• Health Policy and Management
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• v.22 no.4
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• pp.497-521
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• 2012

Objectives This study aimed to investigate the effect of social capital, health risk behavior and health status on medical care utilization by the elderly. The data and Research method Data were obtained from the 4th wave survey of the Korea Welfare Panel Study. 4,087 household members aged 65 years and over were subject to analysis. Descriptive statistics are used to describe the basic features of the data in a study. we performed a structural equation modeling(SEM) analysis to evaluate the effect of social capital and mediating effect of health risk behavior and health status. Results Results showed that factors related to medical care utilization of the elderly were different depending on types of service (inpatient and outpatient service) except health status. Age, higher social capital, more health-risk behavior and poorer health status were associated with increased use of inpatient service. Social capital was found to have a positive direct effect on it. Also, social capital had an indirect effect on reducing use of inpatient services by improving health status. On the other hand, lower age and higher household income tended to increase use of outpatient service, while higher social capital and higher health status were inversely related. Social capital had a direct effect and an indirect effect on reducing use of outpatient service and, at that time, health status played a mediating role. Conclusions Social capital may contribute to improve health status and indirectly reduce medical care utilization of the elderly by enhancing their health status. These results provide evidence that more policy and strategy considerations should be needed for the elderly to strengthen their social capital in order to enhance their levels of health and more efficient utilization of medical care.

• Journal of Preventive Medicine and Public Health
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• v.48 no.6
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• pp.319-329
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• 2015

Objectives: Parental socioeconomic status (SES) exerts a substantial influence on children's health. The purpose of this study was to examine factors determining children's private health insurance (PHI) enrolment and children's healthcare utilization according to PHI coverage. Methods: Korea Health Panel data from 2011 (n=3085) was used to explore the factors determining PHI enrolment in children younger than 15 years of age. A logit model contained health status and SES variables for both children and parents. A fixed effects model identified factors influencing healthcare utilization in children aged 10 years or younger, using 2008 to 2011 panel data (n=9084). Results: The factors determining children's PHI enrolment included children's age and sex and parents' educational status, employment status, and household income quintile. PHI exerted a significant effect on outpatient cost, inpatient cost, and number of admissions. Number of outpatient visits and total length of stay were not affected by PHI status. The interaction between PHI and age group increased outpatient cost significantly. Conclusions: Children's PHI enrolment was influenced by parents' SES, while healthcare utilization was affected by health and disability status. Therefore, the results of this study suggest disparities in healthcare utilization according to PHI enrollment.

• Journal of the Korean Institute of Rural Architecture
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• v.26 no.1
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• pp.11-20
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• 2024

Due to the decrease in the school-age population and the overall population, school closures will continue to occur. Currently, most school closures are happening in rural areas, where geographical conditions often result in relatively poor educational, welfare, and cultural facilities compared to urban areas. Additionally, the proportion of elderly populations and migrant women is continuously increasing. In order to effectively utilize closed schools in the future, various efficient utilization methods that align with the social context of the respective regions will be necessary. The purpose of this study is to examine the status of closed school and utilization types in selected rural and island areas of similar sizes through field surveys and literature reviews. By comparing and analyzing these findings, we have identified the predominant utilization types in rural and island areas and assessed the current situation where utilization is lacking. Based on the results, we aim to provide fundamental data for improving and enhancing the utilization of school closures in the face of the ongoing decline in the school-age population.

