• Journal of Distribution Science
• /
• v.13 no.12
• /
• pp.41-52
• /
• 2015

Purpose - Given globalization, the new niche market of medical tourism is likely to experience sustainable growth for various reasons, such as aging populations and a shift in the medical consumerism paradigm toward prevention. Importantly, understanding medical customers' behavior is necessary to benefit from a competitive advantage in this industry. The existing research primarily accessed the key factors of medical quality and costs to explain health customers' behavior but is limited in terms of enabling an understanding of the decision process. This limitation exists because, given the intangibility and greater associated risks in the highly professional industry of international medical tourism, most customers lack the knowledge and experience needed to evaluate the central factors-such as the medical competence of health care countries-before purchases. Therefore, they actively search for useful information through various distributions to reduce uncertainty and to make better choices. Interestingly, most of these information channels are associated with word-of-mouth (WOM). However, no evidence is found in the literature to estimate the effect of WOM in the medical tourism field. Thus, this study focuses on WOM to explore its interaction with key medical characteristic factors and the attractiveness of destinations referred to by sources. This study also affects customers' evaluations and, in turn, influences their intention to seek health care services abroad. Research design, data, and methodology - The literature review addressed an interesting research model for estimating the relations among WOM, medical characteristics, attractiveness, and customers' choice intention regarding international health care. In the key economic regions in China, such as Beijing, Shanghai, Jiangsu, Shandong, and Guangdong, 2,500 survey questionnaires were distributed to potential customers of different ages, education, and income levels. A resulting 1,717 (68.68 percent of the original 2,500) usable surveys were obtained for analysis. Moderated regression analysis was used to determine the effects of WOM in the decision process regarding international health care destinations. Results - The results indicate that WOM is a good moderator of the relationships between the factors evaluated by sources and customers. More importantly, the WOM effects reflect the factors of tie strength, credibility, and vividness. The results also reveal that, given the moderating role of WOM, the intention of potential Chinese customers to seek the referred health care country varies according to the medical characteristics of medical competency and reputation as evaluated by customers. In contrast, the travel attractiveness of the attractions, facilities, accessibility, and social environment are critical determinants of destination choice intention. Conclusions - The moderating role of WOM has been confirmed through the international healthcare destination selection process. Medical tourism managers should user WOM as an effective marketing tool for industry development. Specially, marketers should consider the effects of WOM determinants, such as tie strength, credibility, and vividness, to develop an effective strategy. Furthermore, this study estimates the factors that affect customers' selection of medical tourism destinations. Health care managers or policy makers should consider a broad variety of variables that may attract more Chinese customers to international health care.

• The Korean Journal of Pain
• /
• v.29 no.3
• /
• pp.172-178
• /
• 2016

Background: This study was designed to assess serum vitamin D status (25-OHD) in the fibromyalgia (FM) patients and to compare it with a healthy control group. It also aimed to investigate the correlation of serum vitamin D level with FM symptom severity and invalidation experiences. Methods: A total of 74 consecutive patients with FM and 68 healthy control participants were enrolled. The eligible FM patients completed the Illness Invalidation Inventory (3*I), the Revised Fibromyalgia Impact Questionnaire (FIQR) and a short-form health survey (SF-12). Venous blood samples were drawn from all participants to evaluate serum 25-OHD levels. Mann-Whitney tests and multiple logistic regression analyses were performed and Spearman's correlations were calculated. Results: 88.4% of FM patients had low levels of serum 25-OHD. FM patients had significantly higher level of serum 25-OHD than the control group ($17.24{\pm}13.50$ and $9.91{\pm}6.47$ respectively, P = 0.0001). There were no significant correlations between serum 25-OHD levels and the clinical measures of disease impact, invalidation dimensions, and health status. Multiple logistic regression analyses revealed that an increased discounting of the disease by the patient's spouse was associated with a 4-fold increased risk for vitamin D deficiency (OR = 4.36; 95% CI, 0.95-19.87, P = 0.05). Conclusions: This study showed that although high rates of vitamin D insufficiency or deficiency were seen among FM patients and healthy non-FM participants, but it seems there was no intrinsic association between FM and vitamin D deficiency. Addressing of invalidation experience especially by the patient's spouse is important in management of FM.

