• Health Policy and Management
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• v.28 no.4
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• pp.339-351
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• 2018

Background: The purpose of this study is to estimate empirically whether there is a difference in medical use among income groups, and if so, how much. This study applies econometric model to the most recent year of Korean Medical Panel, 2015. The model consists of outpatient service and inpatient service models. Methods: The probit model is applied to the model which indicate whether or not the medical care has been used. Two step estimation method using maximum likelihood estimation is applied to the models of outpatient visits, hospital days, and outpatient and inpatient out-of-pocket cost models, with disconnected selection problems. Results: The results show that there was the inequality favorable to the low income group in medical care use. However, after controlling basic medical needs, there were no inequities among income groups in the outpatient visit model and the model of probability of inpatient service use. However, there were inequities favorable to the upper income groups in the models of probability of outpatient service use and outpatient out-of-pocket cost and the models of the number of length of stay and inpatient out-of-pocket cost. In particular, it shows clearly how the difference in outpatient service and inpatient service utilizations by income groups when basic medical needs are controlled. Conclusion: This means that the income contributes significantly to the degree of inequality in outpatient and inpatient care services. Therefore, the existence of medical care use difference under the same medical needs among income groups is a problem in terms of equity of medical care use, so great efforts should be made to establish policies to improve equity among income groups.

• The Journal of the Korea Contents Association
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• v.13 no.5
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• pp.342-353
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• 2013

Objectives: It attempted to analyze influencing factors on the utilization of outpatient services which were adopted to predisposing, enabling, and need factors in Anderson model. Methods: The current study analyzed "2007 Korean National Health Nutrition Survey" data, which selected 3,335 people nationwide by proportional systematic sampling. This study analyzed data of persons who used outpatient services in two weeks. It adopted Anderson Model to control contextual factors including socioeconomic factors. The study compared means and fitted logistic regression models and multilevel model. Results: The logistic regression model showed that persons purchased private medical insurance were less likely to use outpatient services than the persons did not purchase private medical insurance. Persons with hypertension and diabetes mellitus, overweight, and problem drinkers were more likely to use outpatient services. Persons with high school graduates or higher in education level and experience of accidents or intoxications were more likely to use outpatient services according to the multilevel analysis of mixed model which treated region as random effect. Conclusion: Higher level of perceived stress increased the probability to use outpatient service than lower level of perceived stress. As number of days a person had exercised increased, the probability to use outpatient service decreased. Overweight and problem alcohol drinking increased the probability of outpatient service use. Further research should be conducted to find more factors influencing outpatient service use.

• Korean Journal of Social Welfare
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• v.62 no.3
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• pp.83-108
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• 2010

This study aims to estimate the trajectory of outpatient medical service use and examine what factors are associated with the trajectory among older adults 60 and over with specific focuses on age variations. Using the first three waves of the Korean Welfare Panel Study data, the trajectory and predictors were examined through the Latent Growth Curve Modeling and age variations were examined through the Multi-group Comparison Analyses. The research model was developed based on the Anderson Model. The results showed that study participants tend to increase outpatient medical service use with years. Individuals 75 or younger presented a much faster increasing rate of medical service use than those 75 and over. Similar to the findings of the previous studies, most predisposing factors, resource factors, and needs factors were found to be associated with the trajectory of outpatient medical service use. Needs factors were more closely associated with the medical service use trajectory than resource factors. With regard to age variations in predictors, few significant age variations were found. Based on the finding of the study, implications and future research directions were discussed.

• Journal of Pharmaceutical Investigation
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• v.23 no.2
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• pp.97-102
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• 1993

Hospital pharmacy services are divided into dispensing affairs for inpatients and outpatients, pharmaceutical service, stock control, intravenous admixture service, drug information service, pharmacokinetic consultation service, education and research work, etc. But among those affairs, dispensing affair for outpatient is perceived as the most important work in Korea, because it is linked directly with hospital service for patients. Therefore, total computer system for dispensing area was adopted from opening point of hospital in 1989 in Asan Medical Center. Utilization of computer system for outpatient dispensing area is as follows; 1) Order communication system of prescription by Total Hospital Information System, 2) Automatic print-out system of direction for use by sticker connected with on-line net work, 3) Use of automatic tablet counting and packaging machines connected with on-line net work. Those computer system resulted in curtailment of pharmacy manpower and shortening of waiting-time for outpatient.

• 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.

• Korean Parent-Child Health Journal
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• v.13 no.1
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• pp.35-43
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• 2010

Purpose: This study was a descriptive research to provide fundamental data in ensuring a high quality of nursing service needed by children's parent according to perception of uncertainty and care satisfaction of them between pediatric outpatient department and emergency room. Methods: For this study, 192 children's parents were questioned in a general hospital located in Busan from August 1 to 31. 2009. The collected data were scored by use of frequencies, $x^2$ test, t-test, AONVA, Pearson's correlation coefficient via SPSS/WIN 17.0. Results: With the compare of characteristics related to children's parents visiting emergency room and pediatric outpatient department, there were statistically significant difference in relation and age of parent, main caregiver, cause of arrival, and waiting time from arrival to procedure. The perception of uncertainty for parent in the emergency room showed significant difference to outpatient department. In nursing service, the highest score was category of professional skill and technic. In addition, overall parents' perceptions on providing information showed lower than any other nursing service. Last but not least, a significant correlation indicated between the perception of uncertainty and satisfaction of nursing service. Conclusion: Efforts to improve parent satisfaction for nursing service are needed to decrease their perception of uncertainty. Providing information and communication by nurses are necessary to improve quality of nursing service.

