• 보건행정학회지
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• 제3권2호
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• pp.27-80
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• 1993

It is widely known that patients' utilization pattern for medical care facilities and the patientflow are influenced by multi-factors, such as demographic characteristics, structural characteristics of society, socio-psychological characteristics(value, attitude, norms, culture, health behavior, etc.), economic characteristics(income, medical price, relative price, physician induced demand, etc.), geographical accessibility, systematic characteristics(health care delivery system, payment methods for physician fees, form of health care security, etc.), and characteristics of medical facilities(reliability, quality of medical care, convenience, kindness, tec.). This study was conducted to research the mechanism of patient-flow according to changes of health care system(implementation of national health insurance, health care referral system and regionalization of health care utilization, etc.) and characteristics of medical facilities(ownership of hospital, characteristics of medical services, non-medical characteristics, etc.). In this study, the fact could be ascertained that the patient-flow had been influenced by changes of health care system and characteristics of medical facilities.

• Journal of Preventive Medicine and Public Health
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• 제7권1호
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• pp.163-173
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• 1974

A study on the health care of Ewha Womans University staff, faculty and families was conducted during the period from March 1973 to August 1974 using designed questionaire. A total of 196 persons who were randomly sampled as 27.3% of the total staff and faculty 789 were studied. The response rates were 96.0%. The results and findings obtained from the study are summerized as follow. 1. The sex ratio of the members the faculty and the staff shows 83.2% and the singles are 37.2% of the total. Their mean family size being 4.6 persons per capita, each family has mean number of 2.3 childeren. 2. The median monthly income of a member of faculty amounts \114,000 and that of a staff \43,077. It amounts \79,333 when the median monthly income of both the members of the faculty and the staff are taken. Consequently, it amounts \91,727\ per family (Assumed mean). 3. 71.4% of the total hold the house of their own. A spouses of 59.4% of them are working for the additional income of the family. 4. Their health condition is rated fair, i. e. 92.3% of them enjoy good health. Out of total members faculty and the staff, 20.6% are cared by family physician. 36.2% of them feel that they are burdened by heavy medical expense. 5. 76.7% of them have affirmatively responded that they would purchase medical insurance policy when they were offered. It reaches 84.0% of the total who consider buying the policy for their dependents. 74.0% of them desire to purchase the policy for their spouse's parents. 6. The monthly prevalence rate reaches 17.0% and the hospital admission rate 4.7%.12.3% of them affirmatively responded that they had chronic diseas. The number of sick call per capita counts 0.2 per month and the hospital admission rate 0.05. 7. To examine the nature of their disease, the respiratory disease is rated to be the top and the gastro-intestinal disease comes to the next. As far as chronic disease is concerned, the gastro-intestinal disease is predominent. 8. As to their treatment, 65.4% of them get the physician's treatment and 17.0% treatment of drug purchasing and 7.7% prefer Chinesedrug. 6.6% of them gets no medical treatment at all. 9. The treatment ratio, including drug purchasing and other means, reaches 93.4%. 60.7% of them affirmatively responded that they did not or could not get physician's treatment at least once even though they thought they had to. It is disclosed that 25.4% of them are caused by economical reason. 10. Average medical expense per case amounts \7,116 and monthly medical expense per capita \1,345. Consequently, average monthly medical expense per family amounts \6,185. 11. The medical expense of a family is rated 7.7% of total earnings of the same period.

• Journal of Preventive Medicine and Public Health
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• 제46권5호
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• pp.237-248
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• 2013

Objectives: The purpose of this study is to examine and explain the extent of income-related inequity in health care utilization and expenditures to compare the extent in 2005 and 2010 in Korea. Methods: We employed the concentration indices and the horizontal inequity index proposed by Wagstaff and van Doorslaer based on one- and two-part models. This study was conducted using data from the 2005 and 2010 Korean National Health and Nutrition Examination Survey. We examined health care utilization and expenditures for different types of health care providers, including health centers, physician clinics, hospitals, general hospitals, dental care, and licensed traditional medical practitioners. Results: The results show the equitable distribution of overall health care utilization with pro-poor tendencies and modest pro-rich inequity in the amount of medical expenditures in 2010. For the decomposition analysis, non-need variables such as income, education, private insurance, and occupational status have contributed considerably to pro-rich inequality in health care over the period between 2005 and 2010. Conclusions: We found that health care utilization in Korea in 2010 was fairly equitable, but the poor still have some barriers to accessing primary care and continuing to receive medical care.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 1998년도 제50차 추계 학술대회 연제집
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• pp.34-35
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• 1998

