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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
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Volume & Issues
Volume 22, Issue 4 - Dec 2012
Volume 22, Issue 3 - Sep 2012
Volume 22, Issue 2 - Jun 2012
Volume 22, Issue 1 - Mar 2012
Selecting the target year
Difference of Area-based deprivation and Education on Cerebrovascular Mortality in Korea
Sim, Jeoung-Ha ; Ahn, Dong-Choon ; Son, Mi-A ;
Health Policy and Management, volume 22, issue 2, 2012, Pages 163~182
DOI : 10.4332/KJHPA.2012.22.2.163
This study was performed to identify the difference of the area-based deprivation and the educational level on the cerebrovascular mortality in Korea. Data used in this study was obtained from the Death Certificate Data 2000 and the 2000 Census produced by Korean National Statistics(NSO). We classified the whole country into 246 areas based on the administrative districts. Then, the Standardized Mortality Ratio (SMR) in cerebrovascular disease was calculated according to the sex, education level and 246 areas. Its Predicted SMR was calculated by the Empirical Bayes Methods to reduce the variation of the SMR values. The area-based deprivation of 246 areas were measured using the modified Carstairs index in which the 5 indicators consisted of overcrowding, the unemployment ratio of men, the percentage of households classified low social class, the percentage of non home owners, and finally those houses lacking basic amenities. The correlation between the area-based deprivation and the SMR of the whole country and the correlation between the area-based deprivation and the SMR of each metropolitan cities or provinces was analyzed by the Pearson correlation analysis method. After classifying the deprivation of 246 areas into 5 levels, we performed the random intercept Poisson regression analysis after adjusting education level and age using Empirical Bayes Method to investigate the relationship between the 5 deprivation levels and the cerebrovascular mortality. The SMR was increased in lower education level. Each 246 areas had different values in SMR, Predicted SMR and area-based deprivation. The area-based deprivation and the SMR of the whole country was not correlated in both sexes. The education level of an individual was associated the risk of cerebrovascular mortality in men. The risk of cerebrovascular mortality increased with age compared to the reference(<30). The area-based deprivation was not associated with the risk of cerebrovascular in both sexes. The findings of this study suggest that the SMR had positive and negative correlations with area-based deprivation depending on the metropolitan cities or province. It also suggests that the individual education level and age were related with mortality and finally that the area-based deprivation was not associated to the cerebrovascular mortality in Korea.
The Effects of Medical Service Qualities on Satisfaction, Relationship Quality, and Revisit Intent in Long Term Care Hospital an Elderly Out-patients
Kim, Byung-Yong ; Jeong, Myeong-Ae ;
Health Policy and Management, volume 22, issue 2, 2012, Pages 183~206
DOI : 10.4332/KJHPA.2012.22.2.183
Changing social conditions have resulted in a situation where elderly patients are no longer cared for by family and where medical care hospitals play a more prominent role. In this study, the unique elements of the medical service required from a long term care hospital were identified using conventional and exploratory analysis, and the causal relationship between medical service quality, relationship quality, and Revist intent was confirmed. The intermediary role and the quantitative importance of relationship quality (including trust and commitment) were also characterized. This study identifies the key points and indicators that the administrators of a long term care hospital can use to effectively plan their medical service offering in order to secure the commitment of customers through relationship quality. The theoretical indications of this study are set out below. First, four factors are selected as being the key elements determining service quality: medics, administrative service, healthcare environment, and subsidiary facilities. Second, it seems that medics, administration service, and the healthcare environment have some effect on the evaluations made in relation to trust and satisfaction (subsidiary facilities are not considered to be a key element). Third, patient satisfaction has a positive impact on trust and commitment and can be regarded as a key element for establishing connections. Fourth, commitment is likely to be strengthened when trust is significant. Fifth, as trust and commitment increase, revist intent strengthens. Lastly, this study illustrates how the levels of trust and commitment play a modulating role between patient satisfaction and revist intention. There are many practical indications from the findings of this study. First, the influences of medics, the administrative service, and the healthcare environment on trust and satisfaction vary. Especially, the healthcare environment is likely to be more important than medics. Accordingly, it is essential to establish an elderly-friendly environment, to improve a hospital's structure, and to maintain a clean environment. Second, medics must show compassion to their patients and be patient when providing explanations to elderly patients who often lack powers of concentration. Third, in order to establish patient trust, it is essential that medics provide an excellent medical service. Ultimately, these elements of relationship quality may strengthen the revist intention of elderly patients.