• Journal of Korea Trade
• /
• v.24 no.1
• /
• pp.82-98
• /
• 2020

Purpose - This study aims to overcome the limitations of existing studies, which linearly determine the precedence factors of competency in overseas subsidiaries. The research objectives are as follows. First, what kind of nonlinear effects does the level of control held by Korean headquarters over foreign subsidiaries have in terms of competency in the subsidiaries? Second, what kind of nonlinear effects do the local experiences of overseas subsidiaries have on their competency? Design/methodology - With data on Korean multinational corporations (MNCs), this paper analyzes the effects of control levels of headquarters (HQs) and host-country experiences of foreign subsidiaries regarding competency in overseas subsidiaries. In particular, this study focuses on nonlinear models, differentiating it from previous studies. In order to examine research hypotheses, this study conducted a survey of overseas subsidiaries of Korean corporations. Surveys were conducted through various methods including e-mail, online questionnaires, fax, and telephone calls. Copies of the questionnaire were distributed to a total of 2,246 overseas subsidiaries, and 409 completed responses were collected. Excluding 15 copies that were insufficiently answered, responses from a total of 394 copies were used for analysis. Findings - This study presents the following results. First, there is a U-shaped relationship between levels of HQ control and competency in foreign subsidiaries. This means that higher levels of HQ control negatively impact the competency levels of subsidiaries because strict control undermines autonomy in subsidiaries. However, if the level of HQ control exceeds a certain point, then the transfer of knowledge between HQs and subsidiaries is facilitated. Knowledge transferred from HQs can be used as prior knowledge by foreign subsidiaries to the benefit of all parties. Accordingly, knowledge transfer negates the negative effects of excessive HQ control and positively affects competency in subsidiaries. Second, there is an inverted U-shaped relationship between the local (host-country) experiences of subsidiaries and competency in foreign subsidiaries. This means that foreign subsidiaries can overcome the liabilities of foreignness and contribute to capability building by accumulating unique knowledge about their host countries. However, if local experiences accumulate excessively beyond a certain point, then the host country-specific experiences of foreign subsidiaries will offset the benefits discussed above. Excessive local experiences not only increase organizational inertia, but also create a problem of goal incongruence due to information asymmetry between HQs and subsidiaries. Therefore, excessive local experiences have negative effects on competency in foreign subsidiaries. Originality/value - This study suggests the following implications. First, unlike existing studies based mainly on linear models, this study presents important theoretical implications in its focus on nonlinear models and its analysis of the effects of HQ control and local experiences on competency in foreign subsidiaries from perspectives of organizational learning theory and agency theory. Second, in terms of practical implications, the results of this study suggest that optimally raising levels of HQ control and managing the local experiences of subsidiaries without increasing organizational inertia is important for enhancing competency in foreign subsidiaries.

• The Journal of the Korea Contents Association
• /
• v.18 no.12
• /
• pp.208-217
• /
• 2018

The purpose of this study was to provide information on the treatment and management of diabetic patients using all the available data of the Korea National Health and Nutrition Examination Survey (KNHANES, 2013-2015) on the serological and complication patterns of cardiovascular disease (CVD) according to the duration of diabetes mellitus (DM). KNHANES consists of health questionnaires, screenings, and nutrition surveys. The study subjects were 1,316 persons who were aged between 18 and 80 years and who answered the duration of DM. DM was classified as 0-5, 6-10, 11-15, 16-20, and over 20 years according to duration of DM. The longer the duration of DM, the older the BMI, the lower the smoker, the higher the HbA1c and the lower the glomerular filtration rate. Total cholesterol, LDL-C and triglyceride levels were low and HDL-C levels were similar. The proportion of patients receiving insulin and oral hypoglycemic agents increased. The longer the duration of DM, the worse blood glucose control and the increased risk of microvascular and macrovascular complications. To prevent these complications, intensive care and monitoring should be used to control the risk factors.

• International Journal of Human Ecology
• /
• v.4 no.2
• /
• pp.27-37
• /
• 2003

