• Title/Summary/Keyword: Health service accessibility

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The Association Among Individual and Contextual Factors and Unmet Healthcare Needs in South Korea: A Multilevel Study Using National Data

  • Lee, Seung Eun;Yeon, Miyeon;Kim, Chul-Woung;Yoon, Tae-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.49 no.5
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    • pp.308-322
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    • 2016
  • Objectives: The objective of this study is to investigate associations between contextual characteristics and unmet healthcare needs in South Korea after accounting for individual factors. Methods: The present study used data from the 2012 Korean Community Health Survey (KCHS) of 228 902 adults residing within 253 municipal districts in South Korea. A multilevel analysis was conducted to investigate how contextual characteristics, defined by variables that describe the regional deprivation, degree of urbanity, and healthcare supply, are associated with unmet needs after controlling for individual-level variables. Results: Of the surveyed Korean adults, 12.1% reported experiencing unmet healthcare needs in the past. This figure varied with the 253 districts surveyed, ranging from 2.6% to 26.2%. A multilevel analysis found that the association between contextual characteristics and unmet needs varied according to the factors that caused the unmet needs. The degree of urbanity was associated with unmet need due to "financial burden" (odds ratio [OR], 0.53; 95% confidence interval [CI], 0.42 to 0.66 for rural vs. metropolitan), but not unmet need due to "service not available when needed." There were no significant associations between these unmet need measures and regional deprivation. Among individual-level variables, income level showed the highest association with unmet need due to "financial burden" (OR, 5.63; 95% CI, 4.76 to 6.66), while employment status showed a strong association with unmet need due to "service not available when needed." Conclusions: Our finding suggests that different policy interventions should be considered for each at-risk population group to address the root cause of unmet healthcare needs.

Review on Acceptability of Patients towards Obesity Treatment Program (비만 진료 프로그램에 대한 수용성 태도 분석)

  • Lee, Eom-jee;Kim, Seo-Young;Lim, Young-Woo;Park, Young-Bae
    • Journal of Korean Medicine for Obesity Research
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    • v.19 no.1
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    • pp.42-55
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    • 2019
  • Objectives: Acceptability of patients towards obesity treatment program is associated with better weight loss outcomes. The purpose of this study was to review previously published study results of the predictive factors associated with patients' acceptability in obesity treatment. Methods: Authors searched for the articles related to acceptability reported as continuation, attendance and adherence, published from 2011 to 2018 found on Pubmed, Scopus, Research Information Sharing Service, and Koreanstudies Information Service System. A total of 23 articles were finally selected. From the study results, unchangeable and changeable predictors were extracted, and these predictors were examined according to detail categories. Results: Regarding the continuation of the treatment, unchangeable factors such as younger age, lower educational level, male sexuality and lower accessibility to physical activity predicted lower continuation. Furthermore, changeable factors such as early and half weight loss, better accessibility to the treatment and financial incentives for retention predicted higher continuation rate. Greater degree of attendance was predicted by unchangeable factors such as economical affordability, and changeable predictors such as half weight loss and proximity to the clinic. Main factors of adherence to the recommendation were unchangeable predictors such as weight loss experience, and changeable predictors such as more physical activity and appropriate dietary habits. Negative psychological state predicted lower continuation, attendance and adherence rate. Conclusions: Our review results suggest that unchangeable and changeable predictors of acceptability of patients should be carefully examined during treatments of obesity.

Identifying the Causes of Nutrition Inadequacy in Vietnamese Married Immigrant Women and Korean Spouses through Qualitative Research (질적연구조사를 통한 베트남 결혼이민여성과 한국인 배우자의 영양불량 원인 규명)

