• Journal of Preventive Medicine and Public Health
• /
• v.29 no.2 s.53
• /
• pp.311-329
• /
• 1996

This study was designed to compare the level of medical utilization between the urban and rural areas of Korea and to explain the differences between the two regions. Data from the National Health Interview Survey performed by the Korean Institute of Health & Social Affairs in 1992 were used for this study utilizing a sample size of 21,841 people. The level of medical utilization such as the number of physician visits and the number of hospital admissions was compared between the regions with ANOVA. Various determinants for medical use were also compared by univariate analysis. Statistical models which included enabling factors, predisposing factors, need factors and region were constructed for bivariate analysis in order to further elucidate the level of medical utilization. The results were as follows: 1. There was greater medical use, both in terms of physician visits and inpatient care in the rural areas in spite of insufficient health resources. The particular reasons for higher medical utilization in rural areas were attributed to a higher number of initial physician visits as well as a longer the length of stay per hospital admission. Therefore, indicators representing the degree of met need (utilization/need) showed no significant difference between rural and urban areas in spite of the fact that the medical need is larger in rural areas. 2. Use of public health facilities received a significant portion of physician visits in the rural area. The government's effort to enhance primary health care through health centers, health subcenters and the nurse practitioner's post in rural areas has contributed to the increase of access to medical care in the rural areas. 3. There were some differences in the socio-demographic characteristics between two regions ; There were more elderly people over the age of 65: unstable marital status, less education and lower incomes also characterized the rural areas. Therefore, among rural people, there were more predisposing factors for medical use. Additionaly, need factors such as poor self-reported health status and high morbidity level were also high in the rural area. 4. In contrast it was learned that, the supply of health resources was mostly concentrated in the urban areas except for public health facilities. Therefore, geographical access to medical care was lower in the rural area both in terms travel time and travel cost. 5. The coefficient of the region variable was insignificant in the regression model which controlled the supply factor only. However, utilization was significantly higher in urban areas if the model included predisposing factors and need factors in addition to the supply factor. The results were interpreted as rural people have greater medical needs.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.13
• /
• pp.5265-5270
• /
• 2014

Background: In Korea, the National Health Insurance program has initiated various copayment policies over a decade in order to alleviate patient financial burden. This study investigated healthcare spending and utilization in the last 12 months of life among patients who died with lung cancer by various copayment policy windows. Materials and Methods: We performed a retrospective cohort study using nationwide lung cancer health insurance claims data from 2002 to 2012. We used descriptive and multivariate methods to compare spending measured by total costs, payer costs, copayments, and utilization (measured by length of stay or outpatient days). Using 1,4417,380 individual health insurance claims (inpatients: 673,122, outpatients: 744,258), we obtained aggregated healthcare spending and utilization of 155,273 individual patient (131,494 inpatient and 103,855 outpatient) records. Results: National spending and utilization is growing, with a significant portion of inpatient healthcare spending and utilization occurring during the end-of-life period. Specifically, inpatients were more likely to have more spending and utilization as they got close to death. As coverage expanded, copayments decreased, but overall costs increased due to increased utilization. The trends were the same in both inpatient and outpatient services. Multivariate analysis confirmed the associations. Conclusions: We found evidence of the higher end of life healthcare spending and utilizations in lung cancer patients occurring as coverage expanded. The practice pattern within a hospital might be influenced by coverage policies. Health policy makers should consider initiating various health policies since these influence the long-term outcomes of service performance and overall healthcare spending and utilization.

• Proceedings of the Korea Society of Information Technology Applications Conference
• /
• 2002.06a
• /
• pp.149-150
• /
• 2002

A Study on the Utilization of Hospital Information System

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.45 no.4
• /
• pp.173-173
• /
• 2019

