• Korean Journal of Health Education and Promotion
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• v.28 no.1
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• pp.81-92
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• 2011

Objectives: The purpose of this study is to evaluate the influence of depression symptom on the self-rated health status(SRHS), the outpatient health service utilization and quality of life(QOL) also the relationship depression symptom with socio-demographic and health related factors. Methods: We selected 9,550 participants without chronic diseases from a total of 18,104 in the '2009 community health survey in Gyeongnam. They were assessed by using a Korean version of the Center for Epidemiological Studies-Depression Scale(CES-D). Those with CES-D scores of 21 or greater were defined as having probable depression. Results: A probable depression were associated in bivariate analysis with gender, age, educational status, monthly household income, marital status, current smoking status, drinking habit, physical activities and body mass index. After adjustment for covariates, probable depression groups predicted a lower status in SRHS. Likewise probable depression groups predicted a higher utilization in outpatient health service. Also probable depression groups predicted a lower score in QOL. Conclusions: Probable depression influence SRHS, outpatient health service utilization and QOL even after adjusting for the socio-demographic, health related factors and chronic medical illness. Programs for prevention and management of depression will be helpful to promote health and QOL.

• Health Policy and Management
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• v.23 no.1
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• pp.19-34
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• 2013

Background: The study describes the changes resulted from imposition on tertiary hospital outpatient coinsurance rate rise policy and in tertiary or general hospital drug coverage rise policy on healthcare service utilization. Methods: Accordingly, the hypothesis about outpatient healthcare utilization after rise policy in outpatient coinsurance rate and drug coverage was established, using interrupted time-series analysis and segmented regression analysis to test the hypothesis. 5-year analysis period (2007. 3-2012. 3) from the outset year was designated, the data about most common 10 high-ranking of the main diseases targeting visiting patient from age of 6 to 64 were collected. Results: The summary on the major research is followed. First, the medical expense and duration of treatment tends to be increased in case of imposition about rise policy in outpatient coinsurance rate in the tertiary hospital under the interrupted time-series analysis. It showed temporary increase and slow down on account of influenza A even after the policy enforcement. In segmented regression analysis, duration of visit and medical expense in the tertiary hospital increased temporally right after the policy implementation and the decreased rapidly depends on period. Both rise and fall is statistically significant. The second, In case of tertiary or general hospital outpatient drug coverage rise policy, all of the tertiary hospital healthcare service utilization variables by the interrupted time-series analysis, drug coverage policy in the general hospital deeply declined according to decreasing trend before policy implementation. The third, in case of segmented regression analysis, the visit duration and medical expense statistically declined right after the policy implementation in both the tertiary and general hospital. Meanwhile, administration day was statistically meaningful only for the decrease right after the policy implementation. Otherwise, general hospital changes are not statistically meaningful. And the medicine cost was statistically, meaningfully decreased after the increase in drug coverage. Conclusion: Finally, the result demonstrated according to the analysis is only 1 hypothesis is denied, the other 2 are partially supported. Then, tertiary hospital outpatient coinsurance rate increase policy comparatively makes decrease effect on long-term healthcare utilization, and tertiary or general hospital outpatient drug coverage policy showed partially short-term effect is assured.

• The Korean Society of Law and Medicine
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• v.15 no.1
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• pp.123-164
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• 2014

Under the new system of 'Separation of pharmaceutical prescription and dispensing' in Korea, which was implemented in 2000, physician could not dispense a medicine, and outpatient should have a physician's prescription filled at a drugstore. After pharmacist makes up outpatient's prescription, National Health Insurance Service(NHIS) pay for outpatient's medicine to pharmacist, except an outpatient's own medicine charge. And NHIS only pay for outpatient's prescription fee to physician and, physician doesn't derive profit from dispensing medicine in itself. Nevertheless, if physician writes out a prescription with violation of 'Criteria for the Medical Care Benefits', NHIS clawed back the payment of outpatient's prescription and medicine from the physician or the medical institution which the physician belongs to. In the past, NHIS's confiscation was in accordance with 'the National Health Care Insurance Act, Article 52, Clause 1'. But, since 2006 when the Supreme Court declared that there was no legal basis on the NHIS's confiscation of outpatient's medicine payment, NHIS had put in a claim for illegal prescriptions on the basis 'the Korean Civil law, Article 750(tort)'. So, Many medical institutions filed civil actions against NHIS. The key point of this actions was whether the issuing outpatient prescriptions with violations of Criteria for the Medical Care Benefits constitute of the law of tort. On this point, the first trial and the second trial took different position. Finally the Supreme Court acknowledged the constitution of the law of tort in 2013. In this paper, the author will review critically the decision of the Supreme Court, and consider the relativeness between the legal effect of Criteria for the Medical Care Benefits and the constitution of the issuing outpatient prescriptions with violations of Criteria for the Medical Care Benefits as the law of tort.

