• Journal of Families and Better Life
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• v.30 no.6
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• pp.23-37
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• 2012

Using data from the 2008 Korean Longitudinal Survey of Women and Families, this study investigated the income class differences in the modes, amount of time, and expenses for caring and educating a child in early childhood. The sample consisted of 1,849 households with a child aged 6 years or less. The major findings were as follows. First, the lower-income class was more likely to rely on child care centers and less likely to use services provided by kindergarten or private education. Their total amount of time required to provide care and education for their child was about 4 or 5 hours less than that of the other income classes; this result was due to the fact that they consumed less hours for home care, kindergarten, and private education. Second, we found there were more similarities than differences between middle-income and upper-income classes in the modes, amount of time, and expenses to care for and educate their young children; however, the middle-income class used less private education than the upper-income classes in terms of usage rate and length of time. Lastly, the other variables which were significantly related with the amount of time and expenses for child care and education included mother's employment, age of the child, and having siblings, and the family size. Based on the results, implications for public policy on early childhood care and education were suggested.

• Health Policy and Management
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• v.26 no.1
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• pp.4-11
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• 2016

Background: Hospital admissions for ambulatory care sensitive conditions (ACSCs), which are widely used as an indicator of poor access to primary care, can be used as an efficiency indicator of healthcare use in countries providing good access to health care. Korea, which has a national health insurance (NHI) system and a good supply of health care resources, is one such country. To quantify admission rates of ACSC and identify characteristics influencing variation in Korean health care institutions. Methods: By using NHI claims data, we computed the mean ACSC admission rate for all institutions with ACSC admissions. Results: The average ACSC admission rate for 4,461 institutions was 1.45%. Hospitals and clinics with inpatient beds showed larger variations in the ACSC admission rate (0%-87.9% and 0%-99.6%, respectively) and a higher coefficient of variation (7.96 and 2.29) than general/tertiary care hospitals (0%-19.1%, 0.85). The regression analysis results indicate that the ACSC admission rate was significantly higher for hospitals than for clinics (${\beta}=0.986$, p<0.05), and for private corporate institutions than public institutions (${\beta}=0.271$, p<0.05). Conclusion: Substantial variations in ACSC admission rates could suggest the potential problem of inefficient use of healthcare resources. Since hospitals and private corporate institutions tend to increase ACSC admission rates, future health policy should focus on these types of institutions.

• Journal of Preventive Medicine and Public Health
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• v.50 no.1
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• pp.29-37
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• 2017

Objectives: The accurate measurement of geographic patterns of health care utilization is a prerequisite for the study of geographic variations in health care utilization. While several measures have been developed to measure how accurately geographic units reflect the health care utilization patterns of residents, they have been only applied to hospitalization and need further evaluation. This study aimed to evaluate geographic indices describing health care utilization. Methods: We measured the utilization rate and four health care utilization indices (localization index, outflow index, inflow index, and net patient flow) for eight major procedures (coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, surgery after hip fracture, knee replacement surgery, caesarean sections, hysterectomy, computed tomography scans, and magnetic resonance imaging scans) according to three levels of geographic units in Korea. Data were obtained from the National Health Insurance database in Korea. We evaluated the associations among the health care utilization indices and the utilization rates. Results: In higher-level geographic units, the localization index tended to be high, while the inflow index and outflow index were lower. The indices showed different patterns depending on the procedure. A strong negative correlation between the localization index and the outflow index was observed for all procedures. Net patient flow showed a moderate positive correlation with the localization index and the inflow index. Conclusions: Health care utilization indices can be used as a proxy to describe the utilization pattern of a procedure in a geographic unit.

• Health Policy and Management
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• v.30 no.3
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• pp.326-334
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• 2020

Background: Korea has gradually expanded the coverage of medical care services in its national health insurance system. On April 1, 2018, it implemented a policy that expanded the coverage for an ultrasonography in the upper abdomen. In this study, we aimed to investigate the effect of the policy on the utilization of the ultrasonography in the upper abdomen in tertiary care hospitals. Methods: Using the dataset of the Health Insurance Review and Assessment Service, we explored changes in the utilization of the ultrasonography in the upper abdomen in tertiary care hospitals from July 1, 2017 to November 30, 2018 through the difference-in-difference (DID) mixed-effects-model method. Facility factor, equipment factor and personnel factors, type of hospital, the total amount of medical care expenses, and geographic region were considered as control variables. Results: On average, the utilization of the ultrasonography in the upper abdomen increased by 228% after the coverage expansion policy. However, the results of DID mixed-effects-model method analysis showed that the utilization increased by 73%. As for the number of beds, the utilization was higher with a group of 844-930, 931-1,217, and 1,218 or greater compared with a group of 843 or fewer, while the utilization of the number of ultrasonic devices was lower with a group of 45-49 compared with a group of 44 or fewer. The utilization decreased with the number of interns and the number of nurse assistants. Besides, relative to Seoul, the utilization was lower in the other metro-cities and provinces. Conclusion: The coverage expansion policy in the national health insurance system increased service utilization among people. Future research needs to investigate the degree to which such coverage expansion policy reduces the unmet medical care needs among the deprived in Korea.

