DOI QR코드

DOI QR Code

Factors Affecting Medical Service Utilization of Disabled

장애인의 의료이용에 영향을 미치는 요인

  • Hwang, Hong-Gu (Department of Health Service Management, Kyungwoon University) ;
  • Jung, Hyun-Sik (Department of Health Administration, Pohang University)
  • 황홍구 (경운대학교 의료경영학과) ;
  • 정현식 (포항대학교 보건행정과)
  • Received : 2016.12.05
  • Accepted : 2017.05.12
  • Published : 2017.05.31

Abstract

This article examined the condition of medical service utilization and the usage degree for the disabled in Korea, and analyzed factors affecting medical service utilization. This paper offers data for improving the health of disabled Korea residents and for enhancing medical service utilization. We analyzed data for disabled residents aged 19 from the 6th Korea National Health and Nutrition Examination Survey. Results found significant effects depending on gender, age, average monthly income, types of disorders, disability rating, and status of smoking. Concerning gender, men had a higher probability of lacking medical treatment compared with women, had increased probability of having a disability, and smokers had a higher probability of lacking treatment compared with nonsmokers. Therefore, for resolving medically untreated disabled Korean residents, government needs to improve the policy system and to managethe inequality of handicapped welfare work.

본 연구는 우리나라 장애인을 대상으로 장애인의 전반적인 의료이용에 대한 현황 및 수준을 파악하고 장애인의 의료이용에 영향을 미치는 요인을 분석하여 장애인의 건강증진과 의료서비스 이용 활성화를 위한 기초자료를 제공하고자 하였다. 이를 위하여 제6차 국민건강영양조사 대상자 중 만 19세 이상의 장애인을 분석한 결과, 성별, 연령, 월평균가구소득, 장애유형, 장애등급, 흡연 등에서 의료이용에 유의미한 영향을 미치는 것으로 나타났다. 성별에서는 남성보다는 여성이, 연령은 낮을수록, 가구소득이 낮을수록 의료 미치료 확률이 높았다. 장애유형에서는 정신적 장애인이 의료 미치료 확률이 높은 것을 확인하였고, 장애등급이 높을수록, 흡연자일수록 의료 미치료 확률이 높은 것을 확인하였다. 따라서 우리나라 장애인의 의료 미치료 해소를 위하여 장애 의료와 관련한 정책적 제도의 개선과 장애인 복지사업에 대한 불평등 해소 방안의 지속적인 관리가 필요할 것으로 생각된다. 또한, 장애인의 구강 건강 수준을 높일 수 있도록 의료이용의 행태에 대한 지속적이고 정기적인 사회 보험제도의 개선 필요성이 있음을 시사한 것으로 평가 할 수 있다.

