• Journal of muscle and joint health
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• v.27 no.3
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• pp.238-246
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• 2020

Purpose: This study aimed to investigate the effect of home visiting care service and to evaluate the effect from the cost-benefit among older people. Methods: The target participants were enrolled in 2007 and they were classified into 1 year, 2 years, 3 years, and 4 years according to their service provision period. We analyzed health insurance claims data and entitlement data from the National Health Insurance Service databases between 2006 and 2010. This study examined the participants' social-economic and health status factors related to total medical expense. Cost-benefit analysis was done using the net benefit and benefit/cost ratio. Results: Based on the use of home visiting service, the effect was reduced by 223,914 won. The cost for 952,109 people aged 65 or older was 39,891,462,882 won and the benefit was 213,190,534,626 won. The net benefit was 173,299,071,744 won and the benefit/cost ratio was 5.34 times, which was very economical. Conclusion: Home visiting health care should continue to expand as a means of economically effective health care for people aged 65 and older and to ensure health equity for vulnerable groups.

• Journal of Korean Academy of Nursing
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• v.52 no.2
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• pp.202-213
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• 2022

Purpose: This study examined characteristics and patterns of interorganizational networks for smoking prevention and cessation in Korea. Methods: We surveyed two community health centers, ninety-five hospitals or clinics, ninety- two pharmacies, and sixty-five health welfare organizations in two districts of Seoul in 2020. Data on the organizations' characteristics of smoking cessation and interorganizational activities for information sharing, client referral, and program collaboration were collected and analyzed using network statistics and blockmodeling. Results: Network size was in the order of information sharing, client referral, and program collaboration networks. Network patterns for interorganizational activities on information sharing, client referral, and program collaboration among four organizations were similar between the two districts. Community health centers provided information and received clients from a majority of the organizations. Their interactions were not unidirectional but mutual with other organizations. Pharmacies were involved in information sharing with health welfare organizations and client referrals to hospitals or clinics. Health welfare organizations were primarily connected with the community health centers for client referrals and program collaboration. Conclusion: A community health center is the lead agency in interorganizational activities for smoking prevention and cessation. However, hospitals or clinics, pharmacies, and health welfare organizations also participate in interorganizational networks for smoking prevention and cessation with diverse roles. This study would be evidence for developing future interorganizational networks for smoking prevention and cessation.

• Journal of Preventive Medicine and Public Health
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• v.50 no.5
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• pp.303-310
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• 2017

Objectives: The aim of this study was to evaluate socioeconomic inequalities in the prevalence of dental caries among an urban population. Methods: This study was conducted among 2000 people 15-40 years of age living in Kurdistan, Iran in 2015. Using a questionnaire, data were collected by 4 trained dental students. The dependent variable was the decayed, missing, and filled teeth (DMF) index. Using principal component analysis, the socioeconomic status (SES) of families was determined based on their household assets. Inequality was measured using the concentration index; in addition, the Oaxaca analytical method was used to determine the contribution of various determinants to the observed inequality. Results: The concentration index for poor scores on the DMF index was -0.32 (95% confidence interval [CI], -0.40 to -0.36); thus, poor DMF indices had a greater concentration in groups with a low SES (p<0.001). Decomposition analysis showed that the mean prevalence of a poor DMF index was 43.7% (95% CI, 40.4 to 46.9%) in the least privileged group and 14.4% (95% CI, 9.5 to 9.2%) in the most privileged group. It was found that 85.8% of the gap observed between these groups was due to differences in sex, parents' education, and the district of residence. A poor DMF index was less prevalent among people with higher SES than among those with lower SES (odds ratio, 0.31; 95% CI, 0.19 to 0.52). Conclusions: An alarming degree of SES inequality in oral health status was found in the studied community. Hence, it is suggested that inequalities in oral health status be reduced via adopting appropriate policies such as the delivery of oral health services to poorer groups and covering such services in insurance programs.