  • Joe, Mee-Young;Hwang, Ji-Yun
    • Journal of the Korean Dietetic Association
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    • v.25 no.1
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    • pp.59-73
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    • 2019
  • This study examined the possible causes of nutritional inadequacy in Vietnamese immigrant women married to Korean husbands. Qualitative in-depth interviews were conducted with a sample of 34 Vietnamese marriage immigrant women and 17 Korean spouses participating in or having experienced Nutrition Plus from four Community Health Centers in Seoul, Korea. The study results showed that the nutritional staus of the Vietnamese marriage immigrant women was affected by the unfamiliar Korean food (cultural factor), low household income (economical factor), difficulty in purchasing Vietnamese food (environmental factor), and low accessibility to nutrition support systems (social factor). The Korean husbands' nutritional status was affected by the unfamiliar Vietnamese food (cultural factor), low household income (economic factor), and irregular working conditions (social factors). Nutritional interventions as a public service to the community needs to be developed and applied. Suggestions are presented regarding the future efforts to better understand and meet the nutrition needs of intermarried couples to respond to their heterogeneous needs and deliver adequate nutrition service to ever increasing intermarried families.

A Study of the Relationship to the Student's Health Behavior, Belief, Value and Health Service Utilization -With Emphasis on Family Structure and Other Variables- (학생(學生)의 건강행위(健康行爲), 신념(信念), 가치(價値) 및 보건의료(保建醫療) 이용(利用)에 미치는 영향(影響)에 관(關)한 연구 -가족(家族)의 형태(形態) 및 제특성(諸特性)을 중심(中心)으로-)

  • Chung, Yeon Kang
    • Journal of the Korean Society of School Health
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    • v.6 no.1
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    • pp.9-44
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    • 1993
  • An explorative and descriptive study in order to determine the effect of family structure and other socio-demographic variables on health behavior, belief, locus, and value and utilization of public health service was carried out. Data were collected from 1,653 subjects randomly sampled in three areas, Seoul, Kyunggi province, and Cheju province. From Seoul 849 subjects were selected, 397 subjects Kyunggi, and 407 subjects from Cheju, respectively. Self-reporting questionaires were administered during the period from March to June, 1992. The major findings were as follows: 1) The subjects visited herb-doctor's at irregular intervals mainly to have tonic medicine prepared. They preferred herb-doctor's rather than with doctors at clinics and hospitals. Statistically significant difference was found among the regions studied (p<0.05). 2) The reason for visiting hospitals was primarily for treatment of diseases. They preferred hospital because they felt that the hospitals offer much highly reliable treatment services as well as medical accessibility. For the purpose of hospital utilization, statistically significant differences existed among sex, educational level, family type and region. However, no significance was found among sex, educational level, and region (p<0.05). 3) The subjects utilized general hospitals mainly for diagnosis and treatment of diseases. They preferred general hospitals because of their much better facilities and reliability. Statistical significance was found among sex, educational level, and region (p<0.05). 4) The subjects visited dentist at irregular intervals basis. They visited once half a year or three to four months. their purpose of visit was mainly for diagnosis and treatment of diseases. Statistical significance differences were found among educational level, region and economic standard (p<0.05). 5) Whenever their illnesses were mild and the pharmacies was located in nearby they visited to pharmacies. They visited once a month and patient medicines. Statistically significant differences were found among sex, educational level and region (p<0.05). 6) The subjects believed that herb medicine was quite efficacious for treatment of some diseases, particularly by information handed down through time-honored tradition and experience. However, they recognized that the efficacy of folk medicine can vary with type and severity of diseases. Statistical significance was among sex, educational level, region and economic standard (p<0.05). 7) The reason why subjects believed that pray and superstition are effective for treatment of certain type of diseases, particularly in neuropathy, was the belief in God's almighty. Statistically significant differences were found among sex, educational level, regions and economic standard (p<0.05). 8) Most of subjects under same condition preferred western medicine because they believed that it is more scientific and prompts in showing therapeutic effect. Statistical significance was not found in the choice of type of public health service among, regions. But significant differences were found among sex, educational level and region (p<0.05). 9) The subjects looked for pharmacy if they thought the symptom was mild. However, they visited hospitals for chronic disease and general hospitals for emergency treatment. Statistical significances were found among educational level, region and economic standard (p<0.05). 10) Although most of students wanted to have a healthy life as for the component of health standard and value, they think that they are not healthy (p<0.05). As for the health behavior, significant difference was found in the proportion of smoking and drinking between educational level and region (p<0.05). The health locus was affected by educational level, and health behavior was influenced by region, sex and educational level. The utilization of type of public health service was influenced by family type and region, and health belief by region and educational level, and the health values by region and economic standard respectively, most of correlation showed statistical significance. Among them, the highest correlation was seen between locus of control and external/internal locus of control, which is quite obvious. The correlation between health belief and behavior was the next highest, but still low (0.343). All the other variables are low but significant except only a few of those. These findings indicate that health education should be incorporated into the curriculum so as to develop desirable health habit, and ability of self-control in accordance with their growth stages. A systematic and scientific understanding on the herb/folk medicine is needed, and greater reliability of the utilization of public health services are is still required. Health policy for equal distribution of health service throughout the country along the hierarchical health service system and complementary mutual assistance and cooperation among various health organizations are also required.

