• Health Policy and Management
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• v.26 no.4
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• pp.315-324
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• 2016

Underserved area is a region that has a lack of healthcare resources. In the context of Korea, however, there are not enough detailed criteria for underserved areas. In this study, we aimed to develop indicators for underserved area through Delphi technique. We systematically reviewed the existing measure of underserved area. Sixty indicators were extracted as candidates across four domains in secondary medical care. Four domains are demand, medical resource, quality of care, and health outcome. To develop indicator, two round Delphi survey was conducted among 15 professional experts such as professionals and public administrators. In conclusion, 2 final indicators (accessibility, medical utilization) was determined as an appropriate measure in order to designate underserved area for secondary medical services. Using our criteria from Delphi technique, 36 areas were found as underserved areas for the secondary medical care.

• Journal of agricultural medicine and community health
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• v.37 no.2
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• pp.76-83
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• 2012

Objectives: The purpose of this study was to define the underserved emergency medical services (EMS) areas in Daejeon metropolitan city, as well as to identify their distinctive characteristics in public health perspectives. Methods: An underserved EMS area was operationally defined as an area in which it is difficult to arrive at an emergency medical center within 30 minutes. Using a cost-weighted distance algorithm with a geographic information system (GIS), the underserved EMS area was calculated. The characteristics of the underserved areas were analyzed by the Chi-square test. The SPSS statistical software package was used to perform the statistical analysis. All statistical tests were two-sided, and a p-value<0.05 was considered statistically significant. Results: Twelve administrative sectors ('Dong' in Korean) were included in the underserved areas, accounting for a population of approximately 8,100 citizens. The relationships between underserved EMS area and populations of agriculture, fishery, and forestry; citizens who are recipients of national basic livelihood security program; disabled; or aged 65 or older were statistically significant. Conclusion: It was found that 12 administrative sectors were included in the underserved EMS areas. Revealing underserved EMS areas using GIS analysis based on a cost-weighted distance algorithm of road data was an effective analytic method. However, as this study was confined to Daejeon City, South Korea, a nation-wide study should be performed to provide a more accurate conclusion.

• Journal of The Korea Institute of Healthcare Architecture
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• v.27 no.2
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• pp.39-48
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• 2021

Purpose: The study aims to demonstrate regional diagnosis methods and results combined with geographical information to expand the physical infrastructure related to community care services. To this end, the physical infrastructure for the core elements of community care was analyzed in terms of the fulfilment and access of facilities to derive the underserved elements and regions. Methods: Utilizes GIS network analysis techniques that can derive physical infrastructure service areas. Underserved elements are derived by comparing and analyzing the service area for each core element. Next, the underserved regions for each core element are derived through the overlapping of the set service area and the diagnosis population. Results: Among the physical infrastructure by core elements for community care, the housing support element was considerably weak, and the nursing care facility compared to health care was also analyzed to be weak. In addition, underserved regions by dong in Mapo-gu were deduced and presented for each diagnosed population. Implications: The discovery of underserved elements and underserved regions is meaningful as a diagnostic process that can derive the physical infrastructure that needs to be expanded urgently for the realization of community care and determine the priority projects and targets of the projects.

• Journal of Korean society of Dental Hygiene
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• v.21 no.4
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• pp.367-381
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• 2021

Objectives: This study aimed to analyze the status of dental care in underserved areas of Korea. Methods: This study targeted 229 cities in Korea. The analytical index was revised and supplemented with variables related to dental care, and the "oral health level" indexes were further selected to provide a total of 20 analytical indexes. All selected indexes were converted into T scores (cited by the Korea Health Promotion Institute) and subjectively weighted. Finally, the regional oral health indices and areas were derived. PASW Statistics 25.0 (SPSS Inc. Chicago, IL, USA) was used to analyze descriptive statistics. Results: Gyeongbuk Cheongsong-gun had the highest dental underserved index. The city with the highest regional oral health underserved index was Jeonnam Shinan-gun. Daegu Jung-gu had the lowest dental underserved index and regional oral health underserved index. Regional gaps existed between dental care and the regional oral health underserved index according to the city province (p<0.001). Conclusions: To continuously evaluate oral health conditions and projects centered on vulnerable areas, it is necessary to develop indicators to derive vulnerable areas for dental care and to develop effective public dental policies.

