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Increase in Potential Low-value Magnetic Resonance Imaging Utilization Due to Out-of-pocket Payment Reduction Across Income Groups in Korea: An Experimental Vignette Study
Yukyung Shin, Ji-su Lee, Young Kyung Do
J Prev Med Public Health. 2022;55(4):389-397.   Published online July 11, 2022
DOI: https://doi.org/10.3961/jpmph.22.208
  • 3,086 View
  • 108 Download
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
This study examined the effect of out-of-pocket (OOP) payment reduction on the potential utilization of low-value magnetic resonance imaging (MRI) across income groups.
Methods
We conducted an experimental vignette survey using a proportional quota-based sample of individuals in Korea (n=1229). In two hypothetical vignettes, participants were asked whether they would be willing to use MRI if they had uncomplicated headache and non-specific low back pain, each before and after OOP payment reduction. To account for the possible role of physician inducement, half of the participants were initially presented with vignettes that included a physician recommendation for low-value care. The predicted probability, slope index of inequality (SII), and relative index of inequality (RII) were calculated using logistic regression.
Results
Before OOP payment reduction, the lowest income quintile was least likely to use low-value MRI regardless of physician inducement (36.7-49.6% for low back pain; 30.5-39.3% for headache). After OOP payment reduction, almost all individuals in each income quintile were willing to use low-value MRI (89.8-98.0% for low back pain; 78.1-90.3% for headache). Absolute and relative inequalities concerning potential low-value MRI utilization decreased after OOP payments were reduced, even without physician inducement (SII: from 8.15 to 5.37%, RII: from 1.20 to 1.06 for low back pain; SII: from 6.99 to 0.83%, RII: from 1.20 to 1.01 for headache).
Conclusions
OOP payment reduction for MRI has the potential to increase low-value care utilization among all income groups while decreasing inequality in low-value care utilization.
Summary
Korean summary
실험적 비네트 디자인을 활용하여 환자 본인부담금 감소가 잠재적 저가치 MRI 이용에 미치는 영향을 소득 수준별로 분석한 연구이다. 본인부담금 감소로 인해 잠재적 저가치 MRI 이용은 모든 소득 수준에서 증가하고 잠재적 저가치 MRI 이용의 소득 수준에 따른 차이는 감소하는 결과를 보였다.

Citations

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  • Socioeconomic inequality in organized and opportunistic screening for colorectal cancer: results from the Korean National Cancer Screening Survey, 2009–2021
    Xuan Quy Luu, Kyeongmin Lee, Jae Kwan Jun, Mina Suh, Kui Son Choi
    Epidemiology and Health.2023; : e2023086.     CrossRef
“Leisure Life Satisfaction:” Will It Have a Beneficial Impact on Depression Among Older Adults in Community Care Settings in Korea?
Il-Ho Kim, Cheong-Seok Kim
J Prev Med Public Health. 2022;55(4):398-406.   Published online July 7, 2022
DOI: https://doi.org/10.3961/jpmph.22.160
  • 2,687 View
  • 100 Download
  • 5 Crossref
AbstractAbstract AbstractSummary PDF
Objectives
While the risk of depression is expected to substantially increase among older adults receiving community care, leisure life satisfaction can be regarded as a key component in enhancing the mental health of those receiving community care. However, it is not yet known whether community care utilization increases the risk of depression, or what role is played by leisure life satisfaction in these settings. This study investigated the relationship between community care utilization and depression, as well as the main effect and the moderating role of leisure life satisfaction on the link between community care utilization and depression among older adults.
Methods
This study, using the 2019 Korean Welfare Panel Survey, conducted multiple regression analysis on data from 4494 elderly people aged 65 years or older.
Results
After controlling for potential covariates, older community care recipients were more likely to report symptoms of depression than those who did not receive community care. Meanwhile, leisure life satisfaction was negatively associated with depression in older adults. The test for interaction between community care utilization and leisure life satisfaction revealed that leisure life satisfaction significantly attenuated the link between depression and community care utilization.
Conclusions
The findings of this study imply that leisure life satisfaction could play a meaningful role in improving the mental health of older adults receiving community care. Welfare policies affecting older adults should consider leisure life satisfaction as an important resource for reducing depression in community care settings.
Summary
Korean summary
본 연구는 2019년 한국복지패널조사의 4,494명의 노인들을 대상으로 돌봄노인의 우울 수준과 여가생활 만족의 조절효과를 검증하였다. 연구결과, 돌봄노인의 우울증상이 일반노인에 비하여 유의하게 높았다(p<0.001). 반면 여가생활 만족은 돌봄서비스 이용노인의 우울 증상을 조절하는 효과가 있었다. 이 연구의 결과는 여가생활 만족이 돌봄노인의 정신건강을 향상시키는데 의미 있는 역할을 할 수 있다는 것을 암시한다.

