• 한국치위생학회지
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• 제20권5호
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• pp.611-621
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• 2020

Objectives: This study aimed to verify the impact of dental health care insurance coverage policy by analyzing the changes in dental care utilization and expenditures over 5 years from 2012 to 2016, when the dental health insurance coverage expansion policy was implemented. From the national cohort data collected by the Korea Health Panel Survey, a retrospective study was conducted for all household members using dental services. Methods: This study statistically verified the difference in the dependent variables by frequency analysis, chi-square test, t-test, and one-way analysis of variance (SPSS version 22, IBM Co. USA, p<0.05). Results: The annual utilization rate steadily increased from 23.4% to 26.1% between 2012 and 2016. Although there were differences in utilization rates by gender, age, and income level, patients kept using the dental services in 2016 regardless of the type of health insurance. The average annual copayment for patient expenditures (out-of-pocket amount) increased from ￦463,844 to ￦537,401 in 2012 and 2016, respectively. Of the dental care expenditures over 5 years, the ratio of uninsured expenses by the elderly decreased from 38.5% to 25.9%, and the national health insurance service coverage increased from 40.3% to 49.1%. Conclusions: Although this policy did not reduce overall patient expenditures, it has been found that there was a positive effect on the elderly and low-income groups; it increased the utilization and access to dental services.

• 대한치과의사협회지
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• 제54권11호
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• pp.840-849
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• 2016

The purpose of this study was to examine dental care utilization and expenditures among children aged 0 to 19 years using Korea Health Panel Survey (KHPS) data in 2008 - 2013. Weighted estimates were nationally representative and statistical significances were analysed by $x^2$ test or adjusted Wald test using STATA 13 software. While dental care utilization increased steadily among children from 2008 through 2013, less than one-third the children received dental care in 2013. Compared with 2008, the proportion of restorative care, oral surgery, preventive care decreased and the proportion of orthodontic care, prosthetic care increased. While the proportion of amalgam markedly decreased, the proportion of resin increased. This study highlight socioeconomic disparities in dental utilization and expenditures among children. Especially the findings provide a baseline assessment for examining trends on dental care for children in the future.

• 대한치과의사협회지
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• 제57권9호
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• pp.496-503
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• 2019

A dental implant has been covered by National Health Insurance (NHI) in Korea since 2014. Every year the age group covered was extended and the out-of-pocket payment was decreased. This study analyzed the dental implant utilization rate by the National Health Insurance customized DB during the last 5 years. As a result, the utilization rate has been rapidly increasing steeply. The differences by age and sex in the utilization rate of dental implants were explored. The inclusion of a dental implant in the NHI system contributed to improving the dental accessibility of the elderly in Korea. However, a deep discussion is needed whether it is appropriately provided to necessary patients. The utilization rate will increase further in the future. Therefore, continuous monitoring and critical policy review should be continued.

• 대한예방한의학회지
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• 제14권2호
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• pp.67-75
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• 2010

Objectives : Recently, the number of elderly people has been rapidly increasing in Korea, and it led to increase demands of Korean traditional medical services. However, there is a lack of information on Korean traditional service utilization. Thus, this study was intended to identify Korean traditional service utilization patterns such as acupuncture, moxibustion and cupping, since Korean traditional services were specially used in treating chronic diseases for elderly people. It is important to understand health services utilization for quality improvement of healthcare systems. Methods:We used data of 'Survey in Daegu' in 2008 and analyzed characteristics of disease structure and utilization patterns of health care service of 1,097 cases of participated citizens. Results : The proportion of the elderly people (>50 age) in total participators is 52.4%. Male to female ratio is 1:1.65 and most common age group was between 50 and 59 years old. 84.2% of participators were admitted at oriental health care facilities. In addition, the results showed that female were more used the service than man. The most common treated disease is musculoskeletal disorders in both male and female. Conclusions : Acupuncture, moxa and cupping are widely used to treat chronic degenerative diseases such as musculoskeletal disorders at oriental health care facilities. Elders and female prefer to be admitted at oriental health care facilities.

