Journal of Preventive Medicine and Public Health

English Abstracts

Impact of Health Insurance Type on the Quality of Hemodialysis Services: A Multilevel Analysis.: Jin Hee Jung, Soon Man Kwon, Kyoung Hoon Kim, Seon Kyoung Lee, Dong Sook Kim; J Prev Med Public Health. 2010;43(3):245-256.; DOI: https://doi.org/10.3961/jpmph.2010.43.3.245

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OBJECTIVES
This study aims to compare quality indicators for the hemodialysis services between patients with health insurance and those with medical aid. METHODS: This study used data from sampled hospitals that provided a hemodialysis service. A total of 2287 patients were selected, and the information for hemodialysis service has been granted from medical record reviews. A multi-level regression analysis was used to examine the differences in process and outcome indicators for hemodialysis between patients with health insurance and those with medical aid. Process indicators were defined as: frequency of hemodialysis, hemodialysis time, erythropoietin (EPO) use, measurement of hemodialysis dose at least once a month, measurement of phosphate at least once every three months, and measurement of albumin at least once every three months. Outcome indicators were defined as: hemodialysis adequacy, anemia management, blood pressure management, and calcium, phosphate and nutrition management. The total scores for outcome indicators ranged from 0 (worst) to 4 (best). RESULTS: There was a significant difference in the measurement of hemodialysis dose at least once a month between patients with health insurance and those with medical aid (OR 0.66, 95% CI=0.43-0.99). However, frequency of hemodialysis, hemodialysis time, EPO use, measurement of phosphate at least once every three months, measurement of albumin at least once every three months, hemodialysis adequacy management, Hb> or =11 g/dL, blood pressure within the range of 100-140/60-90 mmHg, calcium x phosphate< or =55 g2/dL2 and albumin> or =4 g/dL were not significantly different between the groups. CONCLUSIONS: There were no significant differences in outcome indicators for hemodialysis between the groups. Further studies are warranted into the mechanism that results in no differences in the outcome indicators for hemodialysis.

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A Study of Effect on the Smoking Status using Multilevel Logistic Model
Ji Hye Lee, Tae-Young Heo
Korean Journal of Applied Statistics.2014; 27(1): 89. CrossRef
Multilevel Analysis on Factors Influencing Death and Transfer in Inpatient with Severe Injury
Young Eun Choi, Kang Suk Lee
Health Policy and Management.2013; 23(3): 233. CrossRef
Factors Affecting Diabetic Screening Behavior of Korean Adults: A Multilevel Analysis
Hyeongsu Kim, Minjung Lee, Haejoon Kim, Kunsei Lee, Sounghoon Chang, Vitna Kim, Jun Pyo Myong, Soyoun Jeon
Asian Nursing Research.2013; 7(2): 67. CrossRef

The Medical Use of the Disabled Among Overusers of Medical Aid in Korea.: Sun Mi Shin, Eui Sook Kim, Chang Ki Park, Hee Woo Lee; J Prev Med Public Health. 2010;43(1):35-41.; DOI: https://doi.org/10.3961/jpmph.2010.43.1.35

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OBJECTIVES
In Korea, the top 10% of Medical Aid recipients represent nearly 60% of total payment, with the costs for those disabled for over 365 days representing approximately 30% of total payment. The purpose of this study was to compare Medical Aid use of the disabled with non-disabled recipients, and to identify contributing factors to the total payment in the top 2% of recipients identified as Medical Aid overusers. METHODS: Subjects (n=2,211) selected were > or =18-years-of-age and received >1000 days of co-payment-free type I Medical Aid. Case managers (n=200) conducted interviews in December 2006, and collected data from Health Insurance Review & Assessment Service. Amounts over the 9 months from January September 2006 were analyzed descriptively and using Chi-square, ANCOVA, and robust multiple linear regression. RESULTS: Disabled individuals (mean age 61.3 years) composed 36.6% of subjects; 44.8% of the disabled were male. On a monthly basis per capita, the disabled group averaged 10.5 outpatient days, total payment of 523,000 Korean Won(won), inpatient payment of 359,000won, and outpatient payment of 183,000won. All values exceeded the monthly average for non-disabled individuals. Contributing factors were identified as male gender (82,000won), elementary school or lower educational level (64,000won), residence in a small city (82,000won), lack of family support (61,000won), kidney disability (673,000won), intellectual disability (151,000won), and multiple disabilities (119,000won). CONCLUSIONS: The identification of contributing factors to Medical Aid use by those defined as disabled supports the adoption of comprehensive alternative policies such as strengthening of education and consultation services, provision of alternative facilities, and promotion of self-care.

