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.
Background: Cancer is a major public health problem both in our country and worldwide due to its disease burden, fatality and tendency for increased incidence. In Turkey, breast cancer ranks first with an incidence of 41.6% and cervical cancer is the tenth most common cancer with an incidence of 4.4%. Objectives and Design: This descriptive, cross-sectional study was conducted with 240 women aged from 15 to 65 years admitted to a gynecology-obstetrics outpatient clinic of a private hospital in Gaziantep. Study data were collected by the investigators through a 36-item questionnaire form which was generated using information gathered from similar surveys in the literature. Results: It was determined that 34.6% of women were high-school graduates, and 64.2% had a medium income level. The majority (79.2%) stated that they never performed BSE and 49.5% of them said that they did not know how to do it. Some 79.2% did not know what a Pap smear was and 73.3% had not experienced a smear test ever. Conclusions: In this study, we found that most of the women had insufficient knowledge of breast and cervical cancer, while knowledge and practices increased with the education level. Based on these findings, we suggest that there is a need for planning, implementation and assessment of health policies and healthcare services at the national and regional level and we believe that nurses working in the field of protective health services should develop educational programmes for women with a primary focus on cancer in order to increase awareness among the female population in Turkey.
Objectives: We used the Korea Health Panel Annual Data 2019 to analyze factors related to visits to both Korean medicine and Western medicine (WM) outpatient clinics among patients with overweight and obesity. Methods: The inclusion criteria for this study are as follows: 1) adults over 18 years of age, 2) overweight or obese with a body mass index of 25.0 or more, 3) visited WM outpatient clinics at least once during 2019. Total 2,963 individuals were included in WM group or integrative medicine (IM) group. Using the Andersen healthcare utilization model, factors related to healthcare utilization of the participants were classified. Binomial logistic regression analysis was used to analyze factors associated with IM use. Results: Among the participants, 80.49% (n=2,385) were assigned to WM group and 19.51% (n=578) to IM group. As a result of the regression analysis, factors significantly related to the use of IM included the elderly over 65 years of age, sex (men), college or higher education level, residential area (Gwangju/Jeolla/Jeju), presence of cancer, and presence of musculoskeletal disease. The main diagnosis associated with both WM and IM use was most frequently musculoskeletal conditions. Also, IM group received WM treatment for musculoskeletal conditions more frequently compared to WM group. Conclusions: This study is the first to analyze healthcare utilization patterns among overweight or obese patients in Korea. The current findings suggest that the presence of musculoskeletal conditions, especially in this population, may be strongly associated with concurrent use of IM services.
Although a variety of customer relationship management (CRM) activities have been provided by many hospitals in Korea, there lacks empirical evidence on the effect of CRM. The present study was conducted to examine the effect of CRM in terms of the customer response to CRM in a woman's hospital setting. A total of 380 patients receiving inpatient or outpatient care from woman's hospital between October 25 and November 4, 2005 were surveyed for the degree of their experience of and preference for CRM activities of the hospital by 5-point Likert-type scale. Patients were also asked about the level of customer loyalty to the hospital. Eighteen CRM activities offered by the hospital was classified into 4 types of CRM strategies according to Berry and Parasuranman: price, social, structural, and relationship recovery strategy. There's a significant positive correlation between the degree of experience of CRM and preference for CRM(r=0.49, p<0.001). Regression analysis results showed the significant positive relationship between the degree of experience of CRM and customer loyalty(${\beta}$=0.448, p<0.05). Among the 4 CRM strategies, only social(${\beta}$=0.127, p<0.05) and structural strategy(${\beta}$=0.266, p<0.05) showed signifiant positive relationship with customer loyalty. Overall, the favorable customer response to CRM in terms of preference for CRM and customer loyalty indicates that there's a positive effect of CRM on the continuity of the relationship between patients and health care providers.
