• 한국학교보건학회지
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• 제29권3호
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• pp.123-131
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• 2016

Purpose: Human Papillomavirus(HPV) vaccination is the best prevention for cervical cancer. Therefore, this study was to examine the best predictors of HPV vaccination status in female nursing university students. Methods: Five hundred and forty junior and senior female nursing students from Seoul and provinces of Kyunggi, Chungcheong and Gyungsang completed paper and pencil questionnaires. Descriptive statistics, $x^2$ test, t-test, and multiple logistic regression with dummy variables were conducted using SAS 9.2. Results: Of the total students, 56.8% were vaccinated. As a result of the analysis of the bivariate relationships, family economic status, school type, perceived susceptibility, perceived benefit and perceived barriers (cost, time, distance from hospital and side effects) were significantly related to vaccination status. After controlling for the general characteristics and the HPV related knowledge score, higher family economic status (Adjusted Odds Ratio [AOR]: 3.78, 95% Confidence Interval [CI]: 1.21~11.76), private university (AOR: 1.69, 95% CI: 1.14~2.53), higher perceived benefit (AOR: 1.80, 95% CI: 1.47~2.20), lower perceived barrier (cost) (AOR: 0.86, 95% CI: 0.74~0.99), lower perceived barrier (time) (AOR: 0.71, 95% CI: 0.61~0.84), and lower perceived barrier (side effects) (AOR: 0.82, 95% CI: 0.72~0.94) were significantly related to HPV vaccination. Perceived benefit, perceived barrier (time) and perceived barrier (side effects) were the top 3 predictors of HPV vaccination status. Conclusion: This study suggests that vaccinated female nursing students were more likely to be from higher family economic status and private universities and have a higher perception of benefit and a lower perception of barriers (cost, time, and side effects). Thus, efforts to increase HPV vaccination rates of female nursing students should focus on improving their perception of benefit while lowering their perception of barriers, particularly cost, time and side effects.

• Journal of Preventive Medicine and Public Health
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• 제33권4호
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• pp.484-494
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• 2000

Objective : To evaluate the relative benefits and the costs associated with the introduction of the new pharmaceutical provision called 'Mandatory Prescription System' which separates the role of physicians from that of pharmacists with respect to the prescription and dispensation of from the perspective of consumers (i.e., patients). Methods : The costs of the system were measured by considering both direct and indirect costs. Direct costs included additional payments for ambulatory care and dispensing fees that occurred under the new system. indirect costs consisted of transportation expenses and costs related to time spent for physician consultation, waiting for the prescriptions to be filled, and extra traveling. Benefits identified in this study were the reduction of drug misuse and overuse, and the overall decrease in drug consumption among the Korean population. Sensitivity analysis was peformed for the inclusion of benefits for outpatients of hospitals, price elasticity, and increased fees for established patients. Results : The net benefit was estimated to be about minus 1,862 billion won and the benefit-cost ratio was 0.478. This indicates that the costs of 'Mandatory Prescription' outweigh its benefits, relative to the previous system. The sensitivity analysis results for all the variables considered in this study consistently showed the benefit-cost ratio to be less than 1. Conclusion : The results of this study suggest that implementing Mandatory Prescription System in Korea might be inefficient from the consumer's perspective. The results of this study do not coincide with the results of previous studies, presumably because of the differences in study design and in which items of costs and benefits were considered.

• 한국보건교육건강증진학회:학술대회논문집
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• 한국보건교육건강증진학회 1999년도 3rd International Symposium
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• pp.107-116
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• 1999

.Half of deaths are caused by life-style related problems in developed nations. .Health promotion can improve life-style and health. .Improvements in life-style and health lead to savings in medical care core costs and enhancements in productivity. .Win-Win-Win-Win : Management, Labor, Employees and Government benefit

• 성인간호학회지
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• 제13권1호
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• pp.29-39
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• 2001

The purpose of this study was to identify factors influencing patient satisfaction and to evaluate the utility of patient satisfaction as an outcome indicator. The study was conducted by mailed questionnaire. The subjects were 900 patients discharged from adult nursing units in a tertiary teaching hospital. On the discharge date, questionnaires were distributed by two trained research assistants. The questionnaire developed by the researchers was based on Larson(1996)'s study, and consisted of 71 items with the following components: overall satisfaction, domain-specific satisfaction(administration process, hospital facility and environment, nurses, and doctors), patients' loyalty(intention to use the health care service of the hospital in the future), recommendation to others, health benefits, and demographic characteristics. Each item was rated using a five point Likert scale ranging from '1=strongly disagree' to '5= strongly agree'. The response rate was 43%(387/900). The satisfaction level with the health care service was generally high. Perceived health status was the only significant factor influencing satisfaction level. Satisfaction with doctors contributed the most to explaining overall satisfaction. Overall satisfaction was significantly correlated with patient loyalty, recommendation, to other and perceived health benefit. It was found that the score of satisfaction was positively correlated with the score of loyalty, recommendation, and health benefit. Therefore, patient satisfaction seems to be a good outcome indicator.

