Health Policy and Management (보건행정학회지)

Korean Academy of Health Policy and Management (한국보건행정학회)
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The effect of social capital, health risk behavior and health status on medical care utilization by the elderly

노인의 사회자본과 건강위해 행위 및 건강수준이 의료서비스 이용에 미치는 영향

  • Woo, Kyung-Sook (Department of Preventive Medicine, Hanyang University College of Medicine) ;
  • Seo, Jae-Hee (Department of Preventive Medicine, Hanyang University College of Medicine) ;
  • Kim, Gye-Soo (Department of Business Administration, Semyung University) ;
  • Shin, Young-Jeon (Department of Preventive Medicine, Hanyang University College of Medicine)
  • 우경숙 (한양대학교 의과대학 예방의학교실) ;
  • 서제희 (한양대학교 의과대학 예방의학교실) ;
  • 김계수 (세명대학교 경영학과) ;
  • 신영전 (한양대학교 의과대학 예방의학교실)
  • Received : 2012.10.04
  • Accepted : 2012.11.05
  • Published : 2012.12.31
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Abstract

Objectives This study aimed to investigate the effect of social capital, health risk behavior and health status on medical care utilization by the elderly. The data and Research method Data were obtained from the 4th wave survey of the Korea Welfare Panel Study. 4,087 household members aged 65 years and over were subject to analysis. Descriptive statistics are used to describe the basic features of the data in a study. we performed a structural equation modeling(SEM) analysis to evaluate the effect of social capital and mediating effect of health risk behavior and health status. Results Results showed that factors related to medical care utilization of the elderly were different depending on types of service (inpatient and outpatient service) except health status. Age, higher social capital, more health-risk behavior and poorer health status were associated with increased use of inpatient service. Social capital was found to have a positive direct effect on it. Also, social capital had an indirect effect on reducing use of inpatient services by improving health status. On the other hand, lower age and higher household income tended to increase use of outpatient service, while higher social capital and higher health status were inversely related. Social capital had a direct effect and an indirect effect on reducing use of outpatient service and, at that time, health status played a mediating role. Conclusions Social capital may contribute to improve health status and indirectly reduce medical care utilization of the elderly by enhancing their health status. These results provide evidence that more policy and strategy considerations should be needed for the elderly to strengthen their social capital in order to enhance their levels of health and more efficient utilization of medical care.

