• Korea Journal of Hospital Management
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• v.22 no.1
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• pp.1-9
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• 2017

Purpose : Many studies showed that having a usual source of care improved the efficient access of healthcare service. However in Korea there have been few studies on the usual source of care. So this study aims to find whether having a usual source of care affect the medical utilization and expense. Methodology/Approach : We used the Korean Health Panel data in 2012, 2013 to examine the change of utilization and expenses in ambulatory care affected by having a usual source of care. We selected 1,215 hypertension patients without usual source of care in 2012 and performed linear regression analysis to identify the difference between treatment group(with usual source of care in 2013) and control group(without usual source of care in 2013). Then we performed analysis again separated by the age group. Findings : Among study population, 711(58.5%) reported that they have a usual source of care in 2013. Treatment group reported 1.85 less increase in outpatient visits and 69,234 won less increase in expense than control group with weak significance(visit ${\beta}$ -1.85 p-value 0.0807, expense ${\beta}$ -69,234 p-value 0.0541). People under the age of 65 showed significant change in outpatient visits for tertiary hospital (visit ${\beta}$ -0.78 p-value 0.0154, expense ${\beta}$ -91,462 p-value 0.0168). The analysis which focused outpatient for mild disease showed similar trend. Practical Implications : This study supports the positive effect of having usual source of care which decrease inefficient outpatient utilization. Promoting physician-patient relationships is important for efficiency of healthcare service.

• Health Policy and Management
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• v.31 no.4
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• pp.518-530
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• 2021

Background: This study examined the effect of having a usual source of care on the degree of patient-centered communication among persons with disability. The role of the usual source of care has been emphasized to improve patient experience, especially for patients with complex health conditions. Methods: This study used the 2017-2018 Korean Health Panel data, and the final study observations were 22,475 (20,806 people without disability and 1,669 people with disability). We applied generalized estimating equation model to show the effect of having a usual source of care on patient-centered communication, and subgroup analysis considering the types and severity of disabilities. Results: Persons who have disabilities, compared with ones without it, significantly had more usual sources of care (32.4% vs. 24.6%). By type of disability, persons with mental (51.4%), internal organ (43.8%), visual (37%), and physical disabilities (31.6%) had more usual sources of care than hearing/speech (26.6%), and developmental disabilities (18.6%). The average score of patient-centered communication was higher among who had a usual sources of care (3.2 vs. 2.7), and the regression analysis showed that having a usual sources of care was positively associated with higher patient-centered communication score (𝛽=0.476, p<0.05). However, the positive effects of usual sources of care was not observed among persons with severe hearing/speech, developmental, and mental disabilities. Conclusion: This study showed that role of patient-centered communication was limited in persons with severe hearing/speech disabilities, developmental, and mental disabilities. The education programs and supports are needed to improve communication skills between medical staff and persons with specific types of disabilities.

• Korean Journal of Clinical Pharmacy
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• v.26 no.2
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• pp.128-136
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• 2016

Objective: This study was to explore the association between having a usual source of care and adherence to medicines in patient with chronic diseases. Methods: The 2012 Korea Health Panel was used as a data source. We analyzed 4,418 respondents that were diagnosed with chronic diseases and utilized health care services. Non-adherence to medication, a dependent variable, was defined as "not taking the medicines that were prescribed for treating chronic disease" or "not following the direction for medication". Whether having a usual source of care or not was used as a key independent variable, which was defined as having a regular site or a regular doctor for medical test, treatment, and consultation. Sex, age, education level, marital status, income, the type of health insurance, the number of chronic disease and CCI (Charlson Comorbidity Index) were included as covariates in the analysis. We conducted a multivariate logistic regression. Results: Totally, 30 percent of respondents reported to experience non-adherence to medication. Having a usual source of care was significantly associated with lower non-adherence to medication regardless its type, which is a regular doctor (OR=0.61, 95% CI=0.53-0.70) or a regular site (OR=0.67, 95% CI=0.58-0.78). Furthermore, having a usual source of care was associated with both of medication persistence (OR=0.66, 95% CI=0.54-0.81) and compliance (OR=0.65, 95% CI=0.56-0.76). Conclusion: Our results showed the possibility that usual source of care is able to conduct a positive role in improving adherence to medication with better management of chronic disease.

• The Journal of the Korea Contents Association
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• v.21 no.9
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• pp.609-621
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• 2021

This study investigates the effect of types of usual source of care on medication adherence among the elderly. Using the Korea Health Panel Survey in 2017, this study includes 3,623 elderly people 65 years of age or older taking prescription drugs for treatment of chronic diseases. The type of usual source of care was considered in three aspects: whether having a usual source of care or not, whether having a regular site only or having a regular site and doctor, size of the regular site. The types of usual source of care are heavily associated with medication adherence. Compared to those who have no usual source of care, those who have a regular site only are 1.4 times, and have both regular site and doctor are 1.8 times more likely to comply with the medication guidelines, respectively. The finding shows usual source of care has a positive effect in improving medication adherence of the elderly. The results can provide an evidence for policies for effective management of chronic diseases and efficient use of medical resources.

