• Journal of Korean Academy of Nursing
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• v.39 no.3
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• pp.409-421
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• 2009

Purpose: In this research multi-level analysis was done to identify factors related to quality of services. Patient characteristics and organizational factors were considered. Methods: The data were collected from the Health Insurance Review and Assessment Service(HIRA) data base. The sample was selected from 17,234 patients who had been admitted between January 2007 and May 2008 to one of 253 long-term care hospitals located in Seoul, six other metropolitan cities or nine provinces The data were analyzed with SAS 9.1 using multi-level analysis. Results: The results indicated that individual level variables related to quality of service were age, cognitive ability, patient classification, and initial quality scores. The organizational level variables related to quality of service were ownership, number of beds, and turnover rate. The explanatory power of variables related to organizational level variances in quality of service was 23.72%. Conclusion: The results of this study indicate that differences in the quality of services were related to organizational factors. It is necessary to consider not only individual factors but also higher-level organizational factors such as nurse' welfare and facility standards if quality of service in long term care hospitals is to be improved.

• Journal of Preventive Medicine and Public Health
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• v.55 no.2
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• pp.153-163
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• 2022

Objectives: This study divided the factors that affect participation in health screenings into individual, household, and regional levels and conducted a multi-level analysis to identify the factors related to participation in health screenings. Methods: Participants from the 2017 Community Health Survey were classified into 2 groups (under 40 and 40 or older). A multi-level logistic regression analysis was conducted to identify the factors that affected participation in health screenings. Results: The screening rate of the participants was 69.7%, and it was higher among participants aged 40 and older (80.3%) than it was among participants younger than 40 (49.8%). At the individual level, the factors that influenced participation in health screenings included age, economic activity, smoking status, physician-diagnosed hypertension, and a moderate or high physical activity level. At the household level, the odds ratio of participation in health screenings was high for participants who lived in single-person households, lived with a spouse, earned a high monthly household income, and were not beneficiaries of national basic livelihood security. At the regional level, the odds ratio at the 95% confidence interval level of participation in health screenings was high for participants who had trust in the local community and lived in an area with a proportionally high social welfare budget. Conclusions: This study analyzed nationalwide data and confirmed that individual, household, and regional characteristics affected participation in health screenings. Therefore, policies that prioritize the improvement of regional level factors and especially household level factors are likely to be the most effective for improving the screening rate.

• Korea Journal of Hospital Management
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• v.19 no.4
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• pp.9-20
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• 2014

The purpose of this study is to find out factors affecting patient moving to receive medical service. This study is analyzed by multi-level model with patient and hospital level by using SAS 9.3. Total number of patients is 600,000 persons for inpatients and 550,000 patients for outpatients. The degree of the factors, which is combined with personnel factor and hospital factor, can be analyzed by Intra-Class Correlation (ICC). The percentage of group(hospital) level variance of the total variance for out-bound moving case are 30.6% at inpatients, and 28.3% at outpatients. And the percentage of hospital level variance of the total variance for moving distance, are 26.7%, 32,5% respectively. Conclusionally, although the main factor of moving is patient level, hospital is also very important factor to make decision to go out-bound. It contributed to about 1/3 for hospital choice. And, when the one make decision, he will consider the hospital type, number of bed, and training institute in hospital level. Through this study to find out hospital factors affecting patient moving for medical service, it must be continued to find out which factors have more influence to choice the hospital among disease type after this.

• Health Policy and Management
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• v.30 no.3
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• pp.355-365
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• 2020

Background: This study is aimed to verify individual and regional-level factors affecting the depression of Koreans and to develop social programs for improving the depressive status. Methods: This study used individual-level variables from the Korean Community Health Survey (2018) and used the e-regional index of the Korean Statistical Information Service as the regional-level variable. A multi-level logistic regression was executed to identify individual and regional-level variables that were expected to affect the extent of depressive symptoms and to draw the receiver operating characteristic curve to compare the volume of impact between variables from both levels. Results: The results of the multi-level logistic regression analysis in regards to individual-level factors showed that older age, female gender, a lower income level, a lower education level, not having a spouse, the practice of walking, the consumption of breakfast higher levels of stress, and having high blood pressure or diabetes were associated with a greater increase in depressive symptoms. In terms of regional factors, areas with fewer cultural facilities and fewer car registration had higher levels of depressive symptoms. The comparison of area under the curve showed that individual factors had a greater influence than regional factors. Conclusion: This study showed that while both, individual and regional-level factors affect depression, the influence of the latter was relatively weaker as compared to the first. In this sense, it is necessary to develop programs focused on the individual, such as social prescribing at the local or community-level, rather than the city and nation-level approach that are currently prevalent.

• Health Policy and Management
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• v.25 no.1
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• pp.31-39
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• 2015

Background: The purpose of this study is comparison of the results between regression and multi-level analysis to find out factors influencing outcome indicators (in-hospital death, length of stay, and medical charges) of stroke patients. Methods: By using patient sample data of Health Insurance Review & Assessment Service, patients admitted with stroke were selected as survey target and 15,864 patients and 762 hospitals were surveyed. Results: For the results of existing regression analysis and multi-level analysis, models were assessed through model suitability index value and as a result, the value of results of multi-level analysis decreased compared to the results of regression, showing it is a better model. Conclusion: Factors influencing in-hospital death of stroke patients were analyzed and as a result, intra-class correlation (ICC) was 13.6%. In factors influencing length of stay, ICC was 11.4%, and medical charges, ICC was 17.7%. It was found that factors influencing the outcome indicators of stroke patients may vary in every hospital. This study could carry out more accurate analysis than existing research findings through analysis of reflecting structure at patient level and hospital level factors and analysis on random effect.