• Journal of Preventive Medicine and Public Health
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• 제52권1호
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• pp.41-50
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• 2019

Objectives: The aim of this study was to investigate cancer patients' utilization of tertiary hospitals in Seoul before and after the benefit expansion policy implemented in 2013. Methods: This was a before-and-after study using claims data of the Korean National Health Insurance Service from 2011 to 2016. The unit of analysis was inpatient episodes, and inpatient episodes involving a malignant neoplasm (International Classification of Diseases, Tenth Revision codes: C00-C97) were included in this study. The total sample (n=5 565 076) was divided into incident cases and prevalent cases according to medical use due to cancer in prior years. The tertiary hospitals in Seoul were divided into two groups (the five largest hospitals and the other tertiary hospitals in Seoul). Results: The proportions of the incident and prevalent episodes occurring in tertiary hospitals in Seoul were 34.9% and 37.2%, respectively, of which more than 70% occurred in the five largest hospitals in Seoul. Utilization of tertiary hospitals in Seoul was higher for inpatient episodes involving cancer surgery, patients with a higher income, patients living in areas close to Seoul, and patients living in areas without a metropolitan city. The utilization of the five largest hospitals increased by 2 percentage points after the policy went into effect. Conclusions: The utilization of tertiary hospitals in Seoul was concentrated among the five largest hospitals. Future research is necessary to identify the consequences of this utilization pattern.

• Journal of Preventive Medicine and Public Health
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• 제27권4호
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• pp.807-814
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• 1994

This study is to find out changes in medical practice at a university hospital before and after covering intraocular lens (IOL) from the health insurance benefit. The coverage started on March 1, 1993 and a total of 596 cases who were discharged from July 1 to December 31, 1992 and 580 cases who were discharged from July 1 to December 31, 1993 were analyzed. Since the standard reimbursement scheme was changed from March 1, 1993, the charges for 1992 were transformed into 1993 scheme. Major findings are as follows: Average length of stay was statistically significantly decreased from 8.24 days in 1992 to 6.86 days in 1993. Charges except IOL has been statistically significantly decreased from 501,000 Won in 1992 to 444,000 Won in 1993. Charges for drugs and injection have been reduced. However, charge per day for them was not much different. This is due to decrease in length of stay. Charges for laboratory tests and radiologic examination were quite the same. Charges which are not covered by the insurance remained the same. The revenue of the hospital was reduced as expected. However, the hospital reduced the length of stay and increase the turnover rate In order to compensate the potential loss of revenue due to the difference of reimbursement between the out-of-pocket expense and the insurance coverage. By introducing the IOL benefit in the insurance, the insured pays less, hospital generates more revenue through shortening the hospital stay, and the total medical care cost becomes less nationwidely.

• 한국의료질향상학회지
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• 제7권2호
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• pp.168-179
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• 2000

Background : Economic evaluation of clinical pharmacokinetic consultation services for theophylline, which is being widely used recently, is considered in patients for both proper care and cost efficiency. Mathods : This is a cost-benefit analysis of clinical pharmacokinetic consultation service for theophylline. Trial groups were chosen from 2 general hospitals which was performing clinical pharmacokinetic consultation- services in 1998. Control group was chosen from another one general hospital. The analysis includes 25 patients (sample patients) for trial group and 17 patients for control group. Results : On the basis of incremental analysis, it is estimated that the total (direct and indirect) annual costs of the clinical, pharmacokinetic services of theophylline for the patients in the trial group was about \65 million, whereas total annual benefits from those services was estimated to be about \551 million. The net benefits incurred to the sample patients, thus calculated, was about \485 million per year. In the analysis, we assumed that indirect benefits accruing to those services were non-existent. If that amount was included, the estimated net benefits would be much greater than the calculated one. Conclusion : We found that clinical pharmacokinetic consultation services for theophylline could produce more marginal benefits than marginal costs by those services from the social point of view. More controlled prospective trial in the future would be helpful for affirmation of the results of this study.

