• Korea Journal of Hospital Management
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• v.29 no.2
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• pp.18-36
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• 2024

This study delved into the complex nature of medical services as experience goods and trust services, investigating the profound impact of online word-of-mouth on medical consumers' decisions to visit hospitals. Considering the restrictive legal framework for medical advertising, consumers are increasingly dependent on unrestricted sources of information like online reviews. This research aimed to provide empirical evidence for the significant role online word-of-mouth plays in hospital selection. Utilizing data from Naver reviews, hospital choice factors were classified based on the Kano model, revealing the subtle yet significant influence that word-of-mouth has on consumers' hospital visit intentions beyond merely positive or negative messages. In particular, the study provided insights into how the categorized positive and negative information, along with the presence or absence of emotional expression, affects the efficacy of word-of-mouth. The experiment targeted medical consumers aged over 20 and, through analysis using the SPSS statistical program, yielded important findings. The direction of online word-of-mouth, the presence of emotional expression, and the interaction of Kano attributes all created significant differences in hospital visit intentions. Notably, emotional expression included in negative word-of-mouth concerning one-dimensional attributes markedly decreased visit intentions, whereas the absence of emotional expression in attractive attributes actually enhanced reliability and increased visit intentions. These findings offer critical implications for redefining strategies in medical marketing and online review management. The discoveries of this study underscore the importance of active engagement and strategic management of online reviews by medical service providers, urging careful consideration of the various elements of online word-of-mouth that influence medical consumers' hospital visit intentions.

• Korea Journal of Hospital Management
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• v.26 no.2
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• pp.27-42
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• 2021

This study investigated the differences in patient experience by arrangement type of medical tourism facilitators(MTF) from the pre-visit to visit stages. Specifically, patient experiences from each stage with different service providers (MTFs and medical institutions) were measured: provision of information and respect for patient preferences as pre-visit experiences with the facilitators, communication and concierge services as visit experiences with the facilitators, and medical services as medical institution experiences. The scale to measure foreign patients' experiences was modified from the 'Picker in-patient questionnaire(PPE)' and the 'Picker patient experience questionnaire(PPE-15)'. Quantitative data were collected by conducting a self-administered questionnaire on 173 patients from China, Russia, Mongolia, and Kazakhstan. Qualitative data were collected by conducting in-depth interviews with 9 patients and 9 service providers. The data were collected between January and October in 2019. Quantitative data was analyzed by SPSS 25 for Chi-squared test and ANOVA, and qualitative data were analyzed based on keywords. The main results are as follows. When foreign patients used only overseas MTFs, they had a relatively positive patient experience in respect of receiving pre-visit information(F=7.47, p<.01) and respect for patient preferences(F=3.11, p<.05). Looking at both domestic and overseas facilitators during the visit, the patient experience was relatively negative for communication(F=3.75, p<.05). Regarding medical institutions, patients had a relatively negative patient experience with regards to medical services when they used both domestic and overseas facilitators(F=6.49, p<.01). The implications of this study are as follows. Patients should have a seamless and high-quality experience regardless of the facilitator arrangement type. This can be prepared through service standardization for the service providers. It would be also necessary to consider each other's features and problems at the institutional level and to improve service coordination by having service providers periodically communicate with each other.

• Korea Trade Review
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• v.46 no.4
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• pp.167-188
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• 2021

This study was carried out to identify the key drivers behind the rapid growth of the cosmetic medical tourism industry in recent years and determine the future growth engines. Unlike previous studies that have focused on cosmetic medical tourism in the United States, Japan, and China, this paper examines the related trends in ASEAN countries, where the interest in cosmetic surgery has recently surged among young people, as part of the efforts to promote the expansion of the industry in this particular region. The results of the empirical study showed that those from the ASEAN region traveling abroad for cosmetic surgery found the medical professional's expertise in cosmetic surgery technology, medical care system, and administrative convenience in relation to communication and accessibility appealing, and this is what led to an intention to visit. As for another process that formed the intention to visit, it was the sociocultural attitudes towards appearance arising from the attractiveness of celebrities, and this had an impact on the intention to visit abroad for cosmetic surgery. Especially it was newly discovered, based on an empirical analysis, that sociocultural attitudes towards the appearance and attractiveness of celebrities could be a key influencing factor when it comes to the intention to visit another country for cosmetic surgery.

