- A Study of Factors Related to Korean Physicians' Trust in the Government: On the Target for Board Members of Physicians' Associations.
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Sunhee Lee, Gunmo Yang, Juhyun Seo, Juhye Kim
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J Prev Med Public Health. 2010;43(5):411-422.
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DOI: https://doi.org/10.3961/jpmph.2010.43.5.411
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This study aims to investigate the factors related to Korean physicians' trust in the government. METHODS: We used structured questionnaires that were composed of multidimensional scales for each of the various categories. RESULTS: The recognition levels of trust of the government by Korean physicians were not high, and they ranged from 3.6 to 4.8 for ten scales. The factors related to trust in the government were categorized into seven factors on the basis of a factor analysis. On the regression analysis, a positive relationship was found between "the individual propensity to trust" and trust in the government, while a negative relationship was found between "the recognition level regarding the government as an authoritarian power" and trust in the government. "Confidence about participation in the policy process" as internal efficacy and "belief in governmental ability and motivation toward public demand" as external efficacy also showed a strong positive relationship with trust in the government. CONCLUSIONS: From these results, we can draw the conclusion that making efforts to improve the recognition level of trust in the government among physicians is an important policy task. To increase the trust level, participation of physicians in the policy process in various ways and open communication between the physicians'associations and the government should be facilitated.
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Citations
Citations to this article as recorded by  - The Relationship between Trust in Healthcare System and Health Examination Participation
Baek-Geun Jeong, In-Kyoung Hwang, Hae-Sook Sohn, Kwang-Wook Koh, Tae-Ho Yoon, Jeong-Hun Lim
Journal of agricultural medicine and community health.2010; 35(4): 395. CrossRef
- How Are Consumers, Service and Market Factors Related to Customer Loyalty in Medical Service?: Targeting the Medical Consumer in a City.
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Sunhee Lee, Hyunmi Kim, Juhye Kim, Gwiyeom Ha
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J Prev Med Public Health. 2008;41(5):315-322.
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DOI: https://doi.org/10.3961/jpmph.2008.41.5.315
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This study was performed to explore customer royalty and the related factors. METHODS: 900 households(a 1% sample) were randomly selected from the total population of K city located in Kangwon province. An interview survey was performed with using a structured questionnaire for the subjects(923 persons) who had used medical service during the year before the survey, and the survey was done September, 2002. RESULTS: When comparing the relating factors related with customer royalty according to the sociodemographic characteristics, the older group showed a significantly higher level of recognition for service quality, service reputation, internal customers.attitudes and switching cost. The lower income group showed a higher level of recognition for service quality, service image and switching cost. The lower educated group showed a higher level of recognition for service reputation, service image and internal customers.attitudes. The higher educated group showed a higher level of recognition for perceived risk, and seeking variety. In addition, the expert group or the service and manufacturing workers group showed a higher level of recognition for service involvement. On multiple regression analysis, internal customers' attitudes, service image, service reputation, service quality, switching cost, and substitutability showed significant relations with customer loyalty. CONCLUSIONS: This study showed that customer loyalty was significantly influenced by service factors like internal customers' attitudes, service image, service reputation, and service quality, and by market factors like switching cost, and substitutability. The results of this study can be used as a baseline for developing strategies to create and keep customers with high loyalty.
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Citations
Citations to this article as recorded by - Understanding patients’ behavioral intentions
Ehsan Zarei, Mohammad Arab, Seyed Mahmoud Ghazi Tabatabaei, Arash Rashidian, Abbas Rahimi forushani, Roghayeh Khabiri
Journal of Health Organization and Management.2014; 28(6): 795. CrossRef - Relationship among Nursing Service Quality, Medical Service Satisfaction, and Hospital Revisit Intent
Mi-Aie Lee, Soung-Wha Gong, Su-Jung Cho
Journal of Korean Academy of Nursing Administration.2012; 18(1): 96. CrossRef - Causal Relationships Among Perceived Risk, Satisfaction, Switching Cost and Loyalty in Outpatient Health Services
Young-Hee Yom, Kyu Eun Lee
Journal of Korean Academy of Nursing Administration.2011; 17(4): 516. CrossRef
- Impacts of Implementing Case Payment System to Medical Aid Hemodialysis Patients on Dialysis Frequencies and Expenditure.
