• Journal of Korean Academy of Nursing Administration
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• v.14 no.3
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• pp.229-240
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• 2008

Purpose: To develop the patient classification system based on the resource utilization for reimbursement of long-term care hospitals in Korea. Method: Health Insurance Review & Assessment Service (HIRA) conducted a survey in July 2006 that included 2,899 patients from 35 long-term care hospitals. To calculate resource utilization, we measured care time of direct care staff (physicians, nursing personnel, physical and occupational therapists, social workers). The survey of patient characteristics included ADL, cognitive and behavioral status, diseases and treatments. Major category criteria was developed by modified delphi method from 9 experts. Each category was divided into 2-3 groups by ADL using tree regression. Relative resource use was expressed as a case mix index (CMI) calculated as a proportion of mean resource use. Result: This patient classification system composed of 6 major categories (ultra high medical care, high medical care, medium medical care, behavioral problem, impaired cognition and reduced physical function) and 11 subgroups by ADL score. The differences of CMI between groups were statistically significant (p<.0001). Homogeneity of groups was examined by total coefficient of variation (CV) of CMI. The range of CV was 29.68-40.77%. Conclusions: This patient classification system is feasible for reimbursement of long-term care hospitals.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.30 no.3
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• pp.88-99
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• 2019

Objectives: With increasing concerns for the rapidly growing minority population in South Korea, this literature review addressed a range of mental health risks among multiethnic youths (MY) in South Korea by 1) comparing mental health outcomes with those of native-born youths and 2) identifying multiple layers of relevant environmental factors, from family and school relationships to culture. Methods: We reviewed 54 studies that fulfilled specific inclusion criteria. Results: Multiple common risk/protective factors, including family separation, family relationship quality, parental socioeconomic and mental health status, social relationships at school, and cultural acceptance, were noted. Conclusion: In general, empirical evidence indicates that minority youths have relatively heightened risks for emotional and behavioral problems. Future studies must elucidate the complex interplay between multiple risk and protective factors and the long-term adaptation and mental health service utilization of MY.

• Health Policy and Management
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• v.21 no.3
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• pp.397-413
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• 2011

Purpose: The purpose of this study is to examine the relationship between the income level and the healthcare utilization by health insurance type in all cancer patients in year 2005. Methods: The target population was cancer patients with health insurance who used healthcare as a diagnosis code (C00-C97) from January 1 to December 31 of 2005. The Korea Central Cancer Registry Center's Cancer Patient Registry Data, the list of cancer patients of the National Health Insurance Corporation, and the claim data of the Health Insurance Review & Assessment Service were used. The I was the wealthiest, followed by II, III, IV. The V was the poorest in this study. For the analysis, the $x^2$-test, ANOVA (and Kruskal-Wallis test), and regression were used. Results: Outpatient and hospitalization medical expenses, and outpatient visit days of cancer patients with self-employed health insurance were highest in I (p<.001, respectively), and the hospitalization days were the highest in II (p<.001, respectively). Outpatient and hospitalization medical expenses, and outpatient visit and hospitalization days of cancer patients with occupational health insurance were the highest in I (p<.001, respectively). Outpatient and hospitalization medical expenses, and outpatient visit and hospitalization days in cancer patients were higher in I compared to V, and higher in II and III, IV compared to V (p<.001, respectively). Conclusion: Supporting plan for cancer patients' outpatient healthcare utilization are necessary. Moreover, we should make specialized strategy for low income cancer patients with self-employed health insurance when we develop quality improvement policy for inpatient service.

• Korean Journal of Health Education and Promotion
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• v.23 no.4
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• pp.47-65
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• 2006

Objectives: This research is to provide the basic data for the improvement on oral health by examining the relationship between the dental fear and the dental service utilization, and to discuss a strategy for dental health in order to lower the level of dental fear. Methods: Data were collected by conducting a structured survey of 1,607 people between the age of 13 and 70 who have experiences in visiting a dental institution. Both univariate and multivariate analyses were employed to analyze the relationship between the number of times dental service and dental fears. Results: The average level of dental fear the respondents reported was $52.16{\pm}15.71$ and 31.5% of the response was at the level of high dental fear. A strong physiologic response during the dental treatment was muscle tension and the stimulations that strongly arouse the dental fear were the anaesthetic needle and the sound of drill. A result of analysis on the relationship between the dental fear and the dental service utilization shows that as the level of dental fear became higher, the number of times for the dental service utilization for the last year had reduced. Also when a patient has an experience of putting off or canceling an appointment due to dental fear and as a physiologic response during the dental treatment became stronger, the result shows a tendency that the number of times for the dental service utilization for the last year had reduced. Conclusions: It has been observed that dental fear is one of the main barrier to use dental service. Therefore, a physio-psychological factor like the dental fear should be included in the task of promotion of dental health, and in analyzing the dental service utilization behavior. A discussion about how to lower dental fear was made with respect to oral health promotion. At individual level, improvement of communication skill by dental service providers should be made with rearrangement of clinic environment into more cozy one.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.19
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• pp.8229-8237
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• 2014