Citations

Citations to this article as recorded by  
  • Leisure and Happiness of the Elderly: A Machine Learning Approach
    Eui-Jae Kim, Hyun-Wook Kang, Seong-Man Park
    Sustainability.2024; 16(7): 2730.     CrossRef
  • Social engagement and subjective health among older adults in South Korea: Evidence from the Korean Longitudinal Study of Aging (2006–2018)
    Bo Zhao, Ji Eon Kim, Jiyoung Moon, Eun Woo Nam
    SSM - Population Health.2023; 21: 101341.     CrossRef
  • Do the various leisure forms have equal effects on mental health? A longitudinal analysis of self-selected leisure activities
    Junyi Bian, Zubing Xiang
    Frontiers in Public Health.2023;[Epub]     CrossRef
  • Development of a prediction model for the depression level of the elderly in low-income households: using decision trees, logistic regression, neural networks, and random forest
    Kyu-Min Kim, Jae-Hak Kim, Hyun-Sill Rhee, Bo-Young Youn
    Scientific Reports.2023;[Epub]     CrossRef
  • The Trajectory of Depressive Symptoms Across Years of Community Care Utilization Among Older Adults: A 14-Year Follow-up Study Using the ‘Korean Welfare Panel Survey’
    Il-Ho Kim, Cheong-Seok Kim, Min-Hyeok Jeong
    Journal of Preventive Medicine and Public Health.2023; 56(6): 495.     CrossRef
Evaluation of Geographic Indices Describing Health Care Utilization
Agnus M. Kim, Jong Heon Park, Sungchan Kang, Yoon Kim
J Prev Med Public Health. 2017;50(1):29-37.   Published online December 19, 2016
DOI: https://doi.org/10.3961/jpmph.16.099
  • 8,753 View
  • 190 Download
  • 6 Crossref
AbstractAbstract PDF
Objectives
The accurate measurement of geographic patterns of health care utilization is a prerequisite for the study of geographic variations in health care utilization. While several measures have been developed to measure how accurately geographic units reflect the health care utilization patterns of residents, they have been only applied to hospitalization and need further evaluation. This study aimed to evaluate geographic indices describing health care utilization.
Methods
We measured the utilization rate and four health care utilization indices (localization index, outflow index, inflow index, and net patient flow) for eight major procedures (coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, surgery after hip fracture, knee replacement surgery, caesarean sections, hysterectomy, computed tomography scans, and magnetic resonance imaging scans) according to three levels of geographic units in Korea. Data were obtained from the National Health Insurance database in Korea. We evaluated the associations among the health care utilization indices and the utilization rates.
Results
In higher-level geographic units, the localization index tended to be high, while the inflow index and outflow index were lower. The indices showed different patterns depending on the procedure. A strong negative correlation between the localization index and the outflow index was observed for all procedures. Net patient flow showed a moderate positive correlation with the localization index and the inflow index.
Conclusions
Health care utilization indices can be used as a proxy to describe the utilization pattern of a procedure in a geographic unit.
Summary

