• Health Policy and Management
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• v.4 no.2
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• pp.58-76
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• 1994

In order to study factors affecting the use of the ambulatory physician services. Andersen's model for health utilization was modified by adding the health behavior component and examined with three different approaches. Three different approaches were the multiople regression model, logistic regression model, and LISREL model. For multiple regression, dependent variable was reported illness-related visits to a physician during past one year and independent variables are variaous variables measuring predisposing factor, enabling factor, need factor and health behavior. For the logistic regression, dependent variable was visit or no-visit to a physician during past one year and independent variables were same as the multiple regression analysis. For the LISREL, five endogenous variables of health utiliztion, predisposing factor, enabling factor, need factor, and health behavior and 20 exogeneous variables which measures five endogenous variables were used. According to the multiple regression analysis, chronic illness, health status, perceived health status of the need factor; residence, sex, age, marital status, education of the predisposing factor ; health insurance, usual source for medical care of enabling factor were the siginificant exploratory variables for the health utilization. Out of the logistic regression analysis, health status, chronic illness, residence, marital status, education, drinking, use of health aid were found to be significant exploratory variables. From LISREL, need factor affect utilization most following by predisposing factor, enabling factor and health behavior. For LISREL model, age, education, and residence for predisposing factor; health status, chronic illess, and perceived health status for need factor; medical insurance for enabling factor; and doing any kind of health behavior for the health behavior were found as the significant observed variables for each theoretical variables.

• Health Policy and Management
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• v.23 no.1
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• pp.90-100
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• 2013

Background: This study examined the relationships of dementia, stroke, and combined multimorbidity with long-term care utilizations among older people in South Korea. Methods: A nationally representative sample of 10,130 older adults who used long-term care services in 2010 were analyzed. We used the 5% sample of aged 65 years or older linked with National Health Insurance Corporation registry data of long-term care insurance system. The sample was categorized into three groups: dementia only (47.6%), stroke only (36.3%), and both dementia and stroke (16.1%). We estimated the use of institutional care, home care, and total expenditure of long-term care services, adjusting for the severity of each function (such as daily life, behavior or cognitive change, nursing care needs, and rehabilitation care needs) and sociodemographic characteristics. Results: Having dementia symptoms was positively associated with the use of institutional care services, on the other hand, having stroke symptoms was positively related with the use of home care. The total long-term care cost was higher in the group of having both dementia and stroke. Conclusion: Older persons with dementia symptoms and stroke symptoms have different patterns of long-term care utilization, and the multimorbidity increased the overall expenditure of long-term care utilization. These findings imply a need for differentiated management strategy targeting physically and cognitively impaired older persons, and special concerning for persons with multimorbidity conditions for long-term care insurance program in Korea.

• Journal of Korean Critical Care Nursing
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• v.11 no.3
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• pp.95-107
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• 2018

Purpose : This study aimed to investigate the public's perception of reimbursement for the education and counseling services provided to advanced practice nurses in intensive care units. Method : This was a secondary data analysis study. The original data were collected utilizing an online panel. The sample comprised 615 individuals aged between 19 and 49 years nationwide. The study variables included the public's perception of reimbursement for education and counseling services, age, gender, education level, income, and health status. Variables such as past experience of being admitted to an intensive care unit by self, family, or relatives and the recognition of advanced practice nurses were also examined. Results : The mean of the perception score was 3.15 on a 4-point scale ranging from 1 (strongly disagree) to 4 (strongly agree). Among the participants, 89.2% answered "somewhat agreed" or "strongly agreed" to the question about the education and counseling services being covered by the National Health Insurance. Moreover, education level, past experience of being admitted to an intensive care unit by self, family, or relatives, and recognition of advanced practice nurses were significantly associated with the perception score. Conclusion : Efforts should be made to publicize the need for the education and counseling services that are provided to advanced practice nurses in intensive care units.

