Earticle

Objectives : The aim of the study is to investigate the actual condition of the occurrence and recovery of medical expenses in seafarers insurance and to provide basic data to be helpful to establish efficient management strategies for medical expenses of insurance companies depending on type of seafarers insurance for hospital management. Methods : Three general hospitals located in Busan, Korea were selected and seafarers insurance claim data collected from January 1, 2012 to December 31, 2013(24 months) were analyzed. There were total 5,490 cases. Results : There was a significant difference in distribution of the incidence of disease, accrued medical expenses, payback of medical expenses and the actual condition of medical receivables depending on insurance companies. Conclusions : Therefore, differentiated payback strategies for medical expenses are needed to consider various seafarers insurance companies and treatment characteristics in seafarers insurance.

Objectives : This research used an exploratory approach to identify factors affecting business strategies due to changes in the healthcare market and customer loyalty factors. Methods : The research model was formulated using antecedents divided into diagnosis quality, employee attitudes, and servicescape. Moreover, differences in the structured model were analyzed according to hospital size. The data were gathered through surveys on clients, who has received care at participating hospitals. From the 200 that were distributed, 150 questionnaires were analyzed, to facilitate analysis of the research model. Results : The effects of diagnosis quality, employee attitudes, and servicescape, on customer loyalty were mediated by trust. We also found the differences between small and large hospitals. Conclusions : Customer loyalty in small hospitals was affected by servicescape, whereas that in large hospitals was affected by diagnosis quality and employee attitudes. The research results could be used to develop strategies to improve customer loyalty.

Objectives : This study describes the current state of medical advertisement and quality of advertisement execution according to the different departments based on 2-year case study of actual medical advertisements which were published in newspapers. Additionally, this paper provides data which will help in the efficient planning of medical advertisements. Methods : This study was based on medical advertisements that were in local newspapers, etc. from January 1, 2012 to December 31, 2013. The data were collected from September 20, 2014 to November 2, 2014 (44 days). A total of 4,991 data points were acquired from newspapers supplied by the Busan Public Library directly to the researcher. Results : According to the major findings of this study, the services of clinics had more medical advertisements than that of hospitals. Urology was the most advertised service of clinics while orthopedics and neurosurgery were the most advertised services of hospitals. Conclusions : In the study, the characteristics for the technical advertising factor was evident according to the type of examinations. Some types of examinations showed definite differences compared to other examinations.

Objectives : The aim of this meta-analysis was to draw overall conclusions on the correlation between the organizational effectiveness (OE) of healthcare employees and related factors by summarizing recent studies and to provide a baseline for future research. Methods : A literature search for original articles published from 2005 to 2014 including doctoral theses and KCI journal articles was done in KERIS’ RISS, etc. in a systematic manner. From 77 studies which met the inclusion criteria 190 effect sizes (ESs) were calculated for the analysis. A meta-analysis was done with CMA 3 (Biostat company, USA). Results : The overall ES was moderate for all, positively and negatively related factors. For all related factors, job characteristics, group-leader relations, personal and organizational characteristics had a moderate ES. The ES for work experiences was small. Conclusions : Although the results of this study were meaningful it is necessary to perform follow-up analyses (1) based on a longer data period and more articles, (2) including moderating variables with higher explanatory power and (3) adopting a study model with more specific and simplified variables.

Objectives : The purpose of this study was to examine the health service utilization of elderly patients who visited an emergency medical center in the Gyeongbuk region and to provide basic information for the effective management of emergency medical centers. Methods : This study analyzed the characteristics of the hospital visits and the actual situation for the use of emergency medical care of 10,264 elderly patients that visited an emergency medical center in the Gyeongbuk region from January, 2014 to December, 2014. Frequency analysis and chi-square test were done in this study. Results : This study showed that there is a difference in the characteristics of health service utilization which included hospital visits, duration of hospital visits and mode of arrival to the emergency medical center according to age, gender and other characteristics. Conclusions : Providing efficient emergency services is necessary as well as establishing an emergency medical center management plan that takes into consideration the difference in health service utilization of elderly patients.