Citations

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  • Development and Evaluation of Rehabilitation Service Areas for the United States
    Timothy A. Reistetter, Julianna M. Dean, Allen M. Haas, John D. Prochaska, Daniel C. Jupiter, Karl Eschbach, Yong-Fang Kuo
    BMC Health Services Research.2023;[Epub]     CrossRef
  • Factors Associated with End-Of-Life Health Care Use and Spending in Korea in Comparison with the General Population
    Agnus M. Kim, Yoon Kim
    Journal of Aging & Social Policy.2023; : 1.     CrossRef
  • Presence of Thrombectomy-capable Stroke Centers Within Hospital Service Areas Explains Regional Variation in the Case Fatality Rate of Acute Ischemic Stroke in Korea
    Eun Hye Park, Yong Jin Gil, Chanki Kim, Beom Joon Kim, Seung-sik Hwang
    Journal of Preventive Medicine and Public Health.2021; 54(6): 385.     CrossRef
  • An ecological study of geographic variation and factors associated with cesarean section rates in South Korea
    Agnus M. Kim, Jong Heon Park, Sungchan Kang, Tae Ho Yoon, Yoon Kim
    BMC Pregnancy and Childbirth.2019;[Epub]     CrossRef
  • Geographic variation and factors associated with rates of knee arthroplasty in Korea-a population based ecological study
    Agnus M. Kim, Sungchan Kang, Jong Heon Park, Tae Ho Yoon, Yoon Kim
    BMC Musculoskeletal Disorders.2019;[Epub]     CrossRef
  • Factors associated with the rates of coronary artery bypass graft and percutaneous coronary intervention
    Agnus M. Kim, Jong Heon Park, Seongcheol Cho, Sungchan Kang, Tae Ho Yoon, Yoon Kim
    BMC Cardiovascular Disorders.2019;[Epub]     CrossRef
The Association Among Individual and Contextual Factors and Unmet Healthcare Needs in South Korea: A Multilevel Study Using National Data
Seung Eun Lee, Miyeon Yeon, Chul-Woung Kim, Tae-Ho Yoon
J Prev Med Public Health. 2016;49(5):308-322.   Published online September 7, 2016
DOI: https://doi.org/10.3961/jpmph.16.035
  • 8,025 View
  • 206 Download
  • 14 Crossref
AbstractAbstract PDF
Objectives
The objective of this study is to investigate associations between contextual characteristics and unmet healthcare needs in South Korea after accounting for individual factors.
Methods
The present study used data from the 2012 Korean Community Health Survey (KCHS) of 228 902 adults residing within 253 municipal districts in South Korea. A multilevel analysis was conducted to investigate how contextual characteristics, defined by variables that describe the regional deprivation, degree of urbanity, and healthcare supply, are associated with unmet needs after controlling for individual-level variables.
Results
Of the surveyed Korean adults, 12.1% reported experiencing unmet healthcare needs in the past. This figure varied with the 253 districts surveyed, ranging from 2.6% to 26.2%. A multilevel analysis found that the association between contextual characteristics and unmet needs varied according to the factors that caused the unmet needs. The degree of urbanity was associated with unmet need due to “financial burden” (odds ratio [OR], 0.53; 95% confidence interval [CI], 0.42 to 0.66 for rural vs. metropolitan), but not unmet need due to “service not available when needed.” There were no significant associations between these unmet need measures and regional deprivation. Among individual-level variables, income level showed the highest association with unmet need due to “financial burden” (OR, 5.63; 95% CI, 4.76 to 6.66), while employment status showed a strong association with unmet need due to “service not available when needed.”
Conclusions
Our finding suggests that different policy interventions should be considered for each at-risk population group to address the root cause of unmet healthcare needs.
Summary

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    Woorim Kim, Yeong Jun Ju, Soon Young Lee
    BMC Public Health.2024;[Epub]     CrossRef
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    Min-Jeong Park, Mi-Young Chung, Verda Salman
    PLOS ONE.2023; 18(6): e0286425.     CrossRef
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    Hye-Eun Lee, Jeongbae Rhie
    Safety and Health at Work.2022; 13(1): 17.     CrossRef
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    Eunkyoung Bae, Jeongok Park, Eunyoung Jung
    Military Medicine.2021; 186(1-2): e186.     CrossRef
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    Bola Lukman Solanke
    Women's Reproductive Health.2021; 8(2): 137.     CrossRef
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    Ji-Young Han, Hyeon-Sook Park
    Journal of Korean Academy of Community Health Nursing.2021; 32(2): 131.     CrossRef
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    Jung A. Choi, Oksoo Kim
    International Journal of Environmental Research and Public Health.2021; 18(13): 6862.     CrossRef
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    Purity Njagi, Jelena Arsenijevic, Wim Groot
    BMC Health Services Research.2020;[Epub]     CrossRef
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    BMJ Open Diabetes Research & Care.2020; 8(1): e000729.     CrossRef
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    Seung Eun Lee, Miyeon Yeon, Chul-Woung Kim, Tae-Ho Yoon, Dongjin Kim, Jihee Choi
    Osong Public Health and Research Perspectives.2019; 10(5): 295.     CrossRef
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    Youngmi Kang, Heesook Son
    Asia Pacific Journal of Public Health.2017; 29(6): 495.     CrossRef
  • Regional Disparity and Factors Influencing Unmet Medical Needs: A Study Based on the Sixth Korea National Health and Nutrition Examination Survey (2015)
    Ji Hye Lim
    Osong Public Health and Research Perspectives.2017; 8(5): 295.     CrossRef
The Effect of Geographic Units of Analysis on Measuring Geographic Variation in Medical Services Utilization
Agnus M. Kim, Jong Heon Park, Sungchan Kang, Kyosang Hwang, Taesik Lee, Yoon Kim
J Prev Med Public Health. 2016;49(4):230-239.   Published online July 14, 2016
DOI: https://doi.org/10.3961/jpmph.16.034
  • 10,745 View
  • 159 Download
  • 18 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
We aimed to evaluate the effect of geographic units of analysis on measuring geographic variation in medical services utilization. For this purpose, we compared geographic variations in the rates of eight major procedures in administrative units (districts) and new areal units organized based on the actual health care use of the population in Korea.
Methods
To compare geographic variation in geographic units of analysis, we calculated the age–sex standardized rates of eight major procedures (coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, surgery after hip fracture, knee-replacement surgery, caesarean section, hysterectomy, computed tomography scan, and magnetic resonance imaging scan) from the National Health Insurance database in Korea for the 2013 period. Using the coefficient of variation, the extremal quotient, and the systematic component of variation, we measured geographic variation for these eight procedures in districts and new areal units.
Results
Compared with districts, new areal units showed a reduction in geographic variation. Extremal quotients and inter-decile ratios for the eight procedures were lower in new areal units. While the coefficient of variation was lower for most procedures in new areal units, the pattern of change of the systematic component of variation between districts and new areal units differed among procedures.
Conclusions
Geographic variation in medical service utilization could vary according to the geographic unit of analysis. To determine how geographic characteristics such as population size and number of geographic units affect geographic variation, further studies are needed.
Summary

