• 동의신경정신과학회지
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• 제34권4호
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• pp.349-358
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• 2023

Objectives: We used the 2019 Korea Health Panel Annual Data to analyze factors related to visits to Korean medicine (KM) outpatient clinics among patients with mood disorders in Korea. Methods: Individuals aged 19 years or older, with depressive or bipolar disorders, and with a record of using Western medicine (WM) and/or the KM medical service were included. The 266 subjects were classified into the WM group or the integrative medicine (IM) group. The Andersen healthcare utilization model was used to analyze factors that potentially influenced the subjects' healthcare utilization. Binomial logistic regression analysis was used to analyze factors influencing the use of IM medical services. Results: Among the subjects, 75.56% (n=201) were in the WM group, and 24.44% (n=65) were in the IM group. Statistically significant differences were observed in residential areas, total annual income, the presence of disability, and the level of pain/discomfort between the two groups. Regression analysis found that residential areas and pain/discomfort were factors related to the use of IM services. Specifically, reporting "a lot" of pain/discomfort compared to "no" pain/discomfort showed a significant positive relationship with the use of IM (odds ratio=4.57, 95% confidence interval=1.79 to 11.70). Conclusions: This study was the first to analyze the status of KM medical service use and related factors among patients with mood disorders in Korea. The finding that the presence of pain/discomfort was positively correlated with the use of KM services is potentially related to medically unexplained physical symptoms or somatization phenomena.

• 보건행정학회지
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• 제31권2호
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• pp.232-239
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• 2021

This study aimed to update suicide-related indicators including suicidal ideation, suicide attempts, and the number of suicidal deaths. Based on up-to-date information, we observed the trends of suicide-related indicators. In this study, five data sources were used to observe the trends of suicide-related indicators: Statistics Korea (1983-2019), Korean National Health and Nutrition Examination (KNHANES, '07-13, '15-19), Korean Community Health Survey (KCHS, '08-09, '13, '17), Korean Wealth Panel Study (KOWEPS, '12-19), and Korea Health Panel Survey (KHP, '10-13, '16-17). The suicide rate, which peaked in 2011, declined until 2017 and then started to rise again from 2018, recording a suicide rate of 26.9 per 100,000 people in 2019. The rate of suicidal ideation estimated based on the recently available data was 4.62% (KNHANES, '19), 3.51% (KHP, '16), 2.87% (KHP, '17), and 1.70% (KOWEPS, '19). That of suicide attempt as recent year was 0.43% (KNHANES, '19), 0.07% (KOWEPS, '19). Annual percentage change of death by intentional self-harm was -2.11% (Statistics Korea), and that of suicidal ideation was -14.7% (KNHANES), -2.5% (KCHS), -10.6% (KOWEPS), and -11.3% (KHP). Annual percentage change of suicide attempt was -5.0% (KNHANES), -4.4% (KCHS), and -11.3% (KOWEPS). The lower the income level, the higher the probability of experiencing suicide ideation and suicide attempts. Considering the recent increase in suicide rate in contrast to the continuing decline in suicidal ideation and suicide attempts, continuous data observation and appropriate policies regarding suicide prevention are needed.

• 대한약침학회지
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• 제27권2호
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• pp.110-122
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• 2024

Objectives: This study analyzed the Korea Health Panel Annual Data 2019 to investigate factors related to the use of non-insured Korean medicine (KM) treatment in individuals with chronic diseases. The non-insured KM treatments of interest were herbal decoction (HD) and pharmacopuncture (PA). Methods: Among adults aged 19 or older, 6,159 individuals with chronic diseases who received outpatient KM treatment at least once in 2019 were included. They were divided into three groups according to the KM treatment used: (1) basic insured KM non-pharmacological treatment (BT) group (n = 629); (2) HD group (n = 256); (3) PA group (n = 184). Logistic regression analysis was used to explore factors associated with favoring HD or PA use over BT. Potentially relevant candidate factors were classified using the Andersen Behavior Model. Results: Compared to BT, the 1st to 3rd quartiles of income compared to the 4th quartile (odds ratio: 1.50 to 2.06 for HD; 2.03 to 2.83 for PA), health insurance subscribers compared to medical aid (odds ratio: 2.51; 13.43), and presence of musculoskeletal diseases (odds ratio: 1.66; 1.91) were significantly positively associated with HD and PA use. Moreover, the presence of cardiovascular disease (odds ratio: 1.46) and neuropsychiatric disease (odds ratio: 1.97) were also significantly positively associated with HD use. Conclusion: The presence of some chronic diseases, especially musculoskeletal diseases, was significantly positively associated with HD and PA use, while low economic status was significantly negatively associated with HD and PA use, indicating the potential existence of unmet medical needs in this population. Since chronic diseases impose a considerable health burden, the results of this study can be used for reference for future health insurance coverage policies in South Korea.

