• The Korean Journal of Health Service Management
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• v.6 no.4
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• pp.279-294
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• 2012

The study compared refractive surgery patients' hospital selection factors and satisfaction, through this to see the factors influencing patients' satisfaction, aiming at 235 patients visiting two Eye hospitals. The research results are followed. First, target group's hospital selection factors appeared facilities and environment factor, reliability factor, personal service factor, and accessibility factor in the order. Second, patients' satisfaction appeared reliability factor, facilities and environment factor, and personal factor in the order. Fourth, in the result comparing patients' expectation on hospital selection and satisfaction score, all factors of facilities and environment, personal service, and reliability had high satisfaction score than expectation. Third, in the result of factors influencing refractive surgery patients' satisfaction, in surgery determination period, surgery expenditure, and hospital selection factors among characteristics relating to refractive surgery, facilities and environment, personal service, and reliability appeared as satisfaction influencing factors. In conclusion, the study found that hospital selection factors and satisfaction influencing factors by refractive surgery patients' surgery type are considered to be able to be used to establish marketing strategy in the fields excluded from insurance application, the researches to improve patients' satisfaction in patient-oriented medical market should be continuously proceeded.

• Journal of Society of Preventive Korean Medicine
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• v.3 no.2
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• pp.1-23
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• 1999

The purpose of this paper is to survey the current status of service utilization in oriental medicine, to identify the determinants of consumers' decision in the service utilization, and then suggest policy implications for promoting the consumers' utilization. A multiple regression model was adopted to analyze the factors that influence consumer's decision in purchasing the oriental medical services. Data used in this research relied on National Survey Data conducted by Korea Institute of Health and Social Affairs, and sampling survey. The results could be summarized as follows.: 1. the number of visits to oriental medical institutions has shown an overall increase during the last decade since the inception of health insurance for oriental medical services. It still, however, revealed a relatively iow figure to western medical services. 2. the main factors, after controlling demographic variables, that determine consumers' selection between oriental medical services and western medical services are considered to be price, belief in effectiveness of services, waiting time for service. Implications for policy recommendation include 1. to reduce a barrier to service utilization by discounting dramatically the price of herb medicine, which is believed to be crucial in expanding market share, 2. to encourage consumer's belief in clinical effectiveness through a specialization in competitive services compared with wertern medicine, 3. to keep the affirmative image among consumers alive through an active participation of oriental medical doctors in community activities, 4 to change the health care system in favor of oriental medicine in the long run.

• Journal of The Korean Society of Clinical Toxicology
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• v.18 no.1
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• pp.26-33
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• 2020

Purpose: Agent Orange (AO) is a herbicide and defoliant used by the United States and its military allies during the Vietnam War. Pneumonia is a common cause of death among Vietnam veterans in our hospital. There have been no previous studies researching any association between AO exposure and the prognosis for pneumonia. The primary objective of this study was to investigate associations between AO exposure and 30-day mortality due to pneumonia. The secondary objective was to examine the clinical factors associated with therapeutic outcomes in veterans with pneumonia, and to assess the prevalence of combined diseases in AO-exposed veterans. Methods: This study retrospectively included veteran patients diagnosed with pneumonia in the emergency department and hospitalized between February 2014 and March 2018. The enrolled patients were grouped according to their defoliant exposure history, and the clinical information of defoliant-exposed and non-defoliant-exposed groups were compared. Patients were divided according to 30-day mortality, and significant factors influencing mortality were evaluated by using univariate analysis and multivariate analysis. The final multivariate model revealed the effect of AO exposure on therapeutic outcomes of pneumonia. Results: A total of 1006 patients were analyzed. Of these, 276 patients had a history of AO exposure, whereas 730 patients had not been exposed. Factors positively associated with 30-day mortality were malignancy, respiratory rate, blood urea nitrogen, and albumin which was negatively associated with mortality. Conclusion: Exposure to defoliant is not associated with 30-day mortality in patients with pneumonia. However, veterans with defoliant exposure are associated with a high prevalence of diabetes mellitus, hypertension, cerebrovascular accident, malignancy, and chronic kidney disease.

