• 보건행정학회지
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• 제27권1호
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• pp.75-79
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• 2017

Suicide is becoming a public health issue in many countries, and even more so in Korea. Korea has the highest suicide rate in the Organization for Economic Cooperation and Development countries. To address these issues, we investigated the recent trends in suicidal ideation and suicide attempts among the adult population. We used data from four sources: Korean National Health and Nutrition Examination Survey (KNHANES, '2007-2012, '2013, '2015), Korean Community Health Survey (KCHS, '2008-2009, '2013), Korean Wealth Panel Study (KOWEPS, '2012-2015), and Korea Health Panel Survey (KHP, '2010-2013). Weighted frequencies and trend tests were used. The rate of suicidal ideation as recent year was 5.10% (KNHANES, '2015), 8.95% (KCHS, '2013), 2.34% (KOWEPS, '2015), or 5.39% (KHP, '2013). Regarding the suicide attempts, the rate of suicide attempts as recent year was 0.61% (KNHANES, '2015), 0.41% (KCHS, '2013), or 0.04% (KOWEPS, '2015). Average percent change of suicidal ideation during survey year was -2.80% (KNHANES, '2007-2012), 5.78% (KNHANES, '2013-2015), 0.62% (KCHS, '2008-2013), -5.63% (KOWEPS, '2012-2015), and -10.94% (KHP, '2010-2013). Average percent change of suicide attempts during survey year was -3.84% (KNHANES, '2007-2012), 4.55% (KNHANES, '2013-2015), -2.54% (KCHS, '2008-2013), and -18.96% (KOWEPS, '2012-2015). Those who had lower income level were more likely to have self-reported suicidal ideation and suicide attempts. Our results suggest that further efforts are needed for more effective intervention to identify and manage low income strata with suicide problem.

• 한국노년학
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• 제40권4호
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• pp.747-760
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• 2020

본 연구는 한국의료패널을 통해 인천광역시 고령자의 보건의료이용 행태 예측요인을 확인하여 고령자의 보건의료접근성을 높이거나 보건의료이용의 효율성을 높일 수 있는 서비스 또는 제도를 개발하는데 필요한 기초자료를 마련하는 것을 목적으로 한다. 한국의료패널 중 인천광역시에 거주하는 60세 이상 대상자 총 305개의 자료를 SPSS와 AMOS를 이용하여 분석하였다. 분석 결과, 개인속성과 건강수준, 건강수준과 보건의료이용행태에서 유의미한 상관이 나타났다. 또한, 구축된 연구모형의 적합도 및 효과 분석을 통해 개인속성 요인, 생활습관, 건강수준이 모두 보건의료서비스 이용에 직·간접적으로 유의미한 영향을 미치고 있음을 확인하였다. 이를 통해 인천시가 다른 지역들에 비해 보건의료서비스 수요 및 공급에서 불균형이 심한 편이므로 고령화 사회에 맞춰 인천시의 보건의료체계 정립이 필요함을 알 수 있었으며, 인천시 거주 고령자에게 제공할 보건의료서비스의 방안과 관련 정책 제도 수립 시 본 연구 결과를 기초자료로 활용할 수 있을 것이다.

• 보건행정학회지
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• 제33권1호
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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.

• 보건행정학회지
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• 제24권1호
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• pp.13-23
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• 2014

Background: A need arises to efficiently control health expenditure for medical aid due to a sharp increase in medical aid expenditure. This study experimently analyzes the impact of physician behavior on medical use for medical aid beneficiaries using supplier induced demand (SID) theory. Methods: This study looks into analyze SID effect using expenditure factor analysis of medical aid for the years between 2003 and 2010 in comparison with health insurance. Moreover, this study analyzes the existence and scale of SID using econometrics modeling with panel data on 16 cities and provinces's health expenditure data for medical aid from 2003 1/4 to 2010 4/4. Results: This study finds that the growth rate of visit days per capita and treatment amount per visit days for medical aid is higher than health insurance. Furthermore, the result of econometrics modeling analysis shows the existence of SID in general hospital, hospital, clinic, oriental clinic. Conclusion: In order to efficiently control expenditure for medical aid, it is required to reinforce macro polices such as the introduction of 'target management' and micro policies such as the strengthen of management on medical institutes in the perspective of suppliers as well as regulations of demanders.

