• Journal of Korean Academy of Oral Health
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• v.42 no.4
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• pp.167-174
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• 2018

Objectives: The aim of this study was to analyze the accessibility of dental care services among individuals with precarious employment in South Korea. Methods: We used the $9^{th}$ wave of the Korean Health Panel data (2015) and included 7,736 wage and non-wage earners in our study. We determined precariousness in the labor market as a combination of employment relationship and job income, and categorized individuals based on this into the following four groups: Group A comprising those who report job and income security, Group B comprising those who experience job insecurity alone, Group C comprising those who report a stable job but low income, and Group D comprising those who experience both job and income insecurity. Accessibility to dental care services was determined by experience of unmet dental care needs and unmet dental care needs caused primarily by financial burden. Logistic regression analyses were used to assess the effect of precarious work on access to dental care services. Results: Individuals with job insecurity (Group B; OR=1.445; 95% CI=1.22-1.70) and both job and income insecurity (Group D; OR=1.899; 95% CI=1.61-2.24) were more likely to have unmet needs than the comparison group. Both groups B and D were also 2.048 (95% CI=1.57-2.66) times and 4.435 (95% CI =3.46-5.68) times more likely, respectively, to have unmet dental care needs caused by financial burden. Education status, health insurance, and health status were all also effective factors influencing unmet dental care needs. Conclusions: Unstable employment and low income resulted in diminished access to dental care services. Therefore, governments should consider health policy solutions to reduce barriers preventing individuals with employment and income instability from accessing adequate dental care.

• Journal of Digital Convergence
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• v.19 no.2
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• pp.265-274
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• 2021

The Purpose of this paper was to explore the effect of hearing impairment on HRQOL in Korean elders. We carry out a cross-sectional analysis using nationally representative data from the KNHANES, 2016-2018. The survey was conducted on 4,754 elders who responded to questions about hearing impairment. Quality of life was compared between hearing impaired elders and elders with no hearing impairment using the t-test and chi-square test, and factors related to quality of life were analyzed by multivariate logistic regression using SPSS version 22.0. There was significant difference in quality of life between hearing impaired elders and elders with no hearing impairment. Walking exercise were identified as factors related to quality of life in elders with hearing impairment, while marriage status, walking exercise and limited movement were found to be related to quality of life among elders with no hearing impairment. In order to improve the HRQOL of elders with hearing impairment, multidisciplinary efforts and development of educational programs are required.

• Health Policy and Management
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• v.31 no.2
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• pp.225-231
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• 2021

Unmet healthcare is an important indicator to measure accessibility of healthcare services. To examine the latest status of unmet healthcare needs in South Korea, the four different data which is composed of nationally representative sample of South Korean population were used; the Korea Health and Nutrition Examination Survey (KNAHANES, 2007-2019), the Community Health Survey (CHS, 2008-2019), the Korea Health Panel Survey (KHP, 2011-2017), and the Korean Welfare Panel Study (KOWEPS, 2006-2019). The proportion of individuals reporting unmet healthcare needs were 5.8% (KNHANES), 5.3% (CHS), and 11.6% (KHP). Annual percentage change (APC) which identifies trend for the follow-up period was -9.5%, -8.0%, and -6.5%, respectively. The proportion of individuals reporting unmet healthcare needs due to cost were 1.1% (KNAHANES), 0.7% (CHS), 2.4% (KHP), and 0.4% (KOWEPS). The APC was -10.5%, -14.2%, -12.2%, and -19.6%, respectively. Compared to last year, the rate of unmet healthcare needs has declined in general. However, the low-income and the elderly population were reporting the highest rate of unmet health care needs, and the disparity between lowest and highest groups were remained. These results suggest that adequate benefit coverage is needed for low-income and elderly population.

• Health Policy and Management
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• v.32 no.2
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• pp.237-243
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• 2022

Unmet healthcare is an important indicator to measure accessibility of healthcare services. To examine the latest status of unmet healthcare needs in South Korea, four different data which is composed of nationally representative sample of South Korean population were used; the Korea National Health and Nutrition Examination Survey (KNHANES, 2007-2020), the Community Health Survey (CHS, 2008-2020), the Korea Health Panel Survey (KHP, 2011-2018), and the Korean Welfare Panel Study (KOWEPS, 2006-2020). The proportion of individuals reporting unmet healthcare needs were 6.4% (KNHANES), 5.4% (CHS), and 12.2% (KHP). Annual percentage change (APC) which identifies trend for the follow-up period was -9.9%, -9.1%, and -5.5%, respectively. The proportion of individuals reporting unmet healthcare needs due to cost were 1.0% (KNHANES), 0.4% (CHS), 2.2% (KHP), and 0.4% (KOWEPS). The APC was -11.3%, -17.0%, -12.2%, and -21.2%, respectively. Overall, the low-income and the elderly population reported a higher rate of unmet health care needs. Although the overall experience rate of unmet medical care due to cost decreased over the past decade, the disparity between the lowest and highest income groups still remained in 2020. Disparity between income levels and age groups is a challenge to address in healthcare system, and these results suggest the need for adequate health coverage for the low-income and the elderly populations.

