• Health Policy and Management
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• v.31 no.2
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• pp.197-206
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• 2021

Background: The purpose of this study was to identify factors affecting unmet healthcare needs due to physical accessibility by residential area by utilizing the Korea Community Health Survey (KCHS). Methods: Andersen's medical service behavioral model was applied to analyze the enabling factors, predisposing factors, and needs factors of unmet healthcare needs focusing on residential areas. This study used data from the KCHS (2017-2019, n=440,792). We used multivariate survey logistic regression analysis in order to identify affecting factors. Sub-group analysis was conducted in order to evaluate the effects of residential areas. Results: Some participants (2,621, 0.59%) had experienced unmet healthcare needs due to physical accessibility and 2,047 subjects (78.1%) of them lived in rural areas. Multivariate survey logistic regressions revealed that experience of unmet healthcare needs due to physical accessibility increased when people lived in rural areas (odds ratio [OR], 3.95; 95% confidence interval, 3.46-4.51). Conclusion: This study showed that despite the development of transportation and efforts to alleviate medical inequality, residents in rural areas may still have higher experience of unmet healthcare needs due to physical accessibility compared to the metropolitan city regardless of any other sub-group differences (OR range, 1.90-6.31). This study suggested that government and policymakers should identify the causes of the experience of unmet healthcare needs due to physical accessibility and should develop policies to alleviate those healthcare disparities.

• Journal of the Korean BIBLIA Society for library and Information Science
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• v.26 no.4
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• pp.283-304
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• 2015

The purpose of this study was to identify Web accessibility issues of healthcare websites of the Korean government and public agencies by evaluating these websites' accessibility in accordance with the Korean Web Contents Accessibility Guideline. This study conducted both automated and expert testing to assess the accessibility of a total of 27 health-related websites. The results of the assessment which was conducted in two stages indicated that institutions such as the National Hospital and National Rehabilitation Center demonstrated almost no Web accessibility error. In addition, the Korea Health Insurance Review and Assessment Service, the Ministry of Health and Welfare, the Health Services Agency, the Ministry of Food and Drug Safety, and the Korea Medical Dispute Mediation and Arbitration Agency attained very high web accessibility. However, the results of an expert evaluation highlighted that there were considerable errors in providing appropriate alternative text, which was not found in the automated test, and the color contrast of the text content did not comply with Web accessibility standard. Therefore, these websites did not support web accessibility for the sight-impaired. Furthermore, the present study found that it was difficult to deliver accurate information to users due to errors in the default language display and markup, and also, issues of skipping repeated content, content linearization, and compliance with keyboard use were considered as challenges that might arise for people with sight, cognitive and mobility impairments with respect to Web accessibility. It is the first study that evaluated accessibility of healthcare websites of the Korean government and public agencies based on the Korean Web Contents Accessibility Guideline. The present study made a contribution to research on Web accessibility by conducting expert testing, which provided a more complete assessment that identified the degree and specific issues of accessibility errors when compared to automated testing.

• Journal of the Korean association of regional geographers
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• v.18 no.2
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• pp.203-216
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• 2012

The aim of the research is to lead to suggestions on public health policy, to suggest the direction of accessibility to public health services in rural area through analyzing various health programs and health service system, health care facilities. Nepal's public health policy needs improvement in the quality of the health services as well as accessibility to the services to improve population quality.

• Journal of Fisheries and Marine Sciences Education
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• v.27 no.5
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• pp.1211-1220
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• 2015

There exists dead zone from the aspects of health equity and health medical equity for maritime personnel. They could not have been benefited from disease prevention and health promotion in comparison with shore personnel due to the restricted medical accessibility caused by long voyage ship operation. Furthermore, the system of health management and medical assistance for maritime personnel is insufficient, the continuous health monitoring system does not exist, nor health diagnosis system, maritime industrial accidents and occupational disease control systems are adequate. The International Maritime Organization and the International Labour Organization recommend their Member Governments to take necessary measures in the management of seafarers' health and diseases through conducting continuous and systematic investigation. Thus, this study intends to propose action strategy and tasks for introducing marine telemedicine system aiming to provide seafarers with health management service for the years to come. The conclusions of this study can be given as follows. First, it is required that a systematic medical service system needs to be provided to promote seafarers' health. Second it is recommended to establish the marine telemedicine system incorporating U-Health technology. Third, it is necessary to revise the relevant laws and regulations to introduce the marine telemedicine system. Fourth, it is also necessary to provide various assistance system at the national level in the furtherance of global marketing of marine telemedicine system.