• Journal of Nutrition and Health
• /
• v.29 no.6
• /
• pp.651-660
• /
• 1996

The purpose of this study was to examine and analyze the degrees and the influence factors of job satisfaction of dietitians working in hospitals in relation to performance of duty in their works and to provide effective management of hospital dietitians for high quality health and food service in hospital. The questionaire was prepared with reference to the previous studies on job satisfaction of dietitians working in hospitals throughout the nation. 201 dietitians in the country were surveyed. The period of research was from January 20 to February 28, 1995. The results are as follows. 1) In regard to the degree of job satisfaction of hospital dietitians, they showed the highest degree of job satisfaction in the relationships with fellow dietitians followed by worth and self-confidence, aptitude and interests, relationships with cooks, job stability, degree of recognition of the dietitians competence, supervision of the superiors, degree of application of professional knowledge, work load, wage level, degree of recognition of the importance of duty, cooperative relationships with load, wage level, degree of recognition of the importance of duty, cooperative relationships with doctors, degree of performance of clinical work, the number of dietitians, the prromotion system, and welfare system in that order. On the other hand, they showed the highest dissatisfaction with food service facilities. 2) The influence factors on job satisfaction are as follows. (1) Wage factor : Shorter weekday working hours and higher bonuses make greaster job satisfaction (R2=0.3115). (2) Working condition factor : Larger number of monthly holidays(R2=0.5142), shorter weekday working hours(R2=0.1077), longer previous food service experience and computer utilization (R2=0.1432) make greater job satisfaction. (3) Welfare factor : Welfare system (R2=0.4132) and promotion system (R2=0.1624) have to do with computer utilization. Job stability has to do with marital status and computer utilization (R2=0.1165). consequently, those married dietitians who use computers show higher job satisfaction. (4) Human relationship factor : Smaller mumber of patients receiving food makes greater job satisfaction (R2=0.1334). (5) Superivision factor : Shorter weekday working hours and larger number of monthly holidays make greater job satisfaction (R2=0.1709). (6) Achievement factor : Marriage, larger number of dietitians(R2=9.2293), age, larger number of monthly holiday, higher monthly wages and computer utiliazation (R2=0.1088) make greater job satisfaction. (7) Speciality factor : Marriage, longer current hospital tenure, higher position and working in seoul(R2=0.1142) make higher job satisfaction. (8) Job inclination factor : working in general hospitals rather than in oriental hispitals, working in seoul(R2=0.1776) and better bonuses(R2=0.1078)make greater job satisfaction. As a result, the following is suggested for the job satisfaction of hospital dietitions on the basis of this study : hospital dietitians can achieve miximum job satisfaction through smooth relationships with coworkers, and the responsible managers should improve welfare and working conditions for the job satisfaction of hospital dietitians.

• Korean Institute of Interior Design Journal
• /
• no.34
• /
• pp.86-95
• /
• 2002

In the 1950’s, after modernistic hospital is begun to build in our country, there were much changes in hospital construction plan such as function, scale, operation, technology for 40 years so far. Interest about 'Healing environment furtherance' which is one of basic function of hospital within these change is continued. Specially, concept about furtherance of healing environment limited in ward department in the early time is applied to hospital space magnificently whole coming at present. Entrance of hospital and change of Lobby may speak as the representative example. This interest about practically use of lobby is rising gradually. Lobby adds to existed concept of space to the importance revaluated. The first purpose of this study is to investigates main entrance and lobby of representative hospital in our country and to search change and present condition. The second purpose is hereupon to present necessary objective standard with direction of lobby plan in general hospital forward though this.

• Journal of Acupuncture Research
• /
• v.35 no.3
• /
• pp.108-114
• /
• 2018

Background: The purpose of this survey study was to understand how utilization of X-rays as an adjunct to Chuna manual therapy (CT) supports treatment, as assessed by Korean medicine doctors (KMDs). Methods: A survey was emailed to all 18,289 members of the Association of Korean Oriental Medicine (AKOM)to determine the implications of X-ray use in CT. Surveys were collected from September 22, 2017 to October 15, 2017. Results: Of the 18,289 KMDs 562 completed the survey. The implications of a radiological diagnosis (X-ray) with CT was assessed using 5 items in a questionnaire: time to diagnosis, accuracy of treatment, patient comprehension and satisfaction, CT effect, and safety of CT. Survey participants identified improvement in patient comprehension and satisfaction as the most important factor for X-ray use with CT, followed by increased safety of CT. From the determinant factors for selection of CT intensity and specific techniques, severity of clinical symptoms was shown to be the most influential factor. Degenerative changes of the spine and degree of spinal malposition were also reported to be highly influential. Conclusion: The KMDs' that participated in this study indicated that utilization of X-rays in conjunction with CT administration improved patient comprehension and satisfaction, and CT safety. Installation of radiological equipment in Korean medicine clinics where CT is provided may increase safety and patients' satisfaction.