Objectives : The aim of this study was to investigate the satisfaction determinants of rehabilitation care group inpatients in rehabilitation long-term care hospitals. Methods : A survey was conducted with 262 patients from 6 rehabilitation long-term care hospitals located in Busan·Kyungnam. Data were collected from June 2016 to July 2016 with a structured questionnaire and analyzed with SPSS 23.0. Results : The significant factors affecting the overall satisfaction score were disease group and 5 quality indices of medical services(Medical service quality, Rehabilitation services quality, Hospital reputation, External physical environment, and Internal physical environment). Additionally, the significant factors affecting intention to revisit were age, disease group, length of hospital stay and the 5 quality indices of medical services. Conclusions : The results of this study indicate that rehabilitation long-term care hospitals should try to improve the overall satisfaction of inpatients, especially focusing on the internal physical environment and the quality of the rehabilitation services and medical services, which will lead to a high level of intention for patients to revisit.

Objectives : This study empirically verified the effects of service provided by medical service providers on customer satisfaction and favorable word-of-mouth intention. Moreover, it measured the mediation effects of customer satisfaction in the relationship between medical service quality factors and favorable word-of-mouth intention and proposed implications in terms of marketing. Methods : The research hypothesis was verified with a structural equation, and the Sobel test was used to analyze of customer satisfaction in the relationship between medical service quality factors and word-of-mouth intention. Results : From the hypothesis verification results, physical and human factors among the quality factors of medical service affected customer satisfaction.Additionally,customer satisfaction interacted as a factor influencing favorable word-of-mouth intention. Conclusions : Medical service providers should work to enhance the satisfaction of customers in terms of human and physical factors by providing quality medical service that is different from other providers and by improving the quality of medical service and the environment which could lead to effective word-of-mouth intention.

Objectives : The aim of this study was to investigate the degree of awareness of the national cancer screening program by the Korean public and define its relationship with cancer screening intention. Methods : The study collected data by conducting an online survey from April 19 to 24, 2016, and received a total 354 responses. Additionally, we performed frequency analysis, chi-square test, and logistic regression analysis. Results : Based on the results for the degree of awareness for the national cancer screening program, 151 (42.7%) people were aware of the program, while 203 (57.3%) were not aware the program. From the chi-square test and logistic regression analysis, marital status and awareness of the national cancer screening program were found to have a statistically significant influence on screening intention. Conclusions : An increase in the screening rate should be established with a systematic promotion plan for the national cancer screening program.

Objectives : This study aims to : (i) characterize and differentiate between two different periods of baby boomers, (ii) study the utilization of their health care services, and (iii) establish effective ways of providing better health service utilization and preventive policy strategies for upcoming and older generations. Methods : A multiple regression analysis using descriptive statistics, frequency analysis, and dummy variables was utilized to access the presence of correlations between socio-demographic factors and health care service utilization. Results : Medical insurance type, marital status, and chronic disease were factors that influenced health care service utilization. Furthermore, the factors that influenced individual medical expenses were cohabitation, inpatient days, and chronic disease. Conclusions : Primary findings and exploratory statistics revealed that there were strong correlations and interaction among some of the predictor variables. Because of the chronologically limited nature of the sample data set gathered in 2012, it would be helpful to continue to develop or research related constructs that may capture relationships more effectively among extended populations.

Objectives : This study was conducted to investigate the need of medical supporting service (MSS) as a part of community-based hospice palliative care from the view point of beneficiaries and providers. Methods : This study adopted a methodological triangulation design. A questionnaire regarding intention to use MSS was completed by 175 patients under home-based cancer patient management program. And three focus groups consisted of hospice nurses, public health physicians, and public officials were interviewed to obtain the perceived needs, obstacles, and solutions of MSS. Results : Mean age of home-based cancer patient was 70.18 year old, 48.0% of them were living alone. Only 53.7% of them were treated pain and 93.7% intend to take pain medication prescribed by public health physician. All participants of focus group interviews agreed necessity and importance of MSS. Physicians' lack of confidence and unwillingness to prescribe opioid to terminal patients was the biggest obstacle to provide MSS in the public health center. Conclusions : The necessity and demand of MSS for community-dwelling cancer patients were verified. MSS is urgent issue to meet their needs.