Citations

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  • Healthcare service use and medical outcomes of tracheostomy-dependent children: a nationwide study
    In Gyu Song, You Sun Kim, Min Sun Kim, Ji Weon Lee, Yoon-Min Cho, Youna Lim, Seong Keun Kwon, Dong In Suh, June Dong Park
    BMJ Paediatrics Open.2024; 8(1): e002377.     CrossRef
  • Geographic Distribution of Central Nervous System Rehabilitation Treatment in Korea and Its Associated Factors
    Dong-Gyun Sohn, Jaehong Yoon, Jun-Soo Ro, Ja-Ho Leigh
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • Defining Referral Regions for Inpatient Trauma Care: The Utility of a Novel Geographic Definition
    Cheryl K. Zogg, Robert D. Becher, Michael K. Dalton, Sameer A. Hirji, Kimberly A. Davis, Ali Salim, Zara Cooper, Molly P. Jarman
    Journal of Surgical Research.2022; 275: 115.     CrossRef
  • High Level of Unwarranted Clinical Variation in the Use of Lower Extremity Revascularisation Procedures in Hungary (2013–2017)
    Endre Kolossváry, Tamás Ferenci, Tamás Kováts, Péter Sótonyi, Zoltán Szeberin, Balázs Nemes, Edit Dósa, Katalin Farkas, Zoltán Járai
    European Journal of Vascular and Endovascular Surgery.2022; 63(6): 874.     CrossRef
  • Healthcare utilization among children and young people with life-limiting conditions: Exploring palliative care needs using National Health Insurance claims data
    Cho Hee Kim, In Gyu Song, Min Sun Kim, Jin Yong Lee, Nam Gu Lim, Hee Young Shin
    Scientific Reports.2020;[Epub]     CrossRef
  • Regional Variation of Hospitalization Rates for Asthma in Korea: Association with Ambient Carbon Monoxide and Health Care Supply
    Agnus M. Kim, Sungchan Kang, Jong Heon Park, Yoon Kim
    International Journal of Environmental Research and Public Health.2020; 17(4): 1244.     CrossRef
  • A spatial analysis of geographic variation and factors associated with hospitalization for bacterial pneumonia in Korea
    Agnus M. Kim, Sungchan Kang, Jong Heon Park, Tae Ho Yoon, Yoon Kim
    BMC Pulmonary Medicine.2019;[Epub]     CrossRef
  • Regional Differences in Years of Life Lost in Korea from 1997 to 2015
    Dun-Sol Go, Young-Eun Kim, Munkhzul Radnaabaatar, Yunsun Jung, Jaehun Jung, Seok-Jun Yoon
    Journal of Korean Medical Science.2019;[Epub]     CrossRef
  • Hospitalizations for ambulatory care sensitive conditions as an indicator of access to primary care and excess of bed supply
    Agnus M. Kim, Jong Heon Park, Tae Ho Yoon, Yoon Kim
    BMC Health Services Research.2019;[Epub]     CrossRef
  • An ecological study of geographic variation and factors associated with cesarean section rates in South Korea
    Agnus M. Kim, Jong Heon Park, Sungchan Kang, Tae Ho Yoon, Yoon Kim
    BMC Pregnancy and Childbirth.2019;[Epub]     CrossRef
  • Geographic variation and factors associated with rates of knee arthroplasty in Korea-a population based ecological study
    Agnus M. Kim, Sungchan Kang, Jong Heon Park, Tae Ho Yoon, Yoon Kim
    BMC Musculoskeletal Disorders.2019;[Epub]     CrossRef
  • Factors associated with the rates of coronary artery bypass graft and percutaneous coronary intervention
    Agnus M. Kim, Jong Heon Park, Seongcheol Cho, Sungchan Kang, Tae Ho Yoon, Yoon Kim
    BMC Cardiovascular Disorders.2019;[Epub]     CrossRef
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Dental Care Utilization for Examination and Regional Deprivation
Cheol-Sin Kim, Sun-Young Han, Seung Eun Lee, Jeong-Hee Kang, Chul-Woung Kim
J Prev Med Public Health. 2015;48(4):195-202.   Published online July 23, 2015
DOI: https://doi.org/10.3961/jpmph.15.026
  • 23,791 View
  • 111 Download
  • 7 Crossref
AbstractAbstract PDF
Objectives
Receiving proper dental care plays a significant role in maintaining good oral health. We investigated the relationship between regional deprivation and dental care utilization.
Methods
Multilevel logistic regression was used to identify the relationship between the regional deprivation level and dental care utilization purpose, adjusting for individual-level variables, in adults aged 19+ in the 2008 Korean Community Health Survey (n=220 258).
Results
Among Korean adults, 12.8% used dental care to undergo examination and 21.0% visited a dentist for other reasons. In the final model, regional deprivation level was associated with significant variations in dental care utilization for examination (p<0.001). However, this relationship was not shown with dental care utilization for other reasons in the final model.
Conclusions
This study’s findings suggest that policy interventions should be considered to reduce regional variations in rates of dental care utilization for examination.
Summary