• Journal of Korea Planning Association
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• v.54 no.5
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• pp.129-138
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• 2019

This study aims to empirically examine the relationship between building energy consumption and building and local factors in Seoul. Building energy issue is an important topic for low carbon and eco-friendly city development. Building physical, socio-economic and environmental factors effect to increasing or decreasing energy consumption. However, there are different characteristic in each area, and this kind of variable has a hierarchical structure. The multi-level model was used to consider the hierarchical structure of the variables. In this study, a multi-level model was applied to confirm the difference between areas. Spatial area is Seoul, Korea and the temporal scope is August, summer season. As the result, in Model 1 (Null Model), ICC is 0.817. This shows that the energy consumption differs by 8.174% due to factors at the Dong level. Model 2 (Random Intercept Model) suggests that building's physical factors and Average age, Household size and Land price in Dong level have significant effects on Building energy consumption. In Model 3 (Random Coefficient Model), random effect variables have intercepts and slopes to vary across groups. This study provides a perspective for policy makers that the building energy reduction policies to be applied for buildings should be differently applied on area. Furthermore, not only physical factors but also socio-economic and environmental factors are important when making energy reduction policy.

• Iberoamérica
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• v.12 no.1
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• pp.407-439
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• 2010

Growth of researches addressing cross-culture in international business is exponential. This article reviews the extant researches around the national culture and describes the various conceptualization of culture through discussion of some of popular models of national culture. This article presented some of the most important issues in international business surrounding globalization, especially convergence and divergence of cultures and cultural changes. Global rapid changes in international business environment request the reconsideration of the assumption of cultural stability and the simple view of culture, which tends to examine the static influence of a few cultural factors in isolation form other cultural factors and contextual elements. This paper identifies a valid cultural grouping and proposes the following typology of the possible methodologies in international business; Ethnological description, Use of proxies, Direct values inference, and Indirect values inference. Rather than selecting a single methodology, it appears to be more appropriate to use multi-method in the cross-cultural international business research. It has been shown that cultural change is intertwined with socioeconomic-institutional variables, and that these variables may also add to determine culture contemporarily. This paper also explained the dynamics of culture as multi-level, multi-layer constructs. According to this model, we may understand how the dynamic nature of culture conveys the top-down-bottom-up processes where one cultural level affects changes in other level of culture.

• Journal of Families and Better Life
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• v.30 no.4
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• pp.37-47
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• 2012

The purpose of this study was to grasp the factors having influence upon the social adjustment of children in multi-cultural families and to examine the degree of influence of these influential factors. For these aims, it targeted 186 children of multi-cultural families, that access social welfare institutions or multi-cultural institutions in the Daegu and Gyeongbuk areas. The findings are as follows. First, the factors having influence upon the social adjustment of children in multi-cultural families were indicated to be self-esteem, parental marital relations, bullying, and the support of adults other than their parents. In other words, these children's higher level of social adjustment was correlated with higher self-esteem, better parental marital relations, fewer bullying experiences from their peer group, and more support from adults other than their parents'. Secondly, support from adults other than parents was indicated to be the most influential among the variables affecting the social adjustment of children in multi-cultural families. The factor having the second highest level of influence was indicated to be self-esteem, followed by parental marital relations, and then bullying.

• Korean Journal of Health Education and Promotion
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• v.27 no.4
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• pp.7-16
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• 2010

Objectives: To obtain a more intensive understanding smoking behaviors of young adolescent in the contexts of schools which they attend, this study examined the effects of individual and school level factors divided into psychological and social factors respectively. Methods: Multilevel logistic regression analysis was used to test the effects of school smoking rates on 1 year smoking experience of individual pupils in a sample of 3,449 students from 100 middle schools in Korea. Results: The results of multilevel analysis revealed the importance of social factors in three environments. Especially the social factors in school level, which were sense of school membership and school smoking rate, explained the variances between groups dropping the school effect from 0.194 to 0.046. Conclusion: This study suggests that adolescents' smoking behaviors are related to the multi dimensional and multi level factors. To reduce young adults' smoking rate, school level intervention should not be ignored.

• Journal of Preventive Medicine and Public Health
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• v.45 no.2
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• pp.90-97
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• 2012

Objectives: While there have been many quantitative studies on the public's attitude towards mental illnesses, it is hard to find quantitative study which focused on the contextual effect on the public's attitude. The purpose of this study was to identify factors that affect the public's beliefs and attitudes including contextual effects. Methods: We analyzed survey on the public's beliefs and attitudes towards mental illness in Korea with multi-level analysis. We analyzed the public's beliefs and attitudes in terms of prejudice as an intermediate outcome and social distance as a final outcome. Then, we focused on the associations of factors, which were individual and regional socioeconomic factors, familiarity, and knowledge based on the comparison of the intermediate and final outcomes. Results: Prejudice was not explained by regional variables but was only correlated with individual factors. Prejudice increased with age and decreased by high education level. However, social distance controlling for prejudice increased in females, in people with a high education level, and in regions with a high education level and a high proportion of the old. Therefore, social distance without controlling for prejudice increased in females, in the elderly, in highly educated people, and in regions with a high education and aged community. Conclusions: The result of the multi-level analysis for the regional variables suggests that social distance for mental illness are not only determined by individual factors but also influenced by the surroundings so that it could be tackled sufficiently with appropriate considering of the relevant regional context with individual characteristics.