• Journal of Preventive Medicine and Public Health
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• v.12 no.1
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• pp.99-106
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• 1979

Accessibility to medical facilities and personnels has been known as one of important determinants of medical care utilization. This study attempted to identify the effects of medical accessibility in terms of geographical distance and occupational opportunity to the medical utilizations. Two-year-experiences of Yonsei University Health Insurance Cooperatives were used as the sources of data. Out patient utilization patterns of 713 members sampled from 4,352 members of Health Insurance Cooperatives were analyzed in order to identify the effects of medical accessibilities. Findings: 1 Average clinic visit rate of Yonsei Health Insurance is 1.66 per person per year. 2. The utilization rates of geographically more accessible group were 33% higher than that of less accessible group. 3. No marked difference in clinic visit rate were observed between medical and non-medical personnel and their family members. 4. Clinic visit rates among occupationally accessible group were slightly higher than those of less accessible. The utilization rate was more sensitively changed by the insurance policy changes in occupationally accessible group.

• Journal of Acupuncture Research
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• v.41 no.1
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• pp.17-28
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• 2024

This study aimed to analyze whether the coronavirus disease 2019 (COVID-19) pandemic affected the characteristics of first-visit patients with peripheral facial palsy (PFP) and observe changes in their characteristics. This study analyzed the electronic medical records of 2,310 first-visit patients with PFP who visited the Facial Palsy Center, Kyung Hee University Korean Medicine Hospital from January 1, 2019, to December 31, 2021, in terms of demographic characteristics, disease phase, residence locations, hospital visit route, and patient care. During COVID-19, the proportion of acute patients increased by 5.3%, the proportion of visits by residents in Seoul increased by 3.8%, and the proportion of patients receiving only outpatient treatments increased by 12.8%. Significant relationships were present between the presence of the COVID-19 pandemic and the number of patients by disease phase (p = 0.043), residence locations (p = 0.003), and patient care (p = 0.003). Thus, several differences in the characteristics of first-visit patients with PFP visiting a Korean medicine hospital during the COVID-19 pandemic in terms of demographic characteristics, disease phase, residence locations, and patient care.

• Journal of Acupuncture Research
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• v.22 no.4
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• pp.27-34
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• 2005

Objectives : To evaluate the pain improvement of the frozen shoulder patients taken the electro-acupuncture therapy using Visual Analogue Scale. Methods : The 38 frozen shoulder patients visited department of Acupuncture & Moxibustion in National Medical Center from 1st September 2004 to 28th February 2005 had taken the electroacupuncture therapy or body-acupuncture therapy more than 3 times.(Electroacupuncture group was 24 persons and body-acupuncture group was 14 persons.) We evaluated their improvement of shoulder pain using Visual Analog Scale(VAS) at each visit. Then we analyzed the pain improvement comparing with two groups. Results : Both VAS scores of electroacupuncture group and body-acupuncture group have significantly improved. VAS score at third visit of electroacupuncture group and body-acupuncture group have significantly improved. VAS score at third visit of electroacupuncture group was significantly lower than that of body-acupuncture group (p=0.0057). The decreased VAS score after first visit of electroacupuncture group was also significantly higher than that of body-acupuncture group(p=0.0225). Conclusion : The pain of electroacupuncture group decreased more than body-acupuncture group at early visit. But the total decreased VAS scores of two groups was not significantly different.