• 보건행정학회지
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• 제33권3호
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• pp.253-263
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• 2023

Background: The purpose of this study was to explore the relationship between the local extinction index and total medical service utilization. Methods: A fixed effects model in panel analysis was performed for the 228 administrative districts in Korea. The statistical yearbook on the usage of medical services by region and Korean Statistical Information Service data were used from 2010 to 2019 for analysis. Medical service utilization was represented by the number of visits day, the number of inpatient days, and medical charges. Control variables were selected by using an Anderson model. The local extinction index was calculated using resident registration population data. Results: Descriptive statistics showed that the number of areas at risk of extinction increased from 61 to 95 for the study years. In addition, the number of visits, the number of inpatient days, and medical charges all increased during the study years. After controlling for variables affecting medical service utilization and doing a panel fixed effects model, the result suggested that a one-step increase in the local extinction index was significantly associated with a 12.29% decrease in medical charges of inpatients, a 7.33% decrease in medical charge of outpatient, a 5.21% decrease in the number of inpatient day, and a 5.54% decrease in the number of visits day. Conclusion: This study showed that the higher the region's extinction risks, the higher the region's total medical service utilization. The results of this study suggested that there was a disparity in medical service utilization between areas at risk of extinction and areas not at risk of extinction, so measures should be taken to address this disparity.

• 보건행정학회지
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• 제9권3호
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• pp.53-69
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• 1999

In this study. we present a modified rational addiction model which incorporates social-psychological factors. This is done through a utility function which includes social-psychological factors as its component. We apply this model to a cigarette consumption function in Korea using the data from the Korean Household Panel Study(KHPS). The results provide relatively strong support for the rational addiction model. However. the impact of social-psychological factors and the short-run and long-run price elasticities are statistically insignificant.

• 대한통합의학회지
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• 제7권2호
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• pp.111-119
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• 2019

Purpose : The aim of this study was to investigate patterns of medical use among juveniles and adolescents, including for chronic disease, in Korea. The study sought to do the following: (a) investigate the extent to which chronic diseases account for medical expenditures, (b) investigate and the socio-demographic characteristics associated with medical use, and (c) identify the differences in medical use between juveniles and adolescents. Methods : We used data from the 2015 Korean Health Panel and selected 12 variables. The socio-demographic characteristics investigated included, growth period (juvenile, adolescents), gender, family income, national basic livelihood act status, disability registration, and degree of disability. There were five medical factors that were considered: emergency room use, hospitalization use, hospital outpatient use, chronic disease, and medical expenditure. Data were analyzed using stepwise multiple and logistic regression. Results : The prevalence of chronic disability in juveniles and adolescents was 31.1 % and 1 %, respectively. The factors affecting medical expenditures included hospitalization use, hospital outpatient use, family income, disability, gender, chronic disease, and emergency room use ($R^2=.160$, p<.05). For national basic livelihood act recipients, the probability of having chronic disease was about 1.6 times higher (OR=1.597, 95 % CI=1.092-2.335, p=.016), compared with non-national basic livelihood act recipients. People with disabilities were 6.6 times more likely than those without disabilities to suffer from chronic disease (OR =6.571, 95 % CI=2.776-15.556, p<.001). Hospital outpatient user was 2.3 times higher than non-user (OR=2.260, 95 % CI=1.702-3.001, p<.001). Juveniles had a 1.7 times and 6.2 times higher likelihood of emergency rooms user (OR=1.654, 95 % CI=1.270-2.155, p<.001), and hospital outpatient user than adolescents (OR=6.208, 95 % CI=4.443-8.676, p<.001). Conclusion : The findings of this study suggest that health care services for juveniles is needed to manage chronic diseases that have an effect on medical expenditures.