• Health Policy and Management
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• v.33 no.3
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• pp.273-294
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• 2023

Background: Most developed countries are working to improve their universal health coverage systems. This study investigates regional disparities in unmet healthcare needs and their causes in South Korea. Additionally, it compares the unmet healthcare needs rate in South Korea with that of 33 European countries. Methods: The analysis incorporates information from 13,359 adults aged 19 or older, using data from the Korea Health Panel. The dependent variables encompass the experience of unmet healthcare needs and the three causes of occurrence: "burden of medical expenses," "time constraints," and "lack of care." The primary variable of interest is the region of residence, while control variables encompass 14 socio-demographic, health, and functional characteristics. Multivariable binary logistic regression analysis, accounting for the sampling design, is conducted. Results: The rate of unmet healthcare needs in Korea is 11.7% (95% confidence interval [CI], 11.0%-13.3%), which is approximately 30 times higher than that of Austria (0.4%). The causes of unmet healthcare needs, ranked in descending order, are "lack of care," "time constraints," and "burden of medical expenses." Predictive probabilities for experiencing unmet healthcare needs and each cause differ significantly between regions. For instance, the probability of experiencing unmet healthcare needs due to "lack of care" is approximately 10 times higher in Gangwon-do (13.5%; 95% CI, 13.0%-14.1%) than in Busan (1.3%; 95% CI, 1.3%-1.4%). The probability due to "burden of medical expenses" is approximately 14 times higher in Seoul (4.1%; 95% CI, 3.6%-4.6%) compared to Jeollanam-do (0.3%; 95% CI, 0.2%-0.4%). Conclusion: Amid rapid sociodemographic transitions, South Korea must make significant efforts to alleviate unmet healthcare needs and the associated regional disparities. To effectively achieve this, it is recommended that South Korea involves the National Assembly in healthcare policy-making, while maintaining a centralized financing model and delegating healthcare planning and implementation to regional authorities for their local residents-similar to the approaches of the United Kingdom and France.

• Health Policy and Management
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• v.33 no.1
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• pp.107-113
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• 2023

Unmet healthcare is an important indicator for measuring accessibility of healthcare services. We analyzed the following four data from a nationally representative sample of South Korean population: Korea Health and Nutrition Examination Survey (KNHANES, 2007-2021), Community Health Survey (CHS, 2008-2021), Korea Health Panel Survey (KHP, 2011-2019), and Korean Welfare Panel Study (KOWEPS, 2006-2021). The proportion of individuals reporting unmet healthcare needs were 6.0% (KNHANES), 5.1% (CHS), and 13.1% (KHP). Annual percentage change (APC) which identifies trend for the follow-up period was -9.4%, -9.4%, and -5.3%, respectively. The proportion of individuals reporting unmet healthcare needs due to cost were 1.2% (KNAHANES), 0.5% (CHS), 2.7% (KHP), and 0.4% (KOWEPS). The APC was -10.4%, -16.1%, -11.5%, and -19.1%, respectively. Compared to the previous year, the rate of unmet healthcare needs decreased slightly, but the rate of unmet health care needs due to cost tended to increase. Overall, higher rates of unmet healthcare needs were reported in the low-income and the elderly population. Although it was confirmed through the APC that the rate of unmet healthcare experience has decreased over the past decade, it can be seen that there is still a disparity by income level and age. These results suggest the need for an appropriate health benefit coverage policy for the low-income and the elderly.

• Health Policy and Management
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• v.33 no.4
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• pp.389-399
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• 2023

Background: The purpose of this study is to analyze the factors affecting the unmet healthcare needs of older people with chronic diseases in Korea and provide a basic research report to strengthen their access to medical care. Methods: In the 2020 older people survey data, 8,182 older people aged 65 or older who were diagnosed with one or more chronic diseases were the final subjects of the study. According to Andersen's behavioral model used in unmet healthcare needs, independent variables were composed of predisposing factors, possible factors, and necessary factors, and whether or not unmet healthcare needs was set as dependent variable. Results: Of the older people with chronic diseases, 1.6% experienced unmet healthcare needs, of which 55.9% experienced unmet healthcare needs for reasons related to economic burden, 31.6% physical constraints, and 12.5% time constraints. As a result of the analysis, older people with chronic diseases were more likely to experience unmet healthcare needs if they were relatively low in age, low in education level, no spouse, low in household income, poor subjective health, complex chronic diseases, and functional restrictions. However, by major reasons for experiencing unmet healthcare needs, living in rural areas were more likely to experience unmet healthcare needs due to physical constraints, and those who participated in economic activities and who had were more likely to experience unmet healthcare needs due to time burden. These results were not derived when only unmet healthcare needs was set as the dependent variable. Conclusion: This study emphasizes the need for an approach by cause of unmet medical occurrence by suggesting that there are differences in influencing factors by reason for experiencing unmet healthcare needs.