• Journal of Korea Entertainment Industry Association
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• v.14 no.8
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• pp.345-352
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• 2020

This study conducted a survey targeting 414 medical institution workers to identify the impacts of their emotional labor and the recognition level of medical service fee reduction influencing the reduction rate. The results were as follows. First, a review of the difference in the reduction rate by socio-demographic characteristics revealed that in both inpatient and outpatient reduction rate, there is a significant difference in the occupational description, working history at the current hospital, and the numbers of approved beds. Second, there is a correlation between emotional labor, the recognition level of medical service fee reduction, and the reduction rate. As a result of the analysis, there is a significant positive correlation between emotional labor and outpatient reduction rate, a significant negative correlation between the recognition level of medical service fee reduction and inpatient reduction rate, and a significant negative correlation between the recognition level of medical service fee reduction and outpatient reduction rate. Third, emotional labor has a significant positive effect on the inpatient reduction rate, and the recognition level of the medical service fee reduction has a negative effect on the inpatient reduction rate. The emotional labor also has a significant positive effect on outpatient reduction rate, and the recognition level of the medical service fee reduction has a significant negative effect on outpatient reduction rate.

• Journal of Preventive Medicine and Public Health
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• v.27 no.1 s.45
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• pp.135-144
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• 1994

The purpose of this study compares determinants of eldery medical cost inflation with those of other age groups by analysing aggregated data with a deterministic model. The deterministic model of per capita medical cost inflation consists of increases in price, intensity of services, and medical utilization. We used a time series data($1985{\sim}1991$) from National Medical Insurance and analyzed by age groups. In total population, the average increase rates of inpatient and outpatient medical costs were respectively 9.5% and 8.8% during 6 years and the major cause of inflation was the increase in service intensity in both of inpatient and outpatient cases. But in the population of 65 years old and over, the average increase rates of inpatient and outpatient medical costs were respectively 13.8% and 14.8% and the major cause of inflation was the increase in per-capita medical utilization in both of inpatient and outpatient cases. Also, the increase in service intensity of 65 years old and over was the highest of other age groups. This pattern was similar during study periods. We concluded that the level of medical cost-inflation and the determinants in eldery was the highest-especially in per capita medical utilization, therfore, the inflation of medical costs in eldery will be higher than other age groups for the furture in Korea.

• The Korean Journal of Health Service Management
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• v.14 no.1
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• pp.15-30
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• 2020

Objectives: This study investigated outpatient health care satisfaction and influential factors using data from the "2018 Health Care Experience Survey". Methods: Data on 6,705 participants in the Health Care Experience Survey were statistically examined using a t-test, ANOVA, and multiple regression analysis. Results: First, the level of satisfaction among outpatients was generally positive, and satisfaction among older people was high. Second, the significant factors of outpatient overall satisfaction were gender, consultation time, waiting time, reason for choosing institution, satisfaction with doctors, nurses, institutions, and the therapeutic result. Third, influential factors of intention to recommend were education, institution type, reason for choosing institution, satisfaction with doctors, nurses, institutions, and the therapeutic result. Conclusions: In order to improve the overall satisfaction of outpatients, the treatment method should be improved. For example, the doctor should devote more time for and engage in sufficient conversation with the patient, the nurse should be polite, and patients should be given easy-to-understand explanations.

