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REFERENCE LINKING PLATFORM OF KOREA S&T JOURNALS
> Journal Vol & Issue
Health Policy and Management
Journal Basic Information
Journal DOI :
The Korean Society of Health Policy and Administration
Editor in Chief :
Volume & Issues
Volume 21, Issue 4 - Dec 2011
Volume 21, Issue 3 - Sep 2011
Volume 21, Issue 2 - Jun 2011
Volume 21, Issue 1 - Mar 2011
Selecting the target year
Relationships between Social Support & Social Network and Health Behavior
Park, Jun ; Kang, Gil-Won ; Tak, Yang-Ju ; Chang, Soung-Hoon ; Lee, Kun-Sei ; Kim, Hyeong-Su ;
Health Policy and Management, volume 21, issue 4, 2011, Pages 493~510
DOI : 10.4332/KJHPA.2011.21.4.493
Objectives : This study aims to explore how social support and social network are related with health behavior. Methods : The target population was 12,449 people in Chungcheongbuk-do. The sample was accrued for the period of 3 months in 2008 by face to face interview of direct visiting from systematic sampling method. The instruments used in this study were social support, social network and health behavior. Results : There was significant difference in the level of social support and social network by sex, age, educational level, occupation, and monthly income(p<0.05). There was significant difference in the level of social support by alcohol drinking, physical exercise. There was significant difference in the level of social network by smoking, alcohol drinking, physical exercise, obesity(p<0.05). Multivarite analysis shows significant difference in the level of social instrumental support by smoking, physical exercise. It shows significant difference in the level of social emotional support by smoking. It also shows significant difference in the level of social network by smoking, physical exercise. Conclusion : These results suggest that social support and social network may be associated with health behavior. Because this study was cross sectional research, the order was not found between social support, social network and health behavior. Through a study on monitoring, we will obtain more information for relationship.
Korean People's Perception of Longevity and its Determinants
Jeong, Hyoung-Sun ; Song, Yang-Min ;
Health Policy and Management, volume 21, issue 4, 2011, Pages 511~526
DOI : 10.4332/KJHPA.2011.21.4.511
This study aims at surveying how Koreans look upon and prepare for the age of longevity("age of 100 years") drawing near at hand, analyzing factors affecting such a perception and behavior. To this end, a telephone survey was launched for 1200 persons sampled to evenly comprise the young, middle-aged, and elderly groups. Our findings indicate that more Koreans looked upon the upcoming "age of 100 years" as a 'disaster' rather than a 'blessing.' The sense of combined uneasiness over the aged life being further elongated while they are unprepared for it, anxiety over maintaining health and so forth came into play. However, the better a person is prepared by way of health management, savings for retirement, preparation for leisure activities and employment for the later life, the more positively he or she looked upon the "age of 100 years". An analysis by group indicates that women rather than men, the elderly rather than the young, the less educated rather than the highly educated, the low-income bracket rather than the high-income bracket looked upon the "age of 100 years" more negatively. Under such circumstances, it is suggested that the nation's social system tailored to a life expectancy of 80 years should be readjusted, tailored to a 'longevity paradigm' and that to this end social systems should be reoriented toward the direction where 'healthy aging' and 'active aging' are fully supported.