• Safety and Health at Work
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• 제10권4호
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• pp.504-511
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• 2019

Objectives: We evaluated the physical and mental health problems of waged workers in Korea who had different classes of occupation. Methods: We used data from the Korean National Health and Nutrition Examination Survey (2007-2017) to examine 22,788 workers who were waged employees and categorized these workers into 5 occupational classes. Results: "Unskilled manual workers" were more likely to be older, less educated, have lower monthly income, and work fewer hours per week. Among men and relative to "managers and professionals" (reference group), "skilled manual workers" were more likely to have physician-diagnosed osteoarthritis, "clerks" were less likely to report suicidal ideation, and "unskilled manual workers" were more likely to report suicidal ideation. Among women and relative to "managers and professionals" (reference group), "service and sales workers" and "unskilled manual workers" were more likely to report physician-diagnosed osteoarthritis, depressive feelings, and suicidal ideation. However, hypertension, hyperlipidemia, diabetes, and cardiovascular diseases did not differ among the occupational classes for men and women. Conclusion: We identified differences between men and women and among those in different occupational classes regarding employment status, physical health, and mental health. "Unskilled manual workers" of both genders were more likely to be older, less educated, have less monthly income, work fewer hours per week, and have suicidal ideation. Female "service and sales workers" were more likely to have osteoarthritis, depressive feelings, and suicidal ideation.

• 한국한의학연구원논문집
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• 제18권2호
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• pp.65-89
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• 2012

Objective : In order to investigate and improve public Korean medical health service satisfaction level, this study was designed. Method : A questionnaire has been conducted on 212 patients who received treatments at six public health centers in the northern part of Gyeongbuk during 15 days between Sep. 24 and Oct. 8, 2011. Result : 1. An Investigation on the usage of herbal clinics in public health centers reveals that 63.7% have received three times or more medical treatments previously and 61.8% have had their illness treated at other medical institutions. In regard to illness 32.1% have had arthritis or muscle aches. 50.9% have taken insurance medication after having had treatments at the public health centers. 66% have assessed acupuncture and moxa cautery the most satisfying. 2. To a question regarding whether herbal health treatment costs higher than that of physician's, the highest response at 31.6% is 'No'. And to a question regarding whether herbal medicines administered at public health centers have more side effects than that of physician's, the highest response at 39.6% is 'No'. 3. To a question regarding whether herbal treatment of public health centers has little effect against acute disease, 48.1% of responses are 'Fair'. To a question regarding whether herbal treatments, when compared with physician's treatments, boost better recovery of patients, 48.1% of responses are 'Fair'. To a question regarding whether herbal medicine is unscientific, when compared with that of western medicine, 38.2% of responses are 'Fair', To a question regarding whether herbal medicine has faster effect on disease than western medicine, 41.0% of responses are 'Fair'. To a question regarding whether herbal medicine is more effective on disease prevention and promotion of health than disease treatment, 38.2% of responses are 'Fair'. And to a question regarding whether the lack of various types of physical therapy devices in herbal medicine, when compared with western medicine causes inconvenience in herbal treatment, 42.0% of responses are 'Fair'. Those responses take up highest portion at each questionnaire. 4. A comparative study between herbal treatments and physician's treatments has also been conducted. To questions regarding which one of the two considering types of disease is the better, responses are the latter accounted for 43.9% against 'Cancer', the latter accounted for 45.3% against 'Endocrine disorders', the former accounted for 30.7% against 'Psychiatric disorders', the latter accounted for 38.2% gainst 'Otolaryngological(ENT) disease', the former accounted for 47.6% against 'Post traumatic stress disorder', and the former accounted for 52.4% against 'Muscle-skeletal disease'. 5. An investigation on frequency of patients' visits via (p<0.05) of subjects show a statistically significant difference. 6. First, an investigation on frequency of reasons of medical treatments reveal that age, occupation, monthly income, and insurance type (p<0.05) of subjects show a statistically significant difference. Secondly, an investigation on frequency of subjects taking insurance medicines after herbal health treatments reveal that monthly income (p<0.05) of subject shows a statistically significant difference. 7. First, an investigation on frequency of a claim that herbal treatments of public health center does not have great effect on acute disease reveals that age, education, and insurance type (p<0.05) of subjects show a statistically significant difference. Secondly, an investigation on frequency of analysis that herbal treatments has faster effect on disease compared with western treatments reveals that education level, religion, monthly income, and insurance type (p<0.05) of subjects show a statistically significant difference. 8. When herbal clinics of public health centers and general herbal medicine institutions are compared, a survey on additional treatments that herbal clinics need the most reveals that education level, monthly income, and insurance type (p<0.05) of subjects show a statistically significant difference. Secondly, an investigation on frequency of subjects who want various forms of herbal medicines reveals that occupation and insurance type (p<0.05) of subjects show a statistically significant difference. Conclusion : In order to improve efficiency of treatments and enhance patient's satisfaction level, this study suggests measures such as providing a differentiated acupuncture treatments as a whole, streamlining an reception procedure, adopting more elaborated computer system for a patient to get proper medical attention, standardizing a treatment duration in order for a maximum result, keeping regular office hours, and optimizing a consultation time for a patient.

