• Health Policy and Management
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• v.15 no.2
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• pp.16-36
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• 2005

Due to the existence of asymmetry of information between doctor and patient, it has been believed that doctor might affect patient's decision making process of purchasing medical care. Based on this notion, doctor's reimbursement method has been suggested as an effective policy device of improving efficiency of patient's medical care use by way of its affecting doctor's practice pattern. By using the Community Tracking Study (CTS) household and physician data set, which includes not only various information on patient's medical care use, but doctor's practice arrangements and sources of practice revenue, this paper investigates the effect of community doctor's characteristics of reimbursement method on community patient's medical care use under the control of patient's socio-demographic characteristics and community doctor's practice type. In the process of estimating econometric model, the endogeneity problem of individual health insurance purchase was corrected by using 2818. And due to the existence of sample selection problem, Heckman's two-step estimation method was used for strengthen the robustness of estimation which was adversely affected by sample selection problem The empirical results show that as the average value of community doctor's portion of practice revenue determined by prospective method out of total revenue increases, the community patient's total out-of-pocket medical cost decreases. This results suggest, as doctor's practice revenues are mainly determined by prospective method, such as capitation, doctors would be more conscious about practice cost, which might affect doctor's practice pattern and by which his/her patient's use of medical care would decrease.

• Health Policy and Management
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• v.19 no.2
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• pp.21-35
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• 2009

Limited studies examined Medical Aid recipients' perception for amount of medical use. This study aimed to identify self-perception(optimal, under and overutilization) for amount, and real amount of medical use, and to determine factors associated with the perception. Subjects were 2,489 Medical Aid recipients among top 2% overusers in 2005. 200 case managers(CM) managing them conducted survey. CM interviewed them using 2005 medical claiming data from the Health Insurance Review & Assessment Service and structured questionnaire. Despite of overusers, perception of overutilization was only 26.9% and 23.6% in Class I and Class II, and that of underutilization was 21.4% and 18.7% respectively. In Class I, monthly total outpatient cost per capita of overutilization perception in 2006 was 206 thousand won higher than 150 thousand won of optimal utilization. Amounts of outpatient visit-days and prescribed cases of overutilization perception were higher than those of optimal and underutilization(p <0.0001). In Class II, overutilization perception had more prescribed cases(p 0.004). After adjustment of confounding factors including age and sex, the associated factors(odds ratio) with overutilization perception were hypertension(1.25), arthritis(1.32), depression(1.66), visit of multi medical institutions(3.09), and those of the underutilization were female(1.34), disabled(1.27), no family support(1.49), living in medium and small city(1.48), experience of unabled-visit to medical institution(2.54), frequent visit-recommendation from physician (1.36). In conclusion, education and consult are needed for subjects to improve the reasonable decision of medical use, and the self-care ability to manage diseases and symptoms. We suggest reinforcing the alternative service in community instead of costly medical institution.

• Journal of Preventive Medicine and Public Health
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• v.50 no.3
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• pp.177-187
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• 2017

Objectives: Medical students represent a primary target for tobacco cessation training. This study assessed the prevalence of medical students' tobacco use, attitudes, clinical skills, and tobacco-related curricula in two countries, the US and Italy, with known baseline disparities in hopes of identifying potential corrective interventions. Methods: From September to December 2013, medical students enrolled at the University of Bologna and at Brown University were recruited via email to answer survey questions assessing the prevalence of medical students' tobacco use, attitudes and clinical skills related to patients' smoking, and elements of medical school curricula related to tobacco use. Results: Of the 449 medical students enrolled at Brown and the 1426 enrolled at Bologna, 174 Brown students (38.7%) and 527 Bologna students (36.9%) participated in this study. Italian students were more likely to smoke (29.5% vs. 6.1%; p<0.001) and less likely to receive smoking cessation training (9.4% vs. 80.3%; p<0.001) than their American counterparts, even though the majority of students in both countries desired smoking cessation training (98.6% at Brown, 85.4% at Bologna; p<0.001). Additionally, negative beliefs regarding tobacco usage, the absence of formal training in smoking cessation counseling, and a negative interest in receiving specific training on smoking cessation were associated with a higher risk of not investigating a patient's smoking status during a routine history and not offering tobacco cessation treatment to patients. Conclusions: Medical curricula on tobacco-related health hazards and on smoking cessation should be mandatory in order to reduce smoking among medical students, physicians, and patients, thereby improving tobacco-related global health.

