• Journal of The Korean Society of Agricultural Engineers
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• v.57 no.4
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• pp.39-49
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• 2015

Since most medical facilities and medical personnel are concentrated in urban areas in South Korea, an imbalance of access to medical facilities causes a gap in medical resource availability between urban and rural areas. Accessibility to medical facilities is a means of assessment that evaluates a measure of inequality in utilization of medical resources. The evaluation of accessibility uses Euclidean distance, in general; however, this method has its limits in that Euclidean distance cannot reflect actual distance. This study aims to estimate real road distance from village halls to medical facilities in rural areas using Open Application Programming Interface (Open API) of an internet portal site. Using real road distance, we evaluated medical accessibility and compared it with Euclidean distance. The accessibility to primary medical institutions was valued relatively well, but secondary and tertiary medical institutions were vulnerable in Pyeonchang-gun. Comparing Euclidean distance with real road distance from village halls to medical facilities, real road distance appeared to be approximately 1.4 times that of Euclidean distance. This calculation is similar to the circuity factor of Gangwon-do in Korea that estimated to fix the limits of Euclidean distance and assumed real road distance.

• Korean Journal of Adult Nursing
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• v.12 no.4
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• pp.641-653
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• 2000

A quantitative descriptive survey was conducted to assess the needs of elderly people in relation to accessibility of medical care. Identifying their functional status was done and accessibility of medical care was ascertained. Using a convenient sampling method, 856 elderly aged 65 and over in Taejon-city participated. A multi-dimensional questionnaire containing sections on health status, Activities of Daily Living(ADLs) and accessibility of medical care in terms of use, time, distance, transport, cost and feeling at ease was developed by the researchers of this study to collect data. Data were collected between October and December, 1999. In general, the result of the self-reports from this study found that approximately 40% of participants had difficulties with their health status and ADLs while about 45% of the population did not access medical care. The majority of respondents stated that they had no difficulties with time distance and transport to access medical care. About two-thirds of the respondents felt that they had many or some difficulties with expenses and strategies for emergency to access medical care. Even though these findings need to be generalized, several recommendations for appropriate medical care delivery for the elderly still can be outlined from the study findings. Recommendations suggested are: To identify impediments to access medical care in emergency in elderly people and to remove those factors preventively are required. Responsible governmental involvement for solving problems of the medical care cost and additional costs in relation to separation of dispensary from medical practice for the elderly is required. More constructive and practical uses of public health community centers are recommended.

• Journal of Preventive Medicine and Public Health
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• v.42 no.1
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• pp.35-41
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• 2009

Objectives : The changing population age structure and rapidly increasing medical costs make providing high-quality, effective medical care for the elderly a challenge. This study assessed the satisfaction with medical care in terms of comprehensiveness, general satisfaction, and accessibility among community-dwelling Korean elders. Methods : Data were obtained from a nationwide representative sample of the older adults(aged 65 years old or older) living in the community, who participated in a 2006 telephone survey conducted using random digit dialing(n=881). General satisfaction, comprehensiveness and accessibility were measured using a 10-item satisfaction survey questionnaire. Descriptive analysis was used to assess the distribution of each of three components of subjective satisfaction. Analysis of covariance(ANCOVA) was used to examine the association of each of the three components with socioeconomic variables. Results : Comprehensiveness and general satisfaction were low among older people with a high socioeconomic status. Accessibility was evaluated as low among older people of low socioeconomic status, those living in rural areas and those who were medical aid beneficiaries. Conclusions : Urgent interventions should be considered in order to improve accessibility to medical care for elders of low socioeconomic status and those living in rural communities. Given the rapid aging of the population, we need to develop a monitoring system to improve the quality of geriatric care.

• 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.

• Korea Journal of Hospital Management
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• v.25 no.3
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• pp.38-52
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• 2020

Purpose: The purpose of the study is to suggest the main functions and implications of public hospitals to effectively respond to the future epidemic crisis based on analyzing the accessibility to designated Coronavirus Disease 2019 (COVID-19) medical institutions of Seoul and examining the main features of the quarantine of Seoul municipal hospitals. Method: To analyze the response and function of Seoul municipal hospitals, we reviewed the Infectious Disease Control and Prevention ACT, 258 articles of Seoul Metropolitan Government press releases from January to the end of April, 48 articles of Seoul Metropolitan Government's daily newsletters, 2019 Health Bureau Budget report. We also referred to internal data of Seoul Children's Hospital, Seoul Seobuk Hospital, and Seoul Eunpyeong Hospital during the same period. Besides, the accessibility to medical institutions was analyzed by using the COVID-19 data which was announced daily basis. Results: The accessibility of COVID-19 patients living in the Southeastern part of Seoul to a medical institutions was 16.2km on a distance basis, and it was the lowest accessibility among four regions of Seoul since it took about 40 minutes by car. On the other hand, patients living in the Northeast part had the highest accessibility, as the access to medical institutions was 10.7km and 27 minutes by car. Also, the main functions of the municipal hospital of Seoul against COVID-19 were to shift the public hospital function to COVID-19 patients only hospitals, to perform the epidemiological investigation by medical doctors, and to support the operation of self-isolation facilities, community treatment centers and triage rooms of community health centers. Conclusion: Through the experience of COVID-19, we suggested that the functions of public hospitals will be reorganized as the reinforcement of infectious disease treatment and mental health for quarantined patients, cooperation with private hospitals, supporting for strengthening community health capacity and preparation for another epidemic.

