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Kui Son Choi 13 Articles
Effects of Private Health Insurance on Health Care Utilization and Expenditures in Korean Cancer Patients: Focused on 5 Major Cancers in One Cancer Center.
Jin Hwa Lim, Kui Son Choi, Sung Gyeong Kim, Eun Cheol Park, Jae Hyun Park
J Prev Med Public Health. 2007;40(4):329-335.
DOI: https://doi.org/10.3961/jpmph.2007.40.4.329
  • 4,927 View
  • 55 Download
  • 10 Crossref
AbstractAbstract PDF
OBJECTIVES
To identify the effects of supplemental private health insurance on health care utilization and expenditure under the mandatory National Health Insurance(NHI) system in Korea. METHODS: The data were collected by the National Cancer Center in Korea. Cancer patients who were newly diagnosed with stomach (ICD code, C16), lung(C33-C34), liver (C22), colorectal cancer(C18-C20) or breast(C50) cancer were included as study subjects. Data were gathered using a structured questionnaire from face-to-face interviews, the hospital Order Communication System (OCS) and medical records. Clinical, socio-demographic and private health insurance related factors were also gathered. The differences of health care utilization and expenditure were compared between those who have private health insurance and those who do not using t-test and multivariable regression analysis. RESULTS: Individuals with private health insurance spent larger inpatient costs than those without, but no differences were found in utilization in other service such as hospital admissions, hospital days and physician visits. CONCLUSIONS: We found that private health insurance exerts a significant effect on the health care expenditure in inpatient service. These study results can provide a rational basis to plan a national health policy regarding private health insurance. Further studies are needed to investigate the impacts of private health insurance on cancer patients' outcomes and survival rates.
Summary

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  • Treatment interruption during radiation therapy: Experience at a single institution in the Republic of Korea
    Jung Ae Lee, Nam Kwon Lee, Won Sup Yoon, Dae Sik Yang, Chul Yong Kim, Se Ryun Lee, Hwa Jeong Seong
    Asia-Pacific Journal of Clinical Oncology.2017;[Epub]     CrossRef
  • Cancer Treatment near the End-of-Life Becomes More Aggressive: Changes in Trend during 10 Years at a Single Institute
    Younak Choi, Bhumsuk Keam, Tae Min Kim, Se-Hoon Lee, Dong-Wan Kim, Dae Seog Heo
    Cancer Research and Treatment.2015; 47(4): 555.     CrossRef
  • Ubiquitous Environment with Private Health Insurance and the Relevance of Length of Stay
    Dong-Ruyl Jang, Seong-Woo Choi, Bu-Yeon Park, Sung-Gil Kim
    The Journal of the Korea institute of electronic communication sciences.2014; 9(2): 203.     CrossRef
  • Analysis of factors affecting the life quality of the patients with late stomach cancer
    Yan‐Mei Ma, Cai‐Feng Ba, Yu‐Bin Wang
    Journal of Clinical Nursing.2014; 23(9-10): 1257.     CrossRef
  • The Effect of Private Health Insurance on Health Care Utilization: Evidence from Korea Health Panel (2008~2010)
    Chang-Hoon You, Sung-Wook Kang, Ji-Heon Choi, Eun-Hwan Oh, Young-Dae Kwon
    The Korean Journal of Health Service Management.2014; 8(2): 101.     CrossRef
  • An Association between Private Health Insurance and Use of Endoscopy, An Association between Private Health Insurance and Use of Endoscopy,
    Chang-Hoon You, Young-Dae Kwon, Ji-Heon Choi, Sung-Wook Kang
    The Korean Journal of Health Service Management.2014; 8(4): 25.     CrossRef
  • The Influence of Private Health Insurance on Admission among Some Patients with Cervical or Lumbar Sprain
    Dong-Ryul Jang, Myung-Geun Kang
    Journal of agricultural medicine and community health.2012; 37(2): 84.     CrossRef
  • Private health insurance in South Korea: An international comparison
    Jaeun Shin
    Health Policy.2012; 108(1): 76.     CrossRef
  • Sociodemographic gradients in breast and cervical cancer screening in Korea: the Korean National Cancer Screening Survey (KNCSS) 2005-2009
    Mi Jin Park, Eun-Cheol Park, Kui Son Choi, Jae Kwan Jun, Hoo-Yeon Lee
    BMC Cancer.2011;[Epub]     CrossRef
  • Comparison of hospital charge prediction models for gastric cancer patients: neural network vs. decision tree models
    Jing Wang, Man Li, Yun-tao Hu, Yu Zhu
    BMC Health Services Research.2009;[Epub]     CrossRef
Factors Influencing the Intention to have Stomach Cancer Screening.
