• Journal of Society of Preventive Korean Medicine
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• v.14 no.2
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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.

• Korea Journal of Hospital Management
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• v.12 no.3
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• pp.1-19
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• 2007

This study focused on finding the variation of medical service utilization and medical payments of the patients died by three, cancers, stomach, breast, and colon cancer. For this study, data of the one-year episodes of the health insurance subscribers died in 2004 were selected. The frequency of medical visits, the lengths of slays, the days of outpatient visits, the total period of medical services and the total medical payments were compared by the characteristics of the suppliers and utilizers. The data of the patients died by cerebrovascular diseases and cancer in 2004 were selected. To select the dead by cerebrovascular diseases and cancer in 2004, were matched the 2004 reimbursement data of all medical institutions to the data of funeral fee payment by the National Health Insurance Corporation from January 2004 to May 2005 for the death in 2004. The results of the analysis were as follow. The variation of medical service utilization of the dead by cancers were not small in Korea. The current study found that the variation of medical care utilization was influenced by the factors of suppliers, such as types and locations of medical institutions and the factors of users, such as sex and age. It was suspected that the reimbursement by fee-for-service contributed to the variation quite a lot, but we could not compare the variation between the different reimbursement systems in Korea. The results of the study suggested that tile factors of suppliers and utilizers should he reviewed to reduce the under use and over use expressed by variations of medical service utilization. The processes of care, effective communication and management system should be investigated for the equity of medical service utilization. Additionally, prospective payment could he recommended to reduce the high variation of medical service Use. To find the variation caused by under use and over use, further study need to control the severity of diseases, socio-economic status of the users and the system factors.

• Journal of Korean society of Dental Hygiene
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• v.10 no.5
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• pp.841-849
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• 2010

Objectives : This purpose of this study was to examine worker's Dental care utilization patterns and its related factors, to prepare basic data for oral health promotion of workers. Methods : The study subject were 1016 industrial workers from7 working places in Gyung-Sang-Buk Do and Daegu-City. Data for this study was obtained by self-administrated questionnaire. The questionnaire consists of general characteristics, yes or no of dental care utilization before six month, purpose of visit, yes or no of dental disease form the results of dental examination screening before one years, yes or no of and patterns dental care utilization of workers with dental disease, etc. The data was utilized using frequency test and $x^2-test$. Results : Rate of dental care utilization was 40% within six month last, among the general characteristics, it were statistically significant that higher age, married state, bad oral health state, high Work period. Rate of dental disease as a result of their dental examination last was 53.1% among the general characteristics, it were statistically significant that enough economic state, bad oral health state, blue collar work type. Dental care utilization's rate of dental disease as a result of their dental examination last was 48.6% among the general characteristics, it were statistically significant that Enough economic state, higher age, married state, high Work period. Conclusions : In order to promote workers of abnormal opinions to take the medical treatment on their dental diseases later dental examination, it is necessary to educate them consistently for the importance of early medical treatment.

• Health Policy and Management
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• v.24 no.1
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• pp.47-55
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• 2014

Background: Korea is considered to have an integrative health system where both western medicine and Korean (traditional) medicine are officially recognized and provided. Although Korean medicine has been covered by National Health Insurance over 20 years, equity in the utilization of Korean medical care has rarely been examined. Methods: We examined medical care utilization and expenditure of outpatient Korean medicine using panel fixed effects model to remove selection bias. Then we compared it with pooled ordinary least square (OLS) model. This study used Korea Health Panel data, which provides accurate information on out-of-pocket health care payment, including non-covered medical services. Results: Principal findings indicate that the frequency of the utilization of Korean medicine is related with unobservable individual choices different from western medicine, so the panel fixed effect model is appropriate. But pooled OLS model is better fitted for the expenditure of Korean medicine, after controlling for western medical care expenditure. After adjusting for the selection bias, socioeconomic status (income, education) was significantly associated with the expenditure of Korean medicine, but not with the frequency of the utilization of Korean medicine. Conclusion: This study shows that expenditure of Korean medicine utilization is inequitable across socioeconomic groups, which implies that health insurance coverage of Korean medicine is not sufficient.

• Journal of Preventive Medicine and Public Health
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• v.50 no.1
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• pp.29-37
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• 2017

Objectives: The accurate measurement of geographic patterns of health care utilization is a prerequisite for the study of geographic variations in health care utilization. While several measures have been developed to measure how accurately geographic units reflect the health care utilization patterns of residents, they have been only applied to hospitalization and need further evaluation. This study aimed to evaluate geographic indices describing health care utilization. Methods: We measured the utilization rate and four health care utilization indices (localization index, outflow index, inflow index, and net patient flow) for eight major procedures (coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, surgery after hip fracture, knee replacement surgery, caesarean sections, hysterectomy, computed tomography scans, and magnetic resonance imaging scans) according to three levels of geographic units in Korea. Data were obtained from the National Health Insurance database in Korea. We evaluated the associations among the health care utilization indices and the utilization rates. Results: In higher-level geographic units, the localization index tended to be high, while the inflow index and outflow index were lower. The indices showed different patterns depending on the procedure. A strong negative correlation between the localization index and the outflow index was observed for all procedures. Net patient flow showed a moderate positive correlation with the localization index and the inflow index. Conclusions: Health care utilization indices can be used as a proxy to describe the utilization pattern of a procedure in a geographic unit.