Keywords

References

  1. Korea Institute for Health and Social Affairs, Health and Welfare Statistics, Social Welfare: Survey on the Disabled 2014 [cited 2016 October 12] http://data.kihasa.re.kr/db/subjectview.jsp?grp_seq=64&project_seq=321
  2. Employment Development Institute, Disabled statistics 2015 [cited 2016 October 3]. https://www.kead.or.kr/webzine/ibook/ttsbook/stakead2015/book.html
  3. Ministry of Health and Welfare, Korea Centers for Disease, 2014 Survey of Disabled. 2015.
  4. M. J. Bae, S. H. Hwang, S. A. Kim, J. Y. Lee, J. A. Yoon, J. H. Park, S. H. Urm, B. C. Yu, "Related factors of oral health-related quality of life in the severely disabled people", J Korean Soc Dent Hyg, Vol.15, No.3 pp. 461-475, 2015. DOI: https://doi.org/10.13065/jksdh.2015.15.03.461
  5. S. H. Kim, S. A. Lim, S. J. Park, D. K. Kim, "Assessment oral health-related quality of life using the oral health impact profile (OHIP)", J Korean Acad Oral Health, Vol.28, pp. 559-569, 2004.
  6. B. Y. Jeon, S. M. Kwon, "Access Barriers To Health Care Among Persons With Physical Disabilities: Using Three Reasons For Unmet Need As Indicators Of Access", J Korean Social Security Association, Vol.31, No.3 pp. 145-171, 2015.
  7. G. L. Krahn, L. Hammond, A. Turner, "A cascade of disparities: Health and health care access for people with intellectual disabilities", Mental Retardation and Developmental Disabilities Research Reviews, Vol.12, pp. 70-82, 2006. DOI: https://doi.org/10.1002/mrdd.20098
  8. K. V. P. Booth, "Health disparities and intellectual disabilities: Lessons from individuals with down syndrome", Developmental Disabilities Research Reviews, Vol.17, pp. 32-35, 2011. DOI: https://doi.org/10.1002/ddrr.136
  9. G. L. Krahn, M. H. Fox, "Health disparities of adults with intellectual disabilities: What do we know? what do we do?", Journal of Applied Research in Intellectual Disabilities, Vol.27, pp. 431-446, 2014. DOI: https://doi.org/10.1111/jar.12067
  10. G. L. Krahn, D. K. Walker, R. Correa-De-Araujo, "Persons with disabilities as an unrecognized health disparity population", American Journal of Public Health, Vol.105, pp. 198-206, 2015. DOI: https://doi.org/10.2105/AJPH.2014.302182
  11. B. Marks, J. Sisirak, K. Hsieh, "Health services, health promotion, and health literacy: Report from the state of the science in aging and developmental disabilities conference", Disability and Health Journal, Vol.1, pp. 136-142, 2008. DOI: https://doi.org/10.1016/j.dhjo.2008.04.003
  12. B. C. Choi, Y. R. Kim, "Parents' perspectives on current status and support needs towards health.medical services for children with severe brain lesions", Korean Journal of Physical, Multiple & Health Disabilities, Vol.58, No.3, pp. 111-136, 2015. DOI: https://doi.org/10.20971/kcpmd.2015.58.3.111
  13. S. H. Kim, Y. H. Lee, J. H. Hwang, M. Oh, M. K. Lee, D. W. Kang, S. W. Lee, "2014 Survey of the Disabled", Seoul: Korea Institute for Health and Social Affairs, 2014.
  14. K. Y. Kim, Y. S. Lee, K. S. Park, J. H. Son, S. Kam, B. Y. Chun, J. Y. Park, M. H. Yeh, "Oh the determinants of health care utilization of the physically disabled", Korean Journal of Preventive Medicine, Vol.31, No.2, pp. 323-334, 1998.
  15. D. Y. Kim, "Sociodemographic characteristics and desire analysis of education and welfare for the physically disabled persons", Journal of Rehabilitation Research, Vol.18, No.2, pp. 51-78, 2014.
  16. D. Y. Kim, "Sociodemographic characteristics and needs analysis of education and welfare for the people with visual impairment" The Korean Journal of Visual Impairment, Vol.30, No.2, pp. 115-137, 2014.
  17. K. I. Lee, I. S. Kim, B. K. Kang, "A study on the improvement of facilities for the physically disabled in medical facilities: Focused on the OPD in general hospital", Korean Journal of Architectural, Vol.23, No.1, pp. 111-114, 2003.
  18. C. Y. Park, "An Analysis of Spatial Accessibility to Dental Institutions of the Disabled by Region: Metropolis, Small and Medium-sized City, and Rural Area", J Geography Education, Vol.58, pp. 33-45, 2014.