• Journal of Korea Entertainment Industry Association
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• v.14 no.8
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• pp.305-314
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• 2020

The purpose of this study was to provide basic information on regional senior welfare policy setting for the elderly in the metropolitan and nonmetropolitan areas and on the development of senior welfare programs on the basis of the data of the 2019 community health survey conducted by Korea Disease Control and Prevention Agency. The subjects in this study were 74,547 senior citizens who were at the ages of 65 and over as of 2019 and who were 17,423 from the metropolitan area and 57,124 from the nonmetropolitan areas. The collected data were analyzed by SPSS version 26.0. The findings of the study were as follows: As for the levels of happiness in the metropolitan area, happiness was better in the seniors who were aged 75 and up, who had spouses, whose income was larger and who engaged in economic activity. In the nonmetropolitan areas, happiness was better in the seniors who were aged 75 and up, who were better educated, who had spouses, whose income was larger and who engaged in economic activity. In terms of health behaviors and subjective health levels, more happiness was felt by the seniors who didn't smoke at present, who didn't suffer any subjective stress, who were at higher subjective health levels and higher subjective oral health levels and who had unmet health care needs, no matter whether they dwelled in the metropolitan or nonmetropolitan areas. In the nonmetropolitan areas, however, engaging in intensive physical activity and lower BMI were identified as the factors to affect happiness.

• Korean Journal of Psychosomatic Medicine
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• v.32 no.1
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• pp.24-33
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• 2024

Objectives : The purpose of this study was to investigate individual- and community-level factors on suicidal ideation and suicide attempt among Korean adults. Methods : This study was conducted on 225,965 adults collected through data from the 2021 Community Health Survey and the Korean Statistical Information Service (KOSIS). The general characteristics, suicidal behavior (e.g., suicidal ideation, and suicide attempts), and community-level characteristics of the study subjects were analyzed using frequency (%) and mean (standard deviation). The effects on individual- and community-level factors on suicidal ideation and suicide attempts was analyzed using multilevel logistic regression models. Results : The community-level factor associated with suicidal ideation was unmet health care (Odds Ratio [OR]=1.053, 95% CI=1.035-1.071), and the community-level factor associated with suicide attempt was the aging rate (OR=1.015, 95% CI=1.001-1.030). Regarding health-related variables, the individual-level factors associated with suicidal ideation were stress status (OR=9.388, 95% CI=8.629-10.213), depressive experience in the past year (OR=6.737, 95% CI=6.454-7.032), and the predominantly individual-level factors associated with suicide attempt were also stress status (OR=5.213, 95% CI=3.699-7.347), and depressive experience in the last one year (OR=13.433, 95% CI: 11.247-16.044). Conclusions : We confirmed individual-level and community-level factors influencing suicidal ideation and suicide attempt. Through these findings, we need to establish suicide prevention policies, considering managing individual-level factors such as stress and depression as well as community-level factors such as unmet health care.

• Journal of the Korean Applied Science and Technology
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• v.38 no.4
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• pp.1029-1044
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• 2021

This research was conducted to investigate the prevalence of depression and convergent factors related to depression in male and female wage workers. Using data from the 2014 and 2016 Korea National Health and Nutrition Examination Survey, 3,763 adults (1,888 males, 1,875 females) between the ages of 19 and under 65 were analyzed. Depression was measured by the Patient Health Questionnaire-9 (PHQ-9), and the depression (PHQ-9≥10) of all workers was 4.1% (3.2% for men, 5.0% for women). Multiple logistic regression analysis was performed to evaluate the depressive factors of male and female wage workers. In male workers, work-related characteristics such as employment type and working hours per week were found to be significantly related to depression even after adjusting for socio-demographic characteristics, health-related characteristics, and life style characteristics. However, in female workers, work-related characteristics did not expose a significant relationship, showing a difference from male workers. Therefore it is necessary to develop and implement workplace counselling or mental health promotion programs that take into account the gender characteristics of depression risk factors. Also, as health-related characteristics (diagnosis of depression, suicide plan, perceived stress level, unmet medical services, self-rated health status) were found to be related to depression for both male and female workers, continuous management of these factors is required.