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Usability Evaluation of a Mobile App for Sexual Violence Survivors (성폭력 피해 경험자를 위한 모바일 앱 사용성 평가)

  • Lee, Jieha;Park, Young;Jung, Jai E.;Kim, Kihyun;Park, Jooyoung
    • The Journal of the Korea Contents Association
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    • v.22 no.9
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    • pp.700-711
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    • 2022
  • The purpose of this study is to evaluate the usability of the mobile app 'Allive' to improve accessibility to resources and mental health services among sexual violence survivors. Participants include survivors of sexual violence as well as service providers at sexual violence crisis intervention centers. The usability test was conducted as a quantitative and qualitative evaluation after study participants used the app in a real-life environment. The results of usability testing highlighted the positive and beneficial impact on mental health function as well as accessibility to essential resources for those who have experienced sexual violence.

A Study on Utilization of non-residential areal hospitals in Inpatient (입원의료의 타 지역 이용에 관한 연구)

  • Kim, Yoo-Mi;Kang, Sung-Hong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.10 no.11
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    • pp.3444-3450
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    • 2009
  • Our study was carried out to suggest the way of improving the accessibility of medical service through identifying the factors that make patients be hospitalized in non-residential area not in their residential area. The subjects were 523,782 inpatients of the 2005 Patient Survey data. The 2004 Hospital Evaluation data, the 2005 census data which were obtained from the Korean National Statistics Office, and the 2006 Survey on National Healthcare Resources data were used. The data were analyzed using descriptive statistics, chi-square test and logistic regression in a SAS program. The most important factor was quality level of care of local hospitals. In the possibility of being hospitalized in non-residential areas, the region with the score of more than 9.5 per 100,000 people in the hospital evaluation was 8.3 times more than the region with the score of less than 9.5. However patients is hospitalized in the area with the hospitals with above 910 beds per 100,000 people more than in the area with the hospitals with less than 910 beds by 2.0 times. For the accessibility of medical services, government policy should focus on improving the quality of care in local hospitals not on increasing and distributing health care resources.

Innovative approaches to the health problems of rural Korea (한국농촌보건(韓國農村保健)의 문제점(問題點)과 개선방안(改善方案))

