• Health Policy and Management
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• v.19 no.2
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• pp.21-35
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• 2009

Limited studies examined Medical Aid recipients' perception for amount of medical use. This study aimed to identify self-perception(optimal, under and overutilization) for amount, and real amount of medical use, and to determine factors associated with the perception. Subjects were 2,489 Medical Aid recipients among top 2% overusers in 2005. 200 case managers(CM) managing them conducted survey. CM interviewed them using 2005 medical claiming data from the Health Insurance Review & Assessment Service and structured questionnaire. Despite of overusers, perception of overutilization was only 26.9% and 23.6% in Class I and Class II, and that of underutilization was 21.4% and 18.7% respectively. In Class I, monthly total outpatient cost per capita of overutilization perception in 2006 was 206 thousand won higher than 150 thousand won of optimal utilization. Amounts of outpatient visit-days and prescribed cases of overutilization perception were higher than those of optimal and underutilization(p <0.0001). In Class II, overutilization perception had more prescribed cases(p 0.004). After adjustment of confounding factors including age and sex, the associated factors(odds ratio) with overutilization perception were hypertension(1.25), arthritis(1.32), depression(1.66), visit of multi medical institutions(3.09), and those of the underutilization were female(1.34), disabled(1.27), no family support(1.49), living in medium and small city(1.48), experience of unabled-visit to medical institution(2.54), frequent visit-recommendation from physician (1.36). In conclusion, education and consult are needed for subjects to improve the reasonable decision of medical use, and the self-care ability to manage diseases and symptoms. We suggest reinforcing the alternative service in community instead of costly medical institution.

• Journal of Preventive Medicine and Public Health
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• v.43 no.1
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• pp.35-41
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• 2010

Objectives: In Korea, the top 10% of Medical Aid recipients represent nearly 60% of total payment, with the costs for those disabled for over 365 days representing approximately 30% of total payment. The purpose of this study was to compare Medical Aid use of the disabled with non-disabled recipients, and to identify contributing factors to the total payment in the top 2% of recipients identified as Medical Aid overusers. Methods: Subjects (n=2,211) selected were ${\geq}18$-years-of-age and received >1000 days of co-payment-free type I Medical Aid. Case managers (n=200) conducted interviews in December 2006, and collected data from Health Insurance Review & Assessment Service. Amounts over the 9 months from January September 2006 were analyzed descriptively and using Chi-square, ANCOVA, and robust multiple linear regression. Results: Disabled individuals (mean age 61.3 years) composed 36.6% of subjects; 44.8% of the disabled were male. On a monthly basis per capita, the disabled group averaged 10.5 outpatient days, total payment of 523,000 Korean Won(￦), inpatient payment of ￦359,000, and outpatient payment of ￦183,000. All values exceeded the monthly average for non-disabled individuals. Contributing factors were identified as male gender (￦82,000), elementary school or lower educational level (￦64,000), residence in a small city (￦82,000), lack of family support (￦61,000), kidney disability (￦673,000), intellectual disability (￦151,000), and multiple disabilities (￦119,000). Conclusions: The identification of contributing factors to Medical Aid use by those defined as disabled supports the adoption of comprehensive alternative policies such as strengthening of education and consultation services, provision of alternative facilities, and promotion of self-care.

• Korean Journal of Biological Psychiatry
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• v.21 no.2
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• pp.57-64
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• 2014

Objectives The purpose of this study was to investigate the difference of brain activity between internet game overusers in adulthood and normal adults in a state of disembodiment. Methods The fMRI images were taken while the internet game overuser group (n = 14) and the control group (n = 15) were asked to perform the task composed of ball-throwing animations. The task reflected on either self-agency about ball-throwing or location of a ball. And each block was shown with either different (changing viewpoint) or same animations (fixed viewpoint). The disembodiment-related condition was the interaction between agency task and changing viewpoint. Results 1) In within-group analyses, the control group exhibited higher brain activation in the left precentral gyrus, the left inferior frontal gyrus, and the left insula. And the overuser group exhibited higher activation in the right cuneus, the left posterior middle occipital gyrus, and the left parahippocampal gyrus. 2) In between-group analyses, the control group exhibited higher activation in the right posterior superior temporal gyrus. And the overuser group exhibited higher activation in the left cuneus, and the left posterior middle occipital area. Conclusions These results show that the disembodiment-related brain activation of internet game overusers in adulthood is different from that of normal adults.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.12 no.1
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• pp.17-21
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• 2001

Aims of study : The purpose of this study is to measure the chronic and daily voice burden of the professionals in their actual working places. These will be a valuable guideline for preventing and controlling the voice production of professionals. Material and method : Our study was selected to the 10 female telephone operators in the Asan Medical Center, ages ranging from 22 to 38 years old. The symptoms and acoustic analysis of both telephone operators and the controls were evaluated before and after their working. The symptoms were evaluated with questionaires, and the acoustic analysis was measured by using CSL (computerized speech laboratory) system. Results : The symptoms of the professional voice abusers are same as those symptoms in laryngeal fatigue. The acoustic analysis before their working were significantly increased in jitter and shimmer, in comparison with the data of the control. This shows that the experimental group is exposed to the chronic burden of voice production. The jitter, shimmer, and NHR after their working are significantly increased in comparison with the data of the acoustic analysis before their working. This also shows that the experimental group is exposed to the daily burden of voice production. Conclusion : The acoustic analysis of the professional voice overusers has objectively measured that there are chronic and daily overloading to the voice of operators, and these will be a valuable data for preventing and controlling the professionals that abuse their voice.