• Korea Journal of Hospital Management
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• v.22 no.3
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• pp.1-17
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• 2017

Purposes: Diabetes is a metabolic disorder that requires continuous care in order to prevent complications, as it can impose a critical burden on families and society due to various complications, including terminal renal failure, non-traumatic lower extremity amputation, and adult blindness. The usual sources of care are "specified private clinics, public health centers, or other facilities to visit when ill or when health-related advice is needed". These usual sources of care offer preventative services, have a high overall satisfaction rate in terms of public health care, and decrease the inpatient rates and medical costs of medical aid recipients. This study analyzed the current status of diabetic patients over 20 years of age based on their possession of a usual source of care, and the effects of this possession on the frequency of their medical service usage and its costs. Methodology: Based on data from the 7th Korea Health Panel, a Tobit analysis was used to analyze the different factors that can affect the frequency of medical service usage and its costs for diabetic patients with and without a usual source of care. Findings: The medical costs of diabetic patients with a usual source of care decreased in terms of inpatient, and the outpatient visits and inpatient costs of the group with a usual source of care in the form of a mainly-visiting doctor decreased more than those of the group with a mainly-visiting medical institution only. Practical Implications: Having a usual source of care can increase the treatment continuity, leading to reduced inpatient, and having a mainly-visiting doctor as the usual source of care further increases the treatment continuity. Based on these results, a new policy is needed to increase and strengthen diabetic patients? possession of a usual source of care.

• The Korean Journal of Emergency Medical Services
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• v.21 no.3
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• pp.97-107
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• 2017

Purpose: The purpose of the study was to investigate and compare the usual source of healthcare and frequent visits to emergency departments. Methods: The study subjects were 7,252 individuals with chronic diseases who filled out the questionnaire of the 2013 Korea Health Panel Survey. Data were analyzed using chi-square test and logistic regression. Results: Compared to having a public health center or clinic as a usual source of healthcare, it is 1.341 times more likely for a chronic disease patient to visit an emergency department if the hospital is her/his usual source of healthcare, while it is 1.656 times more likely for the patient to visit a general/tertiary hospital. Conclusion: It is important to investigate visits at the emergency department requiring primary care for diseases.

• Health Policy and Management
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• v.32 no.1
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• pp.29-44
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• 2022

Background: This study was conducted to analyze the impact of having a usual source of care on health behaviors of the middle aged and the elderly, in order to investigate the potential effect of enhancing primary health care in a Korean context. Methods: This study constructed a balanced panel of middle-aged and elderly samples using the Korea Health Panel 2016-2018, and fixed-effect models were used to analyze the data. Results: Among three sets of dependent variables (physical activity, smoking, drinking), statistically significant results were found only in physical activity. Subgroup analysis showed that this effect was not observed in the late elderly (aged 75 and older) and those without chronic diseases. Conclusion: Results of the study implied that enhancing primary health care among middle age and the elderly may have an effect on improving health behaviors. Moving forward to person-centered primary health care from disease-focused primary health care should be considered in high-risk groups such as the middle aged and the elderly with chronic diseases.

• Health Policy and Management
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• v.31 no.4
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• pp.531-543
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• 2021

Background: Population aging is a serious problem in Korea. And we have experienced a rapid increase in the health expenditures of the elderly. The purpose of this paper is to analyze the effect of having a usual source of care (USC) for the elderly. Methods: This study used the Korea Health Panel Survey data of 2012, 2013, 2016, 2017, and 2018. The sample was the person who answered the USC questions among the elderly. The panel logit model was used to analyze the determinants of having USC and the panel simultaneous equation model was used to analyze the effect of having USC among the elderly on the medical expenses, medical utilization, and subjective health status. Results: The estimation result shows that age, income, marriage, and so forth turn out to be the factors of having USC. Having the clinic level USC is estimated to reduce the health care utilization and the health expenditure and to improve the subjective health status. Conclusion: It is expected that the result of our analysis will provide evidence for encouraging having USC.

• Health Policy and Management
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• v.26 no.3
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• pp.195-206
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• 2016

Background: Concentration of patients to large hospitals is serious problem in Korea. The purpose of this paper is to propose appropriate policy direction to relieve concentration of patients to large hospitals. It is focused on evaluation of the possibility of family doctor system as a policy alternative to relieve concentration of patients to large hospital by empirically analyzing the effect of usual source of care (USC) on large hospitals medical care use. Methods: Korea Health Panel conducted 2009, 2012, 2013 by KIHASA (Korea Institute for Health and Social Affairs) and NHIS (National Health Insurance Service) was used for analysis. For dependent variables, first, the ratio of the amount of using large hospital to total amount of using medical care, and second, the amount of using large hospital are estimated. Independent variables are having an USC and type of USC. Panel analysis was done with above variables. Results: Main results are as follows. First, having an USC increases using large hospital. Second, having a domestic clinic type USC decreases using large hospital and ratio of using large hospital. Third, the effect of domestic clinic type USC is greater in older group, less income group, worse health status group, not having private insurance group, and having chronic disease group. Conclusion: These results show that family doctor program can be a policy alternative to relieve concentration of patients to large hospital. Nonetheless, primary care system in Korea is unsatisfied. It is recommended to reinforce primary care system and family doctor system to relieve concentration of patients to large hospitals.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.12 no.1
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• pp.43-56
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• 2017

Objectives : To determine the effectiveness of Baduanjin for hypertension Methods : We searched 8 electronic databases(Pubmed, CAJ, EMBASE, Cochrane Library, KISS, KISTI, NDSL, RISS) up to April 2017. We included randomized controlled trials(RCTs) using Badanjin for hypertension. The methodological quality of each RCT was assessed by the Cochrane risk of bias tool. Results : 14 RCT studies were eligible in our review. 14 studies were divided into 4 groups, and 2 of them were meta-analysised. The meta-analysis of 10 studies showed favorable results for the use of Baduanjin with Usual care than Usual care. But, meta-analysis of 2 studies showed Baduanjin and Usual care has no difference. High risk of bias were observed in all studies. Conclusions : Although there are favorable results with meta-analysis, our systematic review are highly dependent on the single source of Chinese electrical database, CAJ. Now limited evidence is available to support Baduanjin combined usual care for hypertension and further well-designed RCTs should be encouraged.