Journal of Preventive Medicine and Public Health

English Abstracts

Impact of Shared-Decision Making on Patient Satisfaction.: Won S Suh, Chae Kyung Lee; J Prev Med Public Health. 2010;43(1):26-34.; DOI: https://doi.org/10.3961/jpmph.2010.43.1.26

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OBJECTIVES
The purpose of this research is to analyze the impact of shared-decision making on patient satisfaction. The study is significant since it focuses on developing appropriate methodologies and analyzing data to identify patient preferences, with the goals of optimizing treatment selection, and substantiating the relationship between such preferences and their impact on outcomes. METHODS: A thorough literature review that developed the framework illustrating key dimensions of shared decision making was followed by a quantitative assessment and regression analysis of patient-perceived satisfaction, and the degree of shared-decision making. RESULTS: A positive association was evident between shared-decision making and patient satisfaction. The impact of shared decision making on patient satisfaction was greater than other variable including gender, education, and number of visits. CONCLUSIONS: Patients who participate in care-related decisions and who are given an explanation of their health problems are more likely to be satisfied with their care. It would benefit health care organizations to train their medical professionals in this communication method, and to include it in their practice guidelines.

Summary

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Factors Affecting Comsumer's Usage of Health Information on the Internet.: Jong Hyock Park, Jin Seok Lee, Hyejung Jang, Yoon Kim; J Prev Med Public Health. 2008;41(4):241-248.; DOI: https://doi.org/10.3961/jpmph.2008.41.4.241

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Abstract PDF

OBJECTIVES
The purpose of the study was to identify a gap between consumer characteristics and utilization of health information on the Internet. METHODS: A telephone survey of nationally representative samples was conducted using structured questionnaires, and 1,000 of the 1,189 responses obtained were included in our analysis. The following variables were included in the analysis as potential predictors of health information use on the Internet: predisposing factors such as gender, age, and education status; enabling factors such as region and monthly household income; consumer need for health information; and attitude to health. Multiple logistic regression analysis was used to evaluate the association between utilization rate and the potential predictors. RESULTS: Thirty-nine percent of consumers had obtained health information on the Internet over a one-year period. The utilization rates were higher for consumers who were young, educated, worked in the office setting, had higher incomes, wanted health information, and were able to use the Internet. The utilization rate was 5.35 times higher in the younger group (20-30 years) than in the elderly group (95% CI=2.21-12.97); 2.21 times higher for office workers than for manual workers (95% CI=1.16-4.20); 3.61 times higher for college graduates than for middle school graduates and below (95% CI=1.07-11.59); 1.99 times higher for people with monthly household incomes over 3,000,000 won than for those with monthly household incomes below 1,500,000 won (95% CI=1.01-3.92). CONCLUSIONS: There needs to be a paradigm shift, with consideration of not only Internet accessibility in the digital age, but also consumer ability and attitudes toward utilization of health information.

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Information Sources and Knowledge on Infant Vaccination according to Online Communities.: Inyoung Choi, Mieun Chung, Soon Choy, Sukil Kim; J Prev Med Public Health. 2007;40(4):291-296.; DOI: https://doi.org/10.3961/jpmph.2007.40.4.291

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Abstract PDF

OBJECTIVES
To explore the information sources and knowledge on infant vaccinations of pro-vaccination community members and anti- accination community members on the internet. METHODS: An online survey of 245 parents from three pro-vaccination communities and 92 parents from one antivaccination community was conducted from June 7 to June 23, 2006. RESULTS: Parents from pro-vaccination communities usually gained the information regarding vaccination efficacy and risk mainly from healthcare providers (49.8%) and mass media (47.7%). Pro-vaccination community members considered healthcare providers as the most credible sources of information on vaccination, whereas the anti-vaccination community members usually gained their information regarding vaccine efficiency and risk from Internet child-care cafes and online vaccination communities. Parents of the anti-vaccination community considered the internet as the most credible information source (77.6% for efficacy, 94.8% for risk). In addition, the major reason why anti-vaccination community members didn't vaccinate and, will not vaccinate, was concern about possible side effects of the vaccine. The knowledge level on infant vaccination, education and economic status was higher in the anti-vaccination community. CONCLUSIONS: On-line communities concerned with vaccination are getting popular. The influence of antivaccination parents on the Internet is expected to be high. The government and healthcare providers need to increase their efforts to improve the credibility of information about vaccination. Our findings suggest that online communication regarding vaccinations needs to be considered as a means to increase vaccination rates.