• 지역사회간호학회지
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• 제21권3호
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• pp.321-332
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• 2010

Purpose: This study examined change in healthcare utilization by disease severity after case management (CM) for Medicaid. Methods: Data were extracted from survey data on "Healthcare utilization and health status of Medicaid beneficiaries" conducted in 2007 and 2008 by the Ministry for Health, Welfare and Family Affairs. This study was designed to compare change in healthcare utilization between the CM group and the non-CM group. The subjects were 528 Type I Medicaid beneficiaries who utilized healthcare more than 365 days during 2006. Results: In beneficiaries having fewer than 3 among the 11 notified diseases, the CM group showed a significantly larger decrease in outpatient day, outpatient expense, medication day, and medication expense than the non-CM group. In beneficiaries having 3 or more among the 11 notified diseases, however, there was no significant difference in healthcare utilization between the CM group and the non-CM group. Conclusion: CM worked effectively on Medicaid beneficiaries outpatient healthcare utilization for mild diseases. However, its effects on hospitalization, which is a major cause increasing the total expense, were not observed. Therefore, a future study is needed to develope strategies to reduce hospitalization and care for Medicaid beneficiaries with severe diseases.

• 보건의료산업학회지
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• 제11권3호
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• pp.65-78
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• 2017

Objectives : Obesity is a worldwide health concern due to an increasing obese population. This study proposed to analyze the differences in medical costs and care utilization between obese and normal group using propensity score matching. Methods : Data were collected from the sample cohort database by the Korea National Health Insurance Corporation. Propensity score matching(PSM) was applied to control selection bias, and factors affecting obesity were used as covariates in PSM. Results : The results showed higher medical costs and care utilization in the obese group than the normal group. According to gender and medical type, there were differences in the relationships between obesity and medical charges and utilization. In particular, the differences in the female population were larger in both outpatients and inpatients than the male population. Conclusions : It is important to manage obesity, because obesity has a negative effect on national health insurance costs. These findings suggest directions for future research.

• 보건행정학회지
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• 제30권1호
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• pp.62-71
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• 2020

Background: The purpose of this study is to analyze the current status and factors of elderly patients' hospitalization for hip replacement, knee replacement, and general spine surgery. Methods: National health insurance data in 2018 was provided by the National Health Insurance Service. We used multiple regression to analyze factors associated with the medical utilization of hip replacement, knee replacement, and general spine surgery in elderly patients over 65 years old. The dependent variables are the length of stay and total health expenditure. The independent variables are the demographic-social factors (sex, age, region, insurance type, income level) and surgery-related factors (institution type, location of the hospital, surgery classification). Results: The most common factor affecting surgery was the location of medical institutions. Compared with the medical institutions located in metropolitan, the length of stay in rural medical institutions was higher and total health expenditure was lower. The lower quartile of income, the higher the length of stay and total health expenditure. In addition, the variables of age, type of health insurance, and type of medical institution were statistically significant. Conclusion: In this study, we confirmed the effect of sociodemographic factors and medical institution factors on the Healthcare Utilization of spinal and joint surgery.

• 한국콘텐츠학회논문지
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• 제16권5호
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• pp.180-193
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• 2016