Differences between Diabetic Patients' Tertiary Hospital and Non-tertiary Hospital Utilization According to Comorbidity Score
Cho, Su-Jin ; Chung, Seol-Hee ; Oh, Ju-Yeon ;
Health Policy and Management, volume 21, issue 4, 2011, Pages 527~540
DOI : 10.4332/KJHPA.2011.21.4.527
Some patients tend to visit tertiary hospitals instead of non-tertiary hospitals for minor illnesses, which is a chronic problem within the Korean health care delivery system. In order to reduce the number of patients with minor severity diseases unnecessarily utilizing the tertiary medical services in Korea, the Ministry of Health and Welfare raised the outpatient co-insurance rate for the tertiary hospitals in July, 2009. Another increase in the prescription drug co-insurance rate by the general and tertiary hospitals is scheduled to take place in the second half of 2011. An increase in copayments may discourage the utilization rate of medical services among the underprivileged or patients who require complicated procedures. This study aims to analyze the diabetic patients' utilization rates of tertiary hospitals according to the Comorbidity score. Diabetic patients' data was gathered from the Health Insurance Claims Records in the Health Insurance Review & Assessment Service between 2007-2009. Comorbidity scores are measured by the Charlson Comorbidity Index and the Elixhauser Index. Chi-square and logistic regressions were performed to compare the utilization rates of both insulin-dependents (n=94,026) and non-insulin-dependents (n=1,424,736) in tertiary hospitals. The higher Comorbidity outcomes in the insulin-dependent diabetic patients who didn't visit tertiary hospitals compared to those who did, was expected. However, after adjusting the gender, age, location, first visits and complications, the groups that scored >=1 on the comorbidity scale utilized the tertiary hospitals more than the O score group. Non-insulin-diabetic patients with higher Comorbidity scores visited tertiary hospitals more than patients who received lower grades. This study found that patients suffering from severe diabetes tend to frequently visit the tertiary hospitals in Korea. This result implied that it is important for Korea to improve the quality of its primary health care as well as to consider a co-insurance rate increase.
The impact of comorbidity (the Charlson Comorbidity Index) on the health outcomes of patients with the acute myocardial infarction(AMI)
Lim, Ji-Hye ; Park, Jae-Yong ;
Health Policy and Management, volume 21, issue 4, 2011, Pages 541~564
DOI : 10.4332/KJHPA.2011.21.4.541
This study aimed to investigate health outcome of acute myocardial infarction (AMI) patients such as mortality and length of stay in hospital and to identify factors associated with the health outcome according to the comorbidity index. Nation-wide representative samples of 3,748 adult inpatients aged between 20-85 years with acute myocardial infarction were derived from the Korea National Hospital Discharge Injury Survey, 2005-2008. Comorbidity index was measured using the Charlson Comorbidity Index (CCI). The data were analyzed using t-test, ANOVA, multiple regression, logistic regression analysis in order to investigate the effect of comorbidity on health outcome. According to the study results, the factors associated with length of hospital stay of acute myocardial infarction patients were gender, insurance type, residential area scale, admission route, PCI perform, CABG perform, and CCI. The factors associated with mortality of acute myocardial infarction patients were age, admission route, PCI perform, and CCI. CCI with a higher length of hospital stay and mortality also increased significantly. This study demonstrated comorbidity risk adjustment for health outcome and presented important data for health care policy. In the future study, more detailed and adequate comorbidity measurement tool should be developed, so patients' severity can be adjusted accurately.
Determinants of untreated experiences among persons with physical disability
Yu, So-Yeon ; Kim, Ye-Soon ; Hong, Hyun-Sook ; Cheon, Mi-Kyung ; Mo, Jin-A ;
Health Policy and Management, volume 21, issue 4, 2011, Pages 565~584
DOI : 10.4332/KJHPA.2011.21.4.565
Objective: This study is examined the factors affecting forms of untreated experiences in persons with physical disability. Method: The data collected from 461 persons with physical disability in community. Based on the Behavioral Model of Andersen, predisposing, enabling, and need factors are hypothesized to affect persons with physical disability's untreated experiences. The data were analyzed by statistical methods such as frequency and multiple logistic regression analysis. Result: Participation rates of untreated experiences were 26.7%. The significant factors of persons with physical disability's untreated experiences are predisposing factors (gender, partner, and religion), enabling factors (income, private insurance, information of assistive device, disability discrimination, and subjective discrimination), and need factors(subjective health status health screening and chronic disease). Also untreated experiences related to gender, subjective health status, health screening, and chronic disease factors using multiple logistic regression analysis. Conclusion: Implications of the findings were discussed and the recommendations for the improvement of health care utilization, subjective health statue. Especially, development of health education and program should be needed persons with physical disability.