• 보건행정학회지
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• 제29권1호
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• pp.77-81
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• 2019

Suicide is a major public health issue that causes over 800,000 deaths each year globally. Korea ranks high in suicide rates, in which around 24.3 per 100,000 individuals are reported to have died by intentional self-harm in 2017 according to Statistics Korea. The aim of this study was to examine the current status and trend of suicide ideation and attempt using data from the following five sources: Korean National Health and Nutrition Examination (KNHANES, '07-13, '15-17), Korean Community Health Survey (KCHS, '08-09, '13, '17), Korean Wealth Panel Study (KOWEPS, '12-17), Korea Health Panel Survey (KHP, '10-13), and Statistics Korea (1983-2017). Suicide ideation and attempts were also further examined based on equalized household income levels. Data published by Statistics Korea were used to show the updated suicide rate and number of deaths by intentional self-harm. The rate of suicide ideation at the recent year was 4.73% (KNHANES, '17), 6.96% (KCHS, '17), 1.63% (KOWEPS, '17), and 5.39% (KHP, '13). That of suicide attempts as recent year was 0.71% (KNHANES, '17), 0.32% (KCHS, '17), and 0.09% (KOWEPS, '17). Annual percentage change of suicidal ideation was -15.4% (KNHANES, '07-17), -2.5% (KCHS, '08-17), -8.6% (KOWEPS, '12-17), and -10.9% (KHP, '10-13). Annual percentage change of suicide attempts was -4.0% (KNHANES, '07-17), -4.4% (KCHS, '08-17), and -14.9% (KOWEPS, '12-17). Individuals with lower income levels were more likely to experience suicide ideation and attempts. Considering that Korea still shows a high suicide rate despite the continuously decreasing trend of suicide ideation and attempt, continuous observation and appropriate policy implementation regarding suicide related problems are necessary.

• 보건행정학회지
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• 제31권1호
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• pp.140-144
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• 2021

Catastrophic health expenditure refers to measure the level of the economic burden of households due to medical expenses. The purpose of this study was to examine the proportion of households that experienced catastrophic health expenditure between 2006 and 2019 using available data from the National Survey of Tax and Benefit (NaSTaB), Korea Health Panel (KHP), and Households Income and Expenditure Survey (HIES). Trend test was used to analyze the proportion of households with catastrophic healthcare expenditure. The households experienced a catastrophic health expenditure of 2.44% in 2019 using the NaSTaB data. Trend analysis was significant with the decreasing trend (annual percentage change [APC], -4.49; p<0.0001) in the proportion of households with catastrophic health expenditure. Also, the results of the 2017 KHP and the 2016 HIES showed 2.20% and 2.92%. The trend was significantly increased in the KHP (APC, 1.79; p<0.0001) and the HIES (APC, 1.43; p<0.0001). Therefore, this study suggests that further public healthcare interventions to alleviate the burden of catastrophic health expenditure, especially for low-income households, are needed.

• 한국융합학회논문지
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• 제10권7호
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• pp.391-397
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• 2019

우리나라의 인구 10만명 당 자살자 수는 24.6명으로 OECD국가 중 가장 높은 수준이다. 연령이 증가함에 따라 자살사망은 증가하고 있어 노인인구는 자살사망의 위험이 다른 인구집단에 비하여 매우 높다. 본 연구는 한국노인의 자살을 예측하는 요인을 확인하기 위하여 시도되었다. 노인을 대상으로 한 자살예방교육의 기초자료로 활용하고자 한국 복지패널의 2016년도에 구축된 11차 년도 복지패널 자료 중 만 65세 이상 노인 가구원 자료를 추출하여 분석하였다. 연구 대상자의 평균연령은 75.55세(표준편차 6.34)이며, 남성은 37%, 여성은 63%였으며, 지난 일 년간 자살생각을 한 적이 있는 대상자는 165명으로 전체의 3.4%였다. 주관적 건강상태와 우울, 자아존중감, 기초생활수급, 의료급여, 노인장기요양급여 등 사회서비스 수급여부의 관련요인을 포함하여 단계적 로지스틱 회귀분석 결과 우울(Exp(B)=1.113), 주관적 건강상태(Exp(B)=.767)가 자살생각을 예측하는 것으로 나타났다(Nagelkerke $R^2=.248$). 따라서 노인을 대상으로 한 자살예방프로그램의 효과적 적용을 위하여 주관적 건강상태의 사정과 우울증 선별검사를 통한 고위험군의 파악이 요구된다.