• Journal of Preventive Medicine and Public Health
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• 제31권3호
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• pp.460-470
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• 1998

By expanding health insurance, customers will carry a smaller burden of medical costs. As a result, the number of visits to a physician increase and this result in the improvement of medical accessibility. But medical care utilization may be changed not only by insurance status but also by socio-demographic factor, economic status and other factors. The question thus remains, at which level of accessibility and what price of medical care service in health insurance will the customer and the medical care service be satisfied. The price of medical care service ls comprised of the customer's out-of-pocket money and the costs not covered by health insurance. If the price of medical care services in health insurance are appropriate, medical care utilization should not differ because of the difference in income status or the acuteness of illness. But If the price is not adequate, low income groups will receive relatively low medical care utilization, particularly in the case of chronic disease. The purpose of this study is to evaluate the differences in medical care utilization among the various income groups and those with varying acuteness of illness. The major hypotheses to test in this study are : (i) whether there are differences in medical care utilization among different income groups exist, (ii) whether differences in medical care utilization among different income groups exist with the hospital type. (iii) whether differences in medical care utilization among different income groups exist with the acuteness of illness and with age. The data was collected from the JongRo District Health Insurance Society in Seoul. A total of 118,336 persons were selected as the final sample for this study. The major findings of this study were as follows; 1. The volume of ambulatory utilization among users was statistically significant by income level. 2. Among different income groups, the volume of ambulatory utilization was statistically significant by the acuteness of illness. 3. Higher income groups with chronic diseases had a greater volume of ambulatory utilization than other groups.

• 보건행정학회지
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• 제24권1호
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• pp.92-99
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• 2014