Expenditure in ambulatory dental care and factors related to its spending
Kim, Hye-Sung ; Kim, Myeng-Ki ; Shin, Ho-Sung ;
Health Policy and Management, volume 22, issue 2, 2012, Pages 207~224
DOI : 10.4332/KJHPA.2012.22.2.207
This study estimates the total health expenditure of ambulatory dental care and explores the factors related to disbursements. The study used two waves of a 2008 Korea Health Panel (KHP) survey, of which each wave is composed of 7866 households and 24,659 persons. The KHP includes missing expanses of reimbursement data of the National Health Insurance (NHI), such as out-of-pocket, drugs, and private health insurance. The study estimates total monthly ambulatory dental expenditure and the sub-special categories of dental care. For influential factors analyses, the study exploits log-linear model with age, gender, education, job, equivalence income, the status of chronic diseases, means-tested benefit recipients, private insurance, and the composite deprivation index as independent variables. The total monthly outpatient health spending is estimated to be 102,468 won per household, and for dental, each household spends 31,115 won per month. Older age, means-test recipients, non-regular workers are more likely to spend less money on dental care, whereas private insurers, high income, and those who live in less deprived areas are more likely to spend more money for dental services. From the study we found that the KHP data are more suitable to estimate the total amount of health care markets, especially when the NHI coverage is low, such as for dental care in Korea.
The Effect of Community Health Planning on public health centers' organizational performance
Jang, Myung-Wha ; Kim, Chang-Yup ; Lee, Hwa-Kyung ; Park, Sun-Hee ; Na, Baeg-Ju ;
Health Policy and Management, volume 22, issue 2, 2012, Pages 225~248
DOI : 10.4332/KJHPA.2012.22.2.225
Community Health Planning has been used in public health centers for over 10 years, but little is known about its effect and how it is utilized by public health centers. This paper examines the effect of Community Health Planning on public health centers'organizational performance through the use of the Structural Equation Modeling(SEM) technique. We conducted e-mail surveys of chiefs, people in charge of planning and other staff members in all the public health centers in the country. The instrument measured self-evaluated levels of Community Health Planning, implementation and the effect on the public health centers. The model of the SEM technique has five latent constructs: requirements of planning, plan formulation, implementation, organizational capacity and performance. The SEM technique validated the instrument used in the study and exhibited a relatively good fit. Results of this study were as follows. First, the requirements of planning have positive effects on plan formulation. Second, plan formulation has positive effects on organizational capacity but plan implementation doesn't. Third, there was no statistically significant path between plan formulation, implementation and performance. Fourth, organizational capacity has positive effects on performance. Consequently, this study revealed that Community Health Planning has a positive influence on organizational performance through organizational capacity.
Factors Related to the Intent to Use the Medical Application(M-APP) of Smart Phone of Hospital Nurses
Sim, Yun-Bok ; Seo, Young-Joon ; Kim, Jang-Mook ; Kim, Sung-Ho ; Sung, Dong-Hyo ;
Health Policy and Management, volume 22, issue 2, 2012, Pages 249~262
DOI : 10.4332/KJHPA.2012.22.2.249
The purpose of this study is to investigate the determinants of intent to use the medical-application(M-APP) of smart phone of nurses working at the nursing department of two university hospitals in Korea. The independent variables used in the study are performance expectancy, effort expectancy, social influence, facilitating condition, attitude toward using technology, self efficacy, anxiety, ability to use a smart phone easily and socio-demographic characteristics. The sample used in the study consisted of 378 nurses selected from two university hospitals located in Seoul and Wonju, Korea. Data were collected with self-administered questionnaires and analyzed using multiple regression analysis. The results of this study revealed 5 independent variables of attitude toward using technology, self efficacy, anxiety, ability of using APP and interest in smart phone have the significant effect on the intent to use the M-APP. The results imply that the hospital administrators and nursing managers should try to give more chances to learn the skills of using M-APP, provide sufficient resources and establish the stable hospital information system in order for their employees to use the M-APP more easily at their working places.
