• Journal of Preventive Medicine and Public Health
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• v.55 no.4
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• pp.389-397
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• 2022

Objectives: This study examined the effect of out-of-pocket (OOP) payment reduction on the potential utilization of low-value magnetic resonance imaging (MRI) across income groups. Methods: We conducted an experimental vignette survey using a proportional quota-based sample of individuals in Korea (n=1229). In two hypothetical vignettes, participants were asked whether they would be willing to use MRI if they had uncomplicated headache and non-specific low back pain, each before and after OOP payment reduction. To account for the possible role of physician inducement, half of the participants were initially presented with vignettes that included a physician recommendation for low-value care. The predicted probability, slope index of inequality (SII), and relative index of inequality (RII) were calculated using logistic regression. Results: Before OOP payment reduction, the lowest income quintile was least likely to use low-value MRI regardless of physician inducement (36.7-49.6% for low back pain; 30.5-39.3% for headache). After OOP payment reduction, almost all individuals in each income quintile were willing to use low-value MRI (89.8-98.0% for low back pain; 78.1-90.3% for headache). Absolute and relative inequalities concerning potential low-value MRI utilization decreased after OOP payments were reduced, even without physician inducement (SII: from 8.15 to 5.37%, RII: from 1.20 to 1.06 for low back pain; SII: from 6.99 to 0.83%, RII: from 1.20 to 1.01 for headache). Conclusions: OOP payment reduction for MRI has the potential to increase low-value care utilization among all income groups while decreasing inequality in low-value care utilization.

• Health Policy and Management
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• v.21 no.2
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• pp.213-248
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• 2011

Past studies on organizational accountability have had similar limitations. First, empirical evidence of organizational accountability is rare as the majority of research takes a conceptual approach of the topic. Only a few of these studies are applicable to health care organizations (HCOs). To fill these gaps, we attempted to develop a model for analysis of organizational accountability for HCOs. Accountability for HCOs was conceptualized by two axes: answerability(X, horizontal) and value-creation(Y, vertical). Our concept building could relieve competing accountability mechanism which past studies stressed. Four elements of accountability(legal, economical, social, and clinical) were applied to specify each of the two features of organizational accountability. And then four types of accountability behavior were coordinated by this x-y axis : high A/high VC, high A/low VC, low A/high VC, low A/low VC. Finally, a multidimensional model of HCOs' accountability, enabling an empirically testable multi-level analysis, was proposed.

• Health Policy and Management
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• v.26 no.2
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• pp.115-124
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• 2016

Background: This study aims at making a survey on health care service providers' cultural competence and making an appraisal of Chinese medical tourists on service quality, health care service providers' cultural competence, perceived value, and satisfaction. Methods: The data was collected from August until November, 2014 and 150 health care service providers and 65 Chinese medical tourists from 12 medical institutions in Daegu were enrolled in analysis. Results: The results showed that health care service provider's knowledge on Chinese culture was very low with 33.5% of correct answer. Health care service providers were found to get 3.82 point on a 5 point-scale in cultural perception, 3.53 points in cultural sensitivity, and 2.85 points in cultural skills. Chinese medical tourists were analyzed to give 4.08 points on a 5-point scale to satisfaction on health care service, followed by 4.01 points to health care service quality, 4.00 points to perceived value of health care service, and last 3.85 points to a health care service providers' cultural skills. However, there was a difference in points in cultural skills between health care service providers and Chinese medical tourists. Chinese medical tourists' satisfaction with health care service in Daegu was found to be comparatively high, but in relation to satisfaction with communication, it was found to be relatively low. Conclusion: Through this research, health care service providers' knowledge level of Chinese culture and cultural skills were low while they seemed to take a half-hearted attitude towards educational experience for building up cultural competence and foreign patient service response.

• Korean Journal of Human Ecology
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• v.23 no.2
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• pp.251-268
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• 2014

Applying the data from 64 single(26 men and 38 women) and 71 childless married men and women(37 men and 34 women) aged between 30 and 45, this study is to understand their future fertility intention. For this purpose, ideal and real number of children that participants plan to have were compared using paired t-test. Second, demographic variables(sex, age, marital status), child care related variables(thoughts about caring children, child care value), individual characteristics(gender role attitude, relation orientation) and social context variables(perceived economic condition, recognition of low fertility policies) were included in a stepwise regression model to explain expected number of children participants plan to have in the future. Results showed that ideal number of children participants wish to have was significantly higher than real number of children they expect to have in the Korean society. The stepwise regression model explained 35% of the variance of the dependent variable. Among four types of variables, child care related variables most powerfully explained expected number of children study participants plan to have in the future. Finally, age, child care value, gender role attitude, and relation orientation significantly explained expected number of children in the future.