• Journal of Internet Computing and Services
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• v.11 no.3
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• pp.87-103
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• 2010

In the study, we introduce the trend in domestic and foreign web accessibility, as well as the legal system that ensures web accessibility. Based on Korean Web Content Accessibility Guidelines (KWCAG)1.0, we investigated the web content accessibility of 80 tertiary health-care hospitals and general hospitals in Korea. We evaluated accessibility by combining accessibility-based criteria (ABC) with usability-based criteria (UBC). ABC was limited to an alternative text for Guideline 1, using a small number of frames and keyboard accessibility for Guideline 2. UBC checked the voice service (TTS), resizing text, providing multi-lingual websites, and disclosing web accessibility policy. KADO-WAH2.0 was used for representing the compliance rate. The evaluation result was a considerable improvement from previous results, even though the rate of compliance with web accessibility was generally insufficient. There was a significant difference between those medical centers which did and did not comply with web accessibility. Incidentally, many hospitals were found to have attempted to confront and come to terms with web accessibility. In future, the following factors are advisable for medical centers with publicity or public interest: they must employ active and aggressive promotion of establishment of independent accessibility guidelines to secure web accessibility, they should effect an improvement of the realization of web accessibility, there can be constant education and promotion, and there can be an institutional supplementation, as well as others.

• Health Policy and Management
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• v.31 no.2
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• pp.197-206
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• 2021

Background: The purpose of this study was to identify factors affecting unmet healthcare needs due to physical accessibility by residential area by utilizing the Korea Community Health Survey (KCHS). Methods: Andersen's medical service behavioral model was applied to analyze the enabling factors, predisposing factors, and needs factors of unmet healthcare needs focusing on residential areas. This study used data from the KCHS (2017-2019, n=440,792). We used multivariate survey logistic regression analysis in order to identify affecting factors. Sub-group analysis was conducted in order to evaluate the effects of residential areas. Results: Some participants (2,621, 0.59%) had experienced unmet healthcare needs due to physical accessibility and 2,047 subjects (78.1%) of them lived in rural areas. Multivariate survey logistic regressions revealed that experience of unmet healthcare needs due to physical accessibility increased when people lived in rural areas (odds ratio [OR], 3.95; 95% confidence interval, 3.46-4.51). Conclusion: This study showed that despite the development of transportation and efforts to alleviate medical inequality, residents in rural areas may still have higher experience of unmet healthcare needs due to physical accessibility compared to the metropolitan city regardless of any other sub-group differences (OR range, 1.90-6.31). This study suggested that government and policymakers should identify the causes of the experience of unmet healthcare needs due to physical accessibility and should develop policies to alleviate those healthcare disparities.

• The Journal of the Society of Korean Medicine Diagnostics
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• v.16 no.3
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• pp.23-32
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• 2012

Objectives: The objective of this study is to investigate and valuate currently provided database management systems (DBMS) of traditional Korean medical knowledge. Methods: We searched DBMS on the web and smart device application markets (Apple App Store and Google Play Store). Key words for searching were 'traditional medicine', 'acupuncture', 'moxibustion', 'herbal medicine', and '한의학'. We looked into each DBMS to find out its scopes and limits, and each was valuated according to its functionality, accessibility, and utility. Results: 186 DBMS of traditional Korean medical knowledge were investigated and 91% of them were applications for smart devices. Almost all DBMS provided acupuncture and herb information, and a small amount of DMBS provided prescription and research paper information. Functionality, accessibility, and utility valuation were performed by using scoring system from 0 to 2. Mean values of functionality, accessibility, and utility were 0.86, 1.29, and 1.09. Conclusions: On the whole, high accessibility and low functionality were found, and various data-calculating functions were not implemented. Further researches and developments about traditional Korean medical knowledge DBMS are necessary to provide correct traditional Korean medical information and to support the studies about Korean medicine.

• Health Policy and Management
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• v.30 no.3
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• pp.399-408
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• 2020

Background: The purpose of this study was to examine the impact of the regional characteristics on the accessibility of emergency care and the impact of emergency medical accessibility on the patients' prognosis and the emergency medical expenditure. Methods: This study used the 13th beta version 1.6 annual data of Korea Health Panel and the statistics from the Korean Statistical Information Service. The sample included 8,119 patients who visited the emergency centers between year 2013 and 2017. The arrival time, which indicated medical access, was used as dependent variable for multi-level analysis. For ordinal logistic regression and multiple regression, the arrival time was used as independent variable while patients' prognosis and emergency medical expenditure were used as dependent variables. Results: The results for the multi-level analysis in both the individual and regional variables showed that as the number of emergency medical institutions per 100 km² area increased, the time required to reach emergency centers significantly decreased. Ordinal logistic regression and multiple regression results showed that as the arrival time increased, the patients' prognosis significantly worsened and the emergency medical expenses significantly increased. Conclusion: In conclusion, the access to emergency care was affected by regional characteristics and affected patient outcomes and emergency medical expenditure.

• Health Policy and Management
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• v.31 no.1
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• pp.125-139
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• 2021

Background: In Korea, the health gap widens due to the number of medical resources and access to medical services between metropolitan and rural. The purpose of this study is to identify the impact of residential migration on medical utilization and accessibility. Methods: This study extracted 528,516 claimed cases in the National Health Insurance Service-Cohort Sample Database from 2006 to 2015. Subjects were classified into two groups by the magnitude of the region, the metropolitan and the rural. The inversed probability weights were calculated for each group. And coefficients of the two-part model were estimated by generalized estimation equation. Results: Those who moved region from metropolitan to rural tend to increase the length of stay and inpatients with ambulatory care sensitive conditions (ACSC) disease. Contrariwise, those who moved areas from rural to metropolitan tend to decrease the total medical cost, the adjusted patient days, the number of outpatients and the number of outpatients and inpatients with ACSC disease. Conclusion: This study identified that between the residents who continued to reside in the region and the migrants, there were significant differences in the medical accessibility, quality of primary care, and unmet medical need.