Myung Il Hahm, Kui Son Choi, Su Yeon Kye, Min Son Kwak, Eun Cheol Park
J Prev Med Public Health. 2007;40(3):205-212.
DOI: https://doi.org/10.3961/jpmph.2007.40.3.205
  • 5,267 View
  • 61 Download
  • 8 Crossref
AbstractAbstract PDF
OBJECTIVES
The purpose of this study was to identify the factors influencing the intention to have stomach cancer screening using the theory of planned behavior (TPB) in Korea. METHODS: For this population-based study, 1,535 adult respondents (aged 40 to 70 years) were recruited using multi-stratified random sampling and a face-to-face administered questionnaire. This study was based on Ajzen's theory of planned behavior. Intentions were divided into three scenarios for fee payment in the next two years: (1) free of charge, (2) co-payment, and (3) full charge. Multiple linear regression was used to identify the factors influencing the intention to have stomach cancer screening. RESULTS: Perceived behavioral control and attitude toward stomach cancer screening were significant predictors of the intention to have stomach cancer screening. However, subjective norm only influenced the intention to have stomach cancer screening with full charge in the next two years. CONCLUSIONS: The results suggest that attitude and perceived behavioral control are likely to contribute toward increasing the intention to have stomach cancer screening. Especially, perceived behavioral control is a good predictor. Because the study subjects were nation wide residents, the study results can be generalized.
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  • A Structural Equation Modeling of Prostate Cancer Screening Intention
    Ji Hye Jeong, Nam Hee Park
    Journal of Korean Academy of Community Health Nursing.2019; 30(4): 471.     CrossRef
  • Factors Influencing the of Middle-Aged Men the NCSP(National Cancer Screening Program)
    Geum-Ja Park, Kyoung-Min Lim, Sook-Nam Kim
    The Korean Journal of Health Service Management.2016; 10(3): 51.     CrossRef
  • Quels sont les facteurs psychosociaux déterminant la participation au dépistage du cancer colorectal ? Intérêt de la théorie du comportement planifié et du concept de coping
    A. Le Bonniec, K. Djoufelkit, F. Cousson-Gélie
    Psycho-Oncologie.2015; 9(2): 108.     CrossRef
  • Barriers to Cancer Screening among Medical Aid Program Recipients in the Republic of Korea: A Qualitative Study
    Yoon Young Lee, Jae Kwan Jun, Mina Suh, BoYoung Park, Yeol Kim, Kui Son Choi
    Asian Pacific Journal of Cancer Prevention.2014; 15(2): 589.     CrossRef
  • Factors Affecting Cancer Screening Intention and Behavior of the Korean Elderly
    Hee-Jung Kim, Hyun-Woo Yim, Nam-Cho Kim
    Asian Pacific Journal of Cancer Prevention.2014; 15(19): 8461.     CrossRef
  • Regional Factors Associated with Participation in the National Health Screening Program: A Multilevel Analysis Using National Data
    Hyung-Kook Yang, Dong-Wook Shin, Seung-Sik Hwang, Juwhan Oh, Be-Long Cho
    Journal of Korean Medical Science.2013; 28(3): 348.     CrossRef
  • Factors Associated with Cancer Screening Intention in Eligible Persons for National Cancer Screening Program
    Rock-Bum Kim, Ki-Soo Park, Dae-Yong Hong, Cheol-Heon Lee, Jang-Rak Kim
    Journal of Preventive Medicine and Public Health.2010; 43(1): 62.     CrossRef
  • Factors Associated with Gastric Cancer Screening of Koreans Based on a Socio-ecological Model
    Sang Soo Bae, Heui Sug Jo, Dong-Hyun Kim, Yong-Jun Choi, Hun Jae Lee, Tae Jin Lee, Hye Jean Lee
    Journal of Preventive Medicine and Public Health.2008; 41(2): 100.     CrossRef
The Determinants of Purchasing Private Health Insurance in Korean Cancer Patients.