• Korean Journal of Health Education and Promotion
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• v.28 no.3
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• pp.31-42
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• 2011

Objectives: Busan had the highest mortality and the shortest life expectancy at birth among 16 provinces in Korea in 2008 and there were considerable health inequalities within the region. This study was performed to build up a priority setting framework in Healthy City Busan project. Methods: Analytic hierarchy process was used to determine the relative priority weight for different strategic and program dimensions along with the consistency of response. An on-site workshop-based meeting (calculating importance) and online survey (calculating risk) were conducted to obtain data from 8 experts. Results: The results showed that in strategic criteria "active health promotion & diseases prevention" and "building infrastructure for the Health City project" were two most important factors. In program criteria, considering both importance and risk scores, "making a healthy community" and "building community health centers" in disadvantaged areas were a top priority group. In addition, "enacting an ordinance for the Healthy City", "building the infrastructure for health impact assessment" and "making health care safety net for vulnerable population" were also higher priorities group. Conclusions: Our findings suggest that the Healthy City project in Busan should be focused on strengthening health equity and building infrastructure for sustainability of the project.

• Health Policy and Management
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• v.30 no.1
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• pp.100-111
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• 2020

Background: Few studies have examined the performance of the public long-term care insurance (LTCI) from the perspective of geographic equity. This study investigated regional variations and associated factors in the supply and utilization of nursing home care within and also between Japan and Korea. Methods: A comparative dataset was developed by extracting data from 2013-2015 LTCI statistics yearbooks and Organization for Economic Cooperation and Development regional statistics, as well as other comparable data in Japan and Korea. The unit of analysis was the prefecture in Japan and the province in Korea. We computed variation indices and conducted regression analyses for regional variations within each country and decomposition analyses to examine the variations between the countries. Results: The overall regional supply and use of nursing home care were higher in Japan, but the regional variations in Korea were larger than in Japan. In both countries, the nursing home supply was negatively associated with the proportion of older people with independent living. Nursing home use was also negatively associated with the supply of hospital beds and home care agencies in Korea; the relationship was the opposite in Japan, however. The country-based differences were more likely to be explained by differences in the distributions of the variables included in the analytical model than country-specific characteristics. Conclusion: Regional-level nursing home supply and use were unequal in both countries, and the contributing factors were not the same. Policy efforts are needed to advance regional equality in long-term care (LTC) and collaboration between health and LTC institutions for frail older people, especially in Korea.

• Journal of Preventive Medicine and Public Health
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• v.54 no.1
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• pp.73-80
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• 2021

Objectives: Household overcrowding (HC) can contribute to both physical and mental disorders among the members of overcrowded households. This study aimed to measure the status of HC and its main determinants across the provinces of Iran. Methods: Data from 39 864 households from the 2016 Iranian Household Income and Expenditures Survey were used in this study. The Equivalized Crowding Index (ECI) and HC index were applied to measure the overcrowding of households. Regression models were estimated to show the relationships between different variables and the ECI. Results: The overall, urban, and rural prevalence of HC was 8.2%, 6.3%, and 10.1%, respectively. The highest prevalence of HC was found in Sistan and Baluchestan Province (28.7%), while the lowest was found in Guilan Province (1.8%). The number of men in the household, rural residency, the average age of household members, yearly income, and the household wealth index were identified as the main determinants of the ECI and HC. Conclusions: The study demonstrated that the ECI and HC were higher in regions near the borders of Iran than in other regions. Therefore, health promotion and empowerment strategies are required to avoid the negative consequences of HC, and screening programs are needed to identify at-risk families.

• Journal of Preventive Medicine and Public Health
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• v.13 no.1
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• pp.47-51
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• 1980