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Sunhee Lee, Hanjoong Kim, Seungho Shin, Woohyun Cho, Hye Young Kang
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J Prev Med Public Health. 2004;37(3):260-266.
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To assess the impacts of implementing case payment system (CPS) to Medical Aid (MA) hemodialysis patients on the frequencies and expenditure of dialysis. METHODS: Fifty-eight clinics and 35 tertiary care hospitals were identified as having a minimum of 10 hemodialysis patients for each of the MA and Medical Insurance (MI) programs, who received hemodialysis from the same dialysis facilities for both periods of July 2001 and July 2002. From these facilities, a total of 2, 167 MA and 2, 928 MI patients were identified as the study subjects. Using electronic claims data, the changes in the total number of monthly treatments and charges for outpatient hemodialysis treatments for each patient after the introduction of the CPS were compared between the MA and MI patients. Multiple regression analyses were performed to examine the independent impact of the CPS on the utilization and expenditure of dialysis treatments among the MA patients. RESULTS: There was a significant decrease in the total charges for the hemodialysis treatments of the MA patients, 3.4% (p< 0.05), whereas a significant increase was observed for the MI patients, 2.5% (p< 0.05). For both the MA and MI patients, the frequency of the monthly hemodialysis treatments were significantly increased, 5.5 (from 12.1 to 12.7) and 7.8% (from 11.6 to 12.5), for the MA and MI patients, respectively. However, a multivariate regression analysis showed no significant difference in the changes in the total number of monthly hemodialysis treatments between the MA and MI patients after implementation of the CPS. Another regression model, regressing on the changes in the monthly claims of dialysis treatments, showed a significant negative coefficient for the MA ( (=-70725, p< 0.05). CONCLUSION: The significant decrease in the total charges for hemodialysis treatments among MA as compared to MI patients suggests that there was a cost reduction in the MA program following the introduction of the CPS.
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- The Difference of Locus-of-control among Western Medical School Students, Oriental Medical School Students, and Non-Medical School Students.
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Kui Son Choi, Sunhee Lee, Hanjoon Lee
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Korean J Prev Med. 2003;36(3):239-247.
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The objectives of this study were to examine the difference in attitude toward health-specific locus-of-control and medical care among western medical students, oriental medical students, and non-medical school students. METHODS: The subjects of this study were 667 students who agreed to respond the questionnaire : 212 western medical school students, 190 oriental medical school students, and 265 non-medical school students. The health-specific locus of control was measured by the structured questionnaire developed by Lau and Ware. The attitude toward western and oriental medicine was also measured by the questionnaire. RESULTS: Western medical students and non-medical school students were more likely than oriental medical students to place high value on 'the provider control over health' and 'the general threat to health' scales (F=20.47, F=19.98). But oriental medical school students ranked 'the self control of health' scale as more important than any other locus of control scale (F=19.34). The health specific locus of control was also different from the grade. When the grade was increased, 'the provider control over health' scale was slowly decreased, especially in western medical students and non medical school students. However, the 'general threat to health' scale was increased in oriental medical students. Western medical school students expressed more positive attitude toward western medicine. Oriental medical school students put a higher score on oriental medicine. Nevertheless, as the grade was increased, the positive attitude toward oriental medicine slightly decreased in oriental medical school students. CONCLUSIONS: There is a difference in health-specific locus of control and attitude toward medicine among western medical students, oriental medical students, and non-medical students. The locus of control and attitude of medical students towards medicine may affect both how they behave towards patients and how they help shape future public policy. Therefore, interdisciplinary educational initiatives may be the best way to handle this issue.
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- Information Searching Behavior of Health Care Consumers by Sociodemographic Characteristics.
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Yoomi Chae, Sunhee Lee, Woohyun Cho
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Korean J Prev Med. 2001;34(4):389-398.
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To investigate the information searching behavior of health care consumers according to sociodemographic characteristics. METHODS: A questionnaire survey was conducted of 1,507 persons who were selected through a multi-stage stratified area cluster sampling of the Republic of Korea, excluding the province of Jeju-do. Personal were conducted through a door-to-door survey between 27 July and 10 August 1999. RESULTS: 80.5% of respondents used more than one source of information and those 40~59 years of age, female, a housewife or student and those who claimed a religion demonstrated more active information searching behavior. A personal informer was used significantly more in those 20~39 years old, female, and those who claimed a religion. Clerical workers, those with post-secondary education and a monthly income greater than 2,000,000 won ($1500) were more actively used a public informer. Low socioeconomic status and older persons used an experimental informer when they chose a health care institution. CONCLUSION: Regardless of the sociodemographic characteristics, personal and experimental informers were the most useful source of information. Because appropriate information was not easy to obtain, the health care consumer was dependent upon word-of-mouth communication(personal informer) when using health care services.