• Journal of Korean Public Health Nursing
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• v.24 no.2
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• pp.323-335
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• 2010

Purpose: This study identified sociodemographic characteristics, health status, health care utilization and related factors of Asian immigrant women in Korea. Methods: Data were collected from 465 immigrant women from China, Vietnam, the Philippines, and other Asian countries using standardized questionnaires. Descriptive statistics and $X^2$-test were performed utilizing SPSS version 17. A p-value <.05 was considered statistically significant. Results: Subjects had relatively good subjective health. The most prevalent conditions were, in order, anemia, gastrointestinal diseases, gynecological diseases, and depression. Subjects utilized mostly hospitals or clinics when sick. There were significant relationships between health care utilization and factors including residence, time since immigration and economic status. The rate of non-treatment in hospitals or clinics was 30.1% during the previous year, with significant relationships between non-treatment and factors including time since immigration and economic status. The major reasons for non-treatment were the burden of hospital expenses followed by communication difficulty. Conclusion: Public health efforts should be targeted to Asian immigrant women to improve their health status and support health care utilization.

• Korean Journal of Health Education and Promotion
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• v.31 no.3
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• pp.27-37
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• 2014

Objectives: This study aims to identify the factors associated with regular medical services utilization of chronic disease patients. Methods: The research selected 4,489 adults aged over 30, diagnosed with hypertension, diabetes, hyperlipidemia, hypercholesterolemia, from the Korea health panel. We analyzed states of regular medical service utilization using descriptive statistics. Multiple regression analysis was used to examine the main factors associated with regular medical services utilization in chronic disease patients. Results: In terms of socio-demographic factors, gender, age, marital status, education level, employment, household income and disability were significantly different between hypertension, diabetes, hyperlipidemia and hypercholesterolemia. Among health status and behavioral factors, number of chronic diseases, subjective health status, smoking, high risk drinking, regular meals, physical activity, obesity were significantly different. From the multiple logistic regression analysis, age, number of chronic diseases, obesity, type of chronic diseases were associated with regular medical services utilization. Conclusions: It is necessary to develop effective health education programs and individualized approach to improve continuous management in chronic diseases patients.

• Health Policy and Management
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• v.4 no.2
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• pp.58-76
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• 1994

In order to study factors affecting the use of the ambulatory physician services. Andersen's model for health utilization was modified by adding the health behavior component and examined with three different approaches. Three different approaches were the multiople regression model, logistic regression model, and LISREL model. For multiple regression, dependent variable was reported illness-related visits to a physician during past one year and independent variables are variaous variables measuring predisposing factor, enabling factor, need factor and health behavior. For the logistic regression, dependent variable was visit or no-visit to a physician during past one year and independent variables were same as the multiple regression analysis. For the LISREL, five endogenous variables of health utiliztion, predisposing factor, enabling factor, need factor, and health behavior and 20 exogeneous variables which measures five endogenous variables were used. According to the multiple regression analysis, chronic illness, health status, perceived health status of the need factor; residence, sex, age, marital status, education of the predisposing factor ; health insurance, usual source for medical care of enabling factor were the siginificant exploratory variables for the health utilization. Out of the logistic regression analysis, health status, chronic illness, residence, marital status, education, drinking, use of health aid were found to be significant exploratory variables. From LISREL, need factor affect utilization most following by predisposing factor, enabling factor and health behavior. For LISREL model, age, education, and residence for predisposing factor; health status, chronic illess, and perceived health status for need factor; medical insurance for enabling factor; and doing any kind of health behavior for the health behavior were found as the significant observed variables for each theoretical variables.

• Health Policy and Management
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• v.29 no.3
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• pp.288-302
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• 2019

Background: The one-person households (OPH) are rapidly increasing and vulnerable to socioeconomic and health problems. Because it is predicted to be inequitable to health care utilization, we would like to find out about the equity of health care utilization of the OPH by comparison with the multi-person households (MPH). Methods: This study followed the theoretical framework of Wagstaff and van Doorslaer (2000), O'Donnell and his colleagues (2008), where the horizontal inequity index is the difference between the concentration indices of actual health care utilization and health care needs. This study employed the 9th Korea Health Panel survey, and a total of 10,807 cases were analyzed. Health care needs were measured by age, sex, subjective health status, chronic disease count, Charlson's Comorbidity Index, limitation of activities, and disability. Results: Compared with the MPH, there were pro-poor inequities in hospitalization, emergency utilization, hospitalization out-of-pocket payments, and pro-rich inequities in outpatient out-of-pocket payments for the OPH. The decomposition of the concentration index revealed that chronic disease count made the largest contribution to socioeconomic inequality in outpatient utilization. Age, health insurance, economic activities, and subjective health status also proved more important contributors to inequality. The variables contributing to the hospitalization and emergency utilization inequity were age, education, Charlson's Comorbidity Index, marital status, and income. Conclusion: Because the OPH was more vulnerable to health problems than the MPH and there were pro-poor inequities in medical utilization, hospitalization, and emergency costs, it is necessary to develop a policy that can correct and improve the portion of high contribution to medical utilization of the OPH.