Journal of Korean Academy of Fundamentals of Nursing
/
v.16
no.2
/
pp.232-241
/
2009
Purpose: The purpose of this study was to analyze the importance, difficulty, and frequency of work (duties and tasks) done by nurses' in Outpatient Departments (OPD). Method: Data were collected using structured questionnaires, which included 11 duties and 92 tasks making up the OPD nurse's job. Questionnaires were completed by 286 nurses. Each duty and task was analyzed for importance, difficulty, and frequency (range 1-3). Results: The mean score for importance was $2.58{\pm}0.29$, for difficulty, $2.11{\pm}0.31$, and for frequency, $2.18{\pm}0.31$. OPD nurses recognized 'patient education and consultation' as important and difficult. However, in practice OPD nurses reported the most frequent task as 'support for medical services'. There was a significant difference in importance and difficulty of duties according to OPD nurses' university degree (F=3.693, p=.026; F=4.089, p=.018) and hospital size (F=4.274, p=.006; F=3.154, p=.025). However there were no differences in importance, difficulty, or frequency according to clinical experience in OPD. Conclusion: The findings indicate that OPD nurses must be able to do important and difficult duties and tasks, especially patient education and consultation. To have time for these uniquely nursing tasks, OPD nurses need to delegate 'preparation for medical service', and 'management of facility and environment' to nonmedical health-care workers.
Korea Health Panel Survey (KHPS) has been conducted to provide nationally representative estimates of health care use and expenditures for non-institutionalized population in Korea since 2008. The aim of this study was to present estimates from KHPS on dental utilization and expenditures from 2008 to 2011. While weighted estimates were presented for each year from 2008 to 2011, the focus of this study was on the 2011 estimates and changes in dental utilization and expenditures between 2008 and 2011. Weighted estimates were obtained using population weights and statistical significances were analysed by independent t-test or ANOVA test using SPSS version 20 for Windows. In 2011, 21.1% of Korean population obtained outpatient dental services from dentists. From 2008 to 2011, the percent of people with a dental visit in each year increased slightly. In 2011, the mean number of dental visits was 4.46. While the mean number of dental visits remained stable by 2010, it increased slightly in 2011. The total annual dental expense in 2011 for people with a visit was about 460,000 Korean Won and 10% higher in 2008. In summary, this study results highlight low rates of dental utilization and high dental expenses in Korean population.
Kim, Jin-A;Lee, Moo-Sik;Hwang, Hye-Jung;Kim, Kwang-Hwan
Journal of the Korea Academia-Industrial cooperation Society
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v.17
no.7
/
pp.357-366
/
2016
This study evaluated the standardization of the outpatient management process in several regions of South Korea. The hospital workers in the administration department of the different medical institutions that are registered with the Korean Hospital Association were surveyed. These institutions can be standard hospitals or hospitals greater in size. A summary of the research results are as follows. There was no significant correlation in their registration procedures in relation to the institution's founder, number of sickbeds, number of staff employed in the administration department, and average number of outpatients per day. On the other hand, the prepayment of medical fees occurred more frequently when the number of sickbeds was larger. In addition, there was no large difference in their appointment procedures in relation to those features. Nevertheless, the prepayment of medical fees accounted for 11.8 % of the entire payment in institutions with less than five hundred beds, while fifty percent of the payment was made in advance in larger institutions with five hundred or more beds. From this research, there was only a small difference among the institutions' outpatient management, but a notable difference was observed in their electronic data processing systems and facilities. Therefore, more financial support should be generated for the implementation of a more integrated process. As a follow-up study, to provide patients with quality medical services, it will be necessary to apply the standardized procedure to an actual medical institution and analyze the expected effect.