Objectives : This study aimed to evaluate the factors influencing health promotion behaviors in elderly men. Methods : We used data from the 6th Korea National Health and Nutrition Examination Survey. We analyzed difference between sociodemographic characters, health statuses, and health promotion behaviors by age. Logistic regression analysis was used to investigate the relation between health promotion behaviors and sociodemographic factors by age. Results : Health promotion behaviors related to aging were weight control effort, health screen examination, smoking cessation, and influenza vaccination. Socioeconomic statuses of elderly men declined from the preliminary age, and health status was influenced by the reduction of social role. Health promotion behaviors such as weight control, health screen examination, and performance of aerobic activities were decreased in men of advanced aged. Conclusions : The health promotion behaviors of elderly men differed significantly with age.

Objectives : The purpose of this study was to examine the effects of an oral health promotion program. And suggest that education on oral health should be given by a professional. Methods : Sixty-four people over the age of 65 years were selected from three elderly care facility located in Gyeongsangbuk-do, A city. From June 7 to August 19, 2016, an oral health promotion program was given to two experimental groups (N=21 and 20) for a total of eight times. One program was conducted by a professional and the other by a non-professional although both were considered experts. Additionally, a control group(N=23) was a observed. Results : While both experimental groups showed a positive change from the oral health promotion program, the experimental group that was given the oral health promotion program by a professional showed more positive changes in oral cavity function. Conclusions : By using professionals, it is possible to provide a health promotion program that actively monitors the oral cavity of the elderly as well as provide elderly care services for oral hygiene. Appropriate elderly health policies and oral health business model for elderly are needed.

Objectives : Recently, concern about the ubiquitous healthcare industry has increased worldwide. This study estimated the economic effects of the ubiquitous healthcare industry by Input-Output Analysis. Methods : In this study, 384*384 sector statistics of the Bank of Korea were used as the initial analysis tool, after adjustments, 9*9 sector statistics were used as the major research method for that industry. The main analysis tools of this study included a comparison of the backward and forward linkage effects, as well as the induced effects of the self-industry and other industries and the induced coefficients including products, value-added, employee's pay, sales surplus, and employment. Results : Based on the results of the analysis, the ubiquitous healthcare industry has great economic impacts which affects major macroeconomic factors including production and the backward linkage effect. Additionally, the induced effects of the self-industry, the ubiquitous healthcare industry, are significant compared to other industries in terms of production, employee's pay and operating surplus. Conclusions : The ubiquitous healthcare industry is a growth engines for national development. This paper offers alternatives for efficient industrial policies.

Objectives : The aim of this study was to identify significant paths that affect the life satisfaction of male baby boomers. Methods : Thus, 1,784 male baby boomers born between 1955 and 1963 were selected, among a total of 22,276 male baby boomers in the Gyungbuk region, who had participated in the 2011 Community Health Survey. Results : Through a path analysis, the following factors that affect life satisfaction were revealed in descending order: mental health (p<.001), income level (p<.001), educational level (p<.001), social support (p<.001), health promotion activities (p<.001), and physical illness (p<.001). The explanatory power of the variables for quality of life was 21%. Among the variables, mental health had the biggest impact. Conclusions : The findings indicate that increasing the life satisfaction of male baby boomers requires the following: alleviating their anxiety over retirement income by improving their welfare at a national level; creating an environment that can enhance their mental health and health promotion activities, and providing health education and health promotion programs to change their perceptions.

Objectives : This study investigated poor self-rated health and its associated factors in married Korean women, focusing on the burdens related to family affairs and social support. Methods : Cross-sectional data from 3,039 married women (between 25 and 64 years old) who completed Korean Longitudinal surveys of Women and Families were analyzed. Results : Among working women, only two factors—lack of husband’s involvement in housework and insufficient communication with husband — influenced poor self-rated health. Among housewives, lack of husband’s involvement in housework, insufficient communication with husband, low satisfaction of marriage, and avoidance of alcohol consumption were associated with poor self-rated health. Conclusions : Regardless of whether women are employed or housewives, husband’s support is a very important factor affecting women’s health. Social efforts for changing perceptions and values are needed so that men and women mutually support each other in family affairs.

