• 한국직업건강간호학회지
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• 제29권1호
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• pp.49-57
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• 2020

Purpose: This study aimed to identify and compare the risk factors of depression among middle-class Korean workers. Methods: A cross sectional study was designed for secondary data analysis. From the 8th Korean Medical Panel Survey (2008~2013), a total of 3,056 data was drawn and analyzed. With SPSS version 24, a developmental stage comparison, with the stage being young adults (20~39), middle-aged adults (40~64), and older adults (65+) were conducted. Frequency, percentage, 𝑥² test and logistic regression analysis were statistical tools used to analyze the data. Results: In all developmental groups, experience of frustration was found to be a common risk factor of depression. Stress from excessive task, peer-compared subjective health status, and self-perceived social class were risk factors of depression in the young adults and the middle-aged adults. Anxiety for the future significantly influenced depression in the middle-aged adults and older adults. Conclusion: Experience of frustration was a major risk factor of depression among Korean middle-class workers. Interventions to reduce depression need to be developed focusing on the specific risk factors by developmental stages such as experience of frustration, stress from task burden, poor peer-compared subjective health status and anxiety for the future.

• 보건의료산업학회지
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• 제11권1호
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• pp.143-158
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• 2017

Objectives : This study aims to analyze differences in the use of postpartum care services and identify the factors affecting their use. Methods : Data were collected from the 2008-2014 Korean Health Panel. Chi-square tests were conducted to analyze differences in the characteristics of women after birth by the use of postpartum care services. Logistic regression analysis was used to identify factors affecting the use of each type of postpartum care service. Results : Participants with higher education and household income levels were more likely to use a postpartum care facility. Individuals with a lower number of household members, who gave birth in 2011-2013, and who used hospitals specializing in obstetrics and gynecology had a greater likelihood of using a postpartum care facility. The probability of using a postpartum caretaker was higher when participants did not perform any economic activities. Conclusions : It is meaningful to confirm that use patterns and determinants of postpartum care facilities and postpartum caretakers are completely different and that the socioeconomic status of women affects the utilization of postpartum care facilities.

• 한국병원경영학회지
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• 제19권4호
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• pp.57-68
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• 2014

Since the introduction of National Health Insurance(NHI) in 1977, it has grown rapidly and contributed to extend patient's access to the health care services. However, limited coverage for health care services of NHI has been ongoing challenge and private health insurance(PHI) has been rising as an alternative source of enhancing coverage and saving out-of-pocket(OOP) expenditure for patients. In this study, after controlling for socio-demographic, economic, health related variables, we identified the patients' healthcare utilization and subsequent OOP expenditure depending on their PHI enrollment and their enrollment types(fixed benefit, indemnity, fixed benefit plus indemnity). Data were collected from the 2010 Korean Health Panel. The unit of analysis was a member of household(n=13,324). Of the 13,324 cases, 70.7% of patients held PHI, in detail, fixed benefit(47.0%), indemnity(3.6%), fixed benefit plus indemnity(20.1%). Major findings showd that patients who enrolled in PHI used more outpatient services(outpatient visit, number of physician visit, number of examination) and spent more OOP expenditure than non-PHI patients. There were also differences of healthcare utilization and OOP expenditure among the types of PHI. In addition, PHI patients used more inpatient services(inpatient use, number of hospitalization, LOS), but there was no significant difference between PHI and non-PHI patients with regard to the OOP expenditure. Thus, we could not find any distinct relationship between the types of PHI and patients' tertiary hospital use. Policy-makers should need careful political deliberation for monitoring the effect of PHI on health care utilization and subsequent expenditure not only to improve patients' coverage but also to save their OOP expenditures.

• Journal of Korean Academy of Oral Health
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• 제42권4호
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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.

