Factors associated with the overuse or underuse of health care services among medical aid Beneficiaries in Korea

Journal of Community Health Nursing

Volumn 28, Issue 4, 2011, Pages 190-203

  Ahn, Yang Heui ^a   Kim, Eui Sook ^b   Ham, Ok Kyung ^c   Kim, Soo Hyun ^c   Hwang, Seung Sik ^d   Chun, Sang Hee ^e   Gwon, Na Yeon ^a   Choi, Jin Yi ^f  

^a Yonsei University Wonju College of Medicine   (South Korea)

^b Yonsei University   (South Korea)

^c Inha University   (South Korea)

^d Inha University School of Medicine   (South Korea)

^e Kyungbuk College   (South Korea)

^f Kyung Hee University   (South Korea)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; AGE; AGED; ARTICLE; FEMALE; HEALTH CARE DELIVERY; HEALTH SERVICE; HEALTH STATUS; HUMAN; MALE; MIDDLE AGED; QUALITY OF LIFE; REIMBURSEMENT; SEX DIFFERENCE; SOUTH KOREA; STATISTICAL MODEL; STATISTICS; UTILIZATION REVIEW;

ADULT; AGE FACTORS; AGED; AGED, 80 AND OVER; FEMALE; HEALTH SERVICES; HEALTH SERVICES ACCESSIBILITY; HEALTH SERVICES MISUSE; HEALTH STATUS; HUMANS; INSURANCE, HEALTH, REIMBURSEMENT; LOGISTIC MODELS; MALE; MIDDLE AGED; QUALITY OF LIFE; REPUBLIC OF KOREA; SEX FACTORS;

EID: 84862934543     PISSN: 07370016     EISSN: None     Source Type: Journal    
DOI: 10.1080/07370016.2011.614837     Document Type: Article

References (27)