Background: Organized cervical screening has decreased the incidence of cervical cancer. However, screening strategies vary in different countries. Objectives: We performed a systematic review to evaluate the economic aspects of different screening methods. Materials and Methods: We searched databases and then data were abstracted from each study. We evaluated articles based on different types of screening tests as well as screening age and intervals, and using incremental cost effectiveness ratio via calculating quality adjusted life years (QALY), or life years gained (LYG) per cost. We compared the incremental cost-effectiveness ratio (ICER) of each study using GDP per capita. Furthermore, we compared national guidelines with recommendations of cost-effectiveness studies in different countries. Results: A total of 21 articles met our criteria, of which 19 studies showed that HPV DNA testing, 13 suggested an age of 30 years or more, and 10 papers concluded that at least a 5-year or longer interval were the most cost-effective strategies. In some countries, the national guidelines did not match the recommendations of the cost-effectiveness studies. Conclusions: HPV testing, starting at age 30 years or older and repeated at 5-year or longer intervals, is the most cost-effective strategy in any setting. Closer collaboration with health economists is required during guideline development.

• Korean Journal of Community Nutrition
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• v.5 no.3
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• pp.529-536
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• 2000

The major purpose of this study was to identify the differences in priorities of nutrition service needs between the service provider and consumers (general population). Identification of the personal characteristics which influence the priorities of nutrition service needs among the general population was also examined. An interview survey using a questionnaire was conducted to collect the data required for analysis. The questionnaire included the priorities of various nutrition service needs as well as the personal characteristics of the study subjects. The study subjects were 300 residents over 40 years of age, and 15 health workers representing health center service personnel in Kyounggi province. Wilcoxon Rank Sums test were adopted to analize the differences in priority between the service providers and consumers. The results showed that priority of nutrition service needs for provider were significantly different from that of consumer. Gender, age, family type, and education levels of the population were the significant factors affecting the differences in priorities for nutrition service needs among consumers (general population). Out of the results, it could be suggested that consumers need should be considered in developing nutrition services to promote nutrition services utilization in health centers. The results may also suggest that one of the causes for the low utilization rate of nutrition services in health centers was the provider oriented program development regardless of the needs of consumers.

• Journal of Preventive Medicine and Public Health
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• v.41 no.4
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• pp.241-248
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• 2008

Objectives: The purpose of the study was to identify a gap between consumer characteristics and utilization of health information on the Internet. Methods: A telephone survey of nationally representative samples was conducted using structured questionnaires, and 1,000 of the 1,189 responses obtained were included in our analysis. The following variables were included in the analysis as potential predictors of health information use on the Internet: predisposing factors such as gender, age, and education status; enabling factors such as region and monthly household income; consumer need for health information; and attitude to health. Multiple logistic regression analysis was used to evaluate the association between utilization rate and the potential predictors. Results: Thirty-nine percent of consumers had obtained health information on the Internet over a one-year period. The utilization rates were higher for consumers who were young, educated, worked in the office setting, had higher incomes, wanted health information, and were able to use the Internet. The utilization rate was 5.35 times higher in the younger group (20-30 years) than in the elderly group (95% CI=2.21-12.97); 2.21 times higher for office workers than for manual workers (95% CI=1.16-4.20); 3.61 times higher for college graduates than for middle school graduates and below (95% CI=1.07-11.59); 1.99 times higher for people with monthly household incomes over 3,000,000 won than for those with monthly household incomes below 1,500,000 won (95% CI=1.01-3.92). Conclusions: There needs to be a paradigm shift, with consideration of not only Internet accessibility in the digital age, but also consumer ability and attitudes toward utilization of health information.

• Clinical and Experimental Reproductive Medicine
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• v.44 no.2
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• pp.85-89
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• 2017