• Archives of Plastic Surgery
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• v.49 no.2
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• pp.215-220
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• 2022

Background In Japan, there is a large regional disparity in plastic surgery availability. In order for plastic surgery to be widely available for all citizens, it is essential for at least one plastic surgery facility to be located in each secondary medical zone. Methods Using the Japan Society of Plastic and Reconstructive Surgery homepage and some databases, we extracted data on secondary medical zones that do not have a plastic surgery facility. The national and regional coverage rates were calculated. The coverage rate for each group divided by the degree of population concentration was also calculated. Results We found that 147 of 344 secondary medical zones did not have a plastic surgery facility, and the area coverage rate was found to be 57.27% nationwide. The coverage rate in terms of population was 87.07% (correlation coefficient of area and population coverage = 0.983). The area coverage rates in Hokkaido-Tohoku, Kanto, Chubu, Kansai, Chugoku-Shikoku, and Kyushu-Okinawa districts were 47.46, 72.15, 76.47, 62.79, 52.08, and 32.81%, respectively. The corresponding population coverage rates were 79.92, 91.62, 94.27, 90.59, 80.68, and 69.54%, respectively. The area coverage rates in metropolitan areas, provincial cities, and rural areas were 98.08, 75.90, and 15.87%, respectively. In contrast, the area coverage rate of dermatology was 62.79% and that of orthopaedics was 97.09%. Conclusion Unfortunately, it is estimated that more than 40% of secondary medical zones are underserved by plastic surgery, and 13% of the population is not able to fully benefit from this specialty in Japan.

• Korea Journal of Hospital Management
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• v.6 no.1
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• pp.147-163
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• 2001

The purpose of this study was to find out the restructuring strategy for five provincial hospitals through the business analysis and survey of the service area. Through the survey of the service area of 5 hospitals. service area was classified into three groups, such as underserved area, adequate area, and overserved area. The strategy for the restructuring the clinical departments was set up based on the result of the business analysis and characteristics of the service area. The result of the study was as follows; 1) Whether or not a provincial hospital has specialized in specific area according to the circumstances and the needs of the community was the major factor influencing on the operating result of the hospital. 2) Provincial hospitals at the underserved area has to invest according to the changes of the occupancy rate and increasing pattern of the number of patients while maintaining the status as a general hospital. 3) Provincial hospitals at the adequate area has to lower the grade from the general hospital down to the hospital first and has to upgrade the competency through the restructuring the clinical departments and investment in specific area. 4) Provincial hospitals at the overserved area has to lower the grade from the general hospital down to the hospital first and has to seek ways to change the hospital fundamentally into geriatric hospital, pneumoconiosis hospital or psychiatric hospital etc. Provincial hospitals incapable to compete with private hospitals and clinics has to lower the grade from the general hospital down to the hospital first, to specialize in specific area and to restructure some clinical departments into rental base or self-operating basis. In case such methods are judged not so good solution, provincial hospitals has to find out ways such as shut-down of several departments or operating under the attending system.

• Korean Journal of Health Education and Promotion
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• v.24 no.4
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• pp.65-85
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• 2007

Objectives: The purpose of this study was to identify the major health problems of poor children, and to provide basic information for developing health care program for low income children in underserved area. Methods: Health data were collected through medical examination(KAHP Social Welfare Service) and analysed for 3,081 poor children in 106 local children's centers nationwide. Results: 1. The mean height and weight of poor children were lower than those of nonpoor children. The differences were increased by age. 2. The rate of relative low weight was higher in poor children than in nonpoor children. On the contrary, The obesity rate was higher in nonpoor children than in poor children. 3. Poor children were more likely to have vision problem, anemia, high blood pressure, and oral health problems than nonpoor children. 4. The Health problems of children were the most serious in single father family. Conclusion: In order to improve children's health status, health promotion program for poor children should be developed and implemented. Health promotion program should include activities including regular health examination, home visiting, nutrition support, managed health care, health counseling and education. And the community support network was suggested for the efficacy of the program, including home, school and community.