  • Loh, In-Kyu
    • Journal of agricultural medicine and community health
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    • v.1 no.1
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    • pp.5-9
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    • 1976
  • The categories of national health problems may be mainly divided into health promotion, problems of diseases, and population-economic problems which are indirectly related to health. Of them, the problems of diseases will be exclusively dealt with this speech. Rurality and Disease Problems There are many differences between rural and urban areas. In general, indicators of rurality are small size of towns, dispersion of the population, remoteness from urban centers, inadequacy of public transportation, poor communication, inadequate sanitation, poor housing, poverty, little education lack of health personnels and facilities, and in-accessibility to health services. The influence of such conditions creates, directly or indirectly, many problems of diseases in the rural areas. Those art the occurrence of preventable diseases, deterioration and prolongation of illness due to loss of chance to get early treatment, decreased or prolonged labour force loss, unnecessary death, doubling of medical cost, and economic loss. Some Considerations of Innovative Approach The followings art some considerations of innovative approaches to the problems of diseases in the rural Korea. 1. It would be essential goal of the innovative approaches that the damage and economic loss due to diseases will be maintained to minimum level by minimizing the absolute amount of the diseases, and by moderating the fee for medical cares. The goal of the minimization of the disease amount may be achieved by preventive services and early treatment, and the goal of moderating the medical fee may be achieved by lowering the prime cost and by adjusting the medical fees to reasonable level. 2. Community health service or community medicine will be adopted as a innovative means to disease problems. In this case, a community is defined as an unit area where supply and utilization of primary service activities can be accomplished within a day. The essential nature o the community health service should be such activities as health promotion, preventive measures, medical care, and rehabilitation performing efficiently through the organized efforts of the residents in a community. Each service activity should cover all members of the residents in a community in its plan and performance. The cooperation of the community peoples in one of the essential elements for success of the service program, The motivations of their cooperative mood may be activated through several ways: when the participation of the residents in service program of especially the direct participation of organized cooperation of the area leaders art achieved through a means of health education: when the residents get actual experience of having received the benefit of good quality services; and when the health personnels being armed with an idealism that they art working in the areas to help health problems of the residents, maintain good human relationships with them. For the success of a community health service program, a personnel who is in charge of leadership and has an able, a sincere and a steady characters seems to be required in a community. The government should lead and support the community health service programs of the nation under the basis of results appeared in the demonstrative programs so as to be carried out the programs efficiently. Moss of the health problems may be treated properly in the community levels through suitable community health service programs but there might be some problems which art beyond their abilities to be dealt with. To solve such problems each community health service program should be under the referral systems which are connected with health centers, hospitals, and so forth. 3. An approach should be intensively groped to have a physician in each community. The shortage of physicians in rural areas is world-wide problem and so is the Korean situation. In the past the government has initiated a system of area-limited physician, coercion, and a small scale of scholarship program with unsatisfactory results. But there might be ways of achieving the goal by intervice, broadened, and continuous approaches. There will be several ways of approach to motivate the physicians to be settled in a rural community. They are, for examples, to expos the students to the community health service programs during training, to be run community health service programs by every health or medical schools and other main medical facilities, communication activities and advertisement, desire of community peoples to invite a physician, scholarship program, payment of satisfactory level, fulfilment of military obligation in case of a future draft, economic growth and development of rural communities, sufficiency of health and medical facilities, provision of proper medical care system, coercion, and so forth. And, hopefully, more useful reference data on the motivations may be available when a survey be conducted to the physicians who are presently engaging in the rural community levels. 4. In communities where the availability of a physician is difficult, a trial to use physician extenders, under certain conditions, may be considered. The reason is that it would be beneficial for the health of the residents to give them the remedies of primary medical care through the extenders rather than to leave their medical problems out of management. The followings are the conditions to be considered when the physician extenders are used: their positions will be prescribed as a temporary one instead of permanent one so as to allow easy replacement of the position with a physician applicant; the extender will be under periodic direction and supervision of a physician, and also referral channel will be provided: legal constraints will be placed upon the extenders primary care practice, and the physician extenders will used only under the public medical care system. 5. For the balanced health care delivery, a greater investment to the rural areas is needed to compensate weak points of a rurality. The characteristics of a rurality has been already mentioned. The objective of balanced service for rural communities to level up that of urban areas will be hard to achieve without greater efforts and supports. For example, rural communities need mobile powers more than urban areas, communication network is extremely necessary at health delivery facilities in rural areas as well as the need of urban areas, health and medical facilities in rural areas should be provided more substantially than those of urban areas to minimize, in a sense, the amount of patient consultation and request of laboratory specimens through referral system of which procedures are more troublesome in rural areas, and more intensive control measures against communicable diseases are needed in rural areas where greater numbers of cases are occurred under the poor sanitary conditions.