This study attempts to assess the effect of the 1st class health insurance program to the income redistribution among the participants in a unit health insurance cooperative. One health insurance cooperative, located in Seoul, with 1558 members and 768 households was selected for this purpose. The relationships between amount of premium payed and benefits from the cooperative were compared. Necessary data were obtained from the bills submitted to the health insurance cooperative by the contracted medical institutions from 1st January 1977 to 30th June 1979. Households and individuals were the unit of the assessment. The indicators measuring income redistribution effect were the ratios between the benefit and expected benefit and the ratios between the benefit and the mean benefit. The major findings were: 1. The ratios between the benefits and the expected benefits were lower than 1 in the high income group and greater than 1 in the middle and lower income groups. This fact imply that the income redistribution effect was shown in the studied groups. It was shown that the middle income group received the greatest benefit, and then the lower income group. 2. The ratios between the benefit ana the mean benefit of the households in the higher standard income grade, were found to be higher. This means that the equity of the benefits of households were not achieved by the policy of the health insurance plan. 3. The health insurance utilization rates of the higher standard income group, measured by the household unit, were higher, and by the individual unit, the same rates of the middle income group were higher than other groups.

• The Journal of the Korea Contents Association
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• v.17 no.6
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• pp.63-70
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• 2017

Although the National Health Insurance, many people sign up for private health insurance to alleviate their financial burden. In this study, we analyzed the relationship between private health insurance and subjective financial burden about cost sharing. To confirm the effect we conducted the binary logistic regression by utilizing the Health Care Policy related to public survey. The private health insurance have a significantly association with the subjective financial burden about cost sharing. People who uninsured to purchase private health insurance were more likely to have the burden. Therefore, given the low participation rate of private medical insurance for high age and low income group, we suggest the need for redefining the role of private insurance to enhance the function and resolve equity issues to prepare for the burden.

• Health Policy and Management
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• v.10 no.4
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• pp.99-115
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• 2000

This study was conducted to get a resonable set of budget allocation to public health programs. Matrix Delphi technique was used to obtain the logic of study results and eventually to form a human model which could predict opinion of professionals on budget allocation. Thirty-two professionals in academic and governmental area responded to Delphi survey. Questionnaire was developed using matrix formation, and the matrix was formed by 6 decision criteria on budget allocation and 26 public health programs. The decision criteria are as following: size of problem(morbidity), severity of problem, social equity, importance of prevention, technical feasibility and efficiency of programs. Severity of problem dropped out of the model because it had significant correlation with the size of problem. A total score of each program was obtained by weighting the relative importance of each criteria which also were given by survey respondents. These total scores indicate that the most important public health program is vaccination for infants and children in terms of budget allocation. Monitoring communicable diseases, mental health program, and anti-smoking program are the next. In addition, respondents were asked of the desirable budget size of each program. The result was rearranged by multiple regression model using the scores of each decision criteria. In this process, the current budget size of central government was provided to the respondents, and included in the model. h set of desirable budgets modified using tile model was obtained. Considering the current size of budget, tile results of the model is very different from that of the total score. Managing dementia is ranked the first. Health promotion program for the elderly, rehabilitation of the disabled and monitoring communicable diseases are the next. The need to increase the budget of vaccination for the infants and children was not found as so high. The matrix structure in Delphi survey gave us the precise basis to make optimal decision, and made it possible to develop an opinion predicting model. However the plentifulness and diversity of professional opinions were not fully obtained due to the limited number of decision criteria.

• Korea Journal of Hospital Management
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• v.27 no.1
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• pp.1-10
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• 2022

Background: This study aims to empirically compare and evaluate the current status of medical accessibility and health inequality between people with disabilities and without. We calculated the ACSC hospitalization rate, which is a medical accessibility index, for hypertension, a major risk factor for cardiovascular disease that accounts for more than 20% of deaths among people with disabilities using the 2016 National Health Insurance Big Data. Methods: The subjects of the study were a total of 601,520, including 64,018 people with disabilities and 537,501 people without. Logistic regression was performed to analyze the differences in hypertension hospitalization rates adjusted for demographic and sociological characteristics and disease characteristics using SAS 9.4 program. Results: Before adjusting for the characteristics, the hypertension hospitalization rate of people with disabilities was 1.55%, and the people without disabilities were 0.49%. After adjusting, it was found that people with disabilities were 2.11 times higher than people without disabilities, and it was statistically significant. Conclusion: The preventable hospitalization rate of people with disabilities is higher than that of people without, suggesting that the disabled have problems with access to medical care and health inequality. Therefore, the government's policy improvement is required to close the medical gap for the disabled.