Although the idea that obese people consume higher calorie diets is widely accepted, many dietary surveys have shown that obese people do NOT consume larger amounts of energy. We had an opportunity to study the relationship between calorie intake and obesity in Korea from the data contained in the '98 National Health and Nutrition Examination Survey of Korea. The survey was executed nationwide for two months - from Nov. 1 to Dec.30 in 1998. The survey included 10,876 (aged >10 years) subjects of whom 9,771 underwent health examinations. Surveyors visited each household and checked health status, measured anthropometry and blood pressures, collected blood and urine samples, and interviewed from the health questionnaires. Well-trained dietitians evaluated the food consumption of 11,525 subjects over the age of 1 year with the 24-hour recall method. The number of subjects from whom a complete health examination and food consumption information was obtained was 8,004. Subjects were classified by BMI (< 20, 20-22, 22-24, 24-26, 26-28, 28 $\leq$) and into newly diagnosed patients with DM (FBS $\geq$ 126 mg/㎗), hypertension (SBP $\geq$ 140 mmHg or DBP $\geq$ 90 mmHg) and hyperlipidemia (Total cholesterol $\geq$ 220 mg/㎗ or TG $\geq$ 200 mg/㎗). Our main results were as following：1) their average energy intake was 2,029.6 $\pm$ 908.5 ㎉ and BMI is 22.6 $\pm$ 3.4 kg/$m^2$；2) a comparison of nutrient intakes by BMI level did not show a significant difference of energy intake even though BMI increased (BMI, < 20： 1,999 ㎉ ∼ 28 $\leq$： 2,028 ㎉)；and 3) Even in newly diagnosed patients with diabetes, hypertension or hyperlipidemia, their energy consumption was not significantly increased as BMI increased (from BMI 20). There are several possible explanations for these results：1) Reduced physical activity caused the weight of obese people to increase even with the same energy intake；2) people underreported their energy consumption；or, people intentionally reduced their energy consumption due to self-image regarding their obesity. We might also hypothesize that there is a metabolic problem conceiving obese people, because calorie intake was not higher in obese people than in non-obese people in Korea. Further research is necessary for re-evaluating these current conclusions.

• The Journal of the Convergence on Culture Technology
• /
• v.4 no.1
• /
• pp.175-182
• /
• 2018

The purpose of this study was to investigate the mediating effects of job satisfaction on the relationship between intrinsic and extrinsic motivation of individual and creative behavior and to investigate the relationship between job satisfaction and creative behaviors. For this purpose, a total of 300 questionnaires were distributed to public officials working in three local governments (GGun, KGun and HGun) in Jeollanam-do, and 213 surveys (71%) were used. The results of the study are as follows. First, It was shown that intrinsic and extrinsic motivation has a positive effect on creative behavior. The effect of extrinsic motivation on creative behavior is the same as the recent research flow. Second, intrinsic motivation positively affects job satisfaction, but extrinsic motivation has no statistically significant effect on job satisfaction about intrinsic and extrinsic motivation and job satisfaction. Third, in the relationship between job satisfaction and creative behavior, it was shown that job satisfaction has a positive effect on creative behavior. Fourth, as a result of verifying the mediating effect of job satisfaction on the relationship between intrinsic and extrinsic motivation and creative behavior, intrinsic motivation has a significant influence on creative behavior through the mediation of job satisfaction. On the other hand, there was no mediating effect of job satisfaction between extrinsic motivation and creative behavior.

• Journal of the Korean Dietetic Association
• /
• v.10 no.3
• /
• pp.293-299
• /
• 2004

The purposes of this study were to : a) investigate the current status of contracted hospital food services, b) analyze and clarify various perspectives of contractors and hospitals. Thirty six hospitals and their contractors which were having more than 100 beds located in Seoul, Inchon and Kyungkido, were the subjects of this study. Data were collected through surveys. The survey was conducted during March to April in 2002. Questionnaires were mailed to the 36 directors of dietetic departments of hospitals and 36 managers of contract foodservice management company. Statistical analysis was completed using SPSS Win(11.0) for descriptive analysis, t-test and $x^2$-test. The results of the study can be summarized ; 1. The type of contract considered adequate by directors of dietetic departments and managers of contractors was fee-contract, combined type, followed by profit-and-loss contract. 2. According to the results from analysis on the contract cost per meal considered adequate by directors of dietetic departments and managers, the directors of dietetic department indicated that showing no difference with the current contract cost per meal. However, the managers of contractor indicated that showing significant differences compared with the current contract cost per meal(regular diet p<0.01, therapeutic diet p<0.001). 3. In the composition of contract cost per meal considered adequate, the managers of contracting businesses accounted labor cost (p<0.01) as a major cost, whereas the chiefs of nutrition departments accounted miscellaneous or controllable expense (p<0.001) and VAT (p<0.01) as major costs. 4. The directors of dietetic departments and managers thought that the hospital should be responsible for utility costs. On the other hand, directors of dietetic departments regarded that the contractor and managers thought that the hospital should pay for facility investment cost.