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    Seung Eun Lee, Miyeon Yeon, Chul-Woung Kim, Tae-Ho Yoon
    Journal of Preventive Medicine and Public Health.2016; 49(5): 308.     CrossRef
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English Abstracts
Factors Influencing Utilization of Medical Care Among Osteoarthritis Patients in Korea: Using 2005 Korean National Health and Nutrition Survey Data.
Min Young Kim, Jong Ku Park, Sang Baek Koh, Chun Bae Kim
J Prev Med Public Health. 2010;43(6):513-522.
DOI: https://doi.org/10.3961/jpmph.2010.43.6.513
  • 5,340 View
  • 53 Download
  • 4 Crossref
AbstractAbstract PDF
OBJECTIVES
The purpose of this study was to define the association between the medical utilization of osteoarthritis patient and its related factors. METHODS: We used the 2005 Korean National Health and Nutrition Survey data and we enrolled 2833 participants who were forty or older and who were diagnosed as having osteoarthritis by a doctor within 1 year and who had suffered from osteoarthritis for more than 3 months. The Andersen behavioral model was used as the analytic framework, and the variables were categorized into predisposing, enabling, and need factors. To determine the influence of each variable on the medical utilization of osteoarthritis patient, we applied hierarchical logistic regression analysis with two stages: the first stage included the predisposing and enabling factors and the second stage included the need factors. RESULTS: On the hierarchical logistic analysis, the variables of personal income, the type of medical security, the duration of arthritis related symptoms within 1 month, the subjective health status and the duration of osteoarthritis showed a statistically significant difference between whether the medical utilization in men patients. And the variables of age, limitation activity due to osteoarthritis, arthritis related symptoms within 1 month, and the subjective health status had a statistically significant difference between whether the medical utilization in women patients. CONCLUSIONS: The patients who tend to receive less care are those suffer less from symptoms of osteoarthritis, those who are within the initial phase, or those with a low-level severity of osteoarthritis. It is necessary to encourage patients to receive the treatment in the initial phase.
Summary

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  • Associations Between Fat Mass, Lean Mass, and Knee Osteoarthritis: The Fifth Korean National Health and Nutrition Examination Survey (KNHANES V)
    Seong Rae Kim, Kyung-Hyun Choi, Go-Un Jung, Doosup Shin, Kyuwoong Kim, Sang Min Park
    Calcified Tissue International.2016; 99(6): 598.     CrossRef
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    Yoo-Mi Kim, Sung-Hong Kang
    Journal of Digital Convergence.2015; 13(5): 277.     CrossRef
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The Effect of Outpatient Cost Sharing on Health Care Utilization of the Elderly.
Myunghwa Kim, Soonman Kwon
J Prev Med Public Health. 2010;43(6):496-504.
DOI: https://doi.org/10.3961/jpmph.2010.43.6.496
  • 5,003 View
  • 99 Download
  • 19 Crossref
AbstractAbstract PDF
OBJECTIVES
The purpose of this study was to analyze the effect of outpatient cost-sharing on health care utilization by the elderly. METHODS: The data in this analysis was the health insurance claims data between July 1999 and December 2008 (114 months). The study group was divided into two age groups, namely 60-64 years old and 65-69 years old. This study evaluated the impact of policy change on office visits, the office visits per person, and the percentage of the copayment-paid visits in total visits. Interrupted time series and segmented regression model were used for statistical analysis. RESULTS: The results showed that outpatient cost-sharing decreased office visits, but it also decreased the percentage of copayment-paid visits, implying that the intensity of care increased. There was little difference in the results between the two age groups. But after the introduction of the coinsurance system for those patients under age 65, office visits and the percentage of copayment-paid visits decreased, and the 60-64 years old group had a larger decrease than the 65-69 years old group. CONCLUSIONS: This study evaluated the effects of outpatient cost-sharing on health care utilization by the aged. Cost sharing of the elderly had little effect on controlling health care utilization.
Summary