• Korean Institute of Interior Design Journal
• /
• v.24 no.2
• /
• pp.189-196
• /
• 2015

In case of Senior Hospitals, meticulous care is required in both amount and quality of natural lighting because of the semi-long term residence of patients. Natural lighting has a huge impact on the physical and psychological part for the seniors. Likewise, natural lighting is an important factor considered for hospital design because it can also effect hospitalization period of patients. Research subject was K Senior Hospital which was determined as the courtyard-type building made to provide healing environment through natural lighting. Analysis was performed by dividing the space of K Senior Hospital into Central Treatment Department directly used by patients, Outpatient Department(OPD), Ward Department, Common Use Department. Research was carried out in two ways of integration value analysis using SPACE SYNTAX and illumination intensity analysis using ECOTECT. K Senior Hospital intended to actively let in natural light through courtyard and to make patients exposed to natural light when they walk along the circuit corridor built around the courtyard. This environmental consideration affected the utilization rate of Common Use Department and residence time of patients raising the average of Common Use Department on every floor. As a resuit of this study presenting type C and type D, part of four types of illumination intensity, takes higher percentage of almost every spaces compare to the others therefore K Senior Hospital was designed on the assumption of healing environment composition through natural light. The result of this research would be used meaningfully in the space programming phase of Senior Hospitals in the future. Utilization rate can be adjusted using illumination intensity value in the space that integration rate should be planed to be high. The use(purpose) of space and integration rate can be used as a guideline to set illumination intensity of natural.

• Health Policy and Management
• /
• v.23 no.4
• /
• pp.343-348
• /
• 2013

Background: Price control alone may not successfully restrain growth in health expenditures. This study aimed to propose fee adjustment model suitable for Korea reflecting health service volume and to clarify applicability of the model by comparing actual conversion factor with estimated conversion factor from simulation of this model. Methods: Fee adjustment model was developed based on Alberta's fee adjustment formula in Canada and 7 alternatives were assessed according to diversely applied parameters of the model. Results: Estimated conversion factors of the tertiary care hospital and the hospital were lower than actual conversion factors, since the utilization of heath service has been increased. However, there was no big difference between estimated conversion factors and actual conversion factors of the general hospital and the clinic. Eventually this fee adjustment model could estimate proper conversion factor reflecting health service volume. Conclusion: This model may be applicable to the mechanism as determining conversion factor between insurer and provider via negotiation and controling growth in health expenditures.

• East Asian Economic Review
• /
• v.24 no.2
• /
• pp.127-164
• /
• 2020

We perform an econometric assessment of the role that pharmaceutical innovation-the introduction and use of new drugs-has played in improving the health of Koreans, by investigating whether diseases for which more new drugs were launched had larger subsequent increases in longevity and smaller subsequent increases in hospitalization. Drugs launched during 1993-2012 are estimated to have increased mean age at death from all diseases by 1.71 years between 1995 and 2015 and 1.09 years between 2005 and 2015. We also estimate that new drugs increased the five-year relative survival rate from all cancers combined by 23.2 percentage points-78.5% of the total increase-between 1993-1995 and 2011-2015, and that new drugs launched during 2008-2010 reduced the number of hospital days in 2017 by 13.0 million. If the drugs launched during 2003-2012 had had no effect on other medical expenditure in 2015, the cost per life-year gained would not have exceeded 6332 USD. Therefore, even if we ignore the effect of new drugs on hospital utilization, the drugs launched during 2003-2012 were very cost-effective, overall. When reduced hospital utilization is accounted for, the evidence indicates that, in the long run, pharmaceutical innovation was cost-saving as well as life-year saving.