• Journal of Service Research and Studies
• /
• v.9 no.4
• /
• pp.97-114
• /
• 2019

The relationship quality and recovery of service failures perceived by consumers play an essential role in affecting the service provider's image and sales in terms of the highly involved service industry. In particular, implementation of successful relationship marketing strategies and effective recovery of service failures provide greater satisfaction for customers expecting customized services and reinforce the relationships between the companies and consumers. Based on these previous studies, this research conducted to find out the causal relationship between the variables influencing service recovery expectations and word of mouth(WOM) by approaching the severity of service failures from the perspective of relationship marketing and attribution theory. For the empirical analysis of this research, we conducted a questionnaire surveys of 360 service users of beauty salons, who have experienced in high-involvement services, and utilized 333 questionnaires for the final analysis. The hypothesis was experimented using the Structural Equation Model(SEM), and the results are as follows. First, we identified that the higher the customer perceived the severity of the service failure, the lower the quality of the relationship. Second, we verified that service users observed service failure as a temporary and uncontrollable factor as they distinguished service quality as higher. Third, the hypothesis that customers recognize service failures as a temporary one has a positive impact on service recovery expectation level is determined through empirical analysis. Forth, it was figured out that the higher the perceived quality of the relationship with the service provider, the higher the service recovery level expected by the consumers. At the same time, the hypothesis that optimism for service recovery expectation affects positive word of mouth has been verified. The results of this study help develop the customer-oriented business model of the service companies. Furthermore, the academic significance in that it suggested a new direction for the research of high-involvement service marketing.

• Journal of Korean Medicine Rehabilitation
• /
• v.30 no.2
• /
• pp.139-152
• /
• 2020

Objectives To explore the traffic injury patients' experience on health care utilization of Korean Medicine (KM) practice and perception of health care system for developing a Korean medicine clinical practice guideline (CPG) of traffic injuries by survey method. Methods Two hundred ten patients in suffering from traffic injuries were surveyed from September 1st, 2019 to January 31th, 2020 at 2 University Hospitals (Pusan National Korean Medicine Hospital and Kyung Hee Korean Medicine Hospital at Gangdong) and 1 Spine Specialty Hospital (Jaseng Hospital of Korean Medicine). A structured questionnaire of experience on health care utilization of KM practice and perception of health care system of was distributed to responders by visits and all data were statistically analysed. Results Survey results showed high satisfaction of patients with the experience of KM treatments in order of daoyin exercise (7.8±2.3), chuna manual therapy (7.7±4.0), pharmacoacupuncture (7.4±3.0) etc. Safety concerns were reported in 9.1% subjects and 205 (97.6%) patients answered that collaboration with KM and western medicine is necessary for patients with traffic injuries. For the patients' requirement for extending insurance coverage, the most required therapy was chuna manual therapy (57.5%) and pharmacoacupuncture (42.0%). Conclusions This study presented the realistic patient-centered perception of KM practice and health care system in Korea. These results will provide basic data to be reflected in the process of adaptation for the revision of Korean Medicine CPG for traffic injuries.

• Pediatric Infection and Vaccine
• /
• v.25 no.1
• /
• pp.17-25
• /
• 2018

Purpose: Blood culture is an essential diagnostic tool and requires clear indications, proper techniques, and quality control. We aimed to investigate whether blood cultures in children are appropriate for indications, are performed correctly, and receive proper quality control. Methods: We conducted an online survey targeting pediatric infectious diseases (ID) specialists working in general hospitals and neonatologists (Neo) working at hospitals operating a neonatal intensive care unit in Korea. Results: Approximately 81.1% (30/37) of pediatric ID specialists and 72.2% (52/72) of Neo responded to the survey. Some of the respondents (33.3% of ID and 59.6% of Neo) performed blood culture as a regular test irrespective of the indication. Approximately 40% of ID and 65.4% of Neo ordered only one set of blood culture in patients suspected with bacteremia. The most commonly used disinfectant for skin preparation was povidone-iodine, while the skin preparation method varied by institution. Approximately two-thirds of the institutions were monitoring the blood culture contamination rate, whereas relatively few provided staff with feedback on that rate. In addition, less than half of the institutions were providing regular staff training on blood culture (40% of ID and 28.8% of Neo). Conclusions: The indication and methods of blood culture for children varied according to institution, and few hospitals exert effort in improving the quality of blood culture. Institutions have to strive constantly toward improvement of blood culture quality and evidence-based recommendations for pediatric blood cultures should be standardized.