1. Aday, L. A., & Anderson, R. M. (1974). A framework for the study of access to medical care. Health Services Research, 9, 208-220.
2. Afifi, A. A., Morisky, D. E., Kominski, G. F., & Kotlerman, J. B. (2007). Impact of disease management on health care utilization: Evidence from the "Florida: A Healthy State (FAHS)" Medicaid Program. Preventive Medicine, 44, 547-553.
3. Ahn, Y. H., Kim, E. S., Chang, S. J., Ham, O. K., Kim, S. H., Kim, S. O., & Lee, E. J. (2010). Psychometric evaluation of needs assessment instruments for case management of medical aid beneficiaries. Seoul: Korea Ministry of Health & Welfare.
4. Anderson J. G., & Barktus, D. E. (1973). Choice of medical care: A behavioral model of health & illness. Journal of Health & Social Behavior, 14, 348-362.
5. Center for Medicare & Medicaid Services. (2008). 2009 case management regulation. Retrieved January 5, 2011, from http://www.cms.hhs.gov.
6. Clark, M. J. (2008). Community health nursing. Upper Saddle River, NJ: Pearson, Prentice Hall.
7. Department of Health and Human Services. (2008). Budget of the United States government, FY 2008. Retrieved June 4, 2011, from http://www.gpoaccess.gov/usbudget/fy08/pdf/budget/hhs.pdf.
8. Eun, S. J., Hong, J. Y., Lee, J. Y., Lee, J. S., Kim, Y., Kim, Y. I., & Shin, Y. (2006). Differences in medical care utilization rates of the disabled and the non-disabled with ambulatory care sensitive conditions. Journal of Preventive Medicine and Public Health, 39, 411-418.
9. Gallegos-Carrillo, K., Garcia-Pena, C., Duran-Munoz, C., Mudgal, J., Duran-Arenas, L., & Salmeron-Castro, J. (2008). Health care utilization and health-related quality of life perception in older adults: A study of the Mexican Social Security Institute. Salud Publica de Mexico, 50, 207-217.
10. Ham, O. K., & Lee, C. Y. (2007). Predictors of health service utilization by hypertensive patients in South Korea. Public Health Nursing, 24, 518-528.
11. Institute of Medicine. (2001). Health and behavior: The interplay of biological, behavioral, and societal influences. Washington, DC: National Academy Press.
12. Kim, E. S., Kim, M. Y., Ko, I. S., Lee, D.M., Kim, K. S., Choi, J. S., & Yang, L. S. (2007). The current situation of medical aid utilization and improvement direction in long-term utilizers. Seoul: Korea Ministry of Health & Welfare Nursing Policy Research Institute, Yonsei University.
13. Kim, E. S., Lee, J. Y., Yoo, W. S., Lee, Y. P., Lim, S. J., Cho, J. H., & Lee, K. O. (2009). Case management strategies for Medical Aid beneficiaries for the appropriate use of medical services. Seoul: Korea Human Resources Development Institute for Health & Welfare.
14. Kim, H. J. (2004). How much should the poor pay for their health care services under the national health insurance system? Korean Journal of Social Welfare, 56(3), 113-133.
15. Kim, M. I., Cho, W. J., Kim, E. S., Jung, Y. S., Kang, H. Y., & Lee, C. Y. (2002). Community health nursing. Seoul: Hyunmoonsa.
16. Korea Ministry of Health & Welfare (2009, March 31). Reduction in copayments for type 2 medical aid beneficiaries. Retrieved August 10, 2010, from http://www.mw.go.kr/front/jb/sjb070201vw.jsp?PAR_MENU_ID=03&MENU_ID=03070201&BOARD_ID=930&BOARD_FLAG=01&CONT_SEQ=210910&page=1
17. Korea Ministry of Health & Welfare (2010). 2010 Medical Aid program guide. Seoul: Author.
18. Korea Ministry of Health & Welfare Yonsei University College of Nursing (2008). Planning and development of guide for medical aid case management services. Seoul: Author.
19. Lee, I. S., & Kim, S. W. (2004). The factors influencing behavior of health care of Medicaid recipients. Yonsei Social Welfare Review, 11, 66-99.
20. Lee, W. H. (2006). Developing a case management strategies program for Korean medical aid clients (Unpublished doctoral dissertation). Hanyang University, Seoul, Korea.
21. Matsumura, S., Bito, S., & Fukuhara, S. (2000). Perceived health status as predictor of utilization of health care resources and the number of sick-leave days in Japan [abstract]. Quality of Life Research Abstracts, 9, 1063.
22. Medical-Aid Case Management Center. (2010). Introduction of Medical-Aid Case Management Center. Retrieved January 18, 2011, from http://www.macmc.or.kr/
23. Ryu, H., Young, W. B., & Kwak, H. (2002). Differences in health insurance and health service utilization among Asian Americans: method for using the NHIS to identify unique patterns between ethnic groups. International Journal of Health Planning and Management, 17, 55-68.
24. Park, J. H., Lee, J. S., Lee, J. Y., Hong, J. Y., Kim, S. Y., Kim, S. O., & Kim, Y. (2006). Factors affecting national health insurance mass screening participation in the disabled. Journal of Preventive Medicine and Public Health, 39, 511-519.
25. Shin, S. M., Kim, E. S., Park, C. K., & Lee, H. W. (2010). The medical use of the disabled among overusers of medical aid in Korea. Journal of Preventive Medicine and Public Health, 43, 35-41.
26. Shin, S. M., Kim, M. J., Kim, E. S., Lee, H. W., Park, C. K., & Kim, H. K. (2010). Medical aid service overuse assessed by case managers in Korea. Journal of Advanced Nursing, 66, 2257-2265.
27. Shin, Y. S., Choi, B. H., Shin, H. Y., Hwang, D. K., & Yun, S. J. (2005). A policy report for the current situation of medical aid expenditure and improvement direction. Seoul: Korea Institute for Health & Social Affairs.