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Original Articles

Information Searching Behavior of Health Care Consumers by Sociodemographic Characteristics.: Yoomi Chae, Sunhee Lee, Woohyun Cho; Korean J Prev Med. 2001;34(4):389-398.

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Abstract PDF: OBJECTIVES
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.; 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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Abstract PDF: 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

Dimensions of Consumer Ratings of a Hospital Outpatient Service Quality.: Ki Tae Moon, Seung Hum Yu, Woo Hyun Cho, Dong Kee Kim, Yunwhan Lee; Korean J Prev Med. 2000;33(4):495-504.

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Abstract PDF: OBJECTIVES
To examine various dimensions of consumer ratings of health care service with factor analysis and to find which factors influence the overall quality of health care service. METHODS: A cross-sectional study was conducted on outpatients of a general hospital located in Sungnam City. A self-administered questionnaire was used to assess the consumer? ratings of health care service received. The response rate was 92.8% with a total of 537 persons completing the questionnaire. Factor analysis was performed on 34 items evaluating the quality of health care service. Items were grouped into 5 dimensions as a result of factor analysis and the reliability and validity of influence on patient service assessment were evaluated for each dimension. RESULTS: The 5 dimensions were as follows ; 1) physician services, 2) non-physician services, 3) process 4) facilities, and 5) cleanliness. A positive correlation with the quality of health care service was found for the dimensions of non-physician services and process, while no significant correlation was found for the dimensions of physician services, facilities, and cleanliness. CONCLUSIONS: The result of this study may provide basic information for the development of future self-administered questionnaires of consumer ratings and for the evaluation of quality improvement activities in hospital outpatient settings.; Summary

A Study of Hospital Choice on the basis of Consumption Values Theory.: Sun Hee Lee; Korean J Prev Med. 1997;30(2):413-427.

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Abstract PDF: This research is based on the Consumption Values theory proposed by Sheth(1991). The purpose of this research is finding the factors related to the process of hospital choice. The expectation of six hospital outpatients 600 was analyzed by six consumption values categories: functional values, social values, emotional value, rarity value, situational values, health related values. The main results of this research is as following; 1. In the result of factor analysis 22 consumption value factors which affect the hospital preference were extracted; kindness/clearness, service speed, comfortabness of space, technical competence in functional values, high income/active social life, low income/blue calar, unmarried/man, middle aged/big family, woman/married, introvert in social values, high-class, comfortableness, reliability in emotional value, newness, classiness in rarity value, social relationship, close to residence, social reputation in situational values, priority on health, health behavior, active sense of value on health in health related values. 2. The difference of consumption values among hospital types were analyzed. The critical factors in reference for corporate hospitals newly established were kindness/ clearness, service speed, convenience, classiness, comfortableness, and newness. University hospitals were preferred by the factors of reliability, and social reputation. In general hospital, convenience and close to residence were critical factor. 3. In logistic regression, age, marital status, education level and income as sociodemographic variables were significaltly related to general hospital choice. Also service speed and close to residence were positively and high income/active social life and high class value were negatively related to general hospital choice. On university hospital choice, age and marital status, education show posive relationship whereas income showing negative relationship. Kindness/clearness, service speed, comfortableness of space, unmarried/man, comfortable feeling, newness and close to residence showed negative relationship with university hospital selection whereas technical competence, reliability in emotional value, classiness in rarity value, social relationship in functional values showed positive relationship. Lastly kindness/clearness, comfortableness of space, high income/active social life, unmarried/man, high-class, comfortableness and newness were positively related to corporate hospitals newly established choice in contast to negative relationship in reliability in emotional value and classiness. In summary, we found that hospital user also choose to hospital in base of various consumption value. Further studis to investigate the hospital consumer behavior will be needed.; Summary

Health-Related Behaviors: Theoretical Models And Research Findings.: Sang Soo Bae; Korean J Prev Med. 1993;26(4):508-533.