• 보건행정학회지
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• 제29권1호
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• pp.82-85
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• 2019

Unmet healthcare needs are being used as an important indicator of the accessibility of healthcare services worldwide. To examine current status and trends of unmet needs in Korea, we used data from four sources: the Korea National Health and Nutrition Examination Survey (KNHANES, 2007-2017); the Community Health Survey (CHS 2008-2017); the Korea Health Panel Survey (KHP 2011-2015); and the Korean Welfare Panel Study (KOWEPS 2006-2017). The proportion of individual reporting unmet healthcare needs as of 2017 was 8.8% (KNHANES), 10.6% (CHS), and 12.4% (KHP as of 2015). The proportion of households reporting unmet healthcare needs due to cost was 0.5% (KOWEPS). Annual percentage change was -19.2%, -13.3%, -5.8%, and -13.3% respectively. Low income populations had more unmet healthcare needs than high income populations. However, unlike the last two studies, the main reason for unmet medical reasons was that there was no time regardless of income level.

• 한국병원경영학회지
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• 제27권1호
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• pp.43-57
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• 2022

Background: Avoidable mortality rate has been widely used as an indicator of the quality of health care and the degree of inequality in health levels. The purpose of this study was to identify the factors affecting the avoidable mortality rate in the region. Methods: The data was MDIS(Microdata Integrated Service) Causes of Death Statistics, and the analysis period was from 2010 to 2019. Panel analysis was performed to identify the influencing factors on the avoidable mortality rate. Findings: Result showed that the current smoking rate had a significant positive effects on the avoidable mortality rate of both men and women. And the smoking cessation trial rate, low salt diet rate, weight control trial rate, annual vaccination rate had a significant negative effect. In the social environment, the divorce rate had a significant positive effect. In the economy environment, financial independence and social welfare budget rate had a significant negative effect. In the physical environment, the factory area rate had a significant positive effect. Practical Implication: Practical implication in order to lower the local avoidable mortality rate, various social determinants of health as well as health care resources should be considered together.

• 보건행정학회지
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• 제32권2호
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• pp.228-236
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• 2022

The aim of this study was updating suicide-related indicators, including the number of suicidal deaths, suicide rate, and the prevalence of suicidal ideation and suicide attempts. We observed trends in suicide-related indicators based on up-to-date information. This study used five data sources to evaluate the trends of suicide-related indicators: Statistics Korea (1983-2020), Korean Wealth Panel Study (KOWEPS, 2012-2020), and Korea Health Panel Survey (KHP, 2010-2013, 2016-2018), Korean National Health and Nutrition Examination (KNHANES, 2007-2013, 2015-2020), and Korean Community Health Survey (KCHS, 2008-2009, 2013, 2017). The suicide rate per 100,000 population decrease from 26.9 in 2019 to 25.7 in 2020. Based on recently available data, the rates of suicidal ideation were 1.48% (KOWEPS, 2020), 2.61% (KHP, 2018), 4.62% (KNHANES, 2019), and 6.96% (KCHS, 2017). Those of suicide attempt as were 0.07% (KOWEPS, 2020), 0.44% (KNHANES, 2020), and 0.32% (KCHS, 2017). Annual percentage change (APC) of suicide rate was -1.87% (Statistics Korea, 2011-2020). APC of suicidal ideation was -10.7% (KOWEPS, 2012-2020), -11.5% (KHP, 2010-2013, 2016-2018), -14.7% (KNHANES, 2007-2013, 2015, 2017, 2019), and -2.5% (KCHS, 2008-2009, 2013, 2017). APC of suicide attempt was -11.3% (KOWEPS, 2012-2019), -5.2% (KNHANES, 2007-2013, 2015-2020), and -4.4% (KCHS, 2008-2009, 2013, 2017). Although the suicide rate in Korea has decreased compared to 10 years ago, it is still at a high level. Thus, continuous observation and appropriate suicide prevention policies are needed.

• 보건행정학회지
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• 제31권2호
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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.