• Health Policy and Management
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• v.17 no.3
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• pp.26-49
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• 2007

The purpose of this study is to analyze the equity of health care utilization by income groups in terms of both quantity and quality of care, which is measured by expenditure, type of care, and type of health care institutions. Equity in health care utilization is measured by HIwv index, based on the survey of 1,480 Gwangju-Jeonnam residents. Health care utilization in terms of the probability and quantity of outpatient and inpatient care show equitable or pro-poor inequitable distribution, whereas the distribution of health care expenditure, which can account for the quality of care, is pro-rich inequitable, implying that the better off tend to use more expensive medical care. In terms of the types of care, simple visits for basic care show equitable distribution, whereas the distribution of the utilization of traditional tonic medicine, comprehensive health examination, CT, MRI, and ultrasound is pro-rich inequitable. Utilization of general hospitals and traditional health institutions show pro-rich inequitable distribution, hospitals and dental care institutions equitable, and physician clinics and public health centers pro-poor inequitable.

• Research in Community and Public Health Nursing
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• v.26 no.3
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• pp.278-291
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• 2015

Purpose: This study was conducted to examine differences in health care utilization and related costs between before and after the introduction of the designated doctor system, and to find out factors making the differences. Methods: Data were collected from 200 medical aid beneficiaries having one or more chronic diseases, registered in the designated doctor system during the year of 2012, and the relationship between the use of health services and claimed medical expenses was analyzed through paired t-test and multiple regression analysis using the SPSS 18.0 program. Results: There was a decrease in the number of total benefit days and the number of outpatient and medication days, but some cases showed an increase after the designation of medical institution. In general, hospital stay increased after the introduction of the system. However, the number of medical institutions utilized was reduced in most cases after designation. Conversely, medical expenses increased in most cases after the designation of medical institution. Conclusion: These results suggest that a detailed scheme to designate medical institutions should be made in consideration of the seriousness of illness and classification of medical institutions not only for the beneficiaries' enhanced health but for the effective management of medical aid fund.

• The Journal of the Korea Contents Association
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• v.11 no.5
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• pp.270-279
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• 2011

This study to analyze differences of cancer patient's health utilizations in medical aid program and national health insurance by analysing health insurance claims data, and identify effects of health care systems. The majors results of the research were as follows. First, cancer patients in medical aid program more used total medical expenditures than in national health insurance mostly by many outpatient visits and long term hospitalization. Second, results of multiple regression, cancer patients in medical aid program more used total expenditures and inpatient expenditures. But, outpatient expenditures weren't different, cancer patients in medical aid program more visited medical institutions and hospitalized long term periods than in national health insurance. Therefore, it is too early to conclude that moral hazard is in health utilizations of medical aid program, because cancer patients in medical aid program many use in benefits for many nonbenefit burdens.

• Journal of The Korea Institute of Healthcare Architecture
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• v.22 no.4
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• pp.7-17
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• 2016

Purpose: As our population ages and becomes an elderly society the number of elderly care hospitals is rapidly increasing. Because physical functions and spatial perception in the elderly decrease with age, these hospitals require more systematic and intelligent space designs. The design of these spaces are even more complex because they must accommodate medical programs to treat various different diseases and ailments and also because there are many first time patients and irregular short term patients that seek out outpatient treatment services. Also by analyzing the spatial configuration systems and systematic relationships between each of the functional spaces of the outpatient treatment service departments for hospitals specialized in care for the elderly by focusing on the hallway and corridor systems of these hospitals, the according characteristics and trends were examined. Methods: Based on preceding research, the types of hallway and corridor systems of these hospitals were categorized into five types, including gallery corridors, middle corridors, hall-type, mixed type and cyclic type corridors, and into six types according to function including by medical diagnosis, patient registration, examination, administration and convenience and shared common space to derive any interconnecting relationships between the corridor systems. Also by comprehensively examining the types and combined utilization of the corridor types and the integration and the intelligibility of the space syntax, any trends within the corridor system were derived. The elderly care hospitals examined in this research study were twelve hospitals that opened after the year 2000 in Korea with more that 150 sick beds with areas larger than $1000m^2$ and with all outpatient medical service related rooms located entirely on a single floor of the hospital. Results: The following results could be confirmed based on this research study. 1) The spaces where medical diagnosis and examination occurred were adjacent, and the movement lines for first time patients and re-visiting patients were taken into consideration by separating the treatment space. 2) This research study confirmed that the larger the size of the hospital was, there were more detailed categorizations of treatment services and that there was a tendency for treatment areas to be separated and independent from examination areas. 3) There was a tendency for integration and intelligibility to decrease the more complex and diverse the combination of hall types designed into the corridor systems of these hospitals was. cyclic type corridors dramatically decreased the intelligibility of the corridor systems of these hospitals. 4) The priority rank of these spaces were confirmed to be highest in the order of registration, diagnosis, examination, treatment, administration and shared common spaces. However it was confirmed for the local integration that the diagnosis scope had the highest priority rank. Implications: There were exceptional cases confirmed where the number of unit spaces did not have an absolute effect on integration and intelligibility. These results can be interpreted to mean that this can be overcome through efficient architectural planning.