• Journal of Preventive Medicine and Public Health
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• 제38권1호
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• pp.82-92
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• 2005

Objective : To evaluate the relationships among sociodemographic characteristics, health behaviors, levels of pros and cons and stages of change in Pap testing for uterine cervical cancer. Methods : A questionnaire survey was performed on 560 randomly sampled people who were assigned to participate in a Pap testing program by the National Cancer Screening Project in 2003' between 25 September and 10 October in Gyeonggi, Korea. Data about the behaviors and intentions of Pap testing, sociodemographic characteristics, health behaviors, and levels of acknowledged benefit (pros) and barrier (cons) for Pap testing was collected. The stages of change were grouped according to behaviors and intentions of Pap testing as passive, active, and relapse. Results : Logistic analysis between the passive and active groups showed that city dwellers, 'high' and 'middle' groups in terms of the individual s health belief, those who had undergone a health examination within the past 2 years, and those who had undergone hormone replacement therapy had a higher odds ratios to be in the active group. As the 'benefit' scores increased and the 'Unnecessity' scores decreased, the probabilities to be in the active group increased. According to the logistic analysis results between the active and relapse groups, those who were 60 years or older, members of the National Heath Insurance, and those who had not undergone a health examination within the past 2 years had a higher odds ratio to be in the relapse group. The 'Benefit' scores were not significant in this relationship. The probabilities of being in the relapse group increased as the Unnecessity and 'Shamefulness' scores increased. Conclusions : In conclusion, health planners should inform women in the passive group of the benefits and necessity of Pap testing. It would be better to reduce the barriers to the active group of undergoing Pap smear. This study might be a useful guide for future planning of Pap testing program.

• 대한지역사회영양학회지
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• 제16권6호
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• pp.683-696
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• 2011

This study compared levels of health beliefs and health behavior practices according to lifestyle pattern among adults in Seoul. A self-administered survey questionnaire was collected from a total of 1,004 Seoul residents aged 30-59 years. The levels of perceived benefit, perceived barrier, and self-efficacy from health belief model and health behavior practices were measured across multiple health behavior areas including dietary behavior, drinking, smoking, exercise, functional food consumption, and weight control behavior. Factor analysis and subsequent cluster analysis based on 28 lifestyle questions divided the subjects into four lifestyles of society-, economy-, trend-, and health-oriented lifestyle. Some general characteristics were significantly different by lifestyles. The society-oriented lifestyle was significantly higher in proportions of men and overweight. The trend-oriented lifestyle was significantly younger and spent more monthly allowance. Health-oriented lifestyle was older. The levels of health belief variables and health behavior practices significantly differed by lifestyles. Overall the health-oriented lifestyle showed more desirable levels of health belief variables and health behavior practice in various health behavior areas compared to the other lifestyles, whereas the society-oriented lifestyle was found the other way. Health belief model variables including perceived benefit, perceived barrier, and self-efficacy were generally significant in predicting the levels of various health behavior practice, with somewhat differences by lifestyle pattern and health behavior type. The study findings suggest it may be useful to segment target subjects according to lifestyle pattern in planning and administering health education programs.

• 여성건강간호학회지
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• 제5권3호
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• pp.327-336
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• 1999

The purpose of this study was to identify the health promotion behavior and its related factors of persons who wanted a comprehensive health check-up in order to provide a basis for health education to promote health enhancing behavior. Study variables were induced from Pender's Health Promotion Model. The subjects were 160 persons who had a check-up at the health promotion center in a university hospital in Tae-Gu, between September 8 and 22, 1998. The following instruments were used in the study : Lee Tae Wha's Health Promoting Life-style Profile, Park Chai soon's Self-efficacy Instrument and Moon Jeong Soon's Perceived Benefit and Barrier Instrument. Data was collected by self-reporting questionnaire. Analysis of the data was done by SAS program, t-test, ANOVA and Pearson-Correlation Coefficient. The results of this study were as follows. 1. The average score for the health-promotion behavior was 104.64. In the subcategories, self-actualization showed the highest degree of performance and physical exercise showed the lowest degree of performance. 2. In the relation of general characteristics of subjects to the level of health-promoting behavior, the male, the married, the group with several symptoms showed a high level of health-promoting behavior. 3. The relationship between the degree of performance in health-promotion behavior and its correlates were as follows: Self-efficacy was positively correlated to health promotion behavior, while the perceived barrier was correlated negatively. But the perceived benefit did not show a significant correlation with health promotion behavior. Results suggest that the development of programs with strategies to strengthen doing physical exercise and concerning health, increase self-efficacy and exclude the barriers to health promotion is recommended to individuals seeking a comprehensive health check-up.