• Journal of the Architectural Institute of Korea Planning & Design
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• v.34 no.6
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• pp.57-66
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• 2018

In Japan, apartment housing occupies a great proportion of residence due to high population density like Korea. Although Korea and Japan are similar in big proportions of apartment housing, and apartment housing management systems and utilization behaviors, there are considerable differences. This paper examined Japanese public facilities and the status of public facility management and utilization, which differ from those in Korea. In order to analyze the status of public facilities from a perspective of management companies, a preliminary survey was conducted targeting apartment management companies in the top 100 and a field study on public facilities was conducted targeting chief directors and managers of individual housing facilities to look into public facility utilization methods, problems with public facility management, demands of residents, and utilization situations. Also, the present state of facility utilization and utilization promotion plans were investigated, based on the drawings of facilities collected. As the result, results were found in three respects; 'elements, related to building plans', 'elements, related to utilization promotion', and 'elements, related to facility remodeling, including changes of uses'. In relation to the use of public facilities in the future, a more active communication between managers and users would be needed for planning. Also, there would be a need to provide public facilities for visitors when there are events for both occupants and visitors in order to promote the use of facilities and management companies would have to share information of excellent facility models.

• Journal of Korean Biological Nursing Science
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• v.18 no.3
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• pp.144-152
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• 2016

Purpose: This study compares beneficiaries of Korean Medicaid with those under the National Health Insurance program, seeking to understand how each group utilizes their healthcare. Methods: Data were obtained from a Health Promotion Survey in 2005. Health status was measured by the respondents' perception of health. Health service utilization included the availability of healthcare services, the type of healthcare institution, and intent to revisit. Predisposing and enabling factors, as well as health care needs were used for this study. Results: Compared to National Health Insurance beneficiaries, Medicaid beneficiaries reported lower levels of health status and fewer enabling factors. They had more chronic diseases and disabilities. Education level, existence of chronic diseases, exercise patterns, and disabilities were associated with health status. Conclusion: We found that Medicaid beneficiaries had fewer resources and higher levels of health needs. As Medicaid is reformed, policy makers and administrators should understand healthcare utilization behaviors of Medicaid beneficiaries and the factors hindering access to care.

• Journal of Korean Public Health Nursing
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• v.27 no.3
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• pp.578-591
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• 2013

Purpose: The purpose of this research was to identify the health behaviors, health status, and utilization patterns of health care institutions for homeless shelter residents as well as to compare these research outcomes between younger and older male homeless shelter residents. Methods: The subjects in this study were 357 homeless shelter residents that were recruited by simple random sampling. Data were collected from August to September 2009. Health behaviors, health status, and utilization patterns of health care institutions were measured using structured questionnaires. Data were analyzed using the Chi square test and Fisher's exact test using SPSS 14.0. Results: Both younger and older male subjects showed unhealthy behaviors, and their health status was lower than that of the Health & Nutrition Examination Survey conducted in 2009. Subjects preferred to utilize national or municipal hospitals as well as pharmacies as opposed to general hospitals, clinics, and public health centers. Conclusion: Differentiated comprehensive health care services and monitoring should be provided to homeless shelter residents based on the needs of each group in order to improve their health status as well as to prevent communicable diseases and complications of chronic diseases.