• Journal of dental hygiene science
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• v.15 no.2
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• pp.91-97
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• 2015

The purpose of this study was to examine any possible differences among adolescents in unmet dental care needs according to their demographic and socioeconomic characteristics and oral health status and influential factors on the basis of the fifth national health and nutrition examination survey data. The findings of the study were as follows: Unmet dental care needs were accounted for 19.84 percent. As for the reason, many replied that they couldn't afford to leave school during school hours, and economic factors. As a result of analyzing what affected their unmet dental care needs, this experience was more common in the older age groups than in the 6~12 years age group, and the experience was less common in the respondents with a larger income. As for the subjective oral health status, the experience was 0.61-fold and 0.72-fold less in the respondents who perceived their health as fair or good than who thought their health was poor respectively. And there was a tendency that getting regular dental checkups led to 0.22-fold less experience. Given the above-mentioned findings, the kind of policy that makes dental care services more accessible to youth in consideration of socioeconomic circumstances should be carried out. As many of the adolescents couldn't leave school during school hours, schools should be equipped with dental clinics to improve accessibility to dental care services.

• KDI Journal of Economic Policy
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• v.30 no.2
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• pp.99-128
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• 2008

Nearly all Koreans are insured through National Health Insurance(NHI). While NHI coverage is nearly universal, it is not complete. Coverage is largely limited to minimal level of hospital and physician expenses, and copayments are required in each case. As a result, Korea's public insurance system covers roughly 50% of overall individual health expenditures, and the remaining 50% consists of copayments for basic services, spending on services that are either not covered or poorly covered by the public system. In response to these gaps in the public system, 64% of the Korean population has supplemental private health insurance. Expansion of private health insurance raises negative externality issue. Like public financing schemes in other countries, the Korean system imposes cost-sharing on patients as a strategy for controlling utilization. Because most insurance policies reimburse patients for their out-of-pocket payments, supplemental insurance is likely to negate the impact of the policy, raising both total and public sector health spending. So far, most empirical analysis of supplemental health insurance to date has focused on the US Medigap programme. It is found that those with supplements apparently consume more health care. Two reasons for higher health care consumption by those with supplements suggest themselves. One is the moral hazard effect: by eliminating copayments and deductibles, supplements reduce the marginal price of care and induce additional consumption. The other explanation is that supplements are purchased by those who anticipate high health expenditures - adverse effect. The main issue addressed has been the separation of the moral hazard effect from the adverse selection one. The general conclusion is that the evidence on adverse selection based on observable variables is mixed. This article investigates the extent to which private supplementary insurance affect use of health care services by public health insurance enrollees, using Korean administrative data and private supplements related data collected through all relevant private insurance companies. I applied a multivariate two-part model to analyze the effects of various types of supplements on the likelihood and level of public health insurance spending and estimated marginal effects of supplements. Separate models were estimated for inpatients and outpatients in public insurance spending. The first part of the model estimated the likelihood of positive spending using probit regression, and the second part estimated the log of spending for those with positive spending. Use of a detailed information of individuals' public health insurance from administration data and of private insurance status from insurance companies made it possible to control for health status, the types of supplemental insurance owned by theses individuals, and other factors that explain spending variations across supplemental insurance categories in isolating the effects of supplemental insurance. Data from 2004 to 2006 were used, and this study found that private insurance increased the probability of a physician visit by less than 1 percent and a hospital admission by about 1 percent. However, supplemental insurance was not found to be associated with a bigger health care service utilization. Two-part models of health care utilization and expenditures showed that those without supplemental insurance had higher inpatient and outpatient expenditures than those with supplements, even after controlling for observable differences.

• Journal of Internet Computing and Services
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• v.17 no.6
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• pp.113-122
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• 2016

Information and Communication Technology (ICT) has revolutionized the world and has profound impact on the social and economic development of a country. Implementation, practice and accessibility of ICT is viewed as an integral part of any countries' strategy today. These new technologies are becoming popular due to their ability to produce, distribute and provide instant access to massive information in no time. ICT has pervaded almost every aspect of human endeavor that may include health, education, economics, governance, entertainment etc. Tourism is one such vital industry that find enormous application of ICT in its strategic and operational level, to promise long term benefits and enhance economic growth. Tourism industry in western world and some developed countries of Asia have applied ICT for more than 30 years, and have gained tremendous benefits. Nepal which is also growing as one of the favourite tourist destinations lacks proper implementation of ICT in this industry. In our study we examined how the ICT can play a vital role in developing the tourism industry of Nepal. This study is an exploratory research based on primary data collected from tourist visiting Nepal, supported by information from tour operators, government agencies, NGOs and INGOS. A framework is devised on the basis of data and information collected and finally, discussions elaborate on the prospect and challenges of implementation of ICT in tourism industry of $Nep{\grave{a}}l$.

