Earticle

Objectives: This study aimed to examine the effect of indemnity private health insurance on the use of emergency medical services. Methods: Using the 2014–2018 Korea Health Panel data, the researchers applied propensity score matching based on Andersen’s model (1:1, caliper 0.2) to address endogeneity. The covariate balance was assessed using standardized mean differences, and both average treatment effect on the treated (ATT) and panel regression analyses were conducted. Results: The ATT analysis showed that individuals with indemnity private health insurance had significantly more non-urgent emergency department (ED) visits than uninsured individuals, and therefore significantly more ED visits in total, whereas no significant difference was observed in urgent visits. Panel regression results were consistent with these findings. Conclusions: Indemnity private health insurance was associated with increased non-urgent ED use, rather than with overall utilization, suggesting a potential moral hazard and the need for policy efforts to reduce non-urgent ED use.

Objectives: This study investigated the association of depressive disorders with unmet healthcare needs and preventive health behaviors among middle-aged adults. Methods: The sample consisted of 83,354 middle aged 40-64 years old who had participated in the cross-sectional 2023 Community Health Study. Using binary logistic regression analysis, the effect of independent variables on depressive disorders among middle-aged adults was assessed. Results: The main finding was that a history of unmet healthcare needs during the past 12 months was strongly associated with moderate-to-severe depressive disorders. Additionally, medical checkups in past 2 years and practice of regular walking were related to decreased likelihood of depressive disorders in the middle-aged. Conclusions: The findings of this study demonstrate that there is a need for policies and programs to alleviate depressive disorders. It is necessary to include the improved accessibility to health care services, practice of regular medical checkups, and routine walking for middle-aged adults.

Objectives: This study examined the effects of consumptive and productive leisure on life satisfaction and depression among older adults using, subgroup analyses by economic vulnerability and frailty. Methods: Data of 9,955 participants (aged 65+ years) were obtained from the 2023 National Survey of Older Koreans and analyzed using multiple linear regression and subgroup analyses based on their National Basic Livelihood Security (NBLS) status and Fatigue, Resistance, Ambulation, Illness, and Loss of Weight (FRAIL) scale score. Results: Both types of leisure improved mental health; however, productive leisure had a stronger effect. Among the NBLS recipients, only productive leisure was significant for life satisfaction and depression (p<.001). For frail older adults, only productive leisure enhanced life satisfaction, and its depression-reducing effect intensified with increasing frailty. Conclusions: Among vulnerable older adults, only productive leisure showed significant mental health benefits. Tailored productive leisure programs should be prioritized for vulnerable older adult populations.

Objectives: This study investigated health perception’s influence on depressive mood among adults with comorbid diabetes mellitus and hypertension, focusing on the mediating roles of physical activity and generalized anxiety disorder (GAD). Methods: Data 456 adults aged 19 years or older from the 2022 Korea National Health and Nutrition Examination Survey (KNHANES) were analyzed. Structural equation modeling (SEM) was conducted with four latent variables—health perception, physical activity, GAD, and depressive mood—measured using 34 items. Results: Health perception did not directly affect depressive mood but demonstrated a significant indirect effect through physical activity. Individuals with more positive health perceptions engaged in more physical activity, which subsequently decreased their depressive mood. GAD’s mediating role and the sequential pathway involving GAD were not statistically significant. Subgroup analyses revealed that depressive mood was higher among unmarried, low-income, Medicaid-covered, and unemployed participants. Conclusions: Integrated interventions combining cognitive approaches to enhance health perception with behavioral strategies that promote physical activity are needed for mental health management in populations with chronic diseases. Longitudinal studies incorporating objective activity measures and social support variables can help elucidate the causal pathways and strengthen future models.

Objectives: This study aims to analyze sleep health-related discourseon social media and to compare the characteristics of information-seeking behavior between drug-based and non-drug-based keyword groups using topic modeling techniques. Methods: A total of 4,434 blog posts were collected from Naver using five sleep-related keywords (“sleeping pills,” “Stilnox,” “melatonin,” “sleep routine,” and “sleep hygiene”) between March and October 2025. Latent Dirichlet Allocation (LDA) topic modeling was applied following morphological analysis. Chi-square tests were conducted to compare topic distributions between the drug-based (n=2,621) and non-drug-based (n=1,813) groups. Results: Nine topics were identified, with a coherence score of 0.5287. Significant differences in topic distributions between the two groups were observed (χ²=1815.85, p<0.001). The drug-based group was dominated by medication-related experience topics (53.6%), whereas the non-drug-based group focused primarily on general insomnia management (62.3%) and lifestyle habits (24.0%). Notably, only 1.3% of users in the non-drug-based group discussed medication-related topics. Conclusions: Social media users searching for drug-based and non-drug-based sleep interventions exhibit distinctly different information needs. These findings suggest the necessity for tailored health communication strategies targeting different groups of sleep health information seekers.

Objectives: This study aimed to examine how role conflict and organizational justice, as perceived by nurses, affect the quality of nursing services. Methods: Data were collected through an online survey using Embrain (https://embrain.com/kor/) from June 18 to 30, 2024. A total of 184 valid responses were analyzed using SPSS 28.0.0.0 software with independent t-test, one-way ANOVA, Pearson correlation coefficients, and multiple linear regression analysis. Results: The factors influencing the quality of nursing services were identified, as role conflict (β=−.38, p<.001), organizational justice (β =.19, p=.003), and annual salary (50 million won or higher), and entered as control variables (β=.16, p=.032). The explanatory power of the model was 24%. Conclusions: This study confirmed that role conflict has a negative effect on the quality of nursing services, while organizational justice and a certain salary levels have positive effects.

Objectives: This study examined job satisfaction‘s mediating role in the relationship between work values and life satisfaction among newly graduated nurses. Methods: Data on 992 new graduate nurses working in hospitals were drawn from the Graduates Occupational Mobility Survey (2015–2019GOMS). Results: Mean participant age was 24.67±1.66 years, with 85.4% being women. Job satisfaction significantly mediated the relationships of environment (indirect effect=-0.173, 95% bootstrap confidence interval(CI): -0.264 to -0.087) and career growth values (indirect effect=0.186, 95% bootstrap CI: 0.105 to 0.271) with life satisfaction. Meanwhile, reputation and task values showed no significant mediating effects. Conclusions: Enhancing supportive work environments and career development opportunities may improve job and life satisfaction among new graduate nurses.

Objectives: This study aimed to translate and validate the Korean version of the Partners at Care Transitions Measure (PACT-M) to assess the quality of care during the transition from hospital discharge to home. Methods: Face-to-face surveys were conducted with 383 patients with chronic obstructive pulmonary disease discharged from three university hospitals in Korea. Exploratory factor and reliability analyses were performed using SPSS Statistics 26, and confirmatory factor analysis was conducted using R. Results: Both PACT-M1 and PACT-M2 demonstrated two-factor structures. Two items from the PACT-M2 were removed based on confirmatory factor analysis. The scale showed satisfactory discriminant validity and internal consistency, with Cronbach’s α values above 0.80. Conclusions: The Korean version of the PACT-M is a reliable and valid standardized outcome measure for evaluating the quality and safety of transitional care in Korea. This can support the evaluation and dissemination of transitional care services and inform the development of evidence-based healthcare service models for patients with chronic conditions.