• Journal of agricultural medicine and community health
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• v.19 no.1
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• pp.31-39
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• 1994

We carried out this study by analyzing the annual reports, surveyed by medical college student(Ewha Woman's University) through the medical records of new patients of Su-Dong Myon Health Subcenter from 1982 to 1992, and the specific survey data of 247 in Su-Dong Myon area which consists of 5,454 population and 1,651 household(43.6% farm household), in December, 1993. Results were as follows: 1) The number of population in Su-Dong Myon is 5,265 in 1982, 4,905 in 1984, 4,885 in 1986, 4,820 in 1988, 4,663 in 1990, 5,454 in 1992. 2) Since 1982, the annual utilization rate of a rural health subcenter showed decreasing tendency: such as 609(the highest rate) per 1,000 inhabitants in 1982, 485 in 1984, 525 in 1985, 281 in 1988, 316 in 1990 and 197 in 1992. The utilization rate by sex was decreasing chronologically in male, and age-specific utilization rate showed rapidly decreasing tendency since 1982 : 1,037 per 1,000 inhabitants in 1982, 877 in 1984, 1,084 in 1986, 519 in 1988, 538 in 1990 and 333 in 1992, in age group of 0-14, but not changing tendency in age-groups of 65 and over. 3) The monthly utilization rate of a rural health subcenter showed increasing tendency in March, July and August from 1982 to 1987, and in March and May from 1988 to 1992. 4) The patient rate of medical insurance showed increasing tendency since 1983: 17.0% per 100 patients(the lowest rate) in 1983, 21.3% in 1985, 20.4% in 1987, 70,0% in 1989 and 77.8% in 1991. However, the patient rate of Medicaid showed no specific change. 5) The utilization rate by the remedial measures for primary health care showed 30.8% of the answered in private special clinic, the highest rate, and 30.0% in drug stores, 25.5% in health subcenter, 10.5% in hospital and 1.2% in oriental clinic. In favorite physicians for primary health care, specialist was the highest rate, 48.6% of the answered, and general practitioner, 39.7% and home doctor, 8.9% in next order. And 70.8% of the answered experienced to visit the health subcenter more than once. 6) Disfavorite reasons of health subcenter were insufficient equipment(42.1%, the highest), and the next order, short cure time per day(25.1%), "be not cured"(12.2%), "be not(6.9%) and unkindness(3.6%), And the major obstacles in utilizing the medical facilities for primary health care were farm works(41.7%, the highest), distance(27.1%) and medical cost(11.4%).

• Health Policy and Management
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• v.12 no.1
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• pp.125-143
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• 2002

The objectives of this study were analysis of patient\`s characteristics and market segmentation in oriental medical care and western medical care. This study focused on medical utilization using Anderson's health utilization model. The source of data was 1998 National Health and Nutrition Survey which Korean Institute For Health and Social Affairs carried out. A stratified multistage probability sampling design was used in this survey. The analysis was conducted using the statistical software package SPSS version 10.0 and Answer Tree 2.1 which is one of data mining methodology. The results were as follows ; 1) 44.9% of respondents reported visiting oriental medical center within recent two weeks. 3.4% of them used oriental medical care. The group of age, kind of disease and medical expenditure are associated with the difference western and oriental medical utilization rate. 2) There were several factors related to utilization of oriental medical care according to decision tree. Especially, important factors that patient chose his medical center were kinds of disease, kinds of common medical use, and expenditure. 3) in the results of CART analysis, market of oriental medical care were classified by seven categories. The major groups who have a preference for oriental medicine were those musculo-skeletal, cerebra-vascular disease, or chronic headache patients, and they had a preference fur oriental medical care in common use. These results show that oriental and western medical market were divided into various areas by market segmentation.

• Journal of agricultural medicine and community health
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• v.17 no.2
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• pp.113-121
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• 1992

In order to estimate the pattern of medical care utilization and recognition for health factor among the inhabitants in Wan-do district which is located off the southern seashore from mainland Korea, household interview survey was performed from January 15 to 30, 1990 in Wan-do Gun area. The results observed were following: 1. Among the users of medical facilities 40.8% used public health facility as first contact facility. Lower the income level was and longer the residency duration was, the utilization rate of public health facilities was higher. By age groups and medical security status the utilization pattern was likely to disperse to local clinic and secondary contact medical resources. 2. Medical expense and access time were significantly different between primary contact and secondary contact medical resources. 3. Public health facility was recognized as the favoured institute having advantage of geographic and economic accessibility. 4. Statistically significant determinants in public health facility utilization among total medical service were the region, the medical expense, and the access time.