• Journal of Home Health Care Nursing
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• v.8 no.2
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• pp.159-170
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• 2001

Client(patient) satisfaction has been used for a variety of purposes in different settings, yet, those receiving home care services have been the focus of few satisfaction studies. Satisfaction is considered an indicator of quality of care and is also being used to assess the performance of home care providers and home health care delivery at multiple levels. The aim of this study was to develop the tool for evaluating client satisfaction in several aspects with home care service while maintaining or achieving acceptable reliability and validity. Firstly, Client Satisfaction Instrument made preliminary of 43 items composed basic 6 criteria and 7 indicators, based on a review of literature, quality improvement and client satisfaction findings in home care. Secondly, there were consisted in two expert panel groups who were made in professionals of research and practice in home care field. The tool was modified to 6 criteria and 7 indicators, 25 items after reviewing by two expert panel groups. The content validity index of the tool was above 0.8 and the results of internal consistency was more than 0.8 in all items. Finally. The Client Satisfaction Instrument in Home Care Service was made up 6 criteria such as client satisfaction of nurses's instruction of home care educational need. knowledge/technique/attitude of homecare nurses's performance. interpersonal relationship and emotional support of nurse. easiness of homecare accessibility, continuity of homecare service. overall efficacy of homecare use, 7 indicators. and 25 items. The results of evaluating client satisfaction will be able to contribute in quality improvement and service marketing in home care.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.4
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• pp.1627-1631
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• 2015

Background: Stage at diagnosis is one of the most important prognostic factors of breast cancer survival. Because in the breast cancer case this may vary with socioeconomic characteristics, this study was performed to recognize the relationship between demographic and socioeconomic factors with stage at diagnosis in Iran. Materials and Methods: This cross-sectional, descriptive study conducted on 526 patients suffering from breast cancer and registered in Cancer Research Center of Shahid Beheshti University of Medical Sciences from 2008 to 2013. A reliable and valid questionnaire about family levels of socioeconomic status filled in by interviewing the patients via phone. For analyzing the data, Multinomial logistic regression, Kendal tau-b correlation coefficient and Contingency Coefficient tests were executed by SPSS22. Economic status, educational attainment of patient and household head and/or a combination of these were considered as parameters for socioeconomic status. First, the relationship between stage at diagnosis and demographic and socioeconomic status was assessed in univariate analysis then these relationships assessed in two different models of multinomial logistic regression. Results: The mean age of the patients was 48.3 (SD=11.4). According to the results of this study, there were significant relationships between stage at diagnosis of breast cancer with patient education (p=0.011), living place (p=0.044) and combined socioeconomic status (p=0.024). These relationships persisted in multiple multinomial logistic regressions. Other variables, however, had no significant correlation. Conclusions: Patient education, combined socioeconomic status and living place are important variables in stage at diagnosis of breast cancer in Iranian women. Interventions have to be applied with the aim of raising women's accessibility to diagnostic and medical facilities and also awareness in order to reducing delay in referring. In addition, covering breast cancer screening services by insurance is recommended.

• The Journal of the Korea Contents Association
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• v.22 no.6
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• pp.567-579
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• 2022

The purpose of this study is to find a way to improve the hospice system to increase comfortable home death, which people prefer, by understanding the factors affecting the difference in the rate of home death between South Korea and America within the hospice system. This study employs the Most Similar Systems Design, which is a case study approach. The result of this study is that both countries have public health insurance systems that are identical in terms of the appropriate time for the receipt of hospice services and the application procedure, which requires that two doctors confirm the patient's hospice eligibility. The main difference is that in South Korea, inpatient hospice is prevalent, whereas routine home care is predominant in the United States. Furthermore, in the United States, hospice assistants and housekeepers support at-home daily living care. Additionally, the United States provides inpatient respite care to allow care-giver, such as family to rest and there is no restriction on hospice-eligible diseases. To increase the accessibility of voluntary home death in South Korea, it is necessary to activate and expand the home type hospice service range and provide at-home daily living care, care-giver support services. Furthermore, there should be no restrictions on hospice-eligible diseases.

• Journal of Korean Library and Information Science Society
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• v.51 no.3
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• pp.1-25
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• 2020

The World Health Organization estimated that more than a billion people (or 15% of the world's population) lives with disabilities. They have the same information needs as non-disabled people. Nevertheless, as the World Blind Union estimated, less than 10% of published books are ever made into accessible formats in developed countries. The role of the national library should be very important to improve the information accessibility for the disabled. Based on this perspective, this study analyzed and compared the history and development, legal basis and organization, main functions and tasks, and service features for the disabled for the Library of Congress of the United States, MTM(Myndigheten för Tillgängliga Medier) of Sweden, National Diet Library of Japan, and SALB (South African Library for the Blind) of Republic of South Africa representing the nationwide disability services by continent. And based on the results of the analysis, this study suggested ways to strengthen the capacity of the National Library for the Disabled of Korea.

