• Journal of Preventive Medicine and Public Health
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• v.52 no.1
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• pp.51-59
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• 2019

Objectives: The purpose of this study was to estimate the mediating effect of subjective unmet healthcare needs on poor health. The mediating effect of unmet needs on health outcomes was estimated. Methods: Cross-sectional research method was used to analyze Korea Health Panel data from 2011 to 2015, investigating the mediating effect for each annual dataset and lagged dependent variables. Results: The magnitude of the effect of low income on poor health and the mediating effect of unmet needs were estimated using age, sex, education level, employment status, healthcare insurance status, disability, and chronic disease as control variables and self-rated health as the dependent variable. The mediating effect of unmet needs due to financial reasons was between 14.7% to 32.9% of the total marginal effect, and 7.2% to 18.7% in lagged model. Conclusions: The fixed-effect logit model demonstrated that the existence of unmet needs raised the likelihood of poor self-rated health. However, only a small proportion of the effects of low income on health was mediated by unmet needs, and the results varied annually. Further studies are necessary to search for ways to explain the varying results in the Korea Health Panel data, as well as to consider a time series analysis of the mediating effect. The results of this study present the clear implication that even though it is crucial to address the unmet needs, but it is not enough to tackle the income related health inequalities.

• Quality Improvement in Health Care
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• v.25 no.2
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• pp.44-55
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• 2019

Purpose: To investigate whether changes in Medical Aid (MA) status are associated with unmet need and catastrophic health expenditure (CHE). Methods: Data from the 2010 to 2014 Korea Health Panel (KHP) were used. The impact of changes in annual MA status ('MA to MA,' 'MA to MA Exit,' 'MA Exit to MA,' and 'MA Exit to MA Exit') on unmet need (all-cause and financial