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Medical Accessibility Analysis by Optical Store and Ophthalmic Clinic Distribution (Centering on Special and Metropolitan Cities) (안경원과 안과의원 분포에 따른 의료접근도 분석 (특별시와 광역시 중심으로))

  • Ye, Ki-Hun;Lee, Wan-Seok
    • Journal of Korean Ophthalmic Optics Society
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    • v.21 no.3
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    • pp.159-171
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    • 2016
  • Purpose: This study investigated medical accessibility on optical stores and ophthalmic clinics of Seoul Special City and six other metropolitan cities. Methods: By using a number of households, population, optician stores, ophthalmic hospitals, and real estate (apartments) standard market price of Seoul Special City and six other metropolitan cities provided by the Commercial District Information System (2016.6) of Small Enterprise & Market Authority, we analyzed the level of healthcare accessibility and business area zones, Statistical analyses were performed with SPSS 18.0. Results: Inchon (household 2,227/population 5,723) had the highest household and population rate per optical store, and Gwangju (1,146/2,979) had the lowest. Gwangju (24,612/63,987) had the highest household and population rate per optical store, and Seoul (10,021/24,432) had the lowest. From the consumer and patient's point of view, lower household rate per optical store is a city with good accessibility to healthcare, but from an optical store and ophthalmic clinic's view, it will have great difficulty due to issues of competition. Conclusions: Consumers and patients should be the center of healthcare. A healthcare system that can provide smooth service anywhere anytime should be constructed. However, most metropolitan cities, including Seoul, have optical stores and ophthalmic clinics densely populated where profitability and liquidity are ensured and causing unbalanced distribution of healthcare. To solve such problems, we need proper distribution of optician stores according to the population proportion and industrial-educational research to find balance point of local healthcare.

Barriers to Social Security Accessibility of Elderly North Korean Refugees (고령 북한이탈주민 사회보장제도 활용의 제약요인 및 접근성 제고 방향)

  • Ko, Hyejin;Min, Kichae;Park, Jungsun;Han, Kyounghoon;Kim, Yeseul
    • 한국사회정책
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    • v.25 no.1
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    • pp.161-194
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    • 2018
  • The purpose of this study is to investigate the factors that interrupt the use of social security of elderly North Korean refugees. As a result of qualitative content analysis using interview data, it is found that the elderly North Korean defectors have a lower access to the social security system. The main reason for hindering the use of social security system is low awareness due to limited information channels, psychological distance to South Korean society and residents. Moreover, this psychological distance is a factor that reduces the geographical accessibility of elderly North Korean defectors by preferring to use services in specific institutions for North Korean, while South Korean elderly people can use the service elsewhere. In addition, there are many cases in which the elderly in North Korean defectors do not receive sufficient social security due to low income. On the other hand, social security systems with high accessibility of older North Korean refugees are characterized by the fact that they are provided by experts who have formed sufficient rapport with North Korean refugees. Therefore, it seems possible to improve the accessibility of elderly defectors' friendly system by professional workers with cultural competence. In addition, a multidimensional approach is needed to fully cope with the complex desires of elderly North Korean defectors and a mechanism should be set up to reflect their opinion in system operation.

Appropriate Adjustment according to the Supply and Demand Status and Trend of Doctors (의사 인력의 수급 현황과 추세에 따른 적정 조정)

  • Yun Hwa Jung;Ye-Seul Jang;Hyunkyu Kim;Eun-Cheol Park;Sung-In Jang
    • Health Policy and Management
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    • v.33 no.4
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    • pp.457-478
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    • 2023
  • Background: This study aims to contribute to the adjustment of the appropriate doctor manpower by analyzing the distribution, supply and demand, and estimation of the doctor manpower. Methods: This study utilized the medical personnel data of the Ministry of Health and Welfare, population trend data of the National Statistical Office, and health insurance benefit performance data of the National Health Insurance Service. Based on 2021, we compared the number of doctors in actual supply and the number of doctors in demand according to the amount of medical use by gender and age for 250 regions. Logistic regression analysis and scenario analysis were performed to estimate the future medical workforce by considering the demand for doctors according to the future demographic structure, the size of the quota in medical schools, and the retirement rate. Results: There were 186 regions in which the supply of doctors was below average, and the average ratio of the number of doctors in supply to demand in the region was 62.1%. Conclusion: In order to increase the number of active doctors nationwide to at least 80%, 7,756 people must be allocated. The number of doctors in demand is estimated to decrease after increasing to 1.492 times in 2059. The future projected number of doctors is expected to increase to 1.349 times in 2050 and then decrease taking into account the doctor quota and the retirement rate.