• Journal of agricultural medicine and community health
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• v.38 no.1
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• pp.14-24
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• 2013

Objectives: Pregnant women in rural areas do not have access to sufficient obstetric services in their own communities due to the shortage of obstetricians. Therefore, most of these women must seek obstetrician outside of their communities. The purpose of this study was to investigate the relationship between obstetric complications and accessibility to local obstetric care in Korea. Methods: This study was an ecological study in which the unit of analysis was an administrative district. Using Korea National Health Insurance Corporation data, the total number of deliveries and the delivery proportion within and outside of the community from 2001 to 2008 were calculated for 232 administrative districts nationwide. Three outflow levels were categorized based on each district's out-of-community delivery proportion: high outflow (upper one third), moderate outflow (middle one third), and low outflow (lower one third). In addition, three obstetric complication rates (the rate of complications following abortion, ectopic and molar pregnancy, the abortion rate, and the eclampsia rate) were calculated for the 232 districts. One-way ANOVA and multivariate linear regression were used to evaluate obstetric complications among the three outflow levels. Results: The high outflow districts had higher rates of eclampsia and complications following abortion, ectopic, and molar pregnancy compared to the other districts (ANOVA, p<0.05). However, there was no significant difference in the abortion rate among the three groups. Multiple linear regression analysis showed that high outflow districts were statistically significant in the rate of complications following abortion, ectopic and molar pregnancy and eclampsia rate after adjusting for local tax per capita (p<0.01). Conclusion: These results indicate that poor access to local obstetric care correlate with poor obstetric outcomes (delayed or excessive bleeding, embolism, genital tract or pelvic infection, shock or other complications following abortion and ectopic or molar pregnancy, or eclampsia).

• Journal of Preventive Medicine and Public Health
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• v.39 no.5
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• pp.411-418
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• 2006

Objectives: The purpose of this study was to determine whether the disabled have worse access to primary care than the non-disabled. Methods: We used the National Disability Registry data and the National Health Insurance data for the calendar year 2003, and we analyzed 807,380 disabled persons who had been registered until December 2001 and we also analyzed 1,614,760 non-disabled persons for nine ambulatory care sensitive conditions (ACSCs). The rates of physician visits and hospitalizations for the patients with ACSCs were compared between the disabled and the nondisabled. Multiple logistic regression analysis was used to evaluate the association between medical care utilization and disability and to assess the association between hospitalization and the number of physician visits while controlling for potential confounders. Results: The numbers of physician visits per 100 patients were $0.78{\sim}0.97$ times lower for the disabled than that for the non-disabled with five of nine ACSCs. The numbers of hospitalizations per 100 patients were $1.16{\sim}1.77$ times higher for the disabled than that for the non-disabled with all the ACSCs. While the ORs of a physician visit for the disabled were significantly lower than that for the non-disabled with all the ACSCs (OR: $0.44{\sim}0.70$), and the ORs of hospitalization for the disabled were significantly higher (OR: $1.16{\sim}1.89$). The lower physician visit group (number of physician visits ${\leq}$1) was more likely to be hospitalized than the higher physician visit group (number of physician visits ${\geq}$2) (OR: $1.69{\sim}19.77$). The effect of the physician visit rate on hospitalization was larger than the effect of disability on hospitalization. Conclusions: The results suggest that the disabled were more likely to be hospitalized for ACSCs due to their lower access to primary care.

• 재활복지
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• v.21 no.1
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• pp.47-70
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• 2017

The aim of this study was to explore the effects of the epidemiological factor (depression), the behavioral factor (activities of daily living), the predisposing factor (self-efficacy), reinforcing factors (family support, professional support), and enabling factor (resource availability, accessibility) on quality of life in home-dwelling disabled people in rural areas. The conceptual model for this study was established on the basis of the PRECEDE model which was developed by Green and Kreuter. Data were drawn from the "Preliminary Investigation for Community-centered rehabilitation" conducted by a public health center located in the O province in 2011 and 186 of 190 disabled people who participated in the survey were included in the final analysis. Data were analyzed using Direct effects on quality of life arose from latent variables depicting the epidemiological factor (depression)and reinforcing factor (family support, professional support), while indirect effects arose from the behavioral factor (activities of daily living), the predisposing factor (self-efficacy), and enabling support (resource availability, accessibility). This model explained 85.5% of the variance in quality of life among rural disabled individuals. These findings may have shed some light on the necessity of including strategies to reduce depression and to strengthen supports from family and healthcare professionals when performing rehabilitation programs to improve quality of life in home-dwelling disabled people in rural areas. Furthermore, it suggested that it would be useful to develop specific strategies and tactics which might increase self-efficacy and to expand linkages between public health centers and other professional institutions such as hospitals for community-centered rehabilitation services for individuals with disabilities.