Keywords

References

  1. 강상경. 노년기 외래의료서비스 이용 궤적 및 예측 요인: 연령 차이를 중심으로. 한국사회복지학회 2010; 62(3): 83-108.
  2. 김계수. AMOS를 이용한 구조방정식모형. 서울: 데이터솔루션; 2005.
  3. 김길용, 김은미, 배상수. 사회자본과 신체활동 행위변화 단계. 보건교육․건강증진학회지 2009; 26(1): 63-80.
  4. 김미곤, 여유진, 이봉주, 손창균, 김계연, 김문길 등. 2006 한국복지패널 기초분석 보고서. 서울: 한국보건사회연구원, 서울대학교 사회복지연구소; 2006.
  5. 김선숙. 사회자본이 아동의 심리사회발달에 미치는 영향. 한국복지패널 학술대회 논문집. 서울: 한국보건사회연구원, 서울대학교 사회복지연구소; 2010
  6. 김준홍. 사회자본, 신체활동 그리고 주관적 건강: 구조방정식 모형 검증을 위한 정책의 근거 모색. 보건과사회과학 2010; 28: 61-90.
  7. 김진구. 노인의 의료이용과 영향요인 분석. 노인복지연구 2008; 39: 273-302.
  8. 김태면, 이석구, 전소연. 노인들의 사회적 지지와 건강행태 및 건강수준과의 관련성 보건교육건강증진학회 2006; 23(3): 99-119.
  9. 김혜경, 배상수. 도시지역 노인의 성에 따른 건강행위 및 관련요인의 차이. 보건행정학회지 2004; 14(2): 117-137. https://doi.org/10.4332/kjhpa.2004.14.2.117
  10. 서지원. 중고령기 건강에 대한 인적자본과 사회자본의 효과. 대한가정학회지 2006; 44(10): 133-144.
  11. 송예리아, 남은우. 사회자본 정도 및 건강행동이 한국인의 주관적 건강에 미치는 영향 분석. 한국 보건교육 및 증진학회 2009; 26(3): 1-13.
  12. 유은영, 윤치근. 농촌 노인 입원환자의 질병유형과 의료이용실태 분석: 군단위 종합병원을 중심으로, 한국보건정보통계학회지 2006; 31(2): 41-53.
  13. 이미숙. 고령화연구패널자료를 이용한 노년기 건강불평등의 구조 분석. 보건과 사회과학 2009; 25: 5-32.
  14. 이미진. 노인의 의료서비스 이용에 대한 종단적 연구. 사회복지정책 2009; 36: 201-233.
  15. 이홍직. 노인의 정신건강에 영향을 미치는 요인에 관한 연구: 사회자본 특성을 중심으 로. 사회과학연구 2009; 25(3): 25-42.
  16. 이후연, 김성아, 이혜진, 정상혁. 노인의 사회경제적 수준과 주관적 건강수준과의 관계. 보건행정학회지 2005; 15(7): 70-83.
  17. 임재영, 이태진, 배상수, 이기홍, 강경화, 황연희. 사회자본이 저소득층의 건강생활실천에 미치는 영향. 한국사회정책학회지 2010; 16(2): 131-180.
  18. 임재영, 조창익. 한국 노인의 흡연 및 음주 행위에 대한 사회자본의 효과. 보건경제와 정책연구 2008; 14(2): 73: 92.
  19. 전해숙, 강상경. 연소노인과 고령노인간 의료서비스 이용 예측요인의 연령차: 고령화 사회의 의료서비스에 주는 함의. 보건사회연구 2012; 32(1): 28-57. https://doi.org/10.15709/HSWR.2012.32.1.28
  20. 정민수, 조병희. 지역사회역량이 주민 건강수준에 미치는 영향. 2006년 서울시 도봉구 주민건강행태조사를 중심으로. 보건과 사회과학 2007; 22: 153-182.
  21. 조경순, 이현주. 일부지역사회 노인들의 의료서비스 접근성에 관한 연구. 성인간호학회지2000; 12(4): 641-653.
  22. 조경환. 만성 퇴행성 질환을 가진 노인들의 의료기관 이용 양상에 대한 연구 노인병학회지 1997; 1(1): 55-64.
  23. 통계청. 보도자료. 장래가구추계 : 2010년-2035년. 2012년 4월 26일자
  24. 통계청. 장래인구추계. 2010. Available from : URL : http://www.index.go.kr/egams/stts/jsp/potal/stts/PO_STTS_IdxMain.jsp?idx_cd=1010&bbs=INDX_001
  25. Audrey L, Eric N, Leilei S, Aging, social capital and health care utilization inCanada. Health Ecomics Policy and Law 2008; 3: 393-411.
  26. Bakeera SK, Petzold M., Pariyo GW, Galea S, Tomson G and Wamala S.Community social capital and the use of health care services in Uganda.Journal of Public Health and Epidemigolgy 2010; 2(8): 189-198.
  27. Berkman L, Kawachi I. Social epidemiology. Oxford University Press 2000.
  28. Bourdieu P. The forms of capital", in Richardson JG. Handbook of Theory andResearch for the Sociology of Education. Westport Connecticut:Greenwood press; 1986. pp.241-258.
  29. Carpiano RM. Neighborhood social capital and adult health: an empirical test of a Bourdieu-based model. Health Place 2007; 13(3): 639-55. https://doi.org/10.1016/j.healthplace.2006.09.001
  30. Cooper H, Arber S, Fee L, Ginn J. The influence of support and social capital on health: a review and analysis of British data. London: HEA; 1999.
  31. Deeg DJH, Kardaun JWPF, Fozard JL. Health Behavior and aging. pp 129-149 in Birren JE, Schaie KW. (eds). Handbook of the Psychology of Aging. San Diego, CA: Academic press; 1996
  32. Deri C. Social networks and health service utilization. Journal of Health Economics 2005; 24: 1076-1107. https://doi.org/10.1016/j.jhealeco.2005.03.008
  33. Kang SH, Wallace NT, Hyun JK, Morris A, Coffman J, Bloom JR. Social networks and their relationship to mental health service use and expenditures among Medicaid Beneficiaries. Psychiatric Services 2007; 58: 689-695. https://doi.org/10.1176/appi.ps.58.5.689