• 한국직업건강간호학회지
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• 제32권4호
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• pp.215-224
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• 2023

Purpose: This study uses data from the 12th~17th Korea Welfare Panel (2017~2022) to analyze changes in depression scores due to the COVID-19 outbreak and the factors that influenced depression scores according to employment type. Methods: The difference in depression scores according to employment types before COVID-19 (12th~14th) and after COVID-19 (15th~17th) was analyzed. A fixed-effect model analysis was conducted before and after the occurrence of COVID-19. Results: After the outbreak of COVID-19, job satisfaction and family life satisfaction influenced the depression scores of regular wage workers. After the outbreak of COVID-19, annual income, health status, and satisfaction with family life affected the depression scores of non-regular wage workers. After the outbreak of COVID-19, leisure life satisfaction and family relationship satisfaction influenced the depression scores of self-employed. Self-esteem played a role as a control variable in lowering the depression scores of regular and non-regular workers, but did not play a role as a control variable for self-employed. Conclusion: Rather than the direct impact of infectious diseases such as COVID-19, social and economic changes resulting from policies implemented to prevent the spread affect workers' depression, and the impact varies depending on the type of employment. When implementing policies to prevent the spread of infectious diseases in the future, policies that take employment type into consideration rather than uniform policies should be prepared, and measures for mental health also need to be prepared.

• Journal of Preventive Medicine and Public Health
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• 제56권1호
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• pp.67-76
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• 2023

Objectives: Previous studies have reported that people with disabilities are more likely to be impoverished and affected by excessive medical costs than people without disabilities. Public transfer income (PTI) reduces financial strain in low-income households. This study examined the impact of PTI on catastrophic health expenditures (CHE), focusing on low-income households and households with Medical Aid beneficiaries that contained people with disabilities. Methods: We constructed a panel dataset by extracting data on registered households with disabilities from the Korea Welfare Panel Study 2012-2019. We then used a generalized estimating equation model to estimate the impacts of PTI on CHE. A subgroup analysis was carried out to assess the moderating effects of family income levels and health insurance types. Results: As PTI increased, the odds ratio (OR) of CHE in households that contained people with disabilities decreased significantly (OR, 0.92; 95% confidence interval [CI], 0.89 to 0.94; p<0.001). In particular, PTI effectively reduced the likelihood of CHE for low-income households (OR, 0.85; 95% CI, 0.81 to 0.89; p<0.001) and those who received medical benefits (OR, 0.78; 95% CI, 0.68 to 0.89; p<0.001). Conclusions: This study highlights the positive effect of PTI on decreasing CHE. Household income and the health insurance type were significant effect modifiers, but economic barriers seemed to persist among low-income households with non-Medical Aid beneficiaries. Federal policies or programs should consider increasing the total amount of PTI targeting low-income households with disabilities that are not covered by the Medical Aid program.

• 융합정보논문지
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• 제11권10호
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• pp.194-204
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• 2021

본 연구는 생애주기별 민간의료보험 가입 현황 및 가입 요인을 알아보고, 민간의료보험 가입에 따라 생애주기별 의료이용 행태 차이를 파악하고자 시행하였다. 한국복지패널 12차-15차(2016-2019년) 자료를 SPSS 26 프로그램을 사용하여 58,223명의 인구사회학적 및 건강 특성에 따른 민간의료보험의 가입 현황 차이는 Chi-square, 가입 영향 요인은 다항 로지스틱 분석, 의료이용 행태는 평균분석하였다. 분석결과 민간의료보험의 가장 큰 가입요인은 가구소득이었으며, 성장기의 민간의료보험 가입이 생애주기 중 가장 높았고, 가구소득에 의해 복수 가입되었다. 청장년기는 가구소득과 유배우자, 장애가 없는 경우, 중년기는 가구소득과 경제활동, 유배우자, 건강수준이 큰 영향요인으로 나타났다. 노년기의 민간의료보험 가입률이 가장 낮았고, 저소득가구, 낮은 건강수준, 장애가 있는 경우에서 낮았다. 민간의료보험 가입자들의 의료이용 증가도 성장기와 청장년기에 나타났다. 국민건강보험의 보장성 강화와 이를 보충하기 위한 민간의료보험의 역할을 생애주기에 맞춰 정립하여 상호보완적으로 작용하게 하여 의료보장의 사각지대를 없애고, 국민의 건강과 후생을 최대화하여야 할 것이다.