Department of Nursing, Inje University, Busan 47392, Korea.
Department of Nursing, Daedong College, Busan 46270, Korea.
Int J Environ Res Public Health. 2019 Jul 12;16(14):2485. doi: 10.3390/ijerph16142485.
We explored the healthcare seeking behavior of Medical Aid (MA) beneficiaries who over-utilize healthcare services in South Korea. We employed a qualitative descriptive study using semi-structured interviews with fifteen community-dwelling MA beneficiaries-who were categorized as over-utilizing healthcare services-and conventional content analysis. Four categories emerged: having unmet healthcare needs, wandering in search of effective healthcare services, routinizing their use of healthcare services, and being concerned about benefit restrictions due to their healthcare overutilization. Overall, these categories indicate participants' behaviors used to fill the gap between their high healthcare needs and restricted MA benefits. The findings provide a foundation for healthcare providers, policymakers, researchers, and MA beneficiaries to discuss how to better address beneficiaries' healthcare needs while preventing healthcare overutilization patterns. Effective and innovative interventions that target MA beneficiaries and their case managers are necessary to improve beneficiaries' quality of life.
我们探讨了过度利用韩国医疗服务的医疗救助（MA）受益人的医疗保健寻求行为。我们采用了定性描述性研究方法，对 15 名居住在社区的 MA 受益人进行了半结构化访谈，这些受益人被归类为过度利用医疗服务，并采用了常规内容分析。出现了四个类别：有未满足的医疗需求、四处寻找有效的医疗服务、常规使用医疗服务、以及担心因过度使用医疗服务而受到福利限制。总的来说，这些类别表明参与者的行为用于填补他们高医疗需求和受限的 MA 福利之间的差距。这些发现为医疗保健提供者、政策制定者、研究人员和 MA 受益人提供了一个基础，以讨论如何在防止医疗保健过度利用模式的同时更好地满足受益人的医疗需求。需要针对 MA 受益人和他们的案件管理人员采取有效和创新的干预措施，以提高受益人的生活质量。