  34. Kawachi I, kennedy BP, Glass R. Social capital and self-rated health: a contextual analysis. Am public Health 1999; 89: 1187-1193. https://doi.org/10.2105/AJPH.89.8.1187
  35. Korten AE, Jacomb PA, Jiao Z, Christensen H, Jorm AF, Henderson AS, Rodgers B. Predictors of GP service use: a community survey of an elderly Australian sample. Australian and new zealand journal of public health. 1998; 22(5): 609-615 https://doi.org/10.1111/j.1467-842X.1998.tb01447.x
  36. Laporte A, Nauenberg E, Shen L. Aging, social capital, and health careutilization in Canada. Health Policy 2008; 103(1): 38-46. https://doi.org/10.1016/j.healthpol.2010.12.006
  37. Lee SY, Chen WL, Weiner BJ. Communities and hospital: social capital, community accountability, and service provision in U.S. communityhospitals. HSR 2004; 39(5): 1487-1508.
  38. Macinko J, Starfield B. The utility of social capital in research on health determinants. The Mibank Quarterly 2001; 79: 387-427 https://doi.org/10.1111/1468-0009.00213
  39. Mohabbat M, Lindstrom M. Social capital, political trust self rated-health: a population-based study in southern Sweden. Scandinavian Journal of Public Health 2008; 36: 28-34.
  40. Nyqvist F, Gustavsson J, Gustafsony N. Social Capital and Health in the Oldest Old: The Umea 85+ Study. International Journal of Ageing and Later Life 2006; 1(1): 91-114. https://doi.org/10.3384/ijal.1652-8670.061191
  41. Maulik PK, Eaton WW, Bradshw 체. The role of social network and support in menta l health service use: findings from the Baltimore ECA stuey. Psychira Ser 2009;69(9):1222-1229.
  42. Penning MJ. Health, social support, and the utilization of health services among older adults. J Gerontol B Psychol Sci Soc Sci 1995; 50(5): S330-339.
  43. Perry M, Robert LW, Nina W, Howard W. Social capital and health care experiences among low-income individual. American Journal of Public Health 2008; 98(2): 330-336. https://doi.org/10.2105/AJPH.2006.086306
  44. Pilisuk M, Boylan R, Acredolo C. Social support, life stress events in use of mental health service. Social Science and Medicine 1988; 27: 1393-1400. https://doi.org/10.1016/0277-9536(88)90205-5
  45. Poortinga W. Do health behaviors mediate the association between social capital and health? Preventive Medicine 2006; 43(6): 488-493. https://doi.org/10.1016/j.ypmed.2006.06.004
  46. Putnam RD. Bowling alone: The collapse an revival of American community. New York: Simon and Schuster; 2000.
  47. Rodrigues MAP, Facchini LA, Piccini RX, Tomasi E, Thume E, Siveira DS, Siqueira FV, Paniz VMV, Use of primary acre services by elderly people with chronic conditions, Brazil. Rev Saude Publica 2008; 34(3): 316-319.
  48. Silva MJ, Huttly SR, Harpham T, Kenward MG. Social capital and mental health: a comprehensive analysis of four low income countries. Social Science & Mdicine 2007; 64: 5-20. https://doi.org/10.1016/j.socscimed.2006.08.044
  49. Sohn M, Park CY, Cho WH, Hur YJ, Yi SW. A path analysis on prisoners' health behavior and Medical Utilization. Yonsei Med J 1997; 38(4): 220-232. https://doi.org/10.3349/ymj.1997.38.4.220
  50. Stump TE, Johnson RJ, Wolinsky FD. Change in physician utilization over time among older adult. Journal of Gerontology 1995; 50B(1): 45-58. https://doi.org/10.1093/geronb/50B.1.S45
  51. Wallace ST, Gutierrez VF. Equity of access to health care for older adult in four major Latin American cities. Pan Am J Public Health 2005; 17(5/6): 394-409. https://doi.org/10.1590/S1020-49892005000500012