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The Determinants of the Use of Opportunistic Screening Programs in Korea.
Sungwook Kang, Chang Hoon You, Young Dae Kwon
J Prev Med Public Health. 2009;42(3):177-182.
DOI: https://doi.org/10.3961/jpmph.2009.42.3.177
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AbstractAbstract PDF
OBJECTIVES
Both organized and opportunistic screening programs have been widely used in Korea. This paper examined the determinants of the use of opportunistic screening programs in Korea. METHODS: The subjects were a national stratified random sample of 10,254 people aged 45 or older from the first wave of the Korean Longitudinal Study of Ageing in 2006. A logit model was used to examine the determinants of the use of opportunistic screening programs in terms of the demographic and socioeconomic characteristics, the type of health insurance and the health status. RESULTS: Thirteen point seven percent of the individuals received opportunistic screening programs within 2 years from the time the survey was conducted in 2006. The individuals who graduated from college or who had even more education were 3.0 times more likely to use opportunistic screening programs compared with the individuals who were illiterate. The individuals who resided in urban areas and who had religious beliefs were more likely to receive opportunistic screening programs compared with their counterparts. Those who were in the first quartile for the total household assets were 2.6 times more likely to use opportunistic screening programs than those who were in the fourth quartile for the total household assets. Privately insured people were 1.6 times more likely to use opportunistic screening programs than those who were not insured. Finally, the individuals who self-assessed their health status as worst were 2.1 times more likely to use opportunistic screening programs compared individuals who self-assessed their health status as best. CONCLUSIONS: This study suggests that opportunistic screening programs can be an indicator for whether or not an individual is among the advantaged group in terms of their socioeconomic characteristics and type of health insurance.
Summary

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    So Yoon Park, Young-jeon Shin
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    Kwan-Sik Moon, Yang-Kyun Kim, Hye-Jung Chang
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    Hong-Jun Cho
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Subjective Satisfaction with Medical Care among Older People: Comprehensiveness, General Satisfaction and Accessibility.
Hwa Joon Kim, Young Koh, Eun Jeong Chun, Soong Nang Jang, Chang Yup Kim
J Prev Med Public Health. 2009;42(1):35-41.
DOI: https://doi.org/10.3961/jpmph.2009.42.1.35
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AbstractAbstract PDF
OBJECTIVES
The changing population age structure and rapidly increasing medical costs make providing high-quality, effective medical care for the elderly a challenge. This study assessed the satisfaction with medical care in terms of comprehensiveness, general satisfaction, and accessibility among community-dwelling Korean elders. METHODS: Data were obtained from a nationwide representative sample of the older adults(aged 65 years old or older) living in the community, who participated in a 2006 telephone survey conducted using random digit dialing (n=881). General satisfaction, comprehensiveness and accessibility were measured using a 10-item satisfaction survey questionnaire. Descriptive analysis was used to assess the distribution of each of three components of subjective satisfaction. Analysis of covariance (ANCOVA) was used to examine the association of each of the three components with socioeconomic variables. RESULTS: Comprehensiveness and general satisfaction were low among older people with a high socioeconomic status. Accessibility was evaluated as low among older people of low socioeconomic status, those living in rural areas and those who were medical aid beneficiaries. CONCLUSIONS: Urgent interventions should be considered in order to improve accessibility to medical care for elders of low socioeconomic status and those living in rural communities. Given the rapid aging of the population, we need to develop a monitoring system to improve the quality of geriatric care.
Summary