• Korean Journal of Health Education and Promotion
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• v.25 no.3
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• pp.59-75
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• 2008

Objectives: The purpose of this study was to identify the stages of change distributions for nine major health behaviors among poor children in underserved area, and to provide basic information for developing specific objectives and strategies for health education program. Methods: The health behavior data were obtained with a self-administered questionnaire and analysed for 3,081 poor children in 106 local children's centers nationwide. Stages of change classification were based on self-reported responses to five statements. The health behaviors included were balanced diet, safety behavior (helmet and protective device use while riding), regular exercise, smoking, alcohol use, drug use, sleep pattern, weight management and stress management. Results: Poor children were more likely in precontemplation and less frequently in action and maintenance stages for a safety behavior. 33.1% of respondents were precontemplators, 29.9% contemplators, and 6.5% in preparation stage. Only 4.3% and 9.6% were in action and maintenance stages, respectively. Gender differences were apparent. Boys were more likely to be precontemplators for nine health behaviors. Children from the lowest socioeconomic status and disrupted family were more likely to be in precontemplation for weight management and exercise behaviors. Children living with both parents were more likely to be in the action and maintenance stages for nine health behaviors. Stages of change for balanced diet and smoking were significantly related with those for other eight health behaviors. And the stage of exercise adoption was found to be significantly related with those for other seven health behaviors. Conclusion: Safety education must receive high priority in health education program for low income children. Balanced diet smoking cessation and regular exercise could be a possible gateway behavior toward healthier lifestyle practices.

• Health Policy and Management
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• v.19 no.4
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• pp.53-65
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• 2009

Purpose: This study was conducted to identify the prenatal heath care utilization and expenditure among pregnant women. Method: This was a 5-month follow-up study using a stratified sampling and the data were drawn from the "nationwide claim database of Korean National Health Insurance Corporation". Result: This study found that pregnant women were first diagnosed with pregnancy when they were 7.1 weeks pregnant, received 12.7 times of prenatal examinations and 10.6 times of ultrasonogram. It was revealed that 67.5% of the subjects continued to receive prenatal care at the same medical institutions from the diagnosis of pregnancy to the delivery. The study also showed that the total expenditure of prenatal care per pregnant woman was 700,000 Korean Won (KRW) on average and the insurance coverage rate stood at only 20%. Pregnant women living in metropolitan area spent more on prenatal healthcare expenditure than those who living in medium-sized city or rural area. Conclusion: The results of this study implies that the government needs to provide pregnant women with continuous support by increasing health insurance coverage for prenatal care. Especially, it is considered to provide more support to the pregnant women residing in medically underserved areas.

• Journal of the Economic Geographical Society of Korea
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• v.22 no.4
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• pp.592-609
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• 2019

This study attempts to expand the leverage cycle theory using the subprime real estate investors. The leverage cycle theory has demonstrated asset price fluctuations irrelevant to changes in fundamentals through the restructuring of transaction composition centered on optimistic buyers. However, it needs to understand how this theory works in the depressed housing market with low-income residential regions to explain the geographic origins of the financial crisis. In the depressed housing market, the subprime real estate investors focused on low-income residential regions. Through this spatial focus, the low-income residential regions solely have real estate investor-oriented composition of new purchase transactions in the depressed housing market. The discovery of the subprime real estate investors as new actors lays the foundation for applying the leverage cycle theory to the depressed housing market which has been a underserved area for capital investment. This attempt illustrates how the geographical reinterpretation of an economic theory reestablishes spatio-temporal context of economic phenomena.