• The Korean Journal of Health Service Management
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• v.7 no.2
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• pp.53-67
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• 2013

This study aims to analyze the effect of quality of health care on perceived value, patient satisfaction and revisit intention. Especially, it was focused on outdoor environment, admission procedure, hospital image, service quality of physicians that patients perceived. For inpatients, hospital image and service quality of medical technicians have an effect on perceived value. Service quality of physicians has an effect on the patient satisfaction. For outpatients, hospital image and service quality of physicians and medical technicians have an effect on perceived value. Outdoor environment, hospital image, service quality of physicians and medical technicians, and perceived value have an effect on patient satisfaction. Perceived value and patient satisfaction have an effect on revisit intention. They should evaluate customer satisfaction on their services and analyze various factors that affect on it to improve specialty hospitals.

• Journal of Korean Academy of Nursing
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• v.42 no.7
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• pp.928-935
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• 2012

Purpose: The current study was done to identify individual- and group-level factors associated with health care service utilization among Korean medical aid beneficiaries by applying multilevel modeling. Methods: Secondary data analysis was performed using data on health care service reimbursement and medical aid case management progress from 15,948 beneficiaries, and data from 229 regions were included in the analysis. Results: Results of multilevel analysis showed an estimated intraclass correlation coefficient (ICC) of 18.1%, indicating that the group level accounted for 18.1% of the total variance in health care service utilization, and that beneficiaries within the region are more likely to share common features with regard to health care service utilization. At the individual level, existence of disability and types of medical aid beneficiaries showed a significant association, while, at the group level, social deprivation index, and the number of beneficiaries and case managers within the region showed a significant association with health care service utilization. Conclusion: The significant influence of group level variables in health care service utilization found in this study indicate a need for group level approaches, such as policy change and/or promotion of community awareness.

• Korea Journal of Hospital Management
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• v.8 no.3
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• pp.32-48
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• 2003

Korea is to open its medical markets to foreign hospitals starting in the year 2006 regardless of our will(DDA, Doha Development Agenda). To accurately understand the characteristics of Korean medical users, their detailed and various needs, their attitudes toward the opening of Korean medical markets, and factors affecting these users in choosing foreign medical service providers would be first step needs to be taken by the Korean medical facilities that need to survive and develope through the fiercely competitive era coming with the opening of Korean medical markets to foreign medical service providers and would be very important in hospital management. The subjects of this study were 500 patients randomly selected from the outpatients who visited one of university hospitals in Seoul on the 14th-16th days of April 2003, and conducted a self-completion questionnaire. The answers of 463 respondents among the selected patients(93% of a responding rate)were analyzed through the Excel and statistics programs. The attitudes on the opening of the medical markets were shown in agreement 56.5%(247 persons), disagreement 6.9%(30 persons), and no idea 36.6%(160 persons). In consideration of only the answers as agreement and disagreement exclusive of the answer as no idea, 89.2% of the respondents agreed to the opening of the medical markets while 10.8% objected to the opening. The approval rate was higher with the higher education and income levels. Moreover, The approval rate for the opening of the medical markets was relatively high regardless of the satisfaction in the medical service, and the most important reason of the agreement was the guarantee of the patients(national)option. The main reason of the disagreement was high medical fee(50.5%), and the other reasons showing low rates were outflow of the domestic fund to the foreign countries(13.6%), damage of medical influences on the public(11.4%), lack of competition of the domestic medical industry(9.1%)and so on. As for the factors of selecting the foreign hospitals in the opening of the medical markets, the patients considered the authority(competency)of doctors firstly, and the other principal factors were worldwide fame and reliance, specific explanation of doctors, modernized medical instruments, convenient consultation procedure, etc. The patients agreed to the opening of the medical markets at a high rate regardless of the satisfaction in the medical service, and the most principal reason of the agreement was the guarantee of the patients(national)option for the medical care. Connected with the factors to select the hospitals, the approval reasons for the opening of the medical markets were the authority(competency)of the doctors as the first one, and then fame and tradition, reliance, overall diagnosis and modernized medical instruments, doctors specific explanation, and so on. However, these factors are actually associated with the Quality of the medical care, and consequently the approval reasons for the opening of the medical markets are connected with the security of the medical care. Accordingly, the guarantee of the patients(national)option answered as the main reason of the agreement can be also understood as the awareness of the right to have a variety of options for the security of the medical quality.