• Journal of Korean Academy of Nursing
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• v.4 no.2
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• pp.144-158
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• 1974

This study was undertaken in an attempt to; 1) measure value orientation of nursing activities, 2) identify the relationship between nurse's role perception and patient's expectation, and 3) evaluate the pattern of nursing education and nursing service administration. 203 hospitalized adults and 203 professional nurses from 11 general hospitals in Seoul during the period of July to December 1973 were tested according to questionnaire based on 4 categories of clinical nursing activities, 1) physical care, 2) observation and control, 3) psycho-social care and 4) therapeutic measures. Results of the study are as follows: 1. Nurses were more concerned than patients in the physical care category. Significant difference was revealed by p<.01 level (t=2.800). Mean value score of nurses was average (2.84), and mean value score of patients was relative' y low (2.49). None of the physical care category questionnaire items were over 3.5. 2. Respondents from hospitals of total care system revealed significant difference in the physical care category by P〈.025 level. (t=2.242). Mean value score of both group were average level (nurse 2.90, patient 2.53), nurses showed higher concern. 3. Difference between nurse's role perception and patient's expectation in observation and control category was revealed non- significance by p〉0.05. level (t=1.238). Mean value score of both group revealed relatively high (nurse=3.44, patient 3.19). 4. Difference between nurse's role perception and patient〉expectation in psycho-social cart category revealed non- significance by p〉.05 level (t=0.758), Mean value score of both group revealed average level (nurse =2.71, patient =2.53), 5. Non- significant difference was noted between B. S. N. and diploma nurse's role perception in the psycho- social care category by p> 0.1 level (t=0.316). 4. Difference between nurse's role perception and patient's expectation in the rapeutic me assures category revealed non- significance by p〉0.05 level) t=0.503). Horses showed high concern by mean value score 3.56 level and patients relatively high by 3.41. All items of this category revealed very high or relatively high value score.

• Korean Parent-Child Health Journal
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• v.6 no.1
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• pp.1-17
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• 2003

Thus, I studied Health services supplied by local health centers and the requirements of the inhabitants visiting the health care facilities. The purpose of this study was to provide basic material for the establishment of Health care policy and the development of health care businesses. The target places for this study were 4 health centers; Chungrang-Gu, Nowon-Gu, Eunpyung-Gu, Songpa-Gu, with 509 mothers who were visiting the Centers. The question items of this study concerned a total of 124 health-related services provided by the Health Centers. The data was collected for a total of 92 days; July 1st~September 30th, 1999. 800 questionaries were distributed and 559 answered, 509 were analyzed finally. The collected data were processed using the SAS program to get mean, standard deviation, percentage. Open questions were made to reveal the opinions of mothers using the health care center. The results were as follows : 1. Among the participants of the study, 49.7% were 25~29 years of age, 84.3% were house wives by current occupation, 56.2% were from 4~6 person households. 52.1 were educated at a high school level, and 43.6% were educated at a collage level. 2. The highest percentage(53.6%) of the users were spontaneous in their utilization of health care center. The major reason for using the Health care center is that it is free to 65.8% of those covered and of low cost to 19.3% of those covered. 3. The satisfaction level of those using the health care center appeared to be generally high. The general average value showed up as $3.027{\pm}0.519$. 4. The level of recognition of the value of the heath care center services was high, particularly in the basic item of diagnoses of pregnancy, particularly in the basic item of diagnoses of pregnancy. However, the satisfaction level of health care education In pregnancy is low at 20~40%. In the meantime, the level of recognition in breast- feeding benefits is high at 76.8%. 5. The rate of realizing health care center's service campaign was generally low at 10~20%. 41.3 of the people knew the advertizing material of the health care centers. 32.4% of the people knew the advertizing material of the health care centers. 32.4% of the people knew the campaign of health care center for importance of breast-feeding benefits. 30.1% of the people knew the campaign for testing congenital mechanism disease. In the meantime about 50% was recognised the health care centers campaign for the importance and time of infants vaccination. 6. The need for enhancement of health care center services was shown to be high as $3.266{\pm}0.676$ as an average, chicken pox vaccination being the most highly requested at $3.565{\pm}0.587.$. 7. Among the open questions, the additional service to be provided were as follows ; increase of campaign of health care center services, furnishing advertizing books in public locations, providing shuttle bus service to the health care centers, extension of desire for preventative injections, rest and play areas for the children of the families serviced, consultation rooms, etc.