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- Comparative Analysis of Models for Measuring Consumer Satisfaction in Health Care Organization.
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Sunhee Lee, Woo Huyn Cho, Kui Son Choi, Myungguen Kang
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Korean J Prev Med. 2001;34(1):55-60.
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The SERVQUAL scale is based on gap theory, which suggests the difference between consumers' expectations and the quality of the medical service actually received. However, problems in the implementation of the SERVQUAL scale have been identified by several researchers. Some researchers have proposed a simple performance-based measure (SERVPERF) or an expectation-controlled performance-based measure(Non-Diff) as alternatives to the SERVQUAL scale. On the basis of the theoretical concerns discussed, we examined the capability of each of the three scales(SERVQUAL, Non-Diff, SERVPERF) to explain variations in consumer satisfaction. METHODS: Data was gathered from a self-administered questionnaire in a 430 bed hospital. Questionnaires evaluating medical services were distributed to 180 ambulatory patients. A total of 167 usable questionnaires were gathered. The questionnaire was composed of 10 expectation, performance and expectation-controlled performance items. In addition, overall satisfaction and purchase intention were measured. RESULTS: Compared with the SERVQUAL scale, the Non-Diff and SERVPERF scales better explained the observed variations in consumer satisfaction(SERVQUAL, R2=0.29; Non-Diff, R2=0.51; SERVPERF, R2=0.48) and purchase intention(SERVQUAL, R2=0.22; Non-Diff, R2=0.33; SERVPERF, R2=0.34). CONCLUSION: The major conclusion from our study is that the Non-Diff and SERVPERF scales are more efficient in assessing consumer satisfaction than the SERVQUAL scale. Therefore we suggest that consumer satisfaction be measured by the Non-Diff or SEVPERF scales.
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- Structural Modeling of Quality, Satisfaction, Value and Purchase Intention in Health Care Service.
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Kui Son Choi, Woo Hyun Cho, Sunhee Lee, Jung Mo Nam
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Korean J Prev Med. 2000;33(4):426-435.
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To determine the relationships among quality, satisfaction, value and purchase intention in health care service. METHODS: The data were gathered from out-patients who had used hospital services. They were asked to assess service quality, satisfaction, service value, and purchase intention. A total of 557 usable questionnaires were gathered. The data were analyzed using SAS version 6.12. The analytic methods employed in the study were confirmatory analysis and covariance structural analysis. RESULTS: Service quality exhibited a significant and positive relationship with satisfaction, service value, and purchase intention. Furthermore, satisfaction had a significant and positive relationship with purchase intention. And finally, service value had a significant and positive relationship with both satisfaction and purchase intention. Based on these findings, it is evident that satisfaction was a mediator between service quality and purchase intention. Also service value played a mediating role between service quality and satisfaction. CONCLUSIONS: These results suggest that service quality is an antecedent of satisfaction and service value, and exerts a stronger influence on purchase intentions than satisfaction and service value do. Thus, managers may need to emphasize service quality in health care.
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- The Accuracy of ICD codes for Cerebrovascular Diseases in Medical Insurance Claims.
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Jong Ku Park, Ki Soon Kim, Chun Bae Kim, Tae Yong Lee, Kang Sook Lee, Duk Hee Lee, Sunhee Lee, Sun Ha Jee, Il Suh, Kwang Wook Koh, So Yeon Ryu, Kee Ho Park, Woonje Park, Seungjun Wang, Hwasoon Lee, Yoomi Chae, Hyensook Hong, Jin Sook Suh
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Korean J Prev Med. 2000;33(1):76-82.
