could not find out the positive relationship between the existence of new-building and the volume of medical utilization in rural public health centers. In particular the medical utilization of rural public health centers is significantly affected by IMF economic recession and number of the poor strata, the economically depressed area.

• Journal of Preventive Medicine and Public Health
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• v.48 no.6
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• pp.319-329
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• 2015

Objectives: Parental socioeconomic status (SES) exerts a substantial influence on children's health. The purpose of this study was to examine factors determining children's private health insurance (PHI) enrolment and children's healthcare utilization according to PHI coverage. Methods: Korea Health Panel data from 2011 (n=3085) was used to explore the factors determining PHI enrolment in children younger than 15 years of age. A logit model contained health status and SES variables for both children and parents. A fixed effects model identified factors influencing healthcare utilization in children aged 10 years or younger, using 2008 to 2011 panel data (n=9084). Results: The factors determining children's PHI enrolment included children's age and sex and parents' educational status, employment status, and household income quintile. PHI exerted a significant effect on outpatient cost, inpatient cost, and number of admissions. Number of outpatient visits and total length of stay were not affected by PHI status. The interaction between PHI and age group increased outpatient cost significantly. Conclusions: Children's PHI enrolment was influenced by parents' SES, while healthcare utilization was affected by health and disability status. Therefore, the results of this study suggest disparities in healthcare utilization according to PHI enrollment.

• Health Policy and Management
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• v.25 no.1
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• pp.3-10
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• 2015

Background: Previous studies showed differences in healthcare utilization among insurance types. This study aimed to analyze the difference in healthcare utilization for percutaneous transluminal coronary angioplasty inpatients by insurance types after controlling factors affecting healthcare utilization using propensity score matching (PSM). Methods: The 2011 national inpatient sample based on health insurance claims data was used for analysis. PSM was used to control factors influencing healthcare utilization except insurance types. Length of stay and total charges were used as healthcare utilization variables. Patients were divided into National Health Insurance (NHI) and Medical Aid (MA) patients. Factors representing inpatients (gender, age, admission sources, and Elixhauser comorbidity index) and hospitals (number of doctors, number of beds, and location of hospitals) were used as covariates in PSM. Results: Tertiary hospitals didn't show significant difference in length of stay and total charges after PSM between two insurance types. However, MA patients showed significantly longer length of stay than that of NHI patients after PSM in general hospitals. Multivariate regression analysis provided that admission sources, Elixhauser comorbidity index, insurance types, number of doctors, and location of hospitals (province) had significant influences on the length of stay in general hospitals. Conclusion: Study results provided evidences that healthcare utilization was differed by insurance types in general hospitals. Health policy makers will need to prepare interventions to influence the healthcare utilization differences between insurance types.

• Korean Journal of Health Education and Promotion
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• v.31 no.3
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• pp.27-37
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• 2014

Objectives: This study aims to identify the factors associated with regular medical services utilization of chronic disease patients. Methods: The research selected 4,489 adults aged over 30, diagnosed with hypertension, diabetes, hyperlipidemia, hypercholesterolemia, from the Korea health panel. We analyzed states of regular medical service utilization using descriptive statistics. Multiple regression analysis was used to examine the main factors associated with regular medical services utilization in chronic disease patients. Results: In terms of socio-demographic factors, gender, age, marital status, education level, employment, household income and disability were significantly different between hypertension, diabetes, hyperlipidemia and hypercholesterolemia. Among health status and behavioral factors, number of chronic diseases, subjective health status, smoking, high risk drinking, regular meals, physical activity, obesity were significantly different. From the multiple logistic regression analysis, age, number of chronic diseases, obesity, type of chronic diseases were associated with regular medical services utilization. Conclusions: It is necessary to develop effective health education programs and individualized approach to improve continuous management in chronic diseases patients.

• The Korean Journal of Health Service Management
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• v.11 no.3
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• pp.51-64
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• 2017

Objectives : This study examined the effect of private health insurance on medical care utilization by subscription type. Methods : The data used were the six waves of the Korea Health Panel (2009-2014), and 16,187 persons were the subjects of the analysis. We performed a panel regression with a fixed effects model. Results : Indemnity private health insurance was positively related to the number of physician visits, number of admissions, and total length of stays. However, fixed-benefit private health insurance was not related to medical care utilization. Conclusions : The result of this study, which shows the difference by subscription type in the effect of private health insurance on medical care utilization, suggests that continuous monitoring of indemnity private health insurance is needed in the future.

