Factors influencing medical institution selection for outpatient services

This study analyzes determinants of patients' choice of healthcare providers in outpatient services and identifies their effects. Data were collected from two waves of the Korean Health Panel. The unit of analysis was an outpatient visit (n=189,739). Various types of medical institutions were grouped into general hospitals (including tertiary hospitals), hospitals, and clinics. A multinomial logit model was used to examine the determinants of medical institution selection. Clinics were the most frequent (82.2%) medical institution selected, followed by general hospitals (10.9%) and hospitals (6.9%). Males and beneficiaries of Medical Aid were more likely to choose the upper-level institutions. The upper-level institution selection was also positively associated with the level of education, household income, and severe diseases, while negatively associated with the level of health status. The medical institution selection was significantly different by region. Not only enabling factors for healthcare utilization, such as family and community resources, but also the users' characteristics were strong determinants of the type of medical institution selected. We, therefore, recommend that patients' characteristics and needs, in addition to the sharing of roles and functions among medical institutions, should be considered in making healthcare policies for efficient medical utilization and an effective medical delivery system.

The Determinants of the Use of Opportunistic Screening Programs in Korea / 예방의학회지

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.