• Journal of Digital Convergence
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• v.16 no.7
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• pp.19-26
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• 2018

This study is purposed to analyze how the utilization of rehabilitation services and the desire for service utilization changes with time, to explain the factors affecting service needs and to suggest direction of policy improvement for injured workers. Using the Workers' Compensation Insurance Panel Data ver.1~3, this study analyzed 5,004 observations. Panel regression analysis was performed using STATA to examine changes over time. Two key findings were made: first, the factors influencing the degree of need for rehabilitation services were age, educational period, ability on job performance, community service experience, re-employment and unemployment; second, the significant factors influencing the degree of need for rehabilitation services according to time were age, education period, unemployment, ability on job performance, and experience in using community services. That results were different from the previous cross-section analysis. These findings indicate that it is necessary to check and adjust the initial intervention contents after the end of the period of care on a timely base.

• Journal of Korean society of Dental Hygiene
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• v.15 no.2
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• pp.197-204
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• 2015

Objectives: The purpose of this study was to investigate the relation between health-related quality of life and oral health behavior and oral health status, and to provide the basic data for national oral health policy. Methods: The primary data of the 5th National Health Examination and Nutritional Survey(NHANES) in 2012 were used in this study. The subjects were 2,243 middle-aged people(40-59 years old), 827 persons were excluded for missing value or having diseases affecting quality of life(depression, stroke, cardiac infarction, angina, liver cancer, stomach cancer, colon cancer, breast cancer, cervical cancer, lung cancer, thyroid cancer, other cancers, arthritis), and 1,416 data were finally analyzed. Results: In health-related quality of life by subjects' characteristics, there was significant difference in gender, age, education, family income, and employment status(p<0.01) except for current smoking. Oral health behavior didn't have significant relation to health-related quality of life, but better oral health status showed better health-related quality of life(p<0.01). Conclusions: In conclusion, this study suggested that there was close relationship between the oral health status and health-related quality of life in moddle aged people. Therefore, national oral health policy is needed for the oral health promotion with commitment of oral prophylaxis and care programs to the individual and community.

• Journal of Korean society of Dental Hygiene
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• v.18 no.2
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• pp.217-226
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• 2018

Objectives: The purpose of this study is to find out differences in oral health status, defined as their oral health and oral health quality of life among the elderly depending on their income and education levels. Methods: This study used 922 senior citizens over 65 from the data (2015) of the 6th National Health and Nutrition Survey (NHNS). The regression analysis was adopted to identify factors affecting their oral health status which has effect on their oral health quality of life. The statistical package SPSS 21.0 was employed. Frequency analysis, chi-squared analysis and regression analysis were used, and the significance level or Cronbach's alpha value was 0.05. Results: Depending on income levels, there were differences in their oral health status as to whether they use oral hygiene products, take dental examinations, join private health-insurances, and delay dental treatments or not. And educational levels also made significant differences in their oral health status as to whether they smoke, drink alcohol, how many times they brush teeth a day, whether they use oral hygiene products, take dental treatments, and join private health-insurances. Regression analysis on the relationship between their oral health status and the oral health quality of life showed that there were significant differences depending on whether they take dental treatments, delay dental medical treatments, smoke, take oral examinations, how many times they brush teeth a day, and whether they use oral hygiene products, or join private health-insurances. Conclusions: The study shows that a comprehensive plan is needed to raise attention on proper oral health-care and ultimately to improve the quality of life by considering the daily number of tooth brushing, oral hygiene product use, regular dental treatments, and other medical uses.

• Journal of Society of Preventive Korean Medicine
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• v.23 no.3
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• pp.109-119
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• 2019

Background : Germany is the first country in the world to introduce modern systems of public health insurance, and the country which most widely uses complementary alternative medicine(CAM) in Europe. In early 21^st century, a large evaluation studies were conducted to include acupuncture in health insurance payments, which were eventually decided. Objectives : This study is to investigate and analyze the process of public policy determination on insurance coverage for acupuncture in German health insurance system. Methods : We collected the data and information through the literature search and from the websites of German government departments and health insurance organizations. To obtain contextual information, German experts of health insurance and acupuncture clinical study were interviewed. Results : As use of acupuncture had been growing, German public health insurers wanted to evaluate the validity of acupuncture coverage and sponsored three evaluation projects for clinical effectiveness of acupuncture using randomized clinical trials, systematic reviews, and pragmatic trials from 2001 to 2005. For some pain condition, acupuncture was founded not to be effective than sham acupuncture, but more effective than standard care. The federal joint committee of health insurance decided to cover acupuncture for chronic pain of lumbar spine and chronic pain in at least one knee joint due to gonarthrosis. Conclusions : Considering the controversial subject matter in the process of acupuncture's health insurance coverage in Germany, expanding the benefits of Korean medicine in Korea needs to come up with ways to overcome the difficulties of placebo effect, standardization and lack of literature evidence.