• Asia Marketing Journal
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• v.15 no.4
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• pp.33-49
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• 2014

Environmental concern has been an important issue for a few decades, and the extent of consumer demand for eco-friendly consumption has been increased. This study seeks to investigate consumers' willingness to pay (WTP) a premium for eco-friendly cosmetics. This study evaluates how much more a consumer is willing to pay for eco-friendly cosmetics and examines significant factors influencing consumers' WTP for eco-friendly cosmetics. Consumers' WTP is measured using four different ecofriendly cosmetics: low-priced skin care cosmetics, low-priced makeup cosmetics, high-priced skin care cosmetics, and high-priced makeup cosmetics. This study uses the contingent valuation method (CVM) to estimate consumer's WTP for eco-friendly cosmetics. Survey questions were designed using both dichotomous choice and payment card method of CVM. Through face to face interviews and on-line surveys, the data were collected from women between 20 and 49 years old residing in Seoul and Kyeonggi area, Korea, in May 2010. A total of 226 questionnaires (132 from interviews and 94 from on-line) were included for the analytical sample in this study. The data were analyzed using descriptive analysis, T-test and Log-Logit analysis. The findings are as follows: First, the WTP measured by dichotomous choice method was estimated using the Log-Logit analysis. The results showed that the estimated WTP for low-priced skin care cosmetics was 19,152 won, which was 27.7% higher than the reference price, 15,000 won. For low-priced makeup cosmetics, the estimated WTP was 18,524 won, and its green premium was 21.0%. The estimated WTP for high-priced skin care cosmetics was 59,128 won, which was 18.3% higher than the reference price, 50,000 won. For high-priced makeup cosmetics was 57,666 won, and its green premium was 15.3%. Second, the WTP measure by payment card method was estimated using descriptive analysis. The results showed that the respondents were willing to pay 17,955 won for low-priced skin care cosmetics, which was 19.7% higher than the reference price, 15,000 won and 17,595 won for low-priced makeup cosmetics, which was 17.3% higher than the reference price. For high-priced skin care cosmetics, the average WTP was 56,950 won which was 13.9% higher than the reference price, 50,000 won. For high-priced makeup cosmetics, the average WTP was 55,650 won, which was 11.3% higher than the reference price. Overall, the WTP was higher in order of low-priced skin care, low-priced makeup, high-priced skin care, and high-priced makeup. It means that consumers decide degree of premium based on the price and the attributes of eco-friendly products. Third, the findings showed that age, monthly income, and having children or not were statistically significant factors that influenced consumers' willingness to pay for eco-friendly cosmetics. Other explanatory variables such as education, marital status, job, purchase experience of eco-friendly products, and environmental concerns did not show any statistical significance. The major contribution of this study is the investigation of the value of green attributes of the products by using CVM. Unlike most previous researches, this research used two methods of CVM, the dichotomous choice and the payment card, so it enhanced the reliability of research. According to this study, consumers showed price sensitivity when they pay green premium. These findings can be used as useful information to establish marketing strategies for green cosmetics.

• The Korean Journal of Health Service Management
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• v.12 no.2
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• pp.89-99
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• 2018

Objectives : To compare the degree of achievement of Universal Health Coverage (UHC) among 39 developing countries in Africa and to investigate the correlation between health care financing and the UHC index. Methods : For data, 14 UHC indexes were used in 2015 supplied by the World Health Organization (WHO). In addition, this study used a 10% of threshold point corresponding to the catastrophic health expenditures and a 25% of threshold points as a health care financing index. Results : It was found that there were significant difference among Least Low Developed Countries (LLDCs), Other Low Income Countries (Other LICs), Lower Middle Income Countiies (LMICs), Upper Middle Income Countires (UMICs) to compare the average value by nation on the UHC index. This study showed that the UHC index of LLDCs was lowest, but the average value was higher as it moved towards LMICs and UMICs. In addition, it was found that there was an average value difference among the groups like LLDCs, Other LICs, LMICs and UMICs. As a result of comparison, it was found that the spending of household health expenditure increased as LLDCs moved towards UMICs when the burden of household health expenditure was 25%. Conclusions : This study aimed to compare the UHC indexes of African nations and to investigate the correlation between the degree of spending of total expenditure on health and burden of household health expenditure and UHC, and its effect.