• Korea Journal of Hospital Management
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• v.25 no.1
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• pp.13-20
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• 2020

Purposes: This study has the purpose to the improvement of health promotion for local residents through delivery of high-quality medical service by improving imbalance of medical use and seeking an improvement plan for accessibility of effective medical service by understanding the pattern of medical use by region. Methodology: As for the method, this study derived results at the significance level of p<0.05 through chi square test(χ² test) and Generalized Estimating Equation(GEE) SAS 9.4 version by using the data of the 7th Korean Longitudinal Study of Ageing 2018. Findings: Study results show that local residents use medical service such as hospitalization care and outpatient visit more as compared to the residents in Gyeonggi-do/large or medium-sized cities. The more the number of chronic disease, the more they select hospitalization care rather than outpatient visit. Results also show that patients engaged in labour tend to select outpatient treatment rather than hospitalization treatment. Meanwhile, severity of disease turned out to be higher amongst medical care beneficiaries than that of national health insurance patients when comparing the types of medical security. Practical Implications: In stead of solving the problem of the difference in medical use by region from the aspect of income and economic level, an integrative solution shall be provided putting viewpoint on the social phenomenon suited to the changes of the times. This study suggests a plan for using a health and medical community care center that acts as a gate keeper of regional medical service.

• Health Policy and Management
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• v.21 no.1
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• pp.23-43
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• 2011

Access to health care is complicated to define. It is a multidimensional process. In addition to the matters of quality of care, geographical accessibility and availability of the right type of care, finance, and acceptability are all involved. The purposes of this paper are to measure the geographic distances between patient residency locations and health service organizations in which the patients hadvisited, and to investigate the association between geographical distance measures and variables involved in health service utilization. The study used the first and the second wave of the 2008 Korea Health Panel Survey. The samples of analyses were patients who had visited outpatient or used ambulatory health services, and the total observations (visit numbers) analyzed were 229,128. We divided the samples into a frequent-visit illness group (Group 1) and a non-frequent visit illness group (Group 2) based on over 5,000 total visit numbers. We exploited three level analyses using xtmixed of STATA${\Box}$ 11.1 command with/without interaction terms among age, sex, and occupation. Geographical distances were measured using the Haversine method. Group 1 was tended to older and lower equivalent income than those of Group 2, but the geographic difference were not observed in terms of area deprivation index and standard mortality ratios. Amongst group 1, diabetes mellitus patients travelled far to visit health care organizations, and arthritis patients were more deprived in terms of the personal and areal characteristics. The study revealed that residents in rural areas traveled about 10 times more long distances than those whom lived in larger cities after adjusting for various variables, which we used for analyses. This study contributed to the practical understanding of health service utilizations using empirical analyses, and found that the types of diseases and socioeconomic characteristics of patients tended to define the amount of travel distance to healthcare organizations.