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We attempted to assess the accuracy of ICD codes for cerebrovascular diseases in medical insurance claims (ICMIC) and to investigate the reasons for error. This study was designed as a preliminary study to establish a nationwide surveillance system. METHODS: A total of 626 patients with medical insurance claims who indicated a diagnosis of cerebrovascular diseases during the period from 1993 to 1997 was selected from the Korea Medical Insurance Corporation cohort (KMIC cohort: 115,600 persons). The KMIC cohort was 10% of those insured who had taken health examinations in 1990 and 1992 consecutively. The registered medical record administrators were trained in the survey technique and gathered data from March to May 1999. The definition of cerebrovascular diseases in this study included cases which met one of two criteria (Minnesota, WHO) or 'definite stroke' in CT/MRI finding. We questioned the medical record administrators to explain the error if the final diagnoses were not coded as stroke. RESULTS: The accuracy rate of the ICMIC was 83.0% (425 cases). Medical records were not available for 8.2% (51 cases) due to the closing of hospitals, the absence of a computer system or omission of medical record, etc. Sixty-three cases (10.0%) were classified as impossible to interpret due to insufficient records in 'major clinical symptoms' or 'neurological deficits'. The most common reason was 'to meet review criteria of medical insurance benefits (52.9%)'. The department where errors in the ICMIC occurred most frequently was the department for medical insurance claims in the hospital. CONCLUSION: The accuracy rate of the ICMIC was 83.0%.
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- The Relationship of Organizational Culture and Organizational Effectiveness at the General Hospital.
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Heuisug Jo, Sunhee Lee, Woohyun Cho, Kihong Chun, Okryun Moon
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Korean J Prev Med. 1999;32(3):374-382.
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Organizational culture has been important in field of organizational behavior research for the past decade. Although there has been a growing interest in the organizational culture and organizational effectiveness, there is few research in health care field. This study was carried out to investigate the relationship of organizational culture and organizational effectiveness at general hospital. METHODS: Data was collected by self-administrated questionares. Organizational cultures were measured by using Likert scale. A general hospital in Kyunggi-Do was selected and survey was conducted to 675 workers. Data was analyzed with computer package, PC- SPSS. RESULTS: There were four types of organizational culture in this hospital : consensual culture, developmental culture, hierarchical culture, rational culture. Many workers recognized their culture as rational culture and developmental culture. This finding showed that the hospital had both human related and task related climate. There were some differences in recognition of sub-organizational culture by occupational group, but perceived organizational culture was in accordance with sub-organizational culture in general. Multiple regression analysis and multiple logistic regression analysis were conducted to find the relationship of organizational culture and organizational effectiveness. As a result, developmental culture showed a strong relationship with organizational commitment and job-satisfaction. CONCLUSIONS: These results showed that types of organizational culture were significantly related to organizational effectiveness and understanding the existing culture is essential to develope their organizational effectiveness.
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- Factors Related to the Health Behavior of Urban Residents on the Basis of Theory of Reasoned Action.
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Sunhee Lee, Heuisug Jo
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Korean J Prev Med. 1999;32(2):183-190.
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The purpose of this study is to analyse factors related to the health promotion behavior on the basis of theory of reasoned action(TRA). METHODS: 509 residents in the city of Kyunggi-do were selected through multistage random sampling. A structured questionnaire was developed on the basis of Triandis model and collected by interviewing. RESULTS: Expectation toward act and social normative influence and age showed significant relationship to health promotion behavior. Also, facilitating factors, affective attitude, education level are indirectly related to health promotion behavior. CONCLUSIONS: The result suggest that TRA is useful in understanding the mechanism of health promotion behavior.
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- A study on the Statistical Distribution and Testing of Variation Indicies at the Small Area Variation Analysis .
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Jungmo Nam, Sunhee Lee, Woohyun Cho
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Korean J Prev Med. 1999;32(1):80-87.
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The Study of Small Area Variation(SAV) is most interesting issue in the health care researches. Most studies of SAV have been concluded the existences of variation on the basis of the magnitude of variation without statistical testing. But it is difficult to explain the existence of variation with this way because variation indicies are easily influenced by several parameters and also their distribution are skewed. So, it needs for the study to investigate the distribution of these indices and develop the statistical testing model. METHODS: This study was planned to analyze on the distribution of variation indices such as Extremal Quotient(EQ), Coefficient of Variation(CV), Systematic Component of Variation(SCV) and compare the statistical power among indicies. The simulations was performed on the basis of several assumptions and compared to the empirical data. RESULTS: Main findings can be summarized as follows. 1. If other conditions are constant, the more number of regions, the larger 95 percentile of EQ. But under same situation, 95 percentile of CV and SCV were slightly decreased. 2. If the size of regional population or utilization rate were increased, 95 percentile of all statistics were decreased. Also in the cases of small population size and low utilization rate, 95 percentiles of EQ showed various change contrast to the little change of CV. 3. If the difference at the size of regional population were increased, 95 percentiles of EQ and SCV were increased contrast to the little difference of CV 4. If the utilization rate were increased, 95 percentiles of all indicies were increased. But under the same difference of utilization rate, the power of CV and SCV were increased comparing to no change of the power of EQ. 5. Usually the power of EQ were lower than that of CV or SCV and it is similar between CV and SCV. CONCLUSIONS: Therefore, we suggest that in selecting the variation indicies at the SAV, CV or SCV are superior than EQ in terms of significance level and power.