Objectives : This study develops a salutogenic program and examines its effects on the sense of coherence, acculturative stress, and quality of life of married immigrant women. Methods : The salutogenic program was developed based on Antonovsky's Salutogenic Model, and the study design was a nonequivalent control group pre-post test design. The participants were married immigrant Chinese (n=30) and Vietnamese (n=31) women, who were assigned to either an experimental group (n=29) or a control group (n=32). The data were analyzed using the χ²-test, t-test, Fisher's exact test, and repeated measures ANOVA, and the IBM SPSS for Windows (version 20.0) program was used to perform the analysis. Results : Compared to the control group, the sense of coherence (F=52.05, p 〈.001) and quality of life (F=6.95, p=.002) were significantly improved in the experimental group, and the acculturative stress (F=24.64, p〈.001) in this group significantly decreased after implementing salutogenic program. Conclusions : These findings indicate that a salutogenic program is an effective intervention for married immigrant women. The study suggests that such programs can be applied to married immigrant women at public health or multicultural family support centers to improve their sense of coherence and quality of life.

Objectives : This study was conducted to examine the educational status and needs of both parents and kindergarten teachers pertaining to the prevention of infectious diseaes in children. Methods : The participants were 280 parents and 147 kindergarten teachers. Data were collected from August 21, 2013 to December 30, 2014. Results : Only 16.7% of parents had educational experience with infectious diseases. The source of their education was broadcast media and their preferred educational method was the internet. Parents reported that the childhood infection about which they should be educated were influenza (30.4%) followed by hand-foot-and-mouth disease (13.9%), food poisoning (6.4%), and so on. About 27.2% of kindergarten teachers had received an education about infectious diseases, and the major source of their education was refresher training. The teachers’ preferred educational method was the internet. The teachers wanted to be educated about influenza (22.4%), hand-foot-and-mouth disease (20.4%), food poisoning (20.4%) and so on. Conclusions : Educational programs should be developed and applied to children, parents and kindergarten teachers based on consideration of their educational needs.

Objectives : The purpose of this study was to identify mediating effects of nursing professionalism on the relationship between image of nurses and satisfaction with nursing as a major among nursing students. Methods : A self report questionnaire survey was completed by 429 nursing students in 1 university in K city. Data were collected between April 25 and May 06, 2016 and analyzed using the SPSS 21.0 program. Results : The nursing students recognized that image of nurses had a positive (+) effect on nursing professionalism and satisfaction with nursing as a major, and nursing professionalism had a positive (+) effect on satisfaction with nursing as a major. Further, nursing professionalism had significant partial mediating effect on the relationship between image of nurses and satisfaction with nursing as a major. Conclusions : These results indicate that nursing professionalism has a positive mediating role on the relationship between image of nurses and satisfaction with nursing as a major among nursing students. Therefore, in order to promote satisfaction with nursing as a major in nursing students, it is necessary to develop and implement educational programs that can form a desirable image of nurses and nursing professionalism.

Objectives : The purpose of this study was to examine the mediation effects of self-efficacy on the relationship between life stress and depression in university students to provide a basis for planning nursing interventions to improve the mental health of university students. Methods : Data were collected from September 1 to September 30, 2015 by giving a questionnaire to 272 university students. The instruments for this study were life stress, self-efficacy, and depression. The data were analyzed with descriptive statistics, Pearson's correlation coefficients, and multiple linear regression with the SPSS/WIN 18.0 program. Results : There were significant correlations among life stress, self-efficacy, and depression. Additionally, self-efficacy had a mediating effect on the relationship between life stress and depression. Conclusions : Based on the findings of this study, health management programs focusing on stress management and self-efficacy improvement are highly recommended to promote good mental health in university students.