Jin Hwa Lim, Sung Gyeong Kim, Eun Mi Lee, Sin Young Bae, Jae Hyun Park, Kui Son Choi, Myung Il Hahm, Eun Cheol Park
J Prev Med Public Health. 2007;40(2):150-154.
DOI: https://doi.org/10.3961/jpmph.2007.40.2.150
  • 5,275 View
  • 58 Download
  • 13 Crossref
AbstractAbstract PDF
OBJECTIVES
The aim of this study is to identify factors determining the purchase of private health insurance under the mandatory National Health Insurance(NHI) system in Korea. METHODS: The data were collected by the National Cancer Center in Korea. It includes cancer patients who were newly diagnosed with stomach (ICD code, C16), lung(C33-C34), liver (C22), colorectal cancer(C18-C20) or breast(C50) cancer. Data were gathered from the hospital Order Communication System (OCS), medical records, and face-to-face interviews, using a structured questionnaire. Clinical, socio-demographic and private health insurance related factors were also gathered. RESULTS: Overall, 43.9% of patients had purchased one or more private health insurance schemes related to cancer, with an average monthly premium of won 65,311 and an average benefit amount of won 19 million. Females, younger aged, high income earners, national health insurers and metropolitan citizens were more likely to purchase private health insurance than their counterparts. CONCLUSIONS: About half of Korean people have supplementary private health insurance and their benefits are sufficient to cover the out-of-pocket fees required for cancer treatment, but inequality remains in the purchase of private health insurance. Further studies are needed to investigate the impacts of private health insurance on NHI, and the relationship between cancer patients' burden and benefits.
Summary

Citations

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  • Out-of-pocket costs in gastrointestinal cancer patients: Lack of a perfectly framed problem contributing to financial toxicity
    Roberto Bordonaro, Dario Piazza, Concetta Sergi, Stefano Cordio, Salvatore Tomaselli, Vittorio Gebbia
    Critical Reviews in Oncology/Hematology.2021; 167: 103501.     CrossRef
  • Assessing determinants of health care prepayment in China: Economic growth or government willingness? New evidence from the continuous wavelet analysis
    Ying Zhang, Rui Wang, Xinyi Yao
    The International Journal of Health Planning and Management.2019;[Epub]     CrossRef
  • Evaluating financial performance of insurance companies using rating transition matrices
    Abhijit Sharma, Diara Md Jadi, Damian Ward
    The Journal of Economic Asymmetries.2018; 18: e00102.     CrossRef
  • Having Private Cancer Insurance in Korea: Gender Differences
    Ki-Bong Yoo, Jin-Won Noh, Young Dae Kwon, Kyoung Hee Cho, Young Choi, Jae-Hyun Kim
    Asian Pacific Journal of Cancer Prevention.2015; 16(17): 7981.     CrossRef
  • Equity in health care: current situation in South Korea
    Hong-Jun Cho
    Journal of the Korean Medical Association.2013; 56(3): 184.     CrossRef
  • Factors Associated with the Middle-aged or the Old-aged Koreans' Enrollment in Private Health Insurance
    Hyo-Jin Kim, Jae-Hee Lee
    The Journal of the Korea Contents Association.2012; 12(12): 683.     CrossRef
  • Comparison of Health Promotion Behavior in Middle aged Rural Residents by Cancer Screening Participation
    Myung Suk Lee
    Journal of Korean Academy of Community Health Nursing.2010; 21(1): 43.     CrossRef
  • The Effect of Catastrophic Health Expenditure on the Transition to Poverty and the Persistence of Poverty in South Korea
    Eun-Cheol Song, Young-Jeon Shin
    Journal of Preventive Medicine and Public Health.2010; 43(5): 423.     CrossRef
  • The Effect of Health Care Expenditure on Income Inequality