• The Journal of Korean Medicine
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• v.43 no.1
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• pp.60-72
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• 2022

Objectives: This study aimed to analyze the Korean medical utilization and Korean medical expenses by characteristics of multicultural family members to investigate whether it affects Korean medical utilization. Methods: This study utilized The Korea Health Panel data in 2018, with 238 final participants. We performed a t-test and ANOVA on the difference between Korean medical utilization and Korean medical expenses according to Anderson's Model of Health Service Utilization variables. Logistic regression analysis and generalized linear model analysis were conducted to analyze Korean medical utilization factors. Results: The Korean Medical utilization was 12.61% among the multicultural family members. As a result of regression analysis, the female had high Korean medical utilization(p=.008), and rural area residents had low utilization(p=.017). Korean medical expenses were high when they were female or married. Including the utilization of western medical services by outpatients, Korean medical expenses were high when they were female or outpatients who received western medical services. Conclusions: As a result of this study, the factors influencing Korean medical utilization were gender and residence area. There were differences in Korean medical expenses depending on western medical services use or gender. Therefore, it is necessary to use these factors to expand the Korean Medical utilization by multicultural family members, and research of the Korean medical utilization by disease is needed.

• Journal of Korean Neurosurgical Society
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• v.29 no.12
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• pp.1620-1627
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• 2000

Objectives : DAMA cases were analyzed to examine what the main casual factors of DAMA were and how to deal with these cases effectively in hospital with the DAMA interdisciplinary team including medical social worker whose role is to perform psycho-social assessment, family counsel, to evaluate family's DAMA need. Patients and Methods : The content analysis of medical record and social work record were reviewed in 37 cases referred by medical doctor to DAMA team. These cases were reported by patients' self discharge request or family's request for discharge from September 1998 to February 2000. The DAMA team consists of Assistant Director of Hospital as team leader, medical staff in-charge, social worker, QI nurse, other staff members who are not involved in direct treatment for patient, and administrative clerk. Results : The results of content analysis are as follows : 1) The most causal factors of DAMA consist of combination of more than 2 factors. 2) The major decision-maker is revealed to be son and daughter of patient. 3) In 59.4% of cases, family was not informed of patients' prognosis, alternatives, the consequence of DAMA at all. 4) In cases of DAMA report, the rapid intervention of social worker is carried out. Conclusion : In this study, we propose the interdisciplinary team approach to make decision legitimately and ethically for DAMA. The suggestions from this study are as follows : 1) To deal with DAMA case properly, the interdisciplinary team approach should be considered. 2) The criteria for DAMA case should be formed carefully. For the explicit selection of DAMA case, preliminary system for high-risk patient screening is recommended. 3) The medical social worker is available for the psycho-social problems of the patient once family members. For the effective family counselling, discharge planning and nursing home placement, the participation of medical social worker should be mandatory.

• Korea Journal of Hospital Management
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• v.12 no.4
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• pp.1-21
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• 2007

The relaxation of the regulation in selection of medical institution allows patients to use their own judgement in choosing proper institution for their diseases. Since the change of the regulation, there should have been many changes in medical institution selection behavior. The analysis of the change in disease specific selection pattern is critical because there be an optimal selection criteria that ensure the efficient and effective utilization of medical resources. This study analysis the institution selection factors by comparing the choice among the cases of acute diseases, the cases of chronic diseases, inpatient services, outpatient services, and emergency medical service. The comparisons performed in terms of size, class and other characteristics of medical institutions. For the study the nationally surveyed database was used and the data were analyzed using logistic regression procedure. The results indicates that the primary care facilities were not properly utilized. This study speculates that the reason for the undesirable pattern of utilization is that the roles of primary care facilities in the healthcare delivery system was not clearly defined. Based on the results, the medical policy implications are discussed.

• Journal of The Korea Institute of Healthcare Architecture
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• v.17 no.1
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• pp.15-22
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• 2011

Nowadays, a proportion of healthcare service for the elderly has been improved due to the factors, such as a prolonged life expectancy, a growth of aging population and a change of member of family. For these factors, it is necessary for the elderly to receive treatment for multidisciplinary diseases, associated with psychological care of sociological concept. It is quite difficult in an acute-care hospital to accommodate the elderly patient because of the fact that an acute-care hospital is required to maintain a high level of medical care and technical standard. That is why specialized medical service is needed for the elderly. In the case of Germany, they are at the stage of the change from large scale facilities to specialized facilities applying the integrated concept. This paper addresses the medical environmental factor and distinction of medical facilities for the elderly through survey and analysis relating to all change in Germany. Therefore, it aims to suggest a fundamental resource for architectural planning and network of medical facilities for the elderly.