Research in Community and Public Health Nursing

Original Articles

The Effect of Health Literacy and Self-care Performance on Health Care Utilization of Medicaid Elderly: Yun Hee Hwang, Ga Eon Lee; J Korean Acad Community Health Nurs. 2019;30(4):484-493. Published online December 31, 2019; DOI: https://doi.org/10.12799/jkachn.2019.30.4.484

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PURPOSE
The purpose of this study was to examine the effect of health literacy and self-care performance on health care utilization of medicaid elderly.
METHODS
A total of 203 medicaid elderly over 65 and living in B-metropolitan city were interviewed. Data were analyzed with descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients and Hierarchical Multiple regression.
RESULTS
The average score of the health literacy was 7.88Â±2.84 out of 12. The average score of self-care was 3.26Â±0.77 points on the 5 point scale. The frequency of health care utilization by the subjects was 6.65Â±5.25 a month. The health literacy and self-care performance showed a statistically significant positive correlation. The health literacy and self-care performance showed a statistically significant negative correlation with health care utilization. The factors affecting health care utilization of the subjects were self-care performance, health literacy, and religion, and the explanatory power was 25%.
CONCLUSION
The results indicate that the self-care performance, health literacy, religion are significant factors of health care utilization in medicaid elderly. Therefore, it is necessary to develop strategies to improve their self-care performance and health literacy for reasonable health care utilization. Also, it is necessary to provide the elderly with correct information about medical use from accessible religious institutions, senior community center, and welfare centers.

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Factors influencing handwashing among community dwelling older adults, using the 2021 Community Health Survey: A secondary analysis study
Yun Hee Hwang, Hye Jung Jun
Journal of Korean Gerontological Nursing.2023; 25(2): 197. CrossRef

Social Network, Self-Care Agency and Quality of Life of High-risk Beneficiaries in Case Management of Medicaid: Ju Young Park, Jung Tae Son; J Korean Acad Community Health Nurs. 2017;28(4):421-430. Published online December 31, 2017; DOI: https://doi.org/10.12799/jkachn.2017.28.4.421

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Abstract PDF: PURPOSE
This study investigates the social network, self-care agency, and quality of life of high-risk beneficiaries in case management of Medicaid and the correlations between these variables. It also identifies influencing factors on their quality of life.
METHODS
The subjects included 187 individuals chosen from the high-risk beneficiaries in case management of Medicaid in D Metropolitan City. Data was collected through direct interviews based on a structured questionnaire on home visits.
RESULTS
The perceived health status was the most influential factor in their quality of life, followed by self-care agency, mutual support network, and natural support network in order. These factors explained 40.6% of their quality of life.
CONCLUSION
These findings raise a need to develop a nursing intervention program to increase the self-care agency of the high-risk beneficiaries in case management of Medicaid.

The Effects of the Designated Doctor System on Health Care Utilization of Medical Aid Beneficiaries with Chronic Diseases: Min Jung Kim, Young Ha Cho, Nam Hee Park; J Korean Acad Community Health Nurs. 2015;26(3):278-291. Published online September 30, 2015; DOI: https://doi.org/10.12799/jkachn.2015.26.3.278

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Abstract PDF

PURPOSE
This study was conducted to examine differences in health care utilization and related costs between before and after the introduction of the designated doctor system, and to find out factors making the differences.
METHODS
Data were collected from 200 medical aid beneficiaries having one or more chronic diseases, registered in the designated doctor system during the year of 2012, and the relationship between the use of health services and claimed medical expenses was analyzed through paired t-test and multiple regression analysis using the SPSS 18.0 program.
RESULTS
There was a decrease in the number of total benefit days and the number of outpatient and medication days, but some cases showed an increase after the designation of medical institution. In general, hospital stay increased after the introduction of the system. However, the number of medical institutions utilized was reduced in most cases after designation. Conversely, medical expenses increased in most cases after the designation of medical institution.
CONCLUSION
These results suggest that a detailed scheme to designate medical institutions should be made in consideration of the seriousness of illness and classification of medical institutions not only for the beneficiaries' enhanced health but for the effective management of medical aid fund.

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A Two-step Clustering Approach for Measuring Socioeconomic Factors Associated with Cardiovascular Health among Older Adults in South Korea
Chi-Young Lee
Korean Journal of Adult Nursing.2020; 32(6): 551. CrossRef

The Effect of Copayment on Medical Aid Beneficiaries in Korea: Jin Joo Oh, Jeong Myung Choi, Hyun Joo Lee; J Korean Acad Community Health Nurs. 2015;26(1):11-17. Published online March 31, 2015; DOI: https://doi.org/10.12799/jkachn.2015.26.1.11

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Abstract PDF

PURPOSE
This study was to ascertain whether there are differences in health care utilization and expenditure for Type I Medical Aid Beneficiaries before and after applying Copayment.
METHODS
This study was one-group pretest posttest design study using secondary data analysis. Data for pretest group were collected from claims data of the Korea National Health Insurance Corporation and data for posttest group were collected through door to-door interviews using a structured questionnaire. A total of 1,364 subjects were sampled systematically from medical aid beneficiaries who had applied for copayment during the period from December 12, 2007 to September 25, 2008.
RESULTS
There was no negative effect of copayment on accessibility to medical services, medication adherence (p=.94), and quality of life (p=.25). Some of the subjects' health behaviors even increased preferably after applying for copayment including flu prevention (p<.001), health care examination (p=.035), and cancer screening (p=.002). However, significant suppressive effects of copayment were found on outpatient hospital visiting days (p<.001) and outpatient medical expenditure (p<.001).
CONCLUSION
Copayment does not seem to be a great influencing factor on beneficiaries'accessibility to medical services and their health behavior even though it has suppressive effects on outpatients' use of health care.