• 한국병원경영학회지
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• 제24권3호
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• pp.1-10
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• 2019

Purpose: The purpose of this study was to investigate determinants of purchasing indemnity private health insurance and its impact on the healthcare utilization among outpatients with chronic disease. Methods: The study analyzed 4,997 chronic ill patients using 2015 Korean Health Panel data. Logistic regression analysis was conducted to analyze the factors affecting the purchase of indemnity private health insurance and multiple regression analysis was conducted to analyze the effect of private health insurance on the number of outpatient visits and outpatient expenditures. Findings: The age, education level, and number of chronic diseases were significant factors affecting the purchasing of indemnity private health insurance among chronic patients. As a result of analyzing the impact of indemnity private health insurance on healthcare utilization, the number of outpatient visits for those who enrolled in the indemnity private health insurance was higher than the number of outpatient visits for those who did not. But there was no statistically significant difference in outpatient medical expenses. Practical Implications: The results of this study shows that indemnity private health insurance may cause inequality in the healthcare utilization of the socially vulnerable. It is necessary to seek ways to strengthen the health security of chronic disease patients and high-risk elderly people who need more healthcare.

• 대한통합의학회지
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• 제11권3호
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• pp.99-114
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• 2023

Purpose : The purpose of this study was to determine factors that affect the quality of life (QoL) of people with diabetes. We hope to provide a basis for intervention strategies for health promotion and related research among patients with diabetes in the field of physical therapy. Methods : We selected individuals diagnosed with diabetes who were aged 19 years or higher by using data from the 2019 Korean Health Panel survey and analyzed the results of 1,527 people. The influencing factors were sex, age, household income, marital status, age, education level, subjective health status, body mass index (BMI), smoking, drinking, regular exercise, experience of depression and anxiety, suicidal thoughts, stress, and frequency of walking (days/week). Frequency analysis, descriptive statistics, independent sample t-test, one-way analysis of variance, and multiple regression analysis were performed. Results : The EQ-5D score for QoL was .87 ± .12, with pain and discomfort being the most detrimental to the QoL of people with diabetes. In terms of patients characteristics, the QoL was lower among participants who were female, older, and separated/widowed/divorced; had an education level below middle school; had a poor subjective health status; were non-smokers and drinkers; and did not walk and exercise regularly, experienced a lot of stress, and experienced depression and anxiety; and had suicidal thoughts (p<.001). Being separated/bereaved/divorced; experiencing a lot of stress, depression, and anxiety; and having suicidal thoughts were negatively associated with QoL in people with diabetes (p<.01). On the other hand, age of 65 years or younger; graduation from high school, fair or better subjective health, regular exercise and alcohol consumption, and walking (days/week) were positively associated with QoL (p<.05). Conclusion : Regarding the QoL of patients with diabetes, intervention strategies should be formulated by considering general characteristics and disease-related characteristics. Among the various factors affecting QoL, the number of walking and regular exercise were found to be the factors that improved the QoL of patients with diabetes. These results can be used as a basis for the education and management of patients with diabetes in the field of physical therapy.

• 한국콘텐츠학회논문지
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• 제21권1호
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• pp.511-519
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• 2021

본 연구는 고령사회에 접어든 우리나라의 인구구조를 제고 하여, 중장년층의 저소득층들이 느끼는 삶에 대한 인식을 고찰하였다. 분석을 위하여, 보건복지부에서 제공하는 2019년 복지패널자료를 토대로 필요로 하는 변수를 선정하였고, 총 14,918명의 패널표본으로부터 '저소득층'의 '60대-70대' 중에서, 무응답 및 불성실한 표본을 제거하여, 최종 1,684명의 표본을 선정하였다. 특히, 본 연구에서는 종속변수로써, 패널자료에서 측정한 '삶의 사다리'로 정의하였다. 이에, '삶의 사다리'에 미치는 개인적 특성 및 생활만족도의 영향요인을 분석하였다. 분석결과, 종속변수인 「삶의 사다리」 변수에 대한 영향요인으로, 개인적 특성만을 고려하였을 경우에는, 대부분의 개인적 특성이 「삶의 사다리」의 영향요인으로 나타났다. 또한, 경제상태변수에 대한 상호작용 효과를 살펴본 결과, 유의미한 상호작용 효과를 나타내지 않았다. 이는 중년노인들의 삶의 사다리에 미치는 영향요인은 경제상태보다는 건강상태가 유의미한 영향요인임을 반증해주고 있다. 따라서, 노인의 '삶의 사다리'에 대한 인식은 노인 개인적인 여건과 환경보다는 노인의 내적 및 외적인 다양한 '환경요인'이 노인의 삶에 대한 인식에 영향을 미침을 제고 해야 한다. 즉, 그들의 삶에 대한 인식에 긍정적인 대안을 제시할 수 있는 방안이 필요할 것이다.