    Eun-Cheol Song, Chang-Yup Kim, Young-Jeon Shin
    Korean Journal of Health Policy and Administration.2010; 20(3): 36.     CrossRef
  • Impact of supplementary private health insurance on stomach cancer care in Korea: a cross-sectional study
    Dong Wook Shin, Kee-Taig Jung, Sung Kim, Jae-Moon Bae, Young-Woo Kim, Keun Won Ryu, Jun Ho Lee, Jae-Hyung Noh, Tae-Sung Sohn, Young Ho Yun
    BMC Health Services Research.2009;[Epub]     CrossRef
  • Comparison of Cancer Survival by Age Group for 1997 and for 2002: Application of Period Analysis using the National Cancer Incidence Database
    Seon-Hee Yim, Kyu-Won Jung, Young-Joo Won, Hyun-Joo Kong, Hai-Rim Shin
    Journal of Preventive Medicine and Public Health.2008; 41(1): 17.     CrossRef
  • Strengthening Causal Inference in Studies using Non-experimental Data: An Application of Propensity Score and Instrumental Variable Methods
    Myoung-Hee Kim, Young Kyung Do
    Journal of Preventive Medicine and Public Health.2007; 40(6): 495.     CrossRef
  • Effects of Private Health Insurance on Health Care Utilization and Expenditures in Korean Cancer Patients: Focused on 5 Major Cancers in One Cancer Center
    Jin Hwa Lim, Kui Son Choi, Sung Gyeong Kim, Eun-Cheol Park, Jae Hyun Park
    Journal of Preventive Medicine and Public Health.2007; 40(4): 329.     CrossRef
Women's Willingness to Pay for Cancer Screenin.
Min Son Kwak, Na Young Sung, Jeong Hee Yang, Eun Cheol Park, Kui Son Choi
J Prev Med Public Health. 2006;39(4):331-338.
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OBJECTIVES
The goal of this study is to measure women's willingness to pay for cancer screening and to identify those factors associated with this willingness to pay METHODS: A population-based telephone survey was performed on 1,562 women (aged 30 years or over) for 2 weeks (9-23th, July, 2004). Data about sociodemographic characteristics, health behaviors, the intention of the cancer screenings and willingness to pay for cancer screening were collected. 1,400 respondents were included in the analysis. The women's willingness to pay for cancer screening and the factors associated with this willingness to pay were evaluated. RESULTS: The results show that 76% of all respondents have a willingness to pay for cancer screening. Among those who are willing to pay, the average and median amount of money for which the respondents are willing to pay are 126,636 (s.d.: 58,414) and 120,000 won, respectively. As the status of education & the income are higher, the average amount that women are willing to pay becomes much more. The amount of money women are willing to pay is the highest during the 'contemplation' stage. Being willing to pay or not is associated with a change of behavior (transtheoretical model), the income, the concern about the cancer risk, the family cancer history, the marital status, the general health exam, age and the place of residence. Income is associated with a greater willingness to pay. Old age was associated with a lower willingness to pay. CONCLUSIONS: According to the two-part model, income and TTM are the most important variables associated with the willingness to pay for cancer screening. The cancer screening participation rate is low compared with the willingness to pay for cancer screening. It is thought that we have to consider the participants' behavior that&s associated with cancer screening and their willingness to pay in order to organize and manage cancer screening program.
Summary
Factors Associated with Cancer Screening Participation, Korea.
Min Son Kwak, Eun Chul Park, Jin Young Bang, Na Young Sung, Ji Young Lee, Kui Son Choi
J Prev Med Public Health. 2005;38(4):473-481.