• Korea Journal of Hospital Management
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• v.7 no.1
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• pp.88-104
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• 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.

• Korea Journal of Hospital Management
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• v.10 no.2
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• pp.26-44
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• 2005

The purpose of this study was to investigate these major factors on patient satisfaction, and to examine the affecting level of major factors in. The subjects in this study was 70 hospitals that were surveyed the hospital evaluation program containing the survey of patient satisfaction by KHIDI(Korea Health Industry Development Institute) from 1997 to 1999. The collected data was analysed SPSS for Windows(Ver 10.0). On basically, frequency analysis, t-test, and ANOVA was performed and, for more analysis, correlation analysis, factor analysis, multiple regression analysis, logistic regression analysis was utilized. According to this study, the major factors of inpatient satisfaction are divided 3 types facility factor, manpower factor, and service factor. And the major factors of outpatient satisfaction are analyzed 5 types; facility factor related direct medical service, facility factor related indirect medical services, manpower factor, pharmacy factor, and facility factor related utilization convenience. The importance of this study lies in the identification of major factors on hospital patient satisfaction.

• Industrial Engineering and Management Systems
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• v.13 no.2
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• pp.193-202
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• 2014

Patients' satisfaction while receiving medical service is affected by whether or not their preferences can be met, including time and physician preference. Due to scarcity of medical resource in China, efficient use of available resources is urgently required. To guarantee the utilization ratio, the scheduling decisions are made after all booking information is received. Two integer models with different objectives are formulated separately, maximizing the degree of satisfaction and revenue. The optimal value of the two models can be considered as the bound of corresponding objectives. However, it is improper to implement any of the extreme policies. Because revenue is a key element to keep the hospital running and satisfaction degree is related to the hospital's reputation, neither the revenue nor the satisfaction can be missed. Therefore, hospitals should make a balance. An integrated model is developed to find out the tradeoff between the two objectives. The whole degree of mismatching that is related to patient satisfaction and other separate mismatching degree are considered. Through a computational study, it is concluded that based on the proposed model hospitals can make their decisions according to service requirement.

• Journal of Society of Preventive Korean Medicine
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• v.14 no.2
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• pp.43-56
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• 2010

Objectives : This study aimed to investigate the attitude of healthcare consumers toward the East-West Collaborative Medical Practices(hereafter EWCMP). Method : The participants were 245 healthcare consumers who visited outpatient clinic of an university hospital, and attended at an emergency rescue educational program held by an emergency medical center, Busan. Data were collected by interviewing or self-reporting with questionnaires and analyzed with descriptive statistics and $X^2$ test with SPSS win 14.0. Results : 53.1 percent of 245 participants has heard, 13.9 percent has ever used, and 82.4 percent wanted to use EWCMP in the future. For participants who has used EWCMP, the decision to use it was made by themselves(58.8%), 26.5% of them was satisfied with EWCMP, and 79.4% showed the intention to introduce EWCMP to others. The use of EWCMP was significantly different by gender($X^2$=4.702, p=0.030) and having job or not($X^2$=14.305, p<0.001). Preferred type of EWCMP was to use both medical and Korean medical treatment at the same time(42.4%). Musculoskeletal disease(51.0%) and circulatory disease(51.0%) were expected to be the most effective when the EWCMP applied to them. Utilization of EWCMP was expected to be effective in disease treatment(88.2%), diagnosis(83.3%), and prevention(75.1%), and to increase medical cost(66.1%). Intention to use of EWCMP was not significantly different by demographic characteristics. Conclusion : Considering low proportion of utilization of and positive attitude toward the EWCMP among general populations, it is needed to introduce or advertise EWCMP to them.