Effects and Participation Predictors of the Health Incentive Point Program among Hypertensive Patients : Using Data From the Incheon Chronic Disease Management System
Oh, Dae-Kyu ; Kang, Kyung-Hee ;
Health Policy and Management, volume 22, issue 2, 2012, Pages 263~274
DOI : 10.4332/KJHPA.2012.22.2.263
This study describes the hypertensive patients characteristics associated with the health incentive point program, and develops and analyzes a simple predictive model of participation in the program. Based on the Incheon Chronic Disease Management System(iCDMS), a model program of community partnership for hypertensive or diabetic patients detection and follow-up since 2005 in Incheon metropolitan city, a cross-sectional design was used in this study. An effective 10.844 adults sample was divided into groups according to participation in the health incentive point program and continuing treatment, and individual and health characteristics among groups were compared. Furthermore, the predictors associated with participation in the program were identified by the logistic regression analysis. After the health incentive point program in iCDMS was introduced, the number of hypertensive patients participation in the program increased 23.9 times which is vastly high given the various programs were provided. There were statistically significant differences among the groups: age(p=0.000), treatment compliance(p=0.000), and blood pressure control at the last measurement(p=0.000), in particular, between participation group(GroupI, n=246) and non-participation group(GroupIII, n=10,408). Furthermore, age over 60 years(OR: 0.33), treatment compliance(OR: 3.49~3.78) and blood pressure controls(OR: 2.13~2.30) were statistically significant predictors associated with participation in the program, based on the logistic regression analysis with GroupI and GroupIII. To increase participation in the health incentive point program, variables such as age, treatment compliance and blood pressure controls are more concerned. And, high-risk patients and family members need targeted health incentive programs.
The factors influencing the occurrence and recurrence of catastrophic health expenditure among households in Seoul
Cheong, Che-Lim ; Lee, Tae-Jin ;
Health Policy and Management, volume 22, issue 2, 2012, Pages 275~296
DOI : 10.4332/KJHPA.2012.22.2.275
Graduate School of Public Health, Seoul National University The national health insurance system in Korea is characterized as relatively high out-of-pocket payments, which are the principal source of catastrophic health expenditure (CHE). The objectives of this study are to estimate the incidence of household CHE and to clarify the characteristics that affect the occurrence and recurrence of household CHE using the Seoul Welfare Panel Survey database for 2008 and 2010. Thresholds to estimate CHE were 10% and 20% of the total household income (T/X), and 25% and 40% of the income excluding food share (T/Y). Determinants of the occurrence and recurrence of CHE at the threshold of T/X=10% were analysed using multiple logistic regression models. Out of the 3,665 households that responded in 2008 survey, households with CHE were 12.07% (T/X
10%), 5.34% (T/X
20%), 6.84% (T/Y
25%), and 4.44% (T/Y
40%). Risk factors associated with household CHE included living with a spouse, non-Medicaid beneficiary, householder unemployment, low household income, the number of disabled members, poor subjective health, and the number of chronic diseases. A total of 41.78% of households with CHE in 2008 repeatedly experienced CHE in 2010. Risk factors of CHE recurrence included decreased household income and an increase in chronic diseases over the two time periods, the number of members with disability or chronic diseases, and the presence of cancer patients in 2008. Households with lower socioeconomic and health status had a higher financial burden on health care than do their counterpart households. There is a need to enhance society-wide financial protection from health spending among vulnerable citizens in Seoul, particularly, households with low income, disabled members or cancer patients.