  • 2,846 View
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OBJECTIVES
We wanted to identify those factors associated with stomach, colon, breast and cervix cancer screening. METHODS: A population-based telephone survey was conducted for 2 weeks (the 9th-23th of July, 2004) by trained interviewers with using a questionnaire. 2, 598 respondents (females aged 30 years or over, and the males aged 40 years or over) were selected by random-digit dialing that was based on the 2000 Population and Housing Census. The data on socio-demographic, health behavior and enabling factors were collected. 2, 571 respondents were included in analysis. The cancer screening rate was classified into 2 categories : the life time screening rate and the screening rate with recommendations. RESULTS: For the 2, 571 respondents, the life time screening rate was as follows: 52.0% (Stomach), 25.3% (Colon), 55.9% (Breast) and 76.8% (Cervix). The screening rate with recommendation was as follows: 39.2% (Stomach), 20.6% (Colon), 42.5% (Breast) and 58.3% (Cervix). On a multiple logistic regression analysis of the life time screening, statistically significant relationships were observed for the screening intention, the health exam, the disease history, the age of the patients and the cancer screening rates. On a multiple logistic regression analysis of the screening with recommendation, statistically significant relationships were observed for the screening intention, the health exam, the age of the patients, the concern about the risk of cancer, the voluntary health insurance for cancer and the cancer screening rates. CONCLUSIONS: The results of this study suggest that the cancer screening intention, the health exam and the age of the patients are the most important factors to participate in life time cancer screening and also screening with recommendations. A positive association was also observed for the concern about the risk of cancer, the voluntary health insurance for cancer. It is hoped that this study will be a base line data for suggesting the representative cancer screening rate in Korea.
Summary
Participation Rate and Related Socio-demographic Factors in the National Cancer Screening Program.
Na Young Sung, Eun Cheol Park, Hai Rim Shin, Kui Son Choi
J Prev Med Public Health. 2005;38(1):93-100.
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BACKGROUND
Cancer is the leading cause of death and one of the largest burdens of disease in Korea. In 1996, the 'Ten year Plan for Cancer Control' was formulated and the government then adopted the plan as a national policy. As part of this plan, the National Cancer Screening Program (NCSP) for Medicaid recipients was formulated, and the government adapted this in 1999. For low-income beneficiaries of the National Health Insurance Corporation (NHIC), the screening program has been in place since 2002. In 2002, the target cancers of NCSP were stomach, breast and cervical cancer. This study was conducted to examine the relationships between the participation rate, the abnormal screening rate and the socio-demographic factors associated with participation in the screening program. METHODS: To analyze the participation rate and abnormal rate for the NCSP, we used the 2002 NCSP records. The information on the socio-demographic factors was available from the database of the beneficiaries in the NHIC and Medicaid. RESULTS: The participation rate of the Medicaid beneficiaries for the stomach, breast and cervical cancer screening were 9.2%, 15.5% and 15.0%, respectively, and 11.3% and 12.5%, except cervical cancer which wasn't be included in the NCSP, for the beneficiaries of the NHIC. The abnormal rate of stomach, breast and cervical cancer screening were 25.7%, 11.2% and 21.0%, respectively, for the beneficiaries of Medicaid and 42.6% and 19.4% for the beneficiaries of the NHIC. On the multiple logistic regression analysis, gender, age and place of residence were significantly associated with participation rates of the NCSP. For stomach cancer, women participated in the NCSP more than men. The participation rate was higher among people in their fifties and sixties than for those people in their forties and those people over seventy years in age. For the breast and cervical cancer, people in their fifties were more likely to participate in the NCSP than people in their forties and people over sixty. For the place of residence, people in the rural areas participated more than those people in any other places. CONCLUSIONS: The above results show that the participation rate and abnormal rate were significantly associated with the socio-demographic factors. To improve the participation rate for the NCSP, more attention should be given to the underserved groups.
Summary
Factors Associated with Performance of National Cancer Screening Program in Korea.
Kui Son Choi, Jeong Hee Yang, Su Yeon Kye, Sun Hee Lee, Eun Cheol Park, Hai Rim Shin, Chang Min Kim
J Prev Med Public Health. 2004;37(3):246-252.