• International Journal of Quality Innovation
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• v.10 no.1
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• pp.77-87
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• 2009

The main aim of the paper is to provide an empirical analysis on patient satisfaction as an indicator of service quality in Malaysian public hospitals. Self-administered questionnaires were administered to patients by convenience sampling. Two sets of questionnaires were used, one for inpatient and another one set for outpatient. Selection of hospitals was made according to states in Peninsular Malaysia. 23 hospitals covering all state level hospitals, the National Referral Centre and selected district hospitals were chosen as respondent hospitals. Two dimensions of service quality emerged, namely clinical and physical dimension of service. Both outpatient and inpatient were found to be more satisfied with clinical dimension of service than physical dimension. For outpatient satisfaction, there was positive correlation between waiting time and patient satisfaction. Patient satisfaction was also found to be higher in the smaller district hospitals than in the larger state hospitals. For clinical dimension of service, patients were satisfied with the services of doctors and nurses, while for physical dimension of service, patients were satisfied with the cleanliness of the facilities. The ability of the research to be conducted by random sampling was inhibited by the reluctance of patients to cooperate, which led to the use of convenience sampling. Studies have also shown that patients are reluctant to express their feelings on services provided by their caregivers. The study provides primary data for a nationwide study on patient satisfaction in Malaysian public hospitals, for both inpatient and outpatient.

• Korea Journal of Hospital Management
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• v.25 no.1
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• pp.13-20
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• 2020

Purposes: This study has the purpose to the improvement of health promotion for local residents through delivery of high-quality medical service by improving imbalance of medical use and seeking an improvement plan for accessibility of effective medical service by understanding the pattern of medical use by region. Methodology: As for the method, this study derived results at the significance level of p<0.05 through chi square test(χ² test) and Generalized Estimating Equation(GEE) SAS 9.4 version by using the data of the 7th Korean Longitudinal Study of Ageing 2018. Findings: Study results show that local residents use medical service such as hospitalization care and outpatient visit more as compared to the residents in Gyeonggi-do/large or medium-sized cities. The more the number of chronic disease, the more they select hospitalization care rather than outpatient visit. Results also show that patients engaged in labour tend to select outpatient treatment rather than hospitalization treatment. Meanwhile, severity of disease turned out to be higher amongst medical care beneficiaries than that of national health insurance patients when comparing the types of medical security. Practical Implications: In stead of solving the problem of the difference in medical use by region from the aspect of income and economic level, an integrative solution shall be provided putting viewpoint on the social phenomenon suited to the changes of the times. This study suggests a plan for using a health and medical community care center that acts as a gate keeper of regional medical service.

• YAKHAK HOEJI
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• v.58 no.3
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• pp.200-207
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• 2014

This study aimed to assess the quality of outpatient antibiotic consumption in Korea compared with other countries. We used the National Health Insurance claims data for outpatient services in March, June, September, and December in 2012 and calculated nine indicator values based on the 12 European Surveillance of Antimicrobial Consumption (ESAC) drug-specific quality indicators. Indicator values in this study reflect the yearly use of antibiotic expressed in defined daily doses for 1,000 inhabitants per day (DID) and the use of main subclasses of antibiotics expressed in DID and as percentage of the total antibiotic use. Korea showed lower quality in the consumption of total antibiotics (J01), especially in the use of Cephalosporins (J01D) expressed in DID. Korea also showed low quality with regard to the use of narrow/broad spectrum antibiotics. The percentage of the use of narrow-spectrum Penicillins (J01CE) was lowest in Korea. The quality on the use of the third- and fourth-generation cephalosporin (J01(DD+DE)) was the fourth lowest among 26 countries. High rates of antibiotic resistance and payment system based on fee-for-service might have influenced on the high consumption of the broad spectrum antibiotics in Korea. It needs to further investigate the use of broad-spectrum antibiotics to identify the target of strategies promoting quality use of antibiotics in Korea.

• Korean Journal of Clinical Pharmacy
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• v.22 no.4
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• pp.291-303
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• 2012

As respiratory tract infections (RTI) account for about 60% of all antibiotic prescriptions in outpatient care setting, there are significant concerns about emerging resistance that are largely due to the excessive or inappropriate use of antibacterial agents for viral respiratory infections. This study was aimed to develop retrospective drug utilization review (DUR) program of antibiotics for RTIs using Delphi methods. Retrospective DUR criteria of antibiotics for RTIs were identified based on clinical practice guidelines and opinion of experts. Expert panel members were clinical doctors and pharmacists and Delphi method was applied by survey on 16 members of panels. The claim data from Korean Health Insurance Review & Assessment (HIRA) were used to examine trends in outpatient antibiotic prescription between Janunary to December of 2008. As results, Quality index for RTI was assessed for the claim type, antibiotics use of quantity, duration, number and cost. Antibiotic prescription rate for RTIs, Defined Daily Dose (DDD), and duration of antibiotics use were more recognized as significant quality index by experts' opinion. Use of first line agents suggested by guidelines was low and duration of antibiotics use was shorter compared to the recommendations. Antibiotics were over prescribed for RITs. However, dose and duration of antibiotics were under-used.