• The Korean Journal of Health Service Management
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• v.7 no.2
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• pp.149-159
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• 2013

There are rapidly increasing in the number of SNS users according to quick supply of smart phones and expansion of wireless internet services, but there is no much researches on hospital promotion using SNS. In this paper, we proposed methods for development of effective hospital promotion by investigating current status of homepages, mobile web contents and SNS operated in 21 dermatology hospitals located at Seoul city and by analyzing contents according to functions as hospital promotion media. In the investigation results, all of three contents such as homepage, mobile web content and SNS are opened in 76.1% of hospitals and external companies occupied the main management body of the three contents at the largest portion(56.2%). There are hospital information, clinic, reservation in all hospitals' homepages and followed by broadcasting(90.5%), medical treatment(85.7%), consultation information(80.9%), member information in 'mypage'(42.9%), staff information(14.3%). In the analysis results, there is need to enlarge departments or staffs taking full charge of in order to manage the three contents professionally and also there is need to prepare and conduct hospital promotion methods using prevalent SNS.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.10 no.1
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• pp.5-14
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• 2003

Recently, there has been an increasing need for long-term care and comprehensive health care services in community settings. The Ministry of Health and Welfare introduced the Hospital-Based Home Nursing Care Program in 2000. Before this initiative, there was a Home Nursing Demonstration Center, affiliated with the Seoul Nurse Association, had offered home nursing services with the financial support from the local government. since 1993, the Center's nursing staff has been engaged in a general hospital in an effort to provide home nursing care services within Korea's health care system. The purpose of this study was to analyze and identify characteristics of community-based home nursing care supplied by a community-based home nursing team engaged in a general hospital. Also. visit nursing care services provided by public health centers were evaluated in terms of accessibility and supply versus demand, to enhance the accessibility of low-income patients living in Seoul to home nursing care services. Data were collected from home nursing insurance reimbursement claims submitted by the community-based home nursing care team from March 1 to October 30 in 2001 and a questionnaire survey on home-visit nursing services of 25 public health centers in Seoul. The subjects consisted of 197 patients and 12 public health centers. The result were as follows. First, medical institution's community-based home nursing care program was better in technical quality than health-center-based home-visit nursing care. In addition. the pattern of the subject patients was similar to that of hospital-based home nursing care program. Second, there was a high demand for community-based home nursing care while only a small number of home-visiting nurses served at public health centers in Seoul. As a result, many patients could not receive adequate care. Finally, we suggest that community-based home nursing care program should be introduced in the national health system to meet the at-home care needs of severely ill low-income patients. Furthermore, to better utilize home nursing and visit-nursing care resources and offer continued care for patients in community settings, an efficient referral network should be built among related institutions. This would require improvement of reimbursement system and amendment of the law related to health insurance system and community-based home nursing care services.

• Korean Journal of Health Education and Promotion
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• v.7 no.2
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• pp.1-14
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• 1990

This papaer discusses the recent tendencies of health approach in the developed countries and suggests the strategy of health approach in order to cope with the changing environmental conditions of Korea in 2000's. In 2000's, Korea will have the environmental conditions and health problems similar to those of the developed countries at present. The American and European developed countries have shown the integrative approach trend by the interdisciplinary cooperation based on the holistic health conception, for example, as in the behavioral medicine, with the active drive of the medical self care movement and the national health preactice movement. The basic solution to the 2000's main health problems such as high morbidity of chronic diseases and high medical expenditure is to decrease the health need through the health promotion, disease prevention and early. ditection and early treatment of disease. The above actions need to induce the public to change their health behavior in the desirable direction through the national health practice movement and the health self care movement. The succeed of the movements depends upon how to use effectively the mass media, health and administrative organizations, schools, industrial and medical insurance organizations with the strong government support of health and preventive policies and programs.

• Journal of Korean Public Health Nursing
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• v.24 no.2
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• pp.182-196
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• 2010

Purpose: This study examined potential determinants of gender differences in utilization of health care services among Korean adults. Methods: The study population was 21,647 adults ${\geq}$25-years-of-age who had responded to a health interview survey conducted as part of the 2005 National Health and Nutrition Surveys. Relative gender differences in the use of each health service were assessed using chi-square test and sex ratios. The contribution of potential factors of sex differences in the use of health services was evaluated by comparing the odds ratio and sex ratio before and after adjustment for such variables. Results & Conclusions: More females had visited a physician and been admitted to hospital, but hospitalization time was longer for males. Adjustment for poor self-rated health, number of chronic disease and limit of full term for ADL led to a reduction in the odds ratio of females compared to males for health service utilization. However, adjustment for socioeconomic factors (household income, education, occupation, and health insurance) magnified the gender difference concerning length of hospitalization. Factors that explain gender-related differences in utilization of health care services are concluded to be different health needs and socioeconomic status.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.15 no.4
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• pp.428-437
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• 2008