  • 2,578 View
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AbstractAbstract PDF
OBJECTIVES
Cancer is the leading cause of death in Korea. Therefore, a National Cancer Screening Program (NCSP) was launched in 1999. This study planned to evaluate the performance of the NCSP to identifying the influencing factors in relation to characteristic public health centers. METHODS: To analyze the performance, the database of the NCSP records for 2002 was used. The performance index was measured by the goal achievement rate, which was defined by the real number of screenees against the expected number of screenees. Also, a survey was conducted by a self-administered questionnaire to identify the factors associated with the goal achievement rate. The questionnaire was divided into two sections. In the first section, the individual characteristics of the program coordinator in each public health center were measured, and second section was comprised of questions about the organizational characteristics associated with the NCSP. A total of 121 subjects from 241 public health centers completed the questionnaire. RESULTS: Of the 121 public health centers (50.2% response rate), the average goal achievement rate was 72.8%. The results of the regression model showed that public health centers located in rural area (parameter estimates=38.2) and had great support from a head of center or province (parameter estimates=0.20) and tended to have higher goal achievement rates. However, the characteristics of the program coordinator, especially their knowledge of and attitude toward cancer screening, were not significantly related to the goal achievement rates. CONCLUSIONS: It appears that the most important associated factors to the goal achievement rate in the NSCP were the location of the public health center and the support for the NCSP from the head of the center or province.
Summary
Factors Associated with Cervical Cancer Screening in Busan, Korea.
Kui Son Choi, Duk Hee Lee, Kap Yeol Jung, Jieun Son, Tae Won Jang, Yoon Kyu Kim, Hai Rim Shin
J Prev Med Public Health. 2004;37(2):166-173.
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OBJECTIONS: Cervical cancer is the second most frequent cancer among women in Busan. The Pap smear test could have a significant effect on detecting cervical cancer, and enhancing their rate of use is an important strategy for reducing the incidence and mortality of cervical cancer. This study aimed to evaluate the factors associated with the past use of the Pap smear test in Korean women. METHODS: A population-based survey was carried out in Busan between November 1999 and March 2000. 1, 673 participants were randomly selected from 2, 684 women in Busan, using a 2-stage cluster sampling method, and interviewed in their homes. Their socio-demographic characteristics, smoking, drinking, familial cancer history, Pap smear screening history, reproductive and menstrual factors, sexual habits and use of contraceptive methods data were collected by a trained interviewer using a questionnaire. The use of the screening test was defined by a self-report from the participants on how many times they had had a Pap smear test in their lifetime, and when they had received their latest examination. RESULTS: Of the 1, 673 respondents (62.3% response rate), 57.6% had had a Pap smear test during her life (mean number, 2.3). Among the health examination participants (1, 064), 961 (90.3%) reported having sexual experience and 70.9% of these had had a Pap smear test. In a multiple logistic regression analysis, statistically significant relationships were observed for age groups and the Pap smear test rate (odds ratio, OR for 35-44 years=2.45; OR for 45-54 years=3.41; OR for 55 years=2.60; reference, under 34 years). The married or cohabiting women were more likely to have used the Pap smear test than those separated or widowed (OR=1.73). Among the reproductive behavioral measures, the number of births (OR for 3 births=4.22; OR for 2 births=3.95; OR for 1 births=3.38; reference, 0 births) and husband's extra-marital affairs (OR=1.50) were associated with the rates of use of Pap smear tests. CONCLUSION: It appears that the most important contributing factors to cervical cancer screening were age, marital status and number of births. A positive association was also observed for the husband's extra-marital affairs. This study enabled us to systematically assess the relationship between Pap smear rates and risk factors for cervical cancer. It is hoped that this study will make a significant contribution to the accumulating scientific evidence on the identification of factors associated with cervical cancer screening in Korea.
Summary
The Difference of Locus-of-control among Western Medical School Students, Oriental Medical School Students, and Non-Medical School Students.