Citations

Citations to this article as recorded by

Impact of co-payment for outpatient utilization among Medical Aid beneficiaries in Korea: A 5-year time series study
Ki-Bong Yoo, Hong-Uk Ahn, Eun-Cheol Park, Tae Hyun Kim, Sun Jung Kim, Jeoung A Kwon, Sang Gyu Lee
Health Policy.2016; 120(8): 960. CrossRef

The Effects of the Designated Doctor System on the Health of Medical Aid Beneficiaries: Jeong Myung Choi, Jin Joo Oh; J Korean Acad Community Health Nurs. 2012;23(4):438-445. Published online December 31, 2012; DOI: https://doi.org/10.12799/jkachn.2012.23.4.438

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Abstract PDF

PURPOSE
Medical Aid Beneficiaries were surveyed to identify differences in health behaviors, adherence to drug regimen, and quality of life between those people in the Designated Doctor System and those who are not.
METHODS
A total of 1,327 study subjects were separated into three groups: those in the Designated Doctor System for 2 years, those in for 1 year, and those not in the system.
RESULTS
After the introduction of the Designated Doctor System, 55.8% and 67.9%, respectively, of the subjects in the Designated Doctor System complained of inconvenience in relation to hospital use and the patient referral process. Also, the rate of emergency room use or hospitalization guided by the Designated Doctor System was only 8.7% and 6.5%, respectively. There were no significant differences in health behaviors and adherence to drug regimens between those in the Designated Doctor System and those who are not.
CONCLUSION
This study was carried out early in the introduction of the system. Therefore, it is necessary to monitor the positive and negative effects of the Designated Doctor System for a full reflection of its impact.

Citations

Citations to this article as recorded by

The Effect of Case Management Services for High-risk Medicaid Beneficiaries
Young Jin Ahn, Yun-Kyoung Choi
Journal of the Korea Academia-Industrial cooperation Society.2015; 16(8): 5430. CrossRef
The Effects of the Designated Doctor System on Health Care Utilization of Medical Aid Beneficiaries with Chronic Diseases
Min Jung Kim, Young-Ha Cho, Nam Hee Park
Journal of Korean Academy of Community Health Nursing.2015; 26(3): 278. CrossRef
A Study on Influential Factors on Satisfaction with the Use of Medical Services by the Qualified Recipients of Medical Aid(focusing on the period after the introduction of the selected medical center system)
Jin-Woo Lee, Se-I Yang, Kwang-Hwan Kim
Journal of Digital Convergence.2014; 12(3): 289. CrossRef

The Effects of Case Management for Medicaid on Healthcare Utilization by the Medicaid System: Seung Joo Lim; J Korean Acad Community Health Nurs. 2010;21(4):375-385. Published online December 31, 2010; DOI: https://doi.org/10.12799/jkachn.2010.21.4.375

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5 Citations

Abstract PDF

PURPOSE
This study examined the effects of case management (CM) for Medicaid on healthcare utilization considering the Medicaid system.
METHODS
Data were extracted from survey data on "Healthcare utilization and health status of Medicaid beneficiaries" conducted in 2007 and 2008 by the Ministry for Health, Welfare and Family Affairs. This study was designed to compare the effects on healthcare utilization between the CM group and the non-CM group. The subjects were 535 Type I Medicaid beneficiaries who utilized healthcare more than 365 days during 2006.
RESULTS
The outpatient days and medication days of the CM group decreased significantly more than those of the non-CM group with the copayment system. There were no significant differences of healthcare utilization between the CM group and the non-CM group with the designated doctor system.
CONCLUSION
CM worked effectively on Medicaid beneficiaries' outpatient healthcare utilization with the copayment system. However, its effects on hospitalization, which is a major cause increasing the total expense, were not observed. Therefore, future studies are needed to develop strategies to reduce hospitalization and Medicaid beneficiaries' outpatient healthcare utilization with the designated doctor system.