• Journal of Korean Public Health Nursing
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• v.3 no.2
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• pp.47-76
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• 1989

The objectives of this study was to analyze the major causes of decreasing utilization rate of health care institutios in pilot-project area of regional medical insurance, Kwang-hwa and Kun-wi country. After the implementation of medical insurance, utilization rate of health institutions turned out' to be lower than it was estimated, when the pilot-project of regional medical insurance was planned. It might be due to changes in inhabitant's behavioral attitude toward medical insurance. So this study was made to find measures for financial stability by increasing utilization rate of health care institutions and to be available for basic demand-supply program of medical care. The hypothesis of this study was as follows; First. there is difference in understanding health care institutions between Kun-wi and Kwang-hwa. Second. respondesnts of inquiry survey have exact knowledge of their past experience of treatment taken prior to enforcement of medical insurance, Questionaire survey was made as to each 700 household among total 11, 884 households in Kun-wi and 20,919 households in Kwang-hwa. In case of Kun-wi, 70% of inquired households (491) gave their answers. In Kwang-hwa, the number was 560 households (80% of inquireds). Dollected data was processed and analyzed by way of using SPSS batch system. To evaluate facto rs distribution aspects of data and to make comparison between two area, percentage and $X^2$ distribution were applied. The results were as follows; L The utilization rate of health care institutions in Kun-wi and Kwang-hwa was lower than it was estimated. when pilot-project of medical insurance was planned. 2. Prior to the implementation of medical insurance. inhabitants in two area chose the medical institutions considering such factors. First was medical care fee cheap. second in habitant's residence, Third was the institutions conveniently easy of access. 3. After the implementation of medical insurance. 26.1% of inqurieds in Kun-wi and 41.6% in Kwang-hwa, changed medical institutions. In case of Kwn-wi, from health care institution (p 0.05), and in case of Kwang-hwa, vice versa, from general medical institutions to health care institutions. 4. Evaluation by factors were made such as follows. Inquired gave high marks to following facts: In case of Kun-wi, general medical institutions were difficult of access and relation between patients: was not friendly, but burden of medical expenditure was light. Effects of treatment and facilities was good. In case of Kwang-hwa, inquired gave high evaluation marks to the follow ing facts; facilities of medical institutions was not good, but the burden of medical expenditure was light. 5. After the implementation of medical insurance, the services was evaluated as good, but inquired hopec for lessening the burden of medical expenditure. 6. In case of exact understanding of cost-sharing, the evaluation rate in Kwang-hwa was higher than that of Kun-wi (p < 0.005). And positive attitude toward necessity of medical insurance was also good in Kwang-hwa (p < 0.05). 7. In case of inquired's attitude toward medical institutions, Kwang-hwa showed positive response (p < 0.05) 8. In the case of comparison between general medical institution and health care institution, two area showed similar positive response; medical manpower, facilities of medical institutions and effest: of treatement was good. 9. In comprehensive evaluation of benefit-service; the general medical institution's positiveness was higher than that of health care institutions in Kun-wi. But in Kwang-hwa vice-versa. 10. If the medical expenditure of general medical institution and health care institutions was equal 77% of inquireds in Kun-wi and 59.1% in Kwang-hwa answered that they chose general medical insurance. Considering results above mentioned, the conclusion of this study was made as follows. 1. In Kwang-hwa county, where the understanding of health care institutions's was good, the utilization's of health care institutions was shown high. Therefore, in case of Kwang-hwa, betterment: should be made to induce increasing utilization rate for negative factors of health care institutions. 2. In case of Kun-wi, where the understanding of health care institutions was on the decrease, measures for changing such negative factors should be taken by way of strengthening public relations. And cases of Kwang-hwa should also be studied. 3. On the side of financial stabilization and establishing health care delivery system, primary health care should be available. Therefore, the major cause of inhabitant's avoiding health care institutions should be known. And measures for activating that institutions have to be taken. So, the facilities of health care institution have to be improved up to the level of clinic. And supportive measures for securing equipment and improving health care services should also be taken. It is necessary that strategy for public relations should be employed with policy considerations and supports.