• The Journal of the Korea Contents Association
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• v.10 no.4
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• pp.247-256
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• 2010

This study, using questionnaires to target Servicemen were investigating. Study period of 2009 October to 24 was 20 days. All 600 questionnaires distributed affair, but 565 cases were collected. The purpose of the this study was serviceman investigate the actual conditions of utilization of private hospitals and awareness for the level of military hospital medical service as well as to the selection of future for the private hospitals is to finding. Results of the study are as follows: Outpatient utilization rate of each other the military hospital and private hospitals was 60.7% and 18.9%.(p<.000) The results of frequency study of the factors which affect the private hospital is satisfaction of medical workforce(58.9%), medical equipment and facilities(49.6%), etc. The choice of hospital were inpatient and outpatient both the selected by private hospitals. Had to prefer a private hospital were statistically significant (p<.005). In conclusion, to increase the preference of the military hospital is level of private hospital health care level of should be to developed. More support to financial should provide for medical workforce and setting of cutting edge medical equipment in the military hospital. Military hospital is should be competition with private hospital. Also should be improve the quality of military medical service.

• Journal of Preventive Medicine and Public Health
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• v.28 no.1 s.49
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• pp.207-223
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• 1995

A new medical delivery system which regulated outpatient department(OPD) use from tertiary care hospitals was adopted in 1989. Under the new system, patients using tertiary care hospital OPD without referral slip from clinics or hospitals could not get any insurance benefit for the services received from the tertiary care hospital. This study was conducted to evaluate the Patient Referral System(PRS) with respect to health care expenditures and utilization. Two data sets were used in this study. One was monthly data set(from January 1986 to December 1992) from the Annual Report of Korea Medical Insurance Corporation(KMIC). The other was monthly joint data set composed of personal data of which 10% were selected randomly with their utilization data of KMIC from January 1988 to December 1992. The data were analyzed by time-series intervention model of SAS-ETS. The results of this study were as follows: 1. There was no statistically significant changes in per capita expenditures following PRS. 2. Utilization episodes per capita was increased statistically significantly after implementation of PRS. The use of clinics and hospitals increased significantly, whereas in tertiary care hospitals the use decreased significantly immediately after implementation of PRS and increased afterwards. 3. Follow-up visits per episode were decreased statistically significantly after implementation of PRS. The decrease of follow-up visits per episode were remarkable in clinics and hospitals, whereas in tertiary care hospitals it was increased significantly after implementation of PRS. 4. There was no statistically significant changes in prescribing days per episode following PRS. Futhermore, clinics and hospitals showed a statistically significant decrease in prescribing days per episode, whereas in tertiary care hospital it showed statistically significant increase after implementation of PRS. 5. Except high income class, the use of tertiary care hospitals showed statistically significant decrease after implementation of PRS. The degree of decrease in the use of tertiary care hospitals was inversely proportional to income. These results suggest that the PRS policy was not efficient because per capita expenditures did not decrease, and was not effective because utilization episodes per capita, follow-up visits per episode. and prescribing days per episode were not predictable and failed to show proper utilization. It was somewhat positive that utilization episodes per capita were decreased temporarily in tertiary care hospitals. And PRS policy was not appropriate because utilization episodes per capita was different among income groups. In conclusion, the PRS should be revised for initial goal attainment of cost containment and proper health care utilization.