본 연구의 목적은 초 중등학교 학생들의 성별 및 소재지별 보건실 이용률 및 건강문제의 연도별 변화를 파악하고, 학생들의 건강문제를 해결하기 위해 보건교사가 제공하였던 간호중재수행 빈도 및 난이도를 분석함에 있다. 자료분석은 경력 3년 이상의 보건교사 59명이 응답한 조사지였다. 분석결과, 연도별 재적 총학생수는 매년 감소한 반면에 보건실 이용률은 점차 증가하였으며, 보건실 이용률은 여학생이 남학생보다 200% 정도 상위를 보였다. 초등학교 도심지역 여학생들의 보건실 이용률이 가장 높았으며 중등학교 도심지역 남학생들이 가장 낮았다. 남학생은 피부 피하계, 근골격계, 소화기계 건강문제 순으로, 여학생은 피부 피하계, 소화기계, 근골격계 건강문제 순으로 이용률을 보였다. 도심지역이 변두리 농촌형보다특정 건강문제에서 보건실 이용률이 높았다. 간호중재수행은 자기건강관리교육과 상담 영역에서 빈도가 가장 높았으며, 자해, 발작, 순환기계 건강문제에서 난이도가 가장 높았다. 결론적으로 보건실 이용률은 점차 증가하여 보건교사의 업무는 가중되었으며, 특별하고 위급한 건강문제를 보건실에서 전문적이고 효과적으로 응급처치를 수행하기 위해서는 자질 있는 보건교사의 인력확충과 표준화된 업무지침이 요청되며 나아가 전문가적 역량을 강화하는 보수교육 프로그램이 필요하다.

• 지역사회간호학회지
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• 제5권1호
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• pp.30-52
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• 1994

The purpose of this study is to look into the health behavior and utilization of health service, and the factors which have influence on both of them. In order to research them, it visited home and interviewed selecting randomly 300 subjects who can understand the purpose of this study, want to participate and are possible to interview. Questionnaries survey was administered during the period from April.6 to May.12. 1993. Collected materials analysis were dealt with a method of SPSS PC Program and used percentage. Mean, SD. t-test, $X^2-test$, Pearson's Correlation Coefficient, Multiple Regression and One-way ANOVA for hypothesis verification. The results of this study are as follows. 1. The hypothesis is that there will be a significant difference in performance degree of health behavior by general characteristics(sex, age, educational background, occupation, religion) of subjects. According to the results, it turned out that sex(P=.035), educational background(P=.0432), and occupation(P=.440) appeared to be a significant difference as P<.05. 2. The hypothesis that the more interesting degree on health of subjects have, the better they performance for health behavior was supported (r=.2552, P<.001). 3. The hypothesis that the healthier subjects are, the better they performance for health behavior was supported(r=.5262, P<.001). The highest correlation was seen between the healthier subjects and health behavior. According to the results of multiple regression analysis with interesting degree on health and healthier subjects as dependent variables, it turned out that R2 was 35% and had a significant difference. 4. The hypothesis is that there will be a difference in the utilization of health service by general characteristics(sex, age, educational background, occupation, religion). According to. the results, it showed that educational background (dental clinic), religion(pharmacy) had an influence on the frequency of utilization of facilities (P<.05).

• 보건교육건강증진학회지
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• 제23권4호
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• pp.47-65
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• 2006

Objectives: This research is to provide the basic data for the improvement on oral health by examining the relationship between the dental fear and the dental service utilization, and to discuss a strategy for dental health in order to lower the level of dental fear. Methods: Data were collected by conducting a structured survey of 1,607 people between the age of 13 and 70 who have experiences in visiting a dental institution. Both univariate and multivariate analyses were employed to analyze the relationship between the number of times dental service and dental fears. Results: The average level of dental fear the respondents reported was $52.16{\pm}15.71$ and 31.5% of the response was at the level of high dental fear. A strong physiologic response during the dental treatment was muscle tension and the stimulations that strongly arouse the dental fear were the anaesthetic needle and the sound of drill. A result of analysis on the relationship between the dental fear and the dental service utilization shows that as the level of dental fear became higher, the number of times for the dental service utilization for the last year had reduced. Also when a patient has an experience of putting off or canceling an appointment due to dental fear and as a physiologic response during the dental treatment became stronger, the result shows a tendency that the number of times for the dental service utilization for the last year had reduced. Conclusions: It has been observed that dental fear is one of the main barrier to use dental service. Therefore, a physio-psychological factor like the dental fear should be included in the task of promotion of dental health, and in analyzing the dental service utilization behavior. A discussion about how to lower dental fear was made with respect to oral health promotion. At individual level, improvement of communication skill by dental service providers should be made with rearrangement of clinic environment into more cozy one.