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- A Comparative Study on Medical Utilization between Urban and Rural Korea.
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Kyungshik Joo, Hanjoong Kim, Sunhee Lee, Hyeyoung Min
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Korean J Prev Med. 1996;29(2):311-330.
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- This study was designed to compare the level of medical utilization between the urban and rural areas of Korea and to explain the differences between the two regions. Data from the National Health Interview survey performed by the korean Institute of Health & social Affairs in 1992 were used for this study utilizing a sample size of 21,841 people. The level of medical utilization such as the number of physician visits and the number of hospital admissions was compared between the regions with ANOVA. Various determinants for medical use were also compared by univariate analysis. Statistical models which included enabling factors, predisposing factors, need factors and region were constructed for bivariate analysis in order to further elucidate the level of medical utilization. The results were as follows: 1. There was greater medical use, both in terms of physician visits and inpatient care in the rural areas in spite of insufficient health resources. The particular reasons for higher medical utilization in rural areas were attributed to a higher number of initial physician visits as well as a longer the length of stay per hospital admission. Therefore, indicators representing the degree of met need (utilization/need) showed no significant difference between rural and urban areas in spite of the fact that the medical need is larger in rural areas. 2. Use of public health facilities received a significant portion of physician visits in the rural area. The government's effort to enhance primary health care through health centers, health subcenters and the nurse practitioner's post in rural areas has contributed to the increase of access to medical care in the rural areas. 3. There were some differences in the socio-demographic characteristics between two regions; There were more elderly people over the age of 65; unstable marital status, less education and lower incomes also characterized the rural areas. Therefore, among rural people, there were more predisposing factors for medical use. Additionally, need factors such as poor self-reported health status and high morbidity level were also high in the rural area. 4. In contrast it was learned that, the supply of health resources was mostly concentrated in the urban areas except for public health facilities. Therefore, geographical access to medical care was lower in the rural area both in terms travel time and travel cost. 5. The coefficient of the region variable was insignificant in the regression model which controlled the supply factor only However, utilization was significantly higher in urban areas if the model included predisposing factors and need factors in addition to the supply factor. The results were interpreted as rural people have greater medical needs.
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- The Study on Volume Relationships in Several Diseases.
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Sunhee Lee, Yonggweon Jwa
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Korean J Prev Med. 1994;27(4):793-806.
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- Investigating the existence of volume-outcome relationships for specific disease groups relates directly to the policy issue of whether, and how, specific inpatient services should be regionalized. This study examined whether medical costs and lengths of stay as outcomes were affected by changes in volume within hospitals. Based on the claims data obtained from National Federation of Medical Associations, each six disease categories from medical and surgical conditions were selected and 29,720 cases from 1,266 hospitals were analyzed. Main findings of the research can be summarized as follows: 1. Analyzing volume and cost per case relationship, tonsillectomy class 1, hernia procedure class 0, appendectomy and cesarean section class 0,1 in surgical conditions showed negative relationship significantly. In cases of medical conditions, costs per case in respiratory neoplasm class 2, COPD class 1, 2, digestive malignancy were also related to volume negatively. 2. Comparing volume with length of stay per case, lens procedure class 0, hernia procedure class 0, appendectomy class 0,1 cesarean section class 1 in surgical conditions showed negative relationships significantly. In medical conditions, volume of respiratory neoplasm class 2, COPD class 1,2, digestive malignancy class 0 were associated with negatively. 3. within same disease categories, changes in cost and length of stay per case to volume were more remarkable in severe cases. These results suggested a significant inverse relationship between disease cases and cost, length of stay per case as outcome variables.
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