• Journal of agricultural medicine and community health
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• v.21 no.2
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• pp.151-157
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• 1996

This study was analyze through the reports which published on the subject matter of Su Dong-Myun from year of 1972-1993, and analysis of data in 1994 was performed with medical records on the health subcenter by PC-SAS program. The result are as follows: The number of population in Su-Dong Myun(study area) was 5,707 in 1995, 4,641 in 1985 and 5,424 in 1975. In the composition rate of population "0-14" of age group only showed markedly decreasing tendancy from 42.8% in 1975 to 19.1% in 1995. However, "65 and over" showed markedly increasing tendancy from 5.7% in 1975 to 9.8% in 1995. Annual utilization rate showed rapidly increasing tendency from year of 1972 to 1978, such as 314 per showed rapidly decreasing tendency, such as 708 in 1981, 485 in 1984, 272 in 1987, 309 in 190 and in 1993. In the annual age-specific utilization rate, the age group of "0-14" showed the highest rate of 621 per thousand population in 1975, 1159 in 1980, 1021 in 1985 and 538 in 1990. However the age group of "65 and over" showed the highest rate of 481 in 1994. Age specific annual utilization rate showed markedly decreasing tendency in the age group of "0-14" and "15-44", however showed slightly decreasing tendency or same level in the group of "45-64" and "65 and over" from year of 1980 to 1994. In the age specific utilization rate, the lower down the age was, the higher tendency the rate showed, such as 621 per 1,000 population in "0-14" of the age group, 543 in "15-44", 406 in "45-64" and 294 in "65 and over" in 1975. However, the higher up the age was, the higher tendency the rate showed in 1980, 1985 and 1994, except "0-14" of age group. The 5 major diseases were disease of Respiratory system, Gastrointestinal system, Skin and Subcutaneous tissue, Accidents, Poisoning and Violence and Nervous system and Sense organ, in 1975, 1980 and 1985. However, in 1990 and 1994, the 5 major disease were disease of Respiratory system, Gastrointestinal system. Skin and Subcutaneous tissue, Musculoskeletal system and, Connective tissue and Circulatory system. In Composition rate of patient in Su Dong-Myun Health Subcenter by Charged Medical Fee, medical insurance showed almost all the highest rate of 93.9% in year of 1994 and C.H.D.A. of 100% in 1975. Proportion of insurance showed increasing tendency such as 6.6% in 1980, 21.3% in 1985, 69.0% in 1990 and relatively C.H.D.A. showed decreasing tendency.

• Journal of Preventive Medicine and Public Health
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• v.24 no.3 s.35
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• pp.265-278
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• 1991

This study was to examine the effects of insurance coverage on the utilization of public health institutions and to identify the factors associated with the utilization. The data were obtained from household interview surveys conducted twice in Hwachun Gun, Kangwon Do. The time period covered in the first survey was December $17{\sim}31$, 1987, before the implementation of regional medical insurance for the self-employed, and that of the second survey was January 28 $\sim$ Febuary 11, 1990, after its implementation. Major findings emerged from the analysis can be summarized as follows (1) Medical care utilization of rural people markedly increased after they were covered by medical insurance. The insurance coverage increased the utilization of public health institutions as well, and this increase was mainly attributable to the utilization by chronically ill patients. (2) Between 1987 and 1990, the proportion of the utilization of public health institutions over whole medical care utilization decreased. But the proportion increased for chronically ill patients covered by regional medical insurance during the same time span. (3) The results of logistic regression suggested that the rural self-employed utilized public health institutions at an increased rate after they were covered by medical insurance. It was also indicated that the increase resulted from the utilization by chronically ill patients. (4) The relative importance of public health institutions for rural medical care decreased after the implementation of regional medical insurance. But considering that the utilization of public health institutions by chronically ill patients increased after insurance coverage, attention should be directed to improving the capability of public health institutions to control chronic degenerative diseases.

• Journal of Preventive Medicine and Public Health
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• v.30 no.4 s.59
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• pp.764-778
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• 1997

To find the medical insurance utilization of workers when suffering from low back pain, an analysis was made toward the data of medical insurance benefits matched with the general characteristics of 10,183 workers, who were registered continuously from 1993 to 1995 at a medical insurance cooperation for industrial workers. The results were as follows; 1. The period prevalence of the medical insurance utilization for low back pain for 3 years from 1993 to 1995 was calculated as 17.1% for male workers and 19.4% for female workers. Most common cause of utilization was other dorsopathies including the herniation of lumbar discs. 2. The utilization rate increased significantly as the present age and the age joining the company got older(p<0.001). As the duration of employment got longer, the utilization rate of the male showed the tendency to increase and that of the female increased significantly(p<0.05). Among male workers employed at cement and concrete manufacturing companies showed higher utilization rate and among female laborers showed significantly higher utilization rate than clerical workers(p<0.01). 3. Annual utilization rate for low back pain didn't show any difference, but the portion of other dorsopathies among cause of utilization showed the tendency to increase from 1993 to 1995. 4. The mean number of claims for outpatient medical care for low back pain differed significantly by age, working duration, type of industries, income level(p<0.05), and the mean of total visiting days for care of low back pain differed significantly by working duration. In conclusion, considering the fact that the medical insurance utilization for low back pain increased annually and other dorsopathies including the herniation of dorsopathies were increasing, an effective preventive or management program for low back pain toward worker employed at industries were required.