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Abstract PDF: A wide range of health professionals have interest in changing the health behavior of individuals. To intervene effectively and to make informed judgements about how to measure the success of such interventions, health professionals must have an deep understanding of health behavior. This paper provides and overview of the thories of health-related behaviors and the strength and weakness of each, how the theories relate to others, and how they can be used in practice. The theories reviewed include Suchmann's stages of illness experience, Health belief model, Attribution theory, Fishbein's theory of reasoned action, Multiattribute utility models, Consumer information processing, and Andersen's models. Finally, this paper introduces the reader to interesting research findings in our country.; Summary

A Study on the Criteria for Selection of Medical Care Facilities.: Woo Hyun Cho, Han Joong Kim, Sun Hee Lee; Korean J Prev Med. 1992;25(1):53-63.

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Abstract PDF: There are increasing interest and need for information on health care consumer with the significance of hospital marketing and strategic planning being increasingly emphasized. This study was conducted to investigate the criteria for selection of medical facilities according to the characteristics of health care consumer by the types of medical services on a sample of 1,500 population aged 20 years and above. Major findings are as follows; 1. When considering the criteria for selection of medical facilities into two factors, namely, quality or convenience factors, convenience factor was the major contributor for outpatient and dental services whereas it was quality factor for inpatient services. 2. Females and those residing in large cities selected medical facilities based on convenience factor in the outpatient services. In the case of inpatient service, persons who considered their present health status to be good and whose ages were 50 years old and above choose medical facilities based on quality factor. 3. Persons who considered medical facilities to be profit-making tended to choose medical facilities based on convenience factor for outpatient services. There were no differences in the cases of inpatient and dental services. 4. There was no significant difference on the criteria for selection of medical facilities according to the decision maker for selection or trust on medical facilities. On the use of health service information, selection of medical facilities was based on qPality factor for those who made more use of the information in the cases of outpatient and dental services. 5. Analysis using the logistic regression model on the criteria for the selection of medical facilities with the characteristics of health care consumer as independent variables was performed. The selection of medical facilities was significantly related with residential area, sex, and use of information on medical facilities for outpatient services and with age, average monthly income, and perception of health status for inpatient services. For dental services significant association with residential area and use of information on medical facilities was seen. The results of this study, despite some limitations, can be used as baseline data for marketing and strategic planning of hospital management.; Summary

Economic Benefits of Implementing National Health Insurance by Measurement of Changes in the Consumer's Surplus.: Han Joong Kim, Hae Jong Lee; Korean J Prev Med. 1989;22(3):398-405.

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Abstract PDF: A change in the consumer's surplus was measured in order to evaluate the social benefit to be derived from expanding health insurance to the entire population. The most refined and correct way to measure a project's net benefit to society is to determine a change in the consumer's surplus. Benefits from introducing the health insurance program to the uninsured people can be classified into two elements. The first is the pricing-down effect(E1) which results from applying the insurance price system, which is lower than the actual price, to the uninsured patients. The second effect(E2) is a decrease in actual payment because an insured patient pays only a portion of the total medical bill(copayment). We collected medical price information from the data banks of 93 hospitals, and obtained information of medical utilization by referring to the results of other research and from data published by the Korean Medical Insurance Societies. The total net benefit was estimated as won214 billion, comprising the first effect(E1) of won57 billion and the second effect(E2) of won157 billion. The price elasticity of physician visits is less than that of hospital admissions; however, benefits from the increase in physician visits are greater than those from hospital admissions because there are considerably more of physician visits than hospital admissions. The sensitivity analysis also shows the conclusion that expansion of the health insurance program to the entire population would result in a positive net benefit. Therefore, we conclude that the National Health Insurance Program is socially desirable.; Summary

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