• Journal of Korean Clinical Nursing Research
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• v.21 no.1
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• pp.105-115
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• 2015

Purpose: This descriptive correlational study was intended to analyze the relationship among menopausal symptoms. competency of self-care agency and social support in middle-aged women. Methods: Participants in the study were 140 women who were 45-60 years of old. Data were collected using structured questionnaires and analyzed using descriptive statistics., t-test, ANOVA, $Scheff{\grave{e}}^{\prime}s$ test and Pearson correlation coefficients. Results: The frequency and discomfort of menopausal symptom were low, but the mean discomfort score were higher than frequency score. Middle-aged women with lower competency of self care experienced more frequent menopausal symptoms (t=-0.28, p=.001) and more discomfort (t=-0.24, p=.004). However, There was no significant difference in menopausal symptoms according to social support. Conclusion: Nursing interventions to enhance competency of self-care agency in middle-aged women are required in order to reduce the discomfort of menopausal symptoms.

• The Journal of the Convergence on Culture Technology
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• v.4 no.4
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• pp.145-154
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• 2018

The aim of this study is to analyze the policy effects of child care leave focusing on the childbirth in South Korea. This instituion of child care leave orinignally seeks to harmonize the work and family. The instituion is increasingly fortified in the receipants and benefits. This study analyze the policy effect of the institution using difference-in-difference method and Korea Welfare Panel Data. The result of the analysis suggest that substantial expansion of child care leave and family-friendly labor environment rebuilding are important.

• Korean Journal of Human Ecology
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• v.14 no.2
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• pp.251-268
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• 2005

This study analyzes the amendment history of Educare Law of Infants and Children, the Equal Employment Opportunity Law, and Employment Insurance Law, and also examines the present status of the employer-supported child care service through secondary analysis of other policy studies. The three laws concerning employer-supported child care can be said to hold in itself two main concepts: employers' obligations to provide child care, and government's financial support and administrative management. In terms of the first concept, laws have been amended to enlarge the number of enterprises legally-responsible for child care service and to relieve the financial burden from them. In terms of the second, laws have been amended to gradually extend the magnitude of government's financial support and to establish the systematic administrative management. Approximately a half of the policy target enterprises, however, is not complying the laws. In addition, employer-supported child care centers are only occupying less than 1% of the whole child care market. Thus, this study evaluates the current employer-supported child care service system and suggests several principles for its improvement.

• Health Policy and Management
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• v.31 no.2
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• pp.207-216
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• 2021

Background: Good patient experience is positively associated with adherence to treatment recommendations, better clinical effectiveness, and health outcomes. This study aims to find out the key factors affecting positive patient experience to improve the quality of care using nationally representative survey data. Methods: The data was collected from the 6th National Health Nutrition Survey in 2015. Four patient experience items were investigated for patients with visiting outpatient care over the past year. Positive patient experience was defined as a case of responding always or usually yes. The t-test, chi-square test, and multiple logistic regression were performed to determine the key factors affecting the outpatient experience. Results: More than 80% of the respondents reported their care experience as positive excluding doctor spending enough time during the consultation. Male, poor health status, and single/divorced, and the longer time interval between outpatient care visit and survey were found to be significantly correlated with negative care experiences in the multiple logistic regression. Patients who received outpatient care at the oriental medicine clinic had a positive experience compared to those received outpatient care at the general hospital. However, patient factors including age, income, job, and insurance type had no significant association with patient experience. Conclusion: Health care providers should prioritize patients who report negative patient experiences and implement management decisions to improve the patient experience.

• Journal of agricultural medicine and community health
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• v.48 no.1
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• pp.13-27
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• 2023

Objectives: The purpose of this study is to investigate changes in public health-related perceptions of residents of Gangwon province after the outbreak of Coronavirus disease-19(COVID-19) of the public. Methods: We performed paired T-test analysis to measure the change in public health-related perceptions before and after COVID-19. We also utilized generalized estimating equations to identify demographic factors correlated with public health-related perceptions. Results: The public perceived public health as 'All citizens can use medical care and protect/promote health.' The concept was the most popular, from 94.3% in 2019 to 95.5% in 2020. In addition, after COVID-19, residents of Gangwon province's satisfaction with medical services increased, but the overall level was not high. Among the eight essential healthcare needs after COVID-19, cardiovascular disease and injury services have emerged as preferred services. However, by sociodemographic factors, distinctive responses were detected. Conclusions: Through COVID-19, Gangwon residents' awareness of the public's health rights has increased. Those living in vulnerable areas or with unmet medical care, supported strengthening public health care. In addition, although medical satisfaction has increased, it is not satisfied, so listening to the voices of the population group with low satisfaction is essential. Lastly, since the necessity of essential health care may change due to specific events, the local government needs to plan health projects reflecting the needs of residents. Therefore, when designing the public health care strategy in Gangwon province, the local government should consider not only political factors but also environmental factors, demographic and conceptual factors.

• Journal of Convergence for Information Technology
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• v.10 no.6
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• pp.200-208
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• 2020

The purpose of this study was to investigate and compare health, medical and welfare service providers' and local residents' perception on community care. The participants were 68 service providers and 95 local residents. The data were analyzed using independent t-test and chi-square test. The results showed that the degree of agreement of service providers on the need for policy, and visiting services were higher. Service providers' ability to link local residents with a need for care to community resources was higher, but in the activation of self-help group in community, local residents agreed more. In add budget of policy to health insurance, local residents agreed less. In perception on priority for community care policy, high priorities were preparation of financial resources and care culture. To effectively operate community care policy, it is necessary to establish a care culture through active exchanges for reducing differences in policy and opinions of recipients.