Purpose: The purposes of this study were to assess the oral health knowledge of nursing staff in long-term care institutions and to identify predictors of oral health knowledge. Method: For this descriptive correlation study, a self-administered and structured questionnaire was used. Respondents were 111 nursing staff in two long-term care facilities and two long-term care hospitals located in G metropolitan area and C province in the Southern part of Korea. Descriptive statistics, t-test or ANOVA, and stepwise multiple regression analysis were used to analyze the data. Results: Participants in this study did not have many opportunities to learn about oral health care for elders in long-term care institutions. The percentage of correct answer for oral health knowledge questionnaire was 64.5%. Predictors of oral health knowledge among nursing staffs were education on oral health in long-term care institutions, type of institution, and length of time working with elders. These three variables accounted for 24.2% of variance in oral health knowledge. Conclusions: Nursing staffs should make an effort to improve their knowledge of oral health. Moreover, oral health educational program for nursing staffs working with elders in long-term care institution is need to be developed and the effectiveness of this education needs to be evaluated.

• Korea Journal of Hospital Management
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• v.6 no.3
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• pp.25-45
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• 2001

The purpose of this study was to evaluate the environments of patient care, education, and research as indicators of university hospital performance. The objective data for this study were collected by secondary data. The subjective data were collected by a total of 523 questionnaire survey interviews conducted in C university hospital, of which 123 were students, interns, or residents, 76 were professors, and the remaining 324 were patients. The major statistical methods used for the analysis were t-test and ANOVA. We found that the environment of patient care is better than the environment of education and research in C university hospital. While the concern for patient care of C university hospital was about 60%, the equivalent figures for education and research were both 20%. And the patients' satisfaction level was higher than the others. The environment of education and research was found to be deficient in some aspects, especially in such areas as facilities, equipment, and investment. In particular for professors the time for research was very limited because of the demands of patient care. These findings clearly demonstrate that university hospitals need to pay greater attention to the areas of education and research, as well as to patient care. This article concludes with a discussion and summary and presents issues in need of further study.

• Journal of Preventive Medicine and Public Health
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• v.24 no.3 s.35
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• pp.328-338
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• 1991

To find out the state of illness, patterns of medical care utilization, and factors which determine medical care utilization for aged we surveyed 679 rural old persons who live in the Chungnam province from Jan. 10 1991 to Jan. 19. The major findings of this study were as follows : 1. The morbidity rate of chronic illness during last 3 months was 56.4% for all surveyed old persons ; 58.7% for female and 52.8% for male. 2. As expected, 80 years old or above group showed the highest morbidity rate, 60.2% and the 65-69 years age group was the lowest, 50.5%. 3. Old persons who are householder, whose family income is less than 290,000 won per month, and who receive benifits from the public medical assistance program had relative higher morbidity rate than other groups and the difference was statistically significant (p<0.05). 4. The most frequent chronic illness was musculoskeletal disease, 49.6% ; the disease from which the aged had suffered for the longest period was gastrointestinal, 11.6yrs : the cerebrovascular was the disease which inflicts the lowest level of physical ability. 5. 67.1% of 383 persons who were suffering from chronic illness were in need of medical care but unmet ; among the remaining 32.9% who utilized medical care, 19.2% utilized it in local clinics or hospital OPD and 15% in th health centers or subcenters. 6. Old person who are married, whose sons are householder and whose family income is 500,000 won or above per month showed relative higher utilization rate than other groups and the difference was statistically significant (p<0.05). 7. The most common reason why the aged did not utilize, in spite of, need medical care was economic problem, 35.4%. For the aged whose family income per month is 500,000 won or above, however the most common reason was tolerable symptom, 46.9% while persons who answered economic problem were 6.1% of them, the lowest frequency.