• Health Policy and Management
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• v.30 no.3
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• pp.399-408
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• 2020

Background: The purpose of this study was to examine the impact of the regional characteristics on the accessibility of emergency care and the impact of emergency medical accessibility on the patients' prognosis and the emergency medical expenditure. Methods: This study used the 13th beta version 1.6 annual data of Korea Health Panel and the statistics from the Korean Statistical Information Service. The sample included 8,119 patients who visited the emergency centers between year 2013 and 2017. The arrival time, which indicated medical access, was used as dependent variable for multi-level analysis. For ordinal logistic regression and multiple regression, the arrival time was used as independent variable while patients' prognosis and emergency medical expenditure were used as dependent variables. Results: The results for the multi-level analysis in both the individual and regional variables showed that as the number of emergency medical institutions per 100 km² area increased, the time required to reach emergency centers significantly decreased. Ordinal logistic regression and multiple regression results showed that as the arrival time increased, the patients' prognosis significantly worsened and the emergency medical expenses significantly increased. Conclusion: In conclusion, the access to emergency care was affected by regional characteristics and affected patient outcomes and emergency medical expenditure.

• Journal of Preventive Medicine and Public Health
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• v.29 no.2 s.53
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• pp.215-225
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• 1996

Decentralization to local governments and amending of Health Center Law are to promote the efforts of health planning at the level of local agencies. In the health facility planning, it is important to take into account that what to be built, where to be located, how far should be service area and so forth, because health facilities are immovable, and require capital as well as personnel and consumable supplies. The aim of our study, answering to the question of 'where to be located?', is to determine the best location of urban health sub-center. At the local level, planning is the matter of finding the best location of specific facilitiy, in relation to population needs. We confine the accessibility, which is basic to location planning, to geographic one. Location-Allocation Model is used to solve the problem where the location is to maximize geographic accessibility. To minimize the weighted travel distance, objective function, $R_k=\sum{\sum}a_{ij}w_{i}d_{ij}$ is used. Distances are measured indirectly by map measure-meter with 1:25,000 Suwon map, and each potential sites, 10 administrative Dongs in Kwonson Gu, Suwon, are weighted by each number of households, total population, maternal age group, child age group, old age group, Relief for the livelihood, and population/primary health clinics. We find that Kuwoon-Dong, Seodun-Dong, Seryu3-Dong, according the descending orders, are best sites which can minimize the weighted distance, and conclude that it is reasonable to determine the location of urban health sub-center among those sites.

• Health Policy and Management
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• v.31 no.1
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• pp.125-139
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• 2021

Background: In Korea, the health gap widens due to the number of medical resources and access to medical services between metropolitan and rural. The purpose of this study is to identify the impact of residential migration on medical utilization and accessibility. Methods: This study extracted 528,516 claimed cases in the National Health Insurance Service-Cohort Sample Database from 2006 to 2015. Subjects were classified into two groups by the magnitude of the region, the metropolitan and the rural. The inversed probability weights were calculated for each group. And coefficients of the two-part model were estimated by generalized estimation equation. Results: Those who moved region from metropolitan to rural tend to increase the length of stay and inpatients with ambulatory care sensitive conditions (ACSC) disease. Contrariwise, those who moved areas from rural to metropolitan tend to decrease the total medical cost, the adjusted patient days, the number of outpatients and the number of outpatients and inpatients with ACSC disease. Conclusion: This study identified that between the residents who continued to reside in the region and the migrants, there were significant differences in the medical accessibility, quality of primary care, and unmet medical need.

• Journal of Korean Society of Water and Wastewater
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• v.25 no.6
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• pp.923-933
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• 2011

In this study, we derived seven customer value factors to evaluate the levels of service in wastewater utilities required by customers. Levels of service according to the customer value were categorized into environmental amenity, accessibility of wastewater service, affordability of wastewater charge, quality of wastewater service, health and safety of wastewater service provision, reliability and responsiveness of wastewater service provision, and satisfaction of customer service. To investigate the levels of wastewater service, questionnaires were prepared according to the customer value factors, and the questionnaire survey was performed with 800 adults in all over Korea including male and female samples. The comprehensive satisfaction score for the wastewater service was 57.5 points, indicating a slightly good satisfaction level. The detailed analysis of the result showed that the satisfaction level was high in the wastewater service accessibility and call center service provision but it was relatively low in the river water quality and nasty smell of wastewater. It was concluded that the quality of wastewater service and customer service satisfaction need to be elevated primarily in order to improve levels of wastewater service required by the customers.