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Comparison of out-of-pocket expenditure and catastrophic health expenditure for severe disease by the health security system: based on end-stage renal disease in South Korea
Sun Mi Shin, Hee Woo Lee
International Journal for Equity in Health.2021;[Epub] CrossRef
Nationwide trends in stroke hospitalization over the past decade
Young Dae Kwon, Hyejung Chang, Youn Jung Choi, Sung Sang Yoon
Journal of the Korean Medical Association.2012; 55(10): 1014. CrossRef
Multilevel Analysis of Health Care Service Utilization among Medical Aid Beneficiaries in Korea
Yang Heui Ahn, Ok Kyung Ham, Soo Hyun Kim, Chang Gi Park
Journal of Korean Academy of Nursing.2012; 42(7): 928. CrossRef
Factors Associated With the Overuse or Underuse of Health Care Services Among Medical Aid Beneficiaries in Korea
Yang Heui Ahn, Eui Sook Kim, Ok Kyung Ham, Soo Hyun Kim, Seung Sik Hwang, Sang Hee Chun, Na Yeon Gwon, Jin Yi Choi
Journal of Community Health Nursing.2011; 28(4): 190. CrossRef

The Contributing Factors to Surplus Medicine by Long-Term Users of Medical Aid in Korea.: Sun Mi Shin, Eui Sook Kim, Hee Woo Lee; J Prev Med Public Health. 2009;42(6):403-407.; DOI: https://doi.org/10.3961/jpmph.2009.42.6.403

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OBJECTIVES
The amount of medical utilization by Medical Aid recipients was 3.7 times that of patients with Korean Medical Insurance. This study aims to describe the surplus medicine and the medication-related utilization, and to determine factors contributing to surplus medicine. METHODS: Among those who used copayment-free Class I Medical Aid in 2005, 146,880 subjects who were > or =19 year-old and received >365 days medical treatment per year were studied with their case managers by conducting face-to-face interviews. The analytic methods were description, chi-square, t-tests, ANCOVA and multiple logistic regressions. RESULTS: Most subjects were female (68.6%), the elderly (62.5%), and the separated (61.6%), had an elementary graduation or less (74.8%), and had disabilities (33.2%). The percentage of subjects with surplus medicine was 18.5%. However, the percentage of females, the elderly, those with non-disabilities, the separated, the uneducated, those with a very poor perceived health status and those with an economical burden for medical treatment was 19.3%, 18.9%, 19.0%, 19.3%, 19.0%, 20.2% and 24.3%, respectively. For subjects with surplus medicine, averages for the number of used pharmacies, the pharmacy-visit days and the medication costs were 4.6 drugstores, 34.9 days and approximately 1,124 thousand Won. These values were higher than those without surplus medicine (4.4 drugstores , 33.8 days, and 1,110 thousand won, respectively). The odds ratios of the contributing factors to surplus medicine were female 1.11 (95% CI=1.07-1.14), the elderly 1.06 (95% CI=1.02-1.10), those with non-disabilities 1.08 (95% CI=1.05-1.12), the separated 1.14 (95% CI=1.10-1.18), the unmarried 1.12 (95% CI=1.07-1.18), the uneducated 1.03 (95% CI=1.01-1.08), those with a very poor perceived health status 1.04 (95% CI=1.01-1.08) and experiencing an economical burden for medical treatment 2.33 (95% CI=2.26-2.40). CONCLUSIONS: 18.5% of subjects had surplus medicine with a higher mean of medication cost. Therefore, health education and health promotion programs to prevent surplus medicine and to improve the appropriate usage of medication are necessary.

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Citations

Citations to this article as recorded by

Comparison of out-of-pocket expenditure and catastrophic health expenditure for severe disease by the health security system: based on end-stage renal disease in South Korea
Sun Mi Shin, Hee Woo Lee
International Journal for Equity in Health.2021;[Epub] CrossRef
Effects of drug price reduction and prescribing restrictions on expenditures and utilisation of antihypertensive drugs in Korea
Ki-Bong Yoo, Sang Gyu Lee, Sohee Park, Tae Hyun Kim, Jeonghoon Ahn, Mee-Hyun Cho, Eun-Cheol Park
BMJ Open.2015; 5(7): e006940. CrossRef
The Effects of the Designated Doctor System on the Health of Medical Aid Beneficiaries
Jeongmyung Choi, Jinjoo Oh
Journal of Korean Academy of Community Health Nursing.2012; 23(4): 438. CrossRef
Factors influencing medical institution selection for outpatient services
Chang Hoon You, Young Dae Kwon
Journal of the Korean Medical Association.2012; 55(9): 898. CrossRef

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