Background: Korea's primary care clinics are seeking increase in consultation fees by expanding supply within the frame of the health insurance system, but inequality of physician income between regions and individuals is exacerbating. The purpose of this study lies in analyzing the distribution of patients of primary care clinics, their specialized field, and the degree of inequality between medical fee income according to region. Data was acquired from the Health Insurance Review and Assessment Service on charged bills made by clinic-size medical institutions from 2008 to 2011. Methods: By comparing the outpatient number per clinic according to the clinic's specialized field, results showed that ophthalmology, otolaryngology, dermatology, orthopedics, and internal medicine showed high numbers whereas plastic surgery, neuropsychiatry, cardiothoracic surgery had fewer outpatients. The number of outpatients for clinic according to region showed Chuncheonnam-do, Jeju-do, Gangwon-do, Chungcheongbuk-do, Ulsan to have higher numbers of outpatients. For those four years, clinics in the Seoul area had a rather lower number. Results: As a result of comparing the decile hierarchy distribution ratio between specialized fields according to primary care clinics income from National Health Insurance, the inequality degree showed that obstetrics and gynecology and general medicine were each 0.130, 0.280 for the decile distribution ratio, which was the highest degree of inequality within the specialized field. Their Gini coefficient were also relatively high at 0.691, 0.528 respectively. On the other hand, the decile distribution ratio for otolaryngology and orthopedics were 0.510, 0.468, respectively, while their Gini coefficient each at 0.318, 0.314 makes their inequality degree relatively lower than other fields. Conclusion: This study is limited in that the data used was the health insurance charges submitted by clinics, which does not provide total information of the doctors' income. However, because most clinics are largely dependant on their income to come from health insurance reimbursements. Therefore, the results of this study can be used effectively. In the future, research that includes data on non-covered service income should be conducted to closely examine policy plans with a new medical fee policy which can resolve the medical fee income inequality issue between clinics as well as revitalize primary medical care.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제32권4호
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• pp.334-347
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• 2006

The aim of this study is to evaluate the reasonableness of the medical fee on oral and maxillofacial surgery field according to surgeon's opinions and actual conditions. The medical fee has significant influence on hospital income, the supply and distribution of medical manpower, quality and facilities of medical services. Questionnaire survey was sent to 86 oral and maxillofacial surgeons who worked more than 3 years in general hospital. Among them, 25 doctors replied the 109 answers survey and the average of treatment time and physician work relative value on each category was calculated. And the health insurance cost (that has been applied since 2003) was compared with the questionnaire results. And finally we investigated items that health insurance system did not include in oral and maxillofacial field but actually performed in oral and maxillofacial surgery clinic. The result was that the medical fee did not properly reflect physician work relative value of actual treatments. In case of complicated extraction, work relative value needed 3.5 times enhancement of present value. For simple impacted tooth extraction 1.8 times, for impacted tooth extraction including odontomy 1.7 times, and for fully impacted tooth more than 2/3 of it located into the alveolar bone, 1.8 times enhancement needed. In respect of the present physician work relative value, hemimandibulectomy with neck lymph node dissection for the malignancy is appropriated as 3.3 times of open reduction and internal fixation for the mandibular fracture, but the questionnaire result showed 25 times discrepancy. In conclusion, this research shows the need for intervention that health insurance included items and legal relative medical value must act in union with treatment in clinic to reduce the imbalance between them.

• 한국산학기술학회논문지
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• 제4권2호
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• pp.102-107
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• 2003

지난 50년 이상 무기장사업자에 적용해 온 표준소득률제도가 금년 소득세 신고시부터 기준경비율제로 변화된다. 병의원간의 의료전달체계가 제자리를 잡지 못하고 전문의들이 경제적 이유 등 여러 가지 이유로 개원 시를 이루고 있는 현재 의료계 상황에서 기준경비율 제도의 도입은 과거와 같이 무원칙, 무계획적인 지출을 더 이상 수용하지 않는다. 따라서 비용으로 공제받을 수 있는 증빙을 잘 준비하는 세무계획이 필연적으로 요구된다 본 연구에서는 새로 시행되는 기준경비율 제도의 취지, 내용, 효과, 보완점 등을 알아보고 이 제도 하에서 적격 증빙의 수취 등 합리적인 세무관리를 알아보았다. 비록 기준경비율제도가 수입 측면에서의 투명성을 확보하는데는 한계가 있으나 비용지출 측면에서 진일보한 정책이며 이 제도가 성공적으로 시행 발전되는 경우 전문가 그룹의 자의적인 세무신고는 어느 정도 줄어들 것으로 판단된다. 나아가 비급여 진료행위가 많은 진료과들의 수입을 보다 투명하게 밝힐 수 있는 제도의 보완이 이루어질 것으로 예상되므로 의원 경영과 관련된 작은 지출에 대해서도 본 연구에서 제시된 것과 갊은 증빙을 갖추도록 노력해야 할 것이다.