Citations

Citations to this article as recorded by

The Effect of Case Management Services for High-risk Medicaid Beneficiaries
Young Jin Ahn, Yun-Kyoung Choi
Journal of the Korea Academia-Industrial cooperation Society.2015; 16(8): 5430. CrossRef
The Effects of the Designated Doctor System on Health Care Utilization of Medical Aid Beneficiaries with Chronic Diseases
Min Jung Kim, Young-Ha Cho, Nam Hee Park
Journal of Korean Academy of Community Health Nursing.2015; 26(3): 278. CrossRef
A Study on Influential Factors on Satisfaction with the Use of Medical Services by the Qualified Recipients of Medical Aid(focusing on the period after the introduction of the selected medical center system)
Jin-Woo Lee, Se-I Yang, Kwang-Hwan Kim
Journal of Digital Convergence.2014; 12(3): 289. CrossRef
Effectiveness of Community-based Case Management for Patients with Hypertension
Soon-Nyoung Yun, In-Sook Lee, Jin Hyun Kim, Young Ko
Journal of Korean Academy of Community Health Nursing.2014; 25(3): 159. 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

The Effects of Tele-care Case Management Services for Medical Aid Beneficiaries: Yang Heui Ahn, Eui Sook Kim, Il Sun Ko; J Korean Acad Community Health Nurs. 2010;21(3):351-361. Published online September 30, 2010; DOI: https://doi.org/10.12799/jkachn.2010.21.3.351

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Abstract PDF

PURPOSE
This study was done to analyze the effects of tele-care case management services using secondary data.
METHODS
A descriptive research design was utilized, and the participants were 134 medical aid beneficiaries who were in either the high-risk group or the preventive group. Case management services were delivered by 8 care managers. Data were analyzed using PAWS Statistics 17 through descriptive statistics and paired t-test.
RESULTS
After the case management intervention, the participants' health quality of life, self-care competency, and reasonable medical care utilization increased significantly for the high-risk group. However there were no significant changes in the preventive group.
CONCLUSION
The results showed that the tele-care case management services were effective for high-risk medical aid beneficiaries. Further studies with controls for constitutional variables and a comparison group are required to validate the robustness of the effectiveness of the case management program in the present study.

Citations

Citations to this article as recorded by

The Effect of Case Management Services for High-risk Medicaid Beneficiaries
Young Jin Ahn, Yun-Kyoung Choi
Journal of the Korea Academia-Industrial cooperation Society.2015; 16(8): 5430. CrossRef
Comparing the Needs of Case Management between Medical Aid Beneficiaries with Simple and Multiple Chronic Diseases
Yang Heui Ahn, Yeonok Suh, Ok Kyung Ham, Hee Kyung Kim
The Korean Journal of Rehabilitation Nursing.2015; 18(2): 98. CrossRef
A study on the Effectiveness of Case Management in Elderly Medicaid Beneficiaries by Geographic Location
Jeong-Hyun Cho, Soon-Ock Kim, Myeong-Kyeong Song, Eun-Shil Yim
Journal of Korean Public Health Nursing.2012; 26(2): 289. CrossRef
Validation of a Needs Assessment Tool for Case Management in Korean Medical Aid Beneficiaries
Yang Heui Ahn, Eui Sook Kim, Ok Kyung Ham, Soo Hyun Kim, Soon Ok Kim, Myung Kyung Song
Journal of Korean Academy of Nursing.2012; 42(4): 549. CrossRef

Change in Healthcare Utilization by Disease Severity after Case Management for Medicaid: Seung Joo Lim; J Korean Acad Community Health Nurs. 2010;21(3):321-332. Published online September 30, 2010; DOI: https://doi.org/10.12799/jkachn.2010.21.3.321

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4 Citations

Abstract PDF

PURPOSE
This study examined change in healthcare utilization by disease severity after case management (CM) for Medicaid.
METHODS
Data were extracted from survey data on "Healthcare utilization and health status of Medicaid beneficiaries" conducted in 2007 and 2008 by the Ministry for Health, Welfare and Family Affairs. This study was designed to compare change in healthcare utilization between the CM group and the non-CM group. The subjects were 528 Type I Medicaid beneficiaries who utilized healthcare more than 365 days during 2006.
RESULTS
In beneficiaries having fewer than 3 among the 11 notified diseases, the CM group showed a significantly larger decrease in outpatient day, outpatient expense, medication day, and medication expense than the non-CM group. In beneficiaries having 3 or more among the 11 notified diseases, however, there was no significant difference in healthcare utilization between the CM group and the non-CM group.
CONCLUSION
CM worked effectively on Medicaid beneficiaries outpatient healthcare utilization for mild diseases. However, its effects on hospitalization, which is a major cause increasing the total expense, were not observed. Therefore, a future study is needed to develope strategies to reduce hospitalization and care for Medicaid beneficiaries with severe diseases.

Citations

Citations to this article as recorded by

The Effect of Case Management Services for High-risk Medicaid Beneficiaries
Young Jin Ahn, Yun-Kyoung Choi
Journal of the Korea Academia-Industrial cooperation Society.2015; 16(8): 5430. CrossRef
Comparing the Needs of Case Management between Medical Aid Beneficiaries with Simple and Multiple Chronic Diseases
Yang Heui Ahn, Yeonok Suh, Ok Kyung Ham, Hee Kyung Kim
The Korean Journal of Rehabilitation Nursing.2015; 18(2): 98. CrossRef
Case Management for Medical Aid Beneficiaries in Korea: Findings from Case-control Study
Hee-Sun Shin, Jin-Joo Oh
Asian Nursing Research.2014; 8(4): 274. 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

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