• Journal of agricultural medicine and community health
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• v.21 no.2
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• pp.243-251
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• 1996

Authors surveyed the inhabitants in Ulnung Island to assess the patterns of medical utilization. One hundred eighty six population(65 male and 121 female) were surveyed with formed questionnaire from Aug. 16 to Aug. 19 in 1994. Results are as follows. 1. The prevalence rate of acute diseases was 19.3%. 2. The prevalence rate of chronic diseases was 35.0%. In classification of chronic disease, the disease of musculoscletal system was the highest(33.9%) and that of digestive system in next order. 3. The first-visit medical facility when disease developed was community health center mainly. The admission care was taken in 37.6%. The 80.0% among location of medical facility for admission care was out of island. The surgical operative care were taken in 19.9%. The 86.5% among location of medical facility for surgical operative care was out of island. 4. Among the contents of dissatisfaction for medical service within island, 'Insufficient equipment' was the highest(35.8%), and 'Insufficient traffic networks' in next order. The results of this study suggest that public health facilities and medical personnel be strengthened and emergency transfer system be secured in Ulnung Island.

• Journal of Preventive Medicine and Public Health
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• v.23 no.2 s.30
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• pp.185-193
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• 1990

The purpose of this study is to observe the pattern of change in medical care utilization over time in early years of insurance coverage. The source of data is the benefit records file of a voluntary medical insurance society for covering the four-year period, from 1982 to 1985. The measure of medical care utilization used in this study is the age-sex standardized percentage of the enrollee who have visited a physician over total analytical population during a three-month period. For six cohorts by the year of enrollment ($1979{\sim}1984$), the relationship between the utilization and duration of insurance coverage was examined controlling for the calender year and season. In the analysis, logistic multiple regression and residual analysis were employed. It was observed that medical care utilization rapidly increased during the early stage of insurance coverage, and after then increased at a slower rate over time to become almost stable in about twenty months.

• Journal of Preventive Medicine and Public Health
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• v.17 no.1
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• pp.31-36
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• 1984

In order to know about the utilization of health subcenter in a Korean rural community, a study was carried out through analyzing the records on the outpatients in Su-Dong Health Subcenter during 5 years from 1978 to 1982, and the following results were obtained. 1. The annual utilization rate of health subcenter of Su-Dong Myun showed decreasing tendency such as 946.6 in 1978, 886.4 in 1979, 736.5 in 1980, 708.3 in 1981 and 609.1 in 1982 per 1,000 people. 2. In terms of annual utilization rate of health subcenter by sex, utilization rate of female was higher than that of male such as in 1978 (male 908.6, female 986.3), 1979 (male 819.2, female 956.7) and 1981 (male 686.0, female 731.5) except 1980(male 790.0, female 683.3) and 1982(male 632.7, female 585.0). 3. Every year the 5 major diseases of the new patients cared in health subcenter were the same as follows; Diseases of the Respiratory System, Diseases of the Digestive System, Diseases of the Skin and Subcutaneous Tissue, Accident Poisoning and Violence, and Diseases of the Nervous System and Sensory Organ. 4. In terms of annual utilization rate of health subcenter by age, utilization rate of $0{\sim}4$ year group was highest every year such as 3,666.0 in 1978, 3,232.5 in 1979, 2,819.0 in 1980, 2,361.4 in 1981 and 2408.7 in 1982 per 1,000 people. 5. The average visiting times per case to health subcenter were not much different every year such as 1.75 times in 1978, 1.79 times in 1979, 1.69 times in 1980, 1.79 times in 1981, and 1.80 times in 1982. 6. The monthly utilization rates per 1,000 people of health subcenter had two peaks in February(40.9 in 1980 and 86.4 in 1981) and July(84.6 in 1980 and 72.1 in 1981) except 1982. 7. The distribution of new patients by the source of medical fee payment was follows; community health organization member 86.9%, medicaid program 6.5%, and medical insurance 6.6% in 1980 and community health organization member 76.8%, medicaid program 11.4%, and medical insurance 11.8% in 1981 and community health organization member 78.2%, medicaid program 14.8% and medical insurance 13.2% in 1982.