Objective: The aim of this study was to explore the effects of the insemination method on the outcomes of elective blastocyst culture. Methods: We retrospectively analyzed the outcomes of elective blastocyst culture performed between January 2011 and December 2014. Results: There were 2,003 cycles of conventional in vitro fertilization (IVF) and 336 cycles of intracytoplasmic sperm injection (ICSI), including 25,652 and 4,164 embryos that underwent sequential blastocyst culture, respectively. No significant differences were found in the female patients' age, basal follicle-stimulating hormone level, basal luteinizing hormone level, body mass index, number of oocytes, maturity rate, fertilization rate, or good-quality embryo rate. However, the blastocyst formation rate and embryo utilization rate were significantly higher in the conventional IVF group than in the ICSI group (54.70% vs. 50.94% and 51.09% vs. 47.65%, respectively, p<0.05). The implantation/pregnancy rate (IVF, 50.93%; ICSI, 55.10%), miscarriage rate (IVF, 12.57%; ICSI, 16.29%), and live birth rate (IVF, 42.12%; ICSI, 44.08%) were similar (p>0.05). No cycles were canceled due to the formation of no usable blastocysts. Conclusion: Although the fertilization method had no effect on clinical outcomes, the blastocyst formation rate and embryo utilization rate in the ICSI group were significantly lower than those observed in the conventional IVF group. Therefore, more care should be taken when choosing to perform blastocyst culture in ICSI patients.

• Korean Parent-Child Health Journal
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• v.6 no.1
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• pp.1-17
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• 2003

Thus, I studied Health services supplied by local health centers and the requirements of the inhabitants visiting the health care facilities. The purpose of this study was to provide basic material for the establishment of Health care policy and the development of health care businesses. The target places for this study were 4 health centers; Chungrang-Gu, Nowon-Gu, Eunpyung-Gu, Songpa-Gu, with 509 mothers who were visiting the Centers. The question items of this study concerned a total of 124 health-related services provided by the Health Centers. The data was collected for a total of 92 days; July 1st~September 30th, 1999. 800 questionaries were distributed and 559 answered, 509 were analyzed finally. The collected data were processed using the SAS program to get mean, standard deviation, percentage. Open questions were made to reveal the opinions of mothers using the health care center. The results were as follows : 1. Among the participants of the study, 49.7% were 25~29 years of age, 84.3% were house wives by current occupation, 56.2% were from 4~6 person households. 52.1 were educated at a high school level, and 43.6% were educated at a collage level. 2. The highest percentage(53.6%) of the users were spontaneous in their utilization of health care center. The major reason for using the Health care center is that it is free to 65.8% of those covered and of low cost to 19.3% of those covered. 3. The satisfaction level of those using the health care center appeared to be generally high. The general average value showed up as $3.027{\pm}0.519$. 4. The level of recognition of the value of the heath care center services was high, particularly in the basic item of diagnoses of pregnancy, particularly in the basic item of diagnoses of pregnancy. However, the satisfaction level of health care education In pregnancy is low at 20~40%. In the meantime, the level of recognition in breast- feeding benefits is high at 76.8%. 5. The rate of realizing health care center's service campaign was generally low at 10~20%. 41.3 of the people knew the advertizing material of the health care centers. 32.4% of the people knew the advertizing material of the health care centers. 32.4% of the people knew the campaign of health care center for importance of breast-feeding benefits. 30.1% of the people knew the campaign for testing congenital mechanism disease. In the meantime about 50% was recognised the health care centers campaign for the importance and time of infants vaccination. 6. The need for enhancement of health care center services was shown to be high as $3.266{\pm}0.676$ as an average, chicken pox vaccination being the most highly requested at $3.565{\pm}0.587.$. 7. Among the open questions, the additional service to be provided were as follows ; increase of campaign of health care center services, furnishing advertizing books in public locations, providing shuttle bus service to the health care centers, extension of desire for preventative injections, rest and play areas for the children of the families serviced, consultation rooms, etc.

• Journal of Korean society of Dental Hygiene
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• v.11 no.5
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• pp.791-799
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• 2011

Objectives : This study aimed at examining the aspects of utilization of the dental services in some regions and analyzing the related factors with a view to helping the old solve the dental problems and overcome the difficulties. Methods : This investigation was intended for 422 old people living in Jeon-ju city and Jang-su county from July 18, 2006 to August 25 by direct interviewing posing questions. The survey data sets were analyzed by chi-square, correlation, multiple regression and logistic regression. Results : 1. The average number of the existing teeth per an old person was 13.6 and the 28.8% of the old who didn't use denture called for dentures. 2. The annual coefficient of utilization in dental services for an old person was 52.3% and the annual average visits to dental clinics were 3.12 days while 38.6% of the old experienced illegal dental treatments. 3. The affecting factors on the dental utilization for treatment were as follows: family income, dental clinics available, the number of existing teeth, the days of dental trouble, the recognition of the prevention of the dental disease, the knowledge for the dental treatment and the oral health judged by himself. 4. The major variables influencing the utilization of dental services were spouse presence, form of family, income, having a regular dental care, denture presence and the experience of inconvenience in living. Conclusions : To conclude, the following suggestions could be made. First, It was necessary that enforcement practice of free dental prosthesis service and application to the national health insurance in old people's prosthetic therapy for government support because the economic factor was barrier to utilization of the dental services. Second, Dental clinic was required to the health center because availability of common dental services was big impact in utilization of the dental services.