• Journal of The Korea Institute of Healthcare Architecture
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• v.13 no.2
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• pp.53-60
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• 2007

Various changes in medical environments including growing elderly population, chronic diseases, deepening competition among hospitals since opening to foreign medical service, economic strategy for improvement of profit system have caused hospitals to be specialized. In this backgrounds, the purpose of this study is to receive basic data for architectural planning on the spatial organization of outpatient department in general hospital. The results of this study were as follows; First, major changes of outpatient department in general hospital are composed of 'co-work in medical examination and treatment', 'decentralization of diagnosis and treatment(D/T)' and 'patient-oriented medical service'. Changes by co-work system include appearance of medical offices for co-work, activation of specialized clinics, grouping of E/T section for outpatient and various types of specialized centers. Second, the grouping of E/T sections means the modification of E/T system and organization in general hospitals, and a new spatial organization will be needed. Third, the types of specialized centers are getting varied. they are classified into several types including disease-resource, social stratum-resource, human organ-resource, health-resource, rehabilitation-resource, alternative medical center and so on.

• The Journal of the Korea Contents Association
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• v.18 no.4
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• pp.516-529
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• 2018

The purpose of this study is to investigate the effect of perceived medical service quality by outpatient on hospital image, satisfaction, and re-use intention in a general hospital. A total of 176 questionnaires were administered to outpatients who presented to a S general hospital in Daejeon. The results of this study are as follows. First, medical service quality had significant effects on re-use intention, satisfaction, and hospital image. Second, the mediating effect of satisfaction on the relationship between medical service quality and re-use intention was not significant but the mediating effect of hospital image on the relationship was significant. Third, satisfaction and hospital image had significant effects on re-use intention. Consequently, this study verified the influence of perceived medical service quality by outpatient on hospital image, satisfaction, and re-use intention in a general hospital. Further, considering that hospital image, rather than satisfaction, mediates the relationship between perceived medical service quality and re-use intention, it suggests that much more general satisfaction is required in the marketing activities of hospitals.

• Health Policy and Management
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• v.21 no.3
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• pp.397-413
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• 2011

Purpose: The purpose of this study is to examine the relationship between the income level and the healthcare utilization by health insurance type in all cancer patients in year 2005. Methods: The target population was cancer patients with health insurance who used healthcare as a diagnosis code (C00-C97) from January 1 to December 31 of 2005. The Korea Central Cancer Registry Center's Cancer Patient Registry Data, the list of cancer patients of the National Health Insurance Corporation, and the claim data of the Health Insurance Review & Assessment Service were used. The I was the wealthiest, followed by II, III, IV. The V was the poorest in this study. For the analysis, the $x^2$-test, ANOVA (and Kruskal-Wallis test), and regression were used. Results: Outpatient and hospitalization medical expenses, and outpatient visit days of cancer patients with self-employed health insurance were highest in I (p<.001, respectively), and the hospitalization days were the highest in II (p<.001, respectively). Outpatient and hospitalization medical expenses, and outpatient visit and hospitalization days of cancer patients with occupational health insurance were the highest in I (p<.001, respectively). Outpatient and hospitalization medical expenses, and outpatient visit and hospitalization days in cancer patients were higher in I compared to V, and higher in II and III, IV compared to V (p<.001, respectively). Conclusion: Supporting plan for cancer patients' outpatient healthcare utilization are necessary. Moreover, we should make specialized strategy for low income cancer patients with self-employed health insurance when we develop quality improvement policy for inpatient service.

• Health Policy and Management
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• v.25 no.3
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• pp.221-228
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• 2015

Background: This study explored the relationship between hospital resources and services uses in outpatient/inpatient-based hospital service area (HSA) in Korea. Methods: Study hospitals included all acute care hospitals except tertiary hospitals. Inpatient and outpatient hospital claims from the Korean National Health Insurance (NHI) program in 2010 were used to identify the service uses. Hospital resources and the degree of insurance premium in study areas were identified with the NHI corporation data. Study variables were computed by summing the service uses or hospital resources of study hospitals in each HSA. Service uses were represented by the total medical charges and number of visits/inpatient days. Hospital resources were measured by number of beds, number of doctors, and number of computed tomography (CT). The economic status of NHI enrollees in each HSA was controlled by the average monthly premium of NHI program per household in each HSA. The degree of using local hospitals was controlled with the localization index. Results: Analysis results showed that hospital resources such as beds, CT were statistically related to the service uses. And also localization index was found to have positive significant relationships with service uses. Conclusion: Hospital resources such as beds, CT had not only positive impacts on inpatient service uses, but also influences on the outpatient setting. Health policy makers will require monitoring and assessing the hospital resources in Korea.