• Korea Journal of Hospital Management
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• v.23 no.2
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• pp.95-105
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• 2018

Objective: This study conducted an empirical research on foreign patients who had visited the medical institutions of Daegu region in order to identify the effects of the factor satisfaction and experience satisfaction with medical services on their revisit intentions. Methods: This study reviewed the existing studies on medical services to foreign patients with a main focus on medical tourism, and conducted the empirical research through a survey on foreign patients from the Russian, Chinese and English-speaking regions based on the Daegu Medical Tourism Promotion Institute's DB of foreign patients. The empirical research conducted a multiple regression analysis on factor satisfaction and experience satisfaction regarding return visit intentions. Results: The multiple regression analysis results showed that both the factor satisfaction and the experience satisfaction with medical services of foreign patients had positive effects on their return visit intentions, especially, with a relatively greater effect from the factor satisfaction. Specifically, it was found that factor satisfaction elements of 'friendliness of employees', 'good communication', and 'expertise of medical workers'; and experience satisfaction elements of 'reliability of medical information', 'efforts to minimize incompatibility towards foreigners', 'convenient access to medical information' and the like enhanced the return visit intentions. Conclusion: We discovered that, in the context of medical tourism activities, it is important to enhance factor satisfaction and experience satisfaction with medical services in order to promote return visits of the foreign patients who we once attracted. Especially, there are implications that reliability of medical information and efforts to minimize incompatibility towards foreigners enhance return visits of foreign patients.

• 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.

• Health Policy and Management
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• v.14 no.4
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• pp.88-113
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• 2004

Starting from April, 2003, new pre-review system has been introduced and implemented to reduce unnecessary conflict with medical care organizations caused by current retrospective claim review system and to enhance efficiency of review system. The main purpose of pre-review system is to educate doctors to contrive adequacy of medical services. This research mainly focuses on effectiveness of pre-review system's influence on physicians' behavior changes. The analysis-participants were drawn from 1,449 clinics which implemented pre-review system, since April of 2003. The research results are as followings. First, the amount per claim has reduced by $\\3,154$, days of visit per claim by 0.1 day, and amount per visit by $\\412$, which were statistically significant. Second, anesthesiologists have decreased in three indicators the most, and the internists had least of changes. Third, the amount per claim and days of visit per claims has dropped significantly on physicians with less periods of practice and physicians with more ages. Fourth, the clinics without the expensive medical equipments, the city clinics showed significant decrease on days of visit per claim. Fifth, in intervention methods, the one-to-one education showed more significant decrease on amount per visit rather than information feedback by paper. In conclusion, the pre-review system have an impact on self-imposed physician behavioral change. The outcome of this research may be utilized for future extension implementation of pre-review system. Furthermore, it is showed that ability of transitions in medical services review system according to the future transition of payment system and context of health service policy.

• Journal of The Korean Society of Clinical Toxicology
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• v.14 no.1
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• pp.26-32
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• 2016

Purpose: Aspiration pneumonia is an important complication of drug intoxication with decreased mental status. The purpose of the study is to investigate the risk factors of aspiration pneumonia in the patients of benzodiazepine overdose with or without co-ingestion of other drugs. Methods: A retrospective chart review of patients who visited the emergency department between January 2012 and December 2014 was conducted. Demographic data, time from ingestion to visit, initial vital signs, symptoms, mental status, medical history, laboratory results, chest radiological findings and co-ingested medications were recorded. Multiple logistic analyses were performed to verify the association between variables and the development of aspiration pneumonia. Results: A total of 249 patients presented to the emergency department with benzodiazepine overdose. Aspiration pneumonia had developed in 24 patients (9.6%). Univariate analysis revealed time from ingestion to visit was longer, Glasgow coma scale score was lower, hypoxia was presented, leukocytosis was shown, types of ingested drugs was high, less activated charcoal was applied and tricyclic antidepressants was taken in patients that developed aspiration pneumonia. Time from ingestion to visit (odds ratio (OR) 1.121, 95% confidence interval (CI), 1.057-1.189, p=0.000), GCS score (OR 0.724. 95% CI, 0.624-0.839, p=0.000), oxygen saturation (OR 0.895, 95% CI, 0.835-0.959, p=0.002), and co-ingestion of TCA (OR 4.595, 95% CI, 1.169-18.063, p=0.029) were identified as risk factors of morbidity of aspiration pneumonia upon multiple logistic regression analysis. Conclusion: Time from ingestion to visit, low GCS score, low oxygen saturation and co-ingestion of TCA were risk factors of the development of aspiration pneumonia in benzodiazepine overdose patients.