• Research in Community and Public Health Nursing
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• v.17 no.4
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• pp.441-450
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• 2006

Purpose: The purposes of this study were to identify variables related to self-care behavior and to find factors related to the control of hypertension. A cross-sectional study was carried out to provide basic data for effective and continuous hypertension control in the low-income elderly. Methods: This study was performed with a total of 189 subjects who were hypertensive and were receiving pharmacological treatment of hypertension from a community health center in D Metropolitan City. Data were collected through a face to face survey, and systolic and diastolic blood pressure (the mean value of the two measures) were measured during May 2004. Obtained data were analyzed by $x^2$ test, t-test, multiple logistic regression and Pearson's correlation coefficient (using SPSS Version 10.1). Results: 1. According to demographical characteristics, the score of self-care behavior was significantly higher in elders living along ($47.63{\pm}7.276$) than in those living with the family ($45.19{\pm}5.501$) (p<.05), and in those with religion ($47.11{\pm}6.722$) than in those without religion ($45.01{\pm}6.110$) (p<.05) 2. As to blood pressure control, the percentage of blood pressure control within the normal range (systolic 140mmHg, diastolic below 90mmHg) was 37.03%. According to demographical characteristics, the percentage of blood pressure control was significantly lower in those without religion (p<.05). In practicing hypertension self-care behavior, those who do not control salk intake showed a significantly lower percentage of hypertension control (p<.05). The score of hypertension self-care was $48.28{\pm}4.443$ in the controlled group, and $45.42{\pm}7.399$ in the uncontrolled group, showing a significant difference (p<.01). 3. Hypertension self-care behavior was in a positive correlation with blood pressure control (r=.210, p<.05). Conclusion: Attention should be paid to self-care behavior to increase the control of hypertension in the low-income elderly. These results can be used guidances for improving self-care behavior and the control of hypertension in the low-income elderly.

• Journal of Korean Academy of Nursing
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• v.5 no.1
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• pp.17-30
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• 1975

The concept and definition of nursing and her role have been changing in accordance with the socio-cultural factors of the initial society. At present, nursing is conceptualized as a health care profession assisting man to restore, maintain and promote health by providing knowledge, wilt strength and resources through various processes of interaction. Man′s behavior, of individual and group activities for health inclusive, is driven by the initial man′s value orientation. The purpose of this study is to investigate the value orientation regarding health of rural health center milieu in order to give data for; 1. the planning for the delivery of community nursing service, 2. the health education plan at all level of nursing care activities, and 3. the planning of curriculum for nursing education. A hundred opinion leaders among the labor population residing in rural areas (P-group), hundred and six professional nurses at rural health centers (N-group) were indirectly interviewed through questionaries. And ninety five of N-group were interviewed likewise of their perceptions of P-group (NP-group) from July 15, to October 15, 1974. The result is as follows: 1. Maintenance of health is revealed to be the most valued component for man′s happiness in all the three groups. (P-group: 7.30 S. D.=1.31), (N-group :7.84 S. D. =49), and (NP-group : 5.93 S. D. =2.28) 2. The average value score of the maintenance of health revealed significant difference by P〈.001 level between each of the three groups. (Between N-group and P-group : T= -4.07 P and NP ; T=-6.93, N and NP: T=-9.35) 3. Basic health maintenance activities necessary for maintenance and promotion of personal health were moderately valued by all the three groups, P-group ; 3.74 (S. D. =.43) , N-group: 3.52 (S. D. =.34), NP-group: 3.07 (S. D. :.55) Among the 8 categories of basic health maintenance activities, "food intake" was highly valued by P-group (mean value score; 4.00 S. D=.51) , "exercise and rest" and "personal cleanliness" was highly valued by both P-group (4.02, 4.08) and N-group (4.08, 4.22). 4. The mean value score of basic health maintenance activities revealed significant difference by P〈.001 level between each of the three groups (between P-group and N-group: T=-4, 07, N-and NP: T=-6.93, P and NP T=-9.35) 5. Among the 30 questionaries, dynamic activities for health maintenance were more valued in comparison to passive activities in an tile three groups. 6. In N-group, correlation between the value of basic health maintenance activities and the personal health status personal revealed moderate significance. Correlation between the value of basic health maintenance activities and the age revealed low significance. 7. In group, correlation between the value of basic health maintenance activities and; perception of personal health status revealed non significance, between the age and sex revealed low sign affiance, and between the educational status revealed moderate significance. Recommendations are as follows ; 1. The efforts towards alteration of value orientation concerning health in general in community nursing practice de focussed be that of family Planning. 2. In order to prepare professional nurses competent in understanding individual and group, social science and behavioral science be strength ended in planning nursing curriculum. 3. Milieu of nursing experience during nursing education be Planned to begin at simple nursing problem and move towards complex, f. e. home care towards health crisis situation in order to achieve dynamic role mastery.