| The purpose of this dissertation is to study patients' choice of health care in the Republic of Korea in 1989 with emphasis on the effect of the Korean Public Health Clinic (PHC) program. PHCs are small hospitals that provide emergency care, outpatient physician services, and limited inpatient care in rural Korea. PHCs were supposed to improve care-seeking and encourage the efficient use of medical resources. This study is important in evaluating the effect of PHCs on improving care-seeking and the substitution of clinical medicine for pharmacy care and Korean traditional medicine care in rural Korea.;The statistical model of this study is distinctive in using conditional logit to estimate the effects of choice-specific and individual-specific characteristics on the choice of providers. This study used, as explanatory variables, average monetary price, travel time, and waiting time required to use the facilities. Furthermore, to measure the effect of prior usage on the choice of care, this study included a preferred-facility variable in the model.;The model was empirically tested using data from the 1989 Korean National Health Survey and the 1990 Korean Public Health Clinic Survey. The results showed that PHCs did not increase the frequency of seeking health care in rural Korea. Rural Koreans responded to travel time and out-of-pocket payment. Increases of travel time and out-of-pocket payment decreased choice of care in rural Korea. Rural Koreans having a preferred provider were more likely to seek care than were those who did not have a preferred provider. Capabilities of PHCs and presence of PHCs did not increase care-seeking as expected. More study is needed after enough time has passed to allow the medical facilities a period of adjustment to be fully ready to provide care. However, policy in rural Korea needs to be focused on managing travel time and out-of-pocket expense for clinical medical care. |