The trend of national health insurance service use among pregnant and postpartum women aged 35 years and older
Hwang, Rah-Il ; Kim, Kyung-Ha ; Yoon, Ji-Won ; Lee, Jung-Suk ;
Health Policy and Management, volume 21, issue 4, 2011, Pages 585~598
DOI : 10.4332/KJHPA.2011.21.4.585
This study was conducted to examine the trend of national health insurance service use with relation to pregnancy, childbirth, and the puerperium among pregnant and postpartum women older than 35 over the last decade. A descriptive analysis was conducted, using the data which were drawn from the "nationwide claim database of Korean National Health Insurance Corporation(NHIC)". Data were composed of the total cases related to pregnancy, childbirth, and the puerperium (International Classification of Disease,
revision [ICD-10] codes O00-O99) from 2001 to 2008. During 2001-2008, the number of pregnant and postpartum women older than 35 had continuously increased and the percentage of them also had increased in both hospital and ambulatory care. There are similar trends in their total use of national health insurance service and total expenditure. According to demographic characteristics, there was the biggest increase of the percentage in residents in large cities, self-employed workers, ones in the highest income level. According to ICD-10 codes, there was the biggest increase of the percentage in O10-O16 (oedema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium). According to the major prevalent disease, there was the biggest increase of the percentage in O60 (preterm labor and delivery). Throughout the past decade, the necessity has been emphasized of supporting pregnant and postpartum women older than 35. But in maternal and child health care, they are in an early stage of development. The findings of this study would be helpful in developing the support programs for the aged pregnant and postpartum women.
Determinants of selecting a doctor in specialized medical institutions and general hospitals
An, Byeung-Ki ; Park, Jae-Yong ;
Health Policy and Management, volume 21, issue 4, 2011, Pages 599~616
DOI : 10.4332/KJHPA.2011.21.4.599
This research was performed to investigate the determination factors of medical service to cover the fee for selecting a doctor which is one of the most important causes of debilitating national health insurance in Korea. Data was from Korea Health Panel and analyzed by Dutton(1986)'s medical service model which was an extended Anderson Model and was widely used in the researches on determination factors of medical service. The results were as follows; In the determinants of selecting a doctor in specialized medical institutions and general hospitals, patients with serious diseases selected doctors more often than other patients. By industrial accident compensation insurance law and enforcement ordinances, insurance covers the fee of selecting a doctor in the hospitals appointed by Labor Welfare Corporation for the patients in critical conditions under industrial accident compensation insurance, while health insurance patients pay the fee themselves for selecting a doctor in all cases. It is suggested that patients with serious diseases proved by medical opinion be provided with health care insurance in selecting a doctor and that the health insurance benefit coverage be enhanced by staged lowering of patient's cost-sharing.
A Study on the Determinants of the Benefits of the Long-term Care Insurance in Korea
SaKong, Jin ; Yoon, So-Young ; Cho, Myung-Duk ;
Health Policy and Management, volume 21, issue 4, 2011, Pages 617~642
DOI : 10.4332/KJHPA.2011.21.4.617
The purpose of our study is to analyze the determinants of the benefits of the long-term care insurance in Korea using 2008 and 2009 cross-sectional data. Per capita long-term care insurance benefits can be divided into home care services utilization rate, institutional care services utilization rate, per capita home care services benefits, and per capita institutional care services benefits, which are used as the dependent variables in our regression analysis. Admission rate and the ratio of the admitted to the applicant also used as the dependent variables. The results of our analysis show that the explanatory variables such as income level, needs for care, family type, access to the services, and regional characteristics are statistically significant to explain the dependent variables, the long-term care insurance benefits. The higher is the regional income and the more of the female residents, the more are the long-term care insurance benefits. The easier is the access to the services, the more are the insurance benefits. In the rural area, the level of the insurance benefits is relatively high. We propose that copayment rates of the long-term care insurance should be examined and monitoring on the over-use of the services should be done. Also preventive services and care by the family member should be expanded.