Kui Son Choi, Sunhee Lee, Hanjoon Lee
Korean J Prev Med. 2003;36(3):239-247.
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OBJECTIVES
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.
Summary
Factors Associated with the Degree of Quality Improvement Implementation.
Sun Hee Lee, Kui Son Choi, Hye Young Kang, Woo Hyun Cho, Yoo Mi Chae
Korean J Prev Med. 2001;34(4):363-371.
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OBJECTIVES
To assess the degree of quality improvement (QI) implementation and to identify its associated factors. METHODS: A mailed questionnaire survey of the QI staffs at hospitals with 400 beds or more was conducted between September 15 and October 30, 2000. Of the 108 hospitals eligible for inclusion in our study, 79 participated, yielding a response rate of 73.1%. After excluding 12 hospitals that did not perform any QI activities, 117 responses from 67 hospitals were used in our analysis. The degree of QI implementation was measured using the Malcolm Baldrige National Quality Award Criteria (MBNQAC). Factors evaluated for association with the degree of QI implementation were cultural, technical, strategic, and structural factors of the hospitals. RESULTS: The average QI implementation score across the 7 dimensions of MBNQAC was 3.34 on a 5-point scale, with the highest score for the area of customer satisfaction (3.88) followed by information and analysis (3.59) and quality management (3.35). The results of regression analysis showed that hospitals with a etter information system (p<0.05) and using scientific and systematic problem solving approach (p<0.01) tended to perform a higher degree of QI implementation. While statistically insignificant, positive associations were observed for the factors of group or developmental culture, the degree of employee empowerment, and the use of prospective strategy. CONCLUSIONS: It appears that the most important factors contributing to active implementation of QI in Korean hospitals were the use of scientific skills in decision making, and having a quality information system to produce precise and valid information.
Summary
Comparative Analysis of Models for Measuring Consumer Satisfaction in Health Care Organization.
Sunhee Lee, Woo Huyn Cho, Kui Son Choi, Myungguen Kang
Korean J Prev Med. 2001;34(1):55-60.
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OBJECTIVES
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.
Summary
Structural Modeling of Quality, Satisfaction, Value and Purchase Intention in Health Care Service.
Kui Son Choi, Woo Hyun Cho, Sunhee Lee, Jung Mo Nam
Korean J Prev Med. 2000;33(4):426-435.
  • 2,792 View
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OBJECTIVES
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.
Summary
A study on appropriateness of price of medical care service in health insurance.
Ki Hong Chun, Kui Son Choi, Im Ok Kang
Korean J Prev Med. 1998;31(3):460-470.
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By expanding health insurance, customers will carry a smaller burden of medical costs. As a result, the number of visits to a physician increase and this result in the improvement of medical accessibility. But medical care utilization may be changed not only by insurance status but also by socio-demographic factor, economic status and other factors. The question thus remains, at which level of accessibility and what price of medical care service in health insurance will the customer and the medical care service be satisfied. The price of medical care service is comprised of the customer's out-of-pocket money and the costs not covered by health insurance. If the price of medical care services in health insurance are appropriate, medical care utilization should not differ because of the difference in income status or the acuteness of illness. But If the price is not adequate, low income groups will receive relatively low medical care utilization, particularly in the case of chronic disease. The purpose of this study is to evaluate the differences in medical care utilization among the various income groups and those with varying acuteness of illness. The major hypotheses to test in this study are : (I) whether there are differences in medical care utilization among different income groups exist, (II) whether differences in medical care utilization among different income groups exist with the hospital type. (III) whether differences in medical care utilization among different income groups exist with the acuteness of illness and with age. The data was collected from the JongRo District Health Insurance Society in Seoul. A total of 118,336 persons were selected as the final sample for this study. The major findings of this study were as follows ; 1. The volume of ambulatory utilization among users was statistically significant by income level. 2. Among different income groups, the volume of ambulatory utilization was statistically significant by the acuteness of illness. 3. Higher income groups with chronic diseases had a greater volume of ambulatory utilization than other groups.
Summary

JPMPH : Journal of Preventive Medicine and Public Health
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