• 보건행정학회지
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• 제28권4호
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• pp.339-351
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• 2018

Background: The purpose of this study is to estimate empirically whether there is a difference in medical use among income groups, and if so, how much. This study applies econometric model to the most recent year of Korean Medical Panel, 2015. The model consists of outpatient service and inpatient service models. Methods: The probit model is applied to the model which indicate whether or not the medical care has been used. Two step estimation method using maximum likelihood estimation is applied to the models of outpatient visits, hospital days, and outpatient and inpatient out-of-pocket cost models, with disconnected selection problems. Results: The results show that there was the inequality favorable to the low income group in medical care use. However, after controlling basic medical needs, there were no inequities among income groups in the outpatient visit model and the model of probability of inpatient service use. However, there were inequities favorable to the upper income groups in the models of probability of outpatient service use and outpatient out-of-pocket cost and the models of the number of length of stay and inpatient out-of-pocket cost. In particular, it shows clearly how the difference in outpatient service and inpatient service utilizations by income groups when basic medical needs are controlled. Conclusion: This means that the income contributes significantly to the degree of inequality in outpatient and inpatient care services. Therefore, the existence of medical care use difference under the same medical needs among income groups is a problem in terms of equity of medical care use, so great efforts should be made to establish policies to improve equity among income groups.

• International journal of advanced smart convergence
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• 제10권2호
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• pp.37-44
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• 2021

At the time of entering the super-aged society, the health problem of the elderly is becoming more prominent due to the rapid digital era caused by COVID-19, but the gap between welfare budgets and welfare benefits according to regional characteristics is still not narrowed and there is a significant difference in emergency medical access. In response, this study proposes an ICT-based New Normal Smart Care System (NNSCS) to bridge the gap I n health and medical problems. This is an integrated system model that links the elderly themselves to health care, self-diagnosis, disease prediction and prevention, and emergency medical services. The purpose is to apply location-based technology and motion recognition technology under smartphones and smartwatches (wearable) environments to detect health care and risks, predict and diagnose diseases using health and medical big data, and minimize treatment latency. Through the New Normal Smart Care System (NNSCS), which links health care, prevention, and rapid emergency treatment with easy and simple access to health care for the elderly, it aims to minimize health gaps and solve health problems for the elderly.

• 보건행정학회지
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• 제14권2호
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• pp.17-33
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• 2004

The present study attempts to examine the progressivity of health care financial sources based on the income approach, for which it decomposes redistributive effects into vertical, horizontal, and re-ranking components. The study data include Korean Household Expenditure Survey (2000) conducted every 5 year by Korea National Statistical Office. The data were sampled from the national population by the multistage probabilistic sampling method, and amounts to 23,270 households. For the better application of the income approach, the study employs household total expenditure in Korea instead of total income, because the former data source is more reliable and less fluctuated over time. Progressivity of health care financing was measured by Kakwani index. Aronson's decomposition equation was used in case of the analysis where differential treatment of health care expenditure needs to be considered. Despite the progressivity of Korea's governmental contributions, total expenditure of health care showed regressive pattern, which may largely be attributable to the higher regressivity in out-of-pocket money. With the result of negative Kakwani index, differential treatment increased income redistribution biased for better-off. It is worth to note that social insurance displays not only negative Kakwani index, but also horizontal inequality, suggesting that the first step of health care financing reform should be the revision of social insurance premium rates toward effective and equable way.

• 한국병원경영학회지
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• 제27권1호
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• pp.1-10
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• 2022

Background: This study aims to empirically compare and evaluate the current status of medical accessibility and health inequality between people with disabilities and without. We calculated the ACSC hospitalization rate, which is a medical accessibility index, for hypertension, a major risk factor for cardiovascular disease that accounts for more than 20% of deaths among people with disabilities using the 2016 National Health Insurance Big Data. Methods: The subjects of the study were a total of 601,520, including 64,018 people with disabilities and 537,501 people without. Logistic regression was performed to analyze the differences in hypertension hospitalization rates adjusted for demographic and sociological characteristics and disease characteristics using SAS 9.4 program. Results: Before adjusting for the characteristics, the hypertension hospitalization rate of people with disabilities was 1.55%, and the people without disabilities were 0.49%. After adjusting, it was found that people with disabilities were 2.11 times higher than people without disabilities, and it was statistically significant. Conclusion: The preventable hospitalization rate of people with disabilities is higher than that of people without, suggesting that the disabled have problems with access to medical care and health inequality. Therefore, the government's policy improvement is required to close the medical gap for the disabled.

• 이베로아메리카
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• 제12권1호
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• pp.149-186
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• 2010

Community participation in health has been praised as a new way of improving health inequality in developing countries for many decades. This paper is an attempt to evaluate community participation programs in health focusing on two intercultural health hospitals in IX Region of Chile. After exploring the process of program building and its impact on the quality of service, this paper concludes that a community participation program with stronger participation resulted in higher patient satisfaction. The author expects such finding to contribute to more comprehensive understanding of the impact of participation in health programs.