  19. Y. M. Kang, S. G. Hong, H. M. Lee, Y. S. Cha, "Website Accessibility Evaluation of the Welfare Centers for the Disabled", J Korea Academia-Industrial Cooperation Society Vol.12, No.11, pp.5260-5271, 2011. DOI: https://doi.org/10.5762/KAIS.2011.12.11.5260
  20. S. Y. Yu, Y. S. Kim, H. S. Hong, M. K. Cheon, J. A. Mo, "Determinants of untreated experiences among persons with physical disability", Korean J. of Health Policy & Administration, Vol.21, No.4, pp.565-584, 2011. DOI: https://doi.org/10.4332/KJHPA.2011.21.4.565
  21. M. H. Hong, "Relationships of Obesity, Total-Cholesterol, Hypertension and Hyperglycemia in Health Examinees with Disabilities", J Korea Academia-Industrial Cooperation Society Vol.17, No.10, pp.591-599, 2016. DOI: https://doi.org/10.5762/KAIS.2016.17.10.591
  22. H. S. Lee, G. S. Ha, "A study on the factors influencing the satisfaction of life of disabled children parents", J Korea Academia-Industrial Cooperation Society Vol.16, No.11, pp.8046-8056, 2015. DOI: https://doi.org/10.5762/KAIS.2015.16.11.8046
  23. S. Y. Lee, J. S. Lee, "Factors Affecting the Life Satisfaction of the Mentally Ill People in Mental Care Facilities", J Digital Convergence, Vol.13, No.3, pp.231-239, 2015. DOI: https://doi.org/10.14400/JDC.2015.13.3.231
  24. J. H. Lee, "A study on the determinants that affect life satisfaction of the disabled", J Digital Convergence, Vol.14, No.1, pp.503-514, 2014.
  25. J. H. Min, H. J. Han, "A Study on Effects of the Convergence of musculoskeletal disorders Women with Disabilities on Quality of life in Jeon-nam Area", J Digital Convergence, Vol.13, No.9, pp.497-504, 2015. DOI: https://doi.org/10.14400/JDC.2015.13.9.497
  26. K. L. Lee, S. H. Ryu, "An Anaysis of current Facilities for the Physically Disabled in Hospital", International Conference on Convergence Technology, Vol.6, No.1, pp.35-41, 2015. DOI: https://doi.org/10.15207/jkcs.2015.6.1.035
  27. W. H. Kim, B. J. Seo, J. M. Lee, "A Study on the Parents' Recognition of School Enterprise Convergence by Type of Disability", International Conference on Convergence Technology, Vol.6, No.4, pp.89-97, 2015. DOI: https://doi.org/10.15207/jkcs.2015.6.4.089
  28. D. W. Kim, "Wheelchair tennis has ever fusion of classroom participation of the physically disabled basic psychological needs and exercise emotional and exercise commitment", International Conference on Convergence Technology, Vol.6, No.4, pp.15-23, 2015. DOI: https://doi.org/10.15207/jkcs.2015.6.4.015
  29. Ministry of Health and Welfare, The fifth Korea national health and nutrition examination survey (KNHANES V-6), Sejong: Ministry of Health and Welfare; 2014.
  30. J. X. Nie, L. Wang, S. Tracy, R. Moineddin, R. E. Upshur, "Health care service utilization among the elderly: Findings from the study to understand the chronic condition experience of the elderly and the disabled" Journal of Evaluation in Clinical Practice, Vol.14, pp. 1044-1049, 2008. DOI: https://doi.org/10.1111/j.1365-2753.2008.00952.x
  31. A. J. Caban-Martinez, D. J. Lee, L. E. Fleming, "Dental care access and unmet dental care needs among U.S. workers", J Am Dent Assoc, Vol.138, pp. 227-230, 2007. DOI: https://doi.org/10.14219/jada.archive.2007.0141
  32. T. Ohi, M. Sai, M. Kikuchi, "Determinants of the utilization of dental services in a community-dwelling elderly Japanese population", Tohoku J Exp, Vol.281, pp. 241-249, 2009. DOI: https://doi.org/10.1620/tjem.218.241
  33. H. S. Kim, E. Ahn, M. Y. Kim, S. M. Kim, H. Shin, Trends of household income and dental care spending. Journal of The Korean Acad Oral Health, Vol.38, pp. 17-24, 2014. DOI: https://doi.org/10.11149/jkaoh.2014.38.1.17
  34. L. A. Lindamer, L. Liu, D. H. Sommerfeld, D. P. Folsom, W. Hawthorne, P. Garcia, G. A. Aarons, D. V. Jeste, "Predisposing, Enabling, and Need Factors Associated with High Service Use in a Public Mental Health System", Administration and Policy in Mental Health and Mental Health Services Research, Vol.39, No.3, pp. 200-209, 2012. DOI: https://doi.org/10.1007/s10488-011-0350-3