Kim, Yang-Soo;Yu, Seung-Hum;Oh, Hyohn-Joo;Kwon, Oh-Whoong
Korea Journal of Hospital Management
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v.7
no.1
/
pp.88-104
/
2002
According to the change of mandatory referral system in July 1, 2000, the effect to the medical utilization of outpatient clinic and medical income in ophthalmology of tertiary care medical institute, S Hospital in Seoul was evaluated for 6 months before(1999. 12$\sim$2000. 5) and after(2000. 12$\sim$2001. 5). The results were as follows: 1. The number of outpatients was reduced by 16.6%. The number of patient with blindness low vision, retina, glaucoma increased and that of patient with accommodation refractive error, cataract decreased. 2. The number of cataract patients was reduced by 36.6%. The major location of patient's address was changed to nearer to the hospital. The number of cataract surgery reduced in 4.1%, the waiting time reduced in 42.2%, however surgery time increased in 20.2% and number of postoperative complications increased in 11.4%. 3. The income of outpatient clinic and cataract surgery reduced. Among items of outpatient clinic income, the most increased was ocular examination and the most reduced was injection and drugs. Among items of cataract surgery income, the most increased was operation fee and the most decreased was doctor's fee. In conclusion, for the patient, due to the lowered density of outpatient population more space was provided to the patients with more severe disease entity such as blindness' low vision, retina and glaucoma. For the hospital, the need for the expansion of ophthalmology was not found, however that for creation of the special clinics dealing with more severe disease entity was found. Due to reduced income and increased need of financial investment for the equipment and manpower for the more severe disease entity, the ophthalmology of tertiary care medical institute is faced with financial disaster. It is strongly suggested that the cost of medical practice of more severe disease entity be raised to achieve the success after change of mandatory referral system in ophthalmology.
Objectives: We used the 2019 Korea Health Panel Annual Data to analyze factors related to visits to Korean medicine (KM) outpatient clinics among patients with mood disorders in Korea. Methods: Individuals aged 19 years or older, with depressive or bipolar disorders, and with a record of using Western medicine (WM) and/or the KM medical service were included. The 266 subjects were classified into the WM group or the integrative medicine (IM) group. The Andersen healthcare utilization model was used to analyze factors that potentially influenced the subjects' healthcare utilization. Binomial logistic regression analysis was used to analyze factors influencing the use of IM medical services. Results: Among the subjects, 75.56% (n=201) were in the WM group, and 24.44% (n=65) were in the IM group. Statistically significant differences were observed in residential areas, total annual income, the presence of disability, and the level of pain/discomfort between the two groups. Regression analysis found that residential areas and pain/discomfort were factors related to the use of IM services. Specifically, reporting "a lot" of pain/discomfort compared to "no" pain/discomfort showed a significant positive relationship with the use of IM (odds ratio=4.57, 95% confidence interval=1.79 to 11.70). Conclusions: This study was the first to analyze the status of KM medical service use and related factors among patients with mood disorders in Korea. The finding that the presence of pain/discomfort was positively correlated with the use of KM services is potentially related to medically unexplained physical symptoms or somatization phenomena.
Objective : This study was intended to provide information pertaining to reasonable consumption of medical services based on comparative analysis of the characteristics of musculoskeletal diseases(MSDs) among outpatients of Korean medical institutes, and furthermore help lay groundwork for mapping out effective Korean medical policies. Method : Based on the data of 3,889 outpatients of Korean medical institutions which were obtained from the Ministry of Health and Welfare's 2011 Report on usage of Korean medicine, the analysis was carried out by using the SAS 9.2. Results : 68.2% of subjects were found to use Korean medicine(KM) for the treatment of MSDs. Patients with MSDs were older than those with nonmusculoskeletal diseases(NMSDs). And married state, education, employed state and incomes are effected on MSDs and NMSDs. Subjective health status, number of outpatient treatments, medical cost, medical treatment satisfaction, and habitue status are depend on MSDs or NMSDs. Acupuncture and physical therapy is Major treatments of subjects investigated to have the highest treatment effect. It was found that they had high degree of satisfaction with Korean medicinal outpatient treatments, and those with MSDs were found to have significantly greater satisfaction than those with NMSDs. Conclusion : Although aforesaid results suggest significant satisfaction with KM and high treatment effects for MSDs. Accordingly it is considered necessary to develop various services related to KM for treatment of MSDs and to plan for cost down of KM. Moreover, in-depth research into NMSDs is required for utilization growth of KM.
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