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  • Optimization and Adjustment of Multilevel Medical Facilities for the Elderly from the Perspective of Accessibility
    Yanyan Gao, Zao Li
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The Effect of the Cost Exemption Policy for Hospitalized Children under 6 Years Old on the Medical Utilization in Korea.
Kyeong Su Jeon, Seok Jun Yoon, Hyeong Sik Ahn, Hyun Woong Shin, Young Hye Yoon, Se Min Hwang, Min Ho Kyung
J Prev Med Public Health. 2008;41(5):295-299.
DOI: https://doi.org/10.3961/jpmph.2008.41.5.295
  • 4,735 View
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AbstractAbstract PDF
OBJECTIVES
The Korean government in January 2006 instigated an exemption policy for hospitalized children under the age of six years old. This study examines how this policy affected the utilization of medical care in Korea. METHODS: A total of 1,513,797 claim records from the Health Insurance Review Agency were analyzed by complete enumeration methods. The changes of medical utilization were compared from 2005 to 2006. In addition, the changes of medical utilization between 2004 and 2005 were compared as a pseudocontrol group. RESULTS: The admission rate increased 1.14-fold from 15.20% in 2004 to 17.32% in 2005, and this further increased 1.08-fold to 18.65% in 2006. The increase of patients with a common cold (1.2-fold) was higher than that of both the general patients (1.08-fold) and the patients with the top 10 fatal diseases (0.91-fold). The average length of stay per case for clinics showed the highest increase rates (1.06-fold). The rates of patients with the common cold showed a higher increase (1.05-fold) than that of the general patients. The average medical expense per case was increased by 1.10-fold from 2005 to 2006, which was higher than that from 2004 to 2005 (1.04-fold). The increase rate for patients with the common cold was higher at 1.18-fold than that of the general patients. CONCLUSIONS: The cost exemption policy has especially led to an increase in the utilization of clinics and the utilization by patients with a common cold.
Summary

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  • Impact of Coinsurance Reduction Policy on Healthcare Utilization Among Children Under 15
    Minah Park, Eun-Cheol Park, Hongin Noh, Sung-In Jang
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
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    Sung-Hoon Park, Sang Gyu Kwak, Ji Yoon Kim
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    Jinha An, Sukil Kim
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    Su Jung Lee, Hyun-Ju Seo, Dong Young Lee, So-Hyun Moon
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Educational Differences in Health Care Utilization in the Last Year of Life among South Korean Cancer Patients.
Soo Young Choo, Sang Yi Lee, Chul Woung Kim, Su Young Kim, Tae Ho Yoon, Hai Rim Shin, Ok Ryun Moon
J Prev Med Public Health. 2007;40(1):36-44.
DOI: https://doi.org/10.3961/jpmph.2007.40.1.36
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AbstractAbstract PDF
OBJECTIVES
There have been few studies examining the differences in health care utilization across social classes during the last year of life. Therefore, in this study we analyzed the quantitative and qualitative differences in health care utilization among cancer patients across educational classes in their last year of life, and derived from it implications for policy. METHODS: To evaluate health care utilization by cancer patients in the last year of life, Death certificate data from 2004 were merged with National Health Insurance data (n=60,088). In order to use educational level as a social class index, we selected the individuals aged 40 and over as study subjects (n=57,484). We analyzed the differences in the medical expenditures, admission days, and rates of admission experience across educational classes descriptively. Multiple regression analysis was conducted to evaluate the association between medical expenditures and independent variables such as sex, age, education class, site of death and type of cancer. RESULTS: The upper educational class spent much more on medical expenditures in the last one year of life, particularly during the last month of life, than the lower educational class did. The ratio of monthly medical expenditures per capita between the college class and no education class was 2.5 in the last 6-12 months of life, but the ratio was 1.6 in the last 1 month. Also, the lower the educational class, the higher the proportion of medical expenditures during the last one month of life, compared to total medical expenditures in the last one year of life. The college educational class had a much higher rate of admission experiences in tertiary hospitals within Seoul than the other education classes did. CONCLUSIONS: This study shows that the lower educational classes had qualitative and quantitative disadvantages in utilizing health care services for cancer in the last year of life.
Summary