• 한국컴퓨터정보학회논문지
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• 제27권11호
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• pp.199-207
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• 2022

본 연구는 근로능력이 노인의 우울에 미치는 영향을 도시와 농촌노인을 중심으로 비교 분석하여 노인근로정책과 정신건강정책 마련을 위한 자료제시에 연구목적을 두고 수행하였다. 연구를 위한 분석자료는 한국복지패널 16차년도 자료(2021년)를 이용하였고, 연구대상은 65세 이상 노인 4,838명의 자료를 발췌하여 분석에 투입하였다. 분석방법은 SPSS 22.0을 이용하여 기술통계, 회귀분석을 실시하였다. 연구결과 전체 노인은 근로능력이 있는 경우 우울이 감소하는 것으로 나타났다. 도시노인은 건강상태와 가구형태가 영향을 주는 것으로 나타났고 농촌노인은 건강상태와 교육수준이 영향을 주는 것으로 나타났다. 따라서 도시와 농촌지역의 자원과 환경에 적절한 지역 특색에 맞은 지역사회복지서비스가 제공이 요구되고 된다.

• 한국사회복지학
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• 제66권3호
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• pp.185-208
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• 2014

본 연구의 목적은 한국의 공공부조제도에서 근로연령대 빈곤인구의 빈곤 탈출과 노동시장에 통합을 촉지 또는 저해하는 요인이 무엇인지를 실증적으로 분석하는 데 있다. 한국보건사회연구원의 복지패널 자료를 활용하여 분석한 결과, 한국의 근로연령대 기초생활보장수급자들의 기간 의존성이 나타나고 있지만, 이는 수급기간이 길어짐에 따라서 복지의존성이 강화되었기 때문이라기보다는 장기 수급의존층의 경우 수급 탈출에 취약한 조건들을 가지고 있기 때문이라는 점을 확인하였다. 특히 수급자들이 빈곤으로부터 탈출해서 노동시장으로 이행하는 데 장애로 작용하는 요인들을 분석한 결과, 인적자본이나 사회적 자본과 같은 특성보다는 청년피부양가구구성원의 존재 여부나 직업알선서비스 참여 여부가 빈곤탈출에 유의한 영향을 주는 것으로 나타났다. 이는 수급으로부터의 탈출이 교육-의료 서비스가 수급여부와 연계되어 있다는 수급제도의 특성이나 적극적 노동시장프로그램의 성격과 같은 제도-정책의 요인이 크게 작용하고 있다는 것을 의미한다.

• 보건행정학회지
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• 제33권3호
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• pp.325-337
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• 2023

Background: While there are many studies estimating the effects of private health insurance on various types of health care utilization, few have examined how such effects change in conjunction with important policy reforms in national health insurance (NHI). This study examined how the effect of private health insurance (supplemental and fixed cash benefit) on high-cost outpatient imaging test utilization changed following the expansion of magnetic resonance imaging (MRI) coverage in 2018, which is a key example of the NHI benefit expansion policy in recent years. Methods: Data from the 2017 and 2019 Korea Health Panel Survey, which contained information about healthcare utilization before and after the expansion of MRI coverage in 2018, were used. The incremental effect of private health insurance on high-cost outpatient imaging test utilization for each period were quantified and compared, with special attention given to the type of private health insurance. Results: While people with supplemental private health insurance were more likely to use high-cost outpatient imaging tests than those without, both before and after the expansion of MRI coverage, the incremental effect increased from 1.6% points in 2017 to 2.5% points in 2019. Conclusion: Benefit expansion in NHI does not necessarily reduce disparities in the use of health care between private health insurance subscribers and non-subscribers. The results of our study also suggest that the path through which private health insurance affects healthcare utilization may not be limited to the price mechanism alone but can be more complex.