• International journal of advanced smart convergence
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• 제10권2호
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• pp.168-174
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• 2021

Korea is ranked as the world's No. 1 country in its aging rate. While the interest and demand for health is rapidly increasing, the health status of the elderly is in the lowest among OECD members. Increased chronic diseases, the burden of medical costs and digital/untact changes of societies after COVID-19 have caused the direction of healthcare to be changed from treatment oriented to health care and prevention oriented, along with increased income levels and a desire for a healthy life. Amid this paradigm of change, the gap in health standards and health inequality for the elderly according to local structure and social conditions affects not only socio-economic but also the quality of life for individual senior citizen. Utilizing prior data of Aging Research Panel Survey, this study aims to compare and analyze health conditions and regional gaps which are significant influences on the satisfaction of the life of the elderly, and to suggest direction of studies for health care to provide solutions for health inequalities. The findings are intended to be a basic data for researching models of the New Normal Smart Healthcare System that bridge the health gap between the elderly and enhance life satisfaction with health care models suitable for regional characteristics in aging society.

• 보건행정학회지
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• 제6권1호
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• pp.59-84
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• 1996

It is generally believed that the medical profession in Korea is an well-paid field along with legal profession. In this vein, the nursing is regarded one of well-paid profession. The actual data, however, reveals that nurses belong to low income bracket. We carefully compare the nurse's earnings with those of other professions. We selected 58 professions, which are similar in vocational characteristics and education background to nurses and conduct a regression analysis to estimate earning functions. Using the estimated coefficients, we project an optimum salary level for nurse, and compare it with the actual salary level. The estimated results show that the nurses are underpaid : their actual salary is less than the optimum level. We provide several explanations for this phenomenon : a tradition based on Confucian value, wage discrimination for women, and wage inequality among hospitals. Undercompensation will result either ratard professional development, or block the motivation for high quality of nursing care. If the current underpaying situation is not improved, a shortage of nurses along with an noticeable decline in the quality of medical services are expected. Therefore an adequate compensation for nurses must be properly assessed and addresed not only be health care authorities but also by legislators. Further research is needed to explain why there is such as wide salary inequality among nurses, and to find what cause it.

• Journal of Preventive Medicine and Public Health
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• 제44권6호
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• pp.242-248
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• 2011

Objectives: Busan is reported to have the highest mortality rate among 16 provinces in Korea, as well as considerable health inequality across its districts. This study sought to examine overall and cause-specific mortality and deprivation at the town level in Busan, thereby identifying towns and causes of deaths to be targeted for improving overall health and alleviating health inequality. Methods: Standardized mortality ratios (SMRs) for all-cause and four specific leading causes of death were calculated at the town level in Busan for the years 2005 through 2008. To construct a deprivation index, principal components and factor analysis were adopted, using 10% sample data from the 2005 census. Geographic information system (GIS) mapping techniques were applied to compare spatial distributions between the deprivation index and SMRs. We fitted the Gaussian conditional autoregressive model (CAR) to estimate the relative risks of mortality by deprivation level, controlling for both the heterogeneity effect and spatial autocorrelation. Results: The SMRs of towns in Busan averaged 100.3, ranging from 70.7 to 139.8. In old inner cities and towns reclaimed for replaced households, the deprivation index and SMRs were relatively high. CAR modeling showed that gaps in SMRs for heart disease, cerebrovascular disease, and physical injury were particularly high. Conclusions: Our findings indicate that more deprived towns are likely to have higher mortality, in particular from cardiovascular disease and physical injury. To improve overall health status and address health inequality, such deprived towns should be targeted.

• 디지털융복합연구
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• 제15권12호
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• pp.625-633
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• 2017

본 연구는 가구소득의 불평등에 민간보험수입과 의료비본인부담지출이 어떠한 영향을 미치는지를 확인하기 위하여 2015년 의료패널조사데이타에 대하여 소득계층별 집중지수와 집중곡선 분석을 실시하였다. 주요 분석결과는 다음과 같다. 첫째, 가구소득 집중지수가 0.3580으로 소득이 고소득층에 집중되어 있어서 불평등 정도가 상당히 큰 것으로 나타났다. 둘째, 민간보험수입이 고소득층에 집중하여 적지만 고소득층 가구의 소득집중현상을 강화시킨다. 셋째, 저소득층의 의료비 본인부담지출이 많은 것으로 나타났다. 끝으로 가구소득에서 전체 의료비본인부담지출을 제외한 소득에 대한 집중지수가 0.3676으로 나타나서 의료비본인부담지출 후에도 소득이 고소득층에 크게 집중되어 있었다. 따라서 민간보험수입과 의료비본인부담지출은 모두 가구소득불평등을 심화시키는 요인으로 작용하고 있어서 융 복합적 연구 및 정책방안 마련을 통한 개선이 요구된다.

• 한국융합학회논문지
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• 제10권12호
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• pp.123-128
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• 2019

이 연구는 경상북도 G시의 지역주민 409명을 대상으로 도심지역과 농촌지역으로 구분하여 보건소 이용에 대한 만족도와 지역주민에게 필요한 건강사업을 분석하기 위하여 설문조사를 실시하였다. 409명의 대상자 중 보건소를 이용한 경험이 있는 284명을 대상으로 보건소 진료에 관한 만족도를 분석하였으며, 일반진료, 한방진료, 치과진료, 물리치료, 검사, 예방접종 등 모든 분야에서 농촌지역의 만족도가 현저히 낮게 나타났다. 이를 개선하기 위하여 지역주민에게 원활한 공공의료서비스가 제공 될 수 있도록 시설 확충 및 개선이 필요하며, 도심지역과 농촌지역 간의 의료 불평등 해소를 위한 보건의료정책을 펼쳐나가야 할 것 이다.