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  • Cross-national differences in wealth inequality in health services and caregiving used near the end of life
    Jennifer A. Ailshire, Cristian A. Herrera, Eunyoung Choi, Margarita Osuna, Elina Suzuki
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    Nayeon Kim, Hye-won Yun, Juwon Park, Fatima Nari, Hee Jin Wang, Jae Kwan Jun, Kui Son Choi, Mina Suh
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  • Cross-National Differences in Wealth Inequality in Health Services and Caregiving Used Near the End of Life
    Jennifer A. Ailshire, Cristian A. Herrera, Eunyoung Choi, Margarita Osuna, Elina M. Suzuki
    SSRN Electronic Journal .2022;[Epub]     CrossRef
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    Hong-Jun Cho
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Original Article
Medical Service Utilization and Trends among Korean Elderly in the Last One Year of Life.
Jee Jeon Yi, Ki Soon Park, Seung Hum Yu, Jeong In Kim, Jae Yong Park, Wang Kun Yoo, Sang Wook Yi
Korean J Prev Med. 2003;36(4):325-331.
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AbstractAbstract PDF
OBJECTIVES
To analyze medical service utilization and trends among the elderly in the last year of life. METHOD: The subjects of this study were people that had died at the age sixty-five and above between January 1st and June 30th 2000 The names of the deceased and their dates of death were collected from the data of the funeral-expenses-receivers of the National Health Insurance Corporation (NHIC). This data was merged with that of the individual medical expenses of the NHIC. RESULTS: In the first half of 2000, 84.2% of the funeral-expenses-receivers (53, 063) utilized medical services during the year prior to their death; 51.0% (27, 042) were female and 49.0% (26, 021) male. In the last twelve months of life, the medical fees, the number of days receiving medical services and the number of days receiving medicine were 3, 107, 935 Won, 47.88 and 153.21, respectively, for each person. As the age of the groups increased, the level of medical service utilization decreased; the change was more obvious in female group. The level of medical service utilization during the twelve months prior to death drastically increased around the time of death. CONCLUSIONS: This study, from an analysis of the level of medical service utilization prior to death, shows a concentrated volume of medical services during a certain time period prior to death.
Summary
Clinical Trial
The Current Status of Utilization and Demand on Cancer Information in the Faculties of Medical School in Korea.
Min Kyung Lim, Sook Kyung Park, Jeong Hee Yang, Young Sung Lee
Korean J Prev Med. 2003;36(1):39-46.
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AbstractAbstract PDF
OBJECTIVES
To investigate the availability and demand for overall cancer-related information, and to establish a basic plan for the construction of a cancer database and information system based on the research results from Korea. METHODS: Postal and telephone surveys were carried out, between August 2001 and November 2001, of 323 affiliated faculty professors from medical universities and colleges in Korea. The data were analyzed with descriptive statistical methods, with regard to the present status and demand for health and cancer-related information. RESULTS: Most (over 80%) subjects studied utilized the health-related information provided on Internet website from foreign countries, such as Medline, but similar comprehensive information system lacked in Korea. The construction of a cancer-related database of domestic research results was revealed to be in a great demand. Information on registration and statistics (52.8%), study results (48.5%) and study resources (37.4%) were the major ingredients required in the database. In constructing a database of the cancer-related research results, a full-text service, continuous updating of data, and the development of standardized user-friendly searching tool were regarded as the necessary components. The formulation of an information sharing system, regarding cancer-related clinical trials, was investigated as being quite feasible. CONCLUSION: This study demonstrated the great importance of cancer information systems, and much demand for an available cancer-related database based on Korean research results.
Summary
Original Article
Drug Utilization Review of Antiulcerative Agents in Korean Elderly Inpatients.
Wonsik Lee, Seung Mi Lee, Hye Won Koo, Byung Joo Park
Korean J Prev Med. 2002;35(1):41-48.
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AbstractAbstract PDF
OBJECTIVES
To review the drug prescription pattern of antiulcerative agents for elderly inpatients. METHODS: The study population comprised inpatients of community hospitals who were members of the Korean Elderly Pharmacoepidemiologic Cohort (KEPEC), aged 65 years or over, beneficiaries of the Korea Medical Insurance Corporation (KMIC) and residing in Busan city in 1993. The drug prescription information was collected from the claims data of hospitals where the cohort members received medical care between January 1993 and December 1994. The information included personal identification, age, gender, diagnosis, drug dosage, date of hospital admission and name of medical institutions where the study subjects received drug prescriptions. The data analysis produced outcomes in terms of distribution of antiulcerative agents by class and by medical institution and trend of relative prescription. Analysis was also performed in terms of combined prescriptions of antiulceratives and drugs that could induce risk from drug interaction with antiulceratives. RESULTS: The number of patients prescribed antiulcerative agents was 1,059 (64.9%) male and 1,724 (65.5%) female among the total inpatients. An antacid and composite agent was the most frequently prescribed antiulcerative agent (70.8%), followed by H2 antagonist (16.0%). Among the potential drugs that could induce risk from drug interaction with the antiulcerative agents, diazepam was the most frequently prescribed. The proportion of diazepam co-prescription was 22.5% of the total cimetidine prescriptions and 14.5% of the total omeprazole prescriptions. CONCLUSIONS: Antiulcerative drugs were frequently prescribed in the elderly inpatients. The adverse drug reaction could possibly be due to drug interaction. The study results could be used as fundamental data for further drug utilization review of antiulcerative agents.
Summary

JPMPH : Journal of Preventive Medicine and Public Health