• Health Policy and Management
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• v.2 no.2
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• pp.194-220
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• 1992

In recent years there has been a rapid influx of high cost MRI equipment into Korea. This diffusion has raised concerns about the changes it will bring for the health care utilization. Therefore, the purpose of this study is to identify socio-economic characteristics of MRI uses in Korea. A structured questionnaire was designed for this purpose, and 1, 091 users were surveyed at the 35 MRI units of 33 hospitals during a week, sometimes March 1992. The study reveals that high cost technology such as MRI, CT scanner is so prevalent in Korea. This is particularly the case in metropolitan areas. Among others, Seoul has the highest percentage of MRI equipment, 51.05%, Pusan 12.10% and Kwangju 11.9%. Unfortunately, most high cost technology equipments are foreign products. Thus, hospitals with such a high cost technology have difficulties in maintenance of the equipment. The average performance of MRI equipment has declined from 10.2 cases per day in 1988 to 7.16 cases in March 1992. Due to the rapid increase, the performance of MRI equipment seems to be deterioration. Male usere are dominant in the case of MRI use. The utilization rate has positively increased with the rise of educational level of users. The same is true for the level of income; the MRI utilization rate by income level shows that it is negatively proportional to income, which indicates that the poor have difficulties in the use of high cost technology. Particularly, the cost of MRI is so high that ordinary patients are unable to pay for it. For example, 86.3% of respondents have answered that the cost is too high even though they are insured by health insurance. This is the first empirical study on the use status of MRI. The information obtained in this study is sufficient to maintain that the Korean health insurance programme is urgently in need of improving the insurance benefit schemes. The easiest way to do this is to include provision of high cost technology service into the benefit package.

• Health Policy and Management
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• v.20 no.4
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• pp.19-44
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• 2010

This study was conducted to investigate the changes in patterns of Daegu- and Gyeongbuk-based patients' use of medical care facilities located in Seoul. The 'Patient Survey' data issued by the Ministry of Health and Welfare for 2002, 2005, and 2008 were used. Among all discharged patients residing in Daegu and Gyeongbuk, 133,456 who used medical facilities in Daegu, Gyeongbuk, and Seoul were selected. Among patients residing in Daegu, 2.2% used medical facilities in Seoul in 2002, 3.7% in 2005, and 3.5% in 2008. The corresponding rates among patients living in Gyeongbuk were 5.6%(2002), 7.1%(2005), and 7.3%(2008). Regarding the ICD-10 disease groups, the use of medical facilities in Seoul by patients residing in either Daegu or Gyeongbuk increased in 2005 right after the introduction of the KTX high-speed train service, covering various disease groups, but decreased again in 2008. 'Neoplasm' cases, however, showed a progressive rising trend during the years studied. Multivariate data analysis for the three years showed that sex, age, payment type, hospital type, residence, year, and disease groups were all significantly associated with the utilization of medical facilities in Seoul. The major results are : First, use of medical facilities in Seoul by Gyeongbuk patients was 2.4-fold higher than that by Daegu patients, but with respect to 2005 and 2008 vs. 2002, use of medical facilities in Seoul by Daegu resident patients' showed a larger increase than that by Gyeongbuk's patients. Second, for patients residing in the two regions, use of medical facilities in Seoul was highest for 'congenital malformations, deformations and chromosomal abnormalities', followed by 'neoplasms'. Third, for patients residing in the two regions, general hospitals comprise the primary factor in the use of medical facilities in Seoul. The study shows that local medical facilities should individually exert more efforts to improve the quality of their medical services. Relevant authorities should likewise help these facilities develop their own unique services and respective specialization.