• Health Policy and Management
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• v.13 no.3
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• pp.104-128
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• 2003

Equity in health care has taken priority in the Korean government's policy agenda after the government-led national health insurance achieved universal coverage in 1989 along with the final inclusion of the self-employed as beneficiary. The purpose of this study is to examine the extent to which there exists difference or inequality in the utilization of health care, especially cancer inpatient services among income classes. We analysed the utilization of cancer inpatient services of residents in Jeju Island for a year of 2000, using the national health insurance data for qualification of beneficiaries and utilization of health care. The independent variable are 10 income classes based on the national health insurance fee imposed on each household for a year of 2000. The dependent variables of this study are an amount of cancer inpatient health care utilization measured by cancer admission days and cancer treatment costs. Also, cancer inpatient health care utilization is analysed by three categories divided into utilization in medical care institutions (1) within Jeju Island, (2) outside Jeju Island, and (3) all within and outside Jeju Island. We measured concentration index of cancer inpatient health care utilization. This analysis showed negative concentration index within Jeju Island and positive outside Jeju Island, and positive in all within and outside Jeju Island. This results suggest inequality against the relatively poor income groups in utilization of cancer inpatient health care services. Especially, inequity of cancer inpatient health care would be more serious in Jeju Island of Korea, considering that lower income groups reportedly have higher incidence rates in most of cancer and thus use more health services.

• Research in Community and Public Health Nursing
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• v.30 no.4
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• pp.484-493
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• 2019

Purpose: The purpose of this study was to examine the effect of health literacy and self-care performance on health care utilization of medicaid elderly. Methods: A total of 203 medicaid elderly over 65 and living in B-metropolitan city were interviewed. Data were analyzed with descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients and Hierarchical Multiple regression. Results: The average score of the health literacy was 7.88±2.84 out of 12. The average score of self-care was 3.26±0.77 points on the 5 point scale. The frequency of health care utilization by the subjects was 6.65±5.25 a month. The health literacy and self-care performance showed a statistically significant positive correlation. The health literacy and self-care performance showed a statistically significant negative correlation with health care utilization. The factors affecting health care utilization of the subjects were self-care performance, health literacy, and religion, and the explanatory power was 25%. Conclusion: The results indicate that the self-care performance, health literacy, religion are significant factors of health care utilization in medicaid elderly. Therefore, it is necessary to develop strategies to improve their self-care performance and health literacy for reasonable health care utilization. Also, it is necessary to provide the elderly with correct information about medical use from accessible religious institutions, senior community center, and welfare centers.

• Health Policy and Management
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• v.27 no.2
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• pp.128-138
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• 2017

Background: The purpose of this study is to analyze the effects of differential coinsurance policy on prescription drug coverage of outpatients by types of medical institutions. Methods: In this study, we used a sample cohort database of the National Health Insurance Service and frequency analysis and marginal logistic regression model using generalized estimating equation were used for statistical analysis. Results: The summary on the major research is followed. First, about 16% of patients who used only tertiary or general hospital due to 52 ambulatory care sensitive conditions before policy implementation moved to hospitals and clinics. However, about 57% of them still use tertiary or general hospital. Second, the factors influencing the utilization of hospitals and clinics after the implementation of the policy were gender, age, and income level. As a result, the policy is effective to reduce the medical use of outpatient mental patients in tertiary or general hospital, but the effect is not significant. Conclusion: Therefore, in order to achieve the purpose of the policy for establishing the health care delivery system, it is necessary to adjust the co-payment so as to feel the burden on the co-payment when the outpatient for 52 ambulatory care sensitive conditions is used at the tertiary or general hospital.

• The Korean Journal of Health Service Management
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• v.10 no.1
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• pp.39-51
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• 2016

Objectives : This study investigated the health care utilization patterns of workers' compensation insurance(WCI) pneumoconiosis patients with excessively long hospital stays. Methods : The discharge summary data of 3,094 WCI pneumoconiosis patients were analyzed. The study sample was divided into 3 groups based on the length of stay(LOS). Health care utilization patterns were compared among the groups with logistic regression analysis, and the LOS determinants were identified with linear regression analysis. Results : The average LOS of the 222 long stay group patients was 1,448 days. Patients in this group tended to use private general hospitals, were admitted through the emergency room and discharged without the consent of a doctor. Conclusions : Many of the long LOS patients will maintain their inpatient status for the rest of their lives. For quality of life and efficient use of health care resources, policy makers need to establish a policy that enables patients to receive outpatient care in appropriate living conditions outside the hospital.

• Research in Community and Public Health Nursing
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• v.12 no.3
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• pp.589-599
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• 2001

The purpose of this study was to analyze the relation amongst health status, health care costs. health service utilization among the low income elderly who were 60 years of age or older, earning a half of the average Korean family income. The cross-sectional descriptive survey research we conducted used families randomly sampled nationwide. The data were collected from July 12 to August 7, 1999 and the total sample was 1.259 household members (421 households). These were the major findings. 1. As for the health status. 72.4% of respondents fell ill in the last 1 month; 54% of respondents had chronic disease. 2. As for the health care cost. the cost of hospitalization and the medical treatment were 1.069,000 won and 226.000won. respectively. 59.3% of respondents experienced a burden from the monthly health care expenses. 3. As for the health service utilization for the last 3months. 28.5% of respondents didn't utilize the health service. In addition, 22.2% of respondents gave up a medical treatment because of economic situation (88.8%). 4. The statistically significant determinants of health service utilization are old age, female, living with a spouse, unemployed state, medicare, and more days sick. 5. It is shown conclusively that equity and efficacy of the health care policy are to be considered for lower income older adult.