• Journal of agricultural medicine and community health
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• v.41 no.4
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• pp.183-194
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• 2016

Objectives: The purpose of this study was to investigate the differences of capacity of local health organization to regional characteristics and the influence of organizational capacity on organizational performance. Methods: The study used the secondary data for 160 local public health organizations from $5^{th}$ Community Health Plans and 2009 Community Health Survey. The collected data were analyzed using one-way ANOVA and multiple regression analysis. Results: Work force and budget showed differences in regional size and elderly population rate. And consumer satisfaction and health care utilization showed differenced in work force and budget. The regression model with total number of employee, number of registered nurses, number of doctors and budget against consumer satisfaction was statistically significant (F=14.70, p=<.001), and number of registered nurses was identified as a factor influencing consumer satisfaction. This model also explained 20.5% of service satisfaction. The regression model for consumer satisfaction was statistically significant (F=45.98, p=<.001), and total number of employee nurses was identified as a factor influencing health care utilization. This model also explained 53.1% of utilization. Conclusions: The findings of this study imply that organizational capacity as work force and budget should be increased to improve the organizational performance as consumer satisfaction and health care utilization.

• Health Policy and Management
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• v.22 no.4
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• pp.497-521
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• 2012

Objectives This study aimed to investigate the effect of social capital, health risk behavior and health status on medical care utilization by the elderly. The data and Research method Data were obtained from the 4th wave survey of the Korea Welfare Panel Study. 4,087 household members aged 65 years and over were subject to analysis. Descriptive statistics are used to describe the basic features of the data in a study. we performed a structural equation modeling(SEM) analysis to evaluate the effect of social capital and mediating effect of health risk behavior and health status. Results Results showed that factors related to medical care utilization of the elderly were different depending on types of service (inpatient and outpatient service) except health status. Age, higher social capital, more health-risk behavior and poorer health status were associated with increased use of inpatient service. Social capital was found to have a positive direct effect on it. Also, social capital had an indirect effect on reducing use of inpatient services by improving health status. On the other hand, lower age and higher household income tended to increase use of outpatient service, while higher social capital and higher health status were inversely related. Social capital had a direct effect and an indirect effect on reducing use of outpatient service and, at that time, health status played a mediating role. Conclusions Social capital may contribute to improve health status and indirectly reduce medical care utilization of the elderly by enhancing their health status. These results provide evidence that more policy and strategy considerations should be needed for the elderly to strengthen their social capital in order to enhance their levels of health and more efficient utilization of medical care.

• Journal of Korean Clinical Health Science
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• v.1 no.1
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• pp.9-17
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• 2013

Purpose. This study is to find the degree of variations and trends of hospital services utilization for hypertensive disease, and have done the comparative analysis of the factors affecting occurring some variations. For this, this study uses the data for patients-survey and health-survey of a regional society by Korea Institute for Heath and Social Affairs in 2008; The regional units are classified into 160 of medium size medical service areas. Methods. I understand the level of variation by using index of Extremal Quotient(EQ) and Coefficient Variation(CV), and analyze critical factors influencing some differences in hospital services utilization by using multi-regression model. Results. The main results are followed:The first, in case of rate of hospital services utilization according to standarization of sex and age by small area, I find the variations of EQ 5.3 and CV 0.3; In Ho-nam, especially, the variation of high rank of 10 of age shows higher distribution. The second, the results analyzing the factors influencing on hospital services utilization by multi regression model are that a number of bed hospitals is significant positive relationship and EQ-5D of health behavior is significant negative one. Conclusions. To increase equity of hospital services utilization for hypertensive disease, this study requests the appropriate supply management of bed hospitals by region, efficient allocation of resources, and revitalization of the health promotion program.

• Journal of Preventive Medicine and Public Health
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• v.12 no.1
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• pp.99-106
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• 1979

Accessibility to medical facilities and personnels has been known as one of important determinants of medical care utilization. This study attempted to identify the effects of medical accessibility in terms of geographical distance and occupational opportunity to the medical utilizations. Two-year-experiences of Yonsei University Health Insurance Cooperatives were used as the sources of data. Out patient utilization patterns of 713 members sampled from 4,352 members of Health Insurance Cooperatives were analyzed in order to identify the effects of medical accessibilities. Findings: 1 Average clinic visit rate of Yonsei Health Insurance is 1.66 per person per year. 2. The utilization rates of geographically more accessible group were 33% higher than that of less accessible group. 3. No marked difference in clinic visit rate were observed between medical and non-medical personnel and their family members. 4. Clinic visit rates among occupationally accessible group were slightly higher than those of less accessible. The utilization rate was more sensitively changed by the insurance policy changes in occupationally accessible group.