• Health Policy and Management
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• v.28 no.1
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• pp.70-76
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• 2018

Background: The purpose of this study was to investigate the determinants of North Korean refugees' trust in South Korea health service. Methods: This study surveyed 168 North Korean refugees aged 19 and over living in Seoul, Gyeonggi, Incheon, and Gangwon. The collected data were analyzed by frequency analysis, t-test, analysis of variance, and hierarchical regression analysis to analyze the effect on the trust of refugees. Results: The difference analysis showed statistically significant difference according to duration of residence and employment status. The determinants of North Korean refugees' trust in South Korea health services were duration of residence, basic communication skills, health communication skills, and experience of health service. Conclusion: In order to increase the trust of North Korean defectors in South Korea medical services, it is necessary to resolve communication problems and improve the satisfaction of health services. For this, the interpreter service should be activated. And specific education should be given to the North Korean refugees about the health care system and the utilization methods of health service in Korea.

• Health Policy and Management
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• v.28 no.1
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• pp.48-52
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• 2018

Background: The current study evaluated the hospital utilization and characteristics of patients who received health care services for acute cerebral infarction outside their own residential area. Methods: Using the 2014 national patient survey data, information on 2,982 patients diagnosed with acute cerebral infarction through emergency department were retrieved for the analyses. Multiple logistic regression was performed to investigate the characteristics associated with using hospitals outside residential area among patients diagnosed with acute cerebral infarction. Results: Fifteen point nine percent of patients admitted for acute cerebral infarction utilized hospitals outside their residential area. Patients residing in a province were 7.7 times more likely to utilize hospitals located outside their residential areas compared to those living in Seoul metropolitan city. Patients living in Gangwon and Jeolla were 0.26 times and 0.48 times more likely to go to hospitals in different geographical areas. Also, patients within the age group of 80 years and over were 0.65 times less likely to be admitted to hospitals outside their residential area compared to those in their 40s-50s. Conclusion: The use of hospitals outside patient's residential area is shown to be substantial, given that the acute cerebral infarction requires immediate recognition and treatment. The findings on the geographical differences in the hospital utilization suggest further investigation.

• Journal of the Korean Society of School Health
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• v.30 no.3
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• pp.211-223
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• 2017

Purpose: The purpose of this study is to clarify the social stigma phenomenon in teachers' perceptions and attitudes toward students who are classified as mental health support needs students in middle and high schools. Methods: Qualitative research was conducted through in-depth interviews and observations of 17 teachers and 2 consultants from 2 middle and high schools in Green City, which were evaluated as successful among the six pilot project schools designated by the Ministry of Education in 2013. The study's analysis is based on Hatch's hermeneutical method. Common categories were developed from the interviews and observations. Then, inferences were made per category and given importance to draw conclusions and lessons. Results: Teachers had a strong stigma in their perceptions of and attitudes to special needs students. Their perception was that those students are bound to go wrong due to family problems, even some having difficulty breathing, and that it's beyond their limit to help them. In addition, their attitudes included stereotypes, favoritism, punishment, and referral to experts. As a result, teachers did not expect those students would be cured or change and showed passive attitudes while shifting the responsibility to families and experts. Conclusion: This study is meaningful in that it showed the limitations of the role of teachers regarding mental health support needs students from the perspective of the teachers themselves. Today, when students' mental health problems are emerging as a serious issue, it is necessary to provide support to improve teacher's awareness and capabilities regarding adolescent mental health problems. In addition, we suggest the current selective policy that sorts out special needs students and provides care for them to evolve into a universal policy that improves public awareness and focus on prevention.

• Health Policy and Management
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• v.31 no.3
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• pp.301-311
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• 2021

Background: This study purposed to analyze the relationship between the local extinction index and medical service uses of chronic diseases. The local extinction index is an indicator of the demographic structure and population aging of the region. Methods: The 2014-2018 statistics of National Health Insurance Corporation and Korean Statistical Information Service data were used for the analysis. First, descriptive statistics were used to analyze the general status of research variables. Second, a panel analysis was performed to analyze the relationship between the local extinction index and medical service uses of chronic diseases (hypertension, diabetes mellitus, periodontal disease, arthritis, mental health, epidemic disease, liver disease). Medical service uses were measured by the number of visits/inpatient days and medical charges of seven chronic diseases. Results: Panel analysis results showed that higher local extinction risks (meaning lower local extinction index) had a positive relationship with the number of visits/inpatient days and medical charges of chronic diseases. But the relationships were varied when the seven chronic diseases were analyzed separately. Conclusion: This study showed a significant relationship between the local demographic structure and medical service uses of chronic disease. Analyzing the local demographic structure will be an essential prerequisite step for implementing appropriate regional health care policies.