• The Journal of Korean Medicine
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• v.31 no.1
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• pp.69-80
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• 2010

Objectives: This study aimed to find determinants of customers' use of and satisfaction with oriental medical services in Korea. Methods: A total of 33 articles which consist of 9 articles published in academic journals, 20 master's theses, and 4 doctoral dissertations were included in the systematic review. Among the articles used in the study, 29 used primary survey data, while 4 used secondary data produced by the Korean National Health and Nutrition Evaluation Survey. Results: First, it was found that people who prefer to use oriental medical services usually have one or more of the following diseases: musculoskeletal disorders, paralysis, or diseases or injuries without clear diagnosis. Other variables of gender, age, expectation of treatment outcome, and kindness of doctor and other staff were found to be significant determinants of using the oriental medical services. Second, the determinants of customers' satisfaction with oriental medical services were found to be age, gender, level of education, chronic disease with long length of stay, kindness of staff, medical cost, clinical environment, doctor's reputation, and public image of the institutions. Conclusion: The results of this study can be used to develop marketing strategies for oriental medical institutions in Korea.

• Proceeding of Spring/Autumn Annual Conference of KHA
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• 2008.04a
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• pp.187-192
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• 2008

This purpose of this study is to figure out the inter-relationship between the residence stories in high-rise mixed-use apartments and their residents' disease patterns throughout the dweller's medical reports in high-rise mixed-use apartments. Research basic data are obtained from medical fee request of National Health Insurance Corportion. Data are limited a housing complex to 'A' high-rise mixed-use apartment and a medical treatment time to 3 years(2004-2006). Analysis data of total 346,286 medical records, 43,159 disease records, and 8,999 persons are collected. By analyzing those data, findings are as follows: 1) Women is more medical treatments than men, 40-50 age group is more treated, and the residents of 6-25 stories are more received medical treatments. Diseases of the respiratory system and diseases of the eye and adnexa are relatively treated higher than other diseases. 2) The diseases of the respiratory system, the eye and adnexa, the skin and subcutaneous tissue, the ear and mastoid process), and the asthma have not relation to the high-storied residence through the data of disease records and personal records. But the analysis on the data of children, 7 ages and less, is showed a significant relation. And to conclude, there is no relationship between the residence of high-stories in that apartment and dwellers' disease patterns, but there is a little probable to the relationship in the pre-school child.

• The Korean Journal of Emergency Medical Services
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• v.12 no.1
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• pp.5-15
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• 2008

Purpose : Centering on users(patients) who are offered the patient transport service by the emergency medical service system in our country, the use and satisfaction are analyzed with the transport service in 119 Emergency Medical Service System and Private transport agent. Results : 1. As for personnel in ambulance cars, 119 emergency staff showed a higher boarding rate of the first-class emergency medical technicians than private transportation centers : 48.4% and 17.7%, respectively. 2. Private transportation centers showed higher user satisfaction with transportation service than 119 emergency staff, which was not statistically significant. 3. As for the case that needs to receive the transport service in the future, the ratio with the will to use 119 Emergency Medical Service System(70.9%) was indicated to be much higher than the ratio of the private transport agent(29.1%). Suggestions : First, Centers transporting first-aid patients should essentially secure a sufficient number of first-class emergency medical technicians as professional emergency medical staff to reinforce qualitative improvement in emergency medical service. Second, It is necessary to establish a systematic monitoring system and develop educational programs in order to enhance satisfaction with the use of 119 emergency staff. Third, the government or the local government needs to positively support and guide the private transport agent, which is in charge of the public medical service.

• International Journal of Knowledge Content Development & Technology
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• v.9 no.2
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• pp.45-64
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• 2019

This study examined the perception and use of web 2.0 applications for academic purposes by medical students of Ambrose Alli University, Ekpoma. The objective was to investigate the medical students' perceptions of web 2.0 applications, web 2.0 tools use, extent of use, perception and purpose for using web 2.0 applications. Descriptive survey method was used for this study. The total population of this study was 3670 and the sample size was 367 representing 10% of the study. The purposive sampling technique was adopted, and the instrument used for this study was questionnaire, a total of 367 copies were administered and 321 were found useful for the study. Percentage means and standard deviation on table and chart were used to analyze the data collected using Statistical Package for the Social Sciences (SPSS) software. Findings showed that the perception of web 2.0 applications of medical students AAU was positive and few of web 2.0 applications were used for academic purposes. It was recommended in the study that medical students should be provided with the facilities in a format more familiar to them and used by most of them and institutions need to equip the learning process with the needed facilities which will be of utmost benefit even for future purposes.

• Korea Journal of Hospital Management
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• v.24 no.1
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• pp.11-20
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• 2019

The purpose of this study was to identify the factors affecting the use of superior general hospitals on public holidays by using the medical use model (Dutton's medical use model) with the medical panel data. The study found that 34.2% of superior general hospital emergency rooms were used on public holidays and the factors which made statistically significant influences on the use of superior general hospital emergency rooms on public holidays were whether patients were operated or emergency care and inspection etc. Also, there was a difference depending on whether the type of establishment of the medical insititution is national or private. In other words, patients who received emergency care and examinations were found to make more frequent visit to hospital emergency room on pubic holiday, compared to patients who underwent surgery and those who visited emergency rooms in the private superior general hospital did so, compared to those who visited emergency room in the national general hospital(OR, 4.4, 3.386, respectively). Therefore, it is necessary to consider the introduction of integrated care of health and social care medical service that focuses on primary care in Denmark, which focuses on patients, and pre-The Canadian Triage and Acuity Scale(pre-CTAS) in the UK.

• Korean Journal of Social Welfare
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• v.62 no.3
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• pp.83-108
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• 2010

This study aims to estimate the trajectory of outpatient medical service use and examine what factors are associated with the trajectory among older adults 60 and over with specific focuses on age variations. Using the first three waves of the Korean Welfare Panel Study data, the trajectory and predictors were examined through the Latent Growth Curve Modeling and age variations were examined through the Multi-group Comparison Analyses. The research model was developed based on the Anderson Model. The results showed that study participants tend to increase outpatient medical service use with years. Individuals 75 or younger presented a much faster increasing rate of medical service use than those 75 and over. Similar to the findings of the previous studies, most predisposing factors, resource factors, and needs factors were found to be associated with the trajectory of outpatient medical service use. Needs factors were more closely associated with the medical service use trajectory than resource factors. With regard to age variations in predictors, few significant age variations were found. Based on the finding of the study, implications and future research directions were discussed.

• Journal of Society of Preventive Korean Medicine
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• v.23 no.3
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• pp.13-20
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• 2019

Objectives : The aim of this study is to investigate the use experience of other medical institution of outpatients of Korean medical institution. Methods : Cross-sectional study using the 2017 Korean Medicine Utilization and Herbal Medicine Consumption Survey was conducted. Demographic variables and frequent diseases were analyzed according to the experience of using other medical institutions. The proportions of experience of using other medical institutions of patients with frequent diseases of Korean medical outpatient were analyzed. Results : Fifty-three percent of outpatient had experiencing using other medical institutions for the same symptoms. The frequent diseases of the two groups were similar. The proportion of single use of Korean medicine for injury of lumbar and pelvic, rhinitis, and menstrual disorders were relatively high. Conclusions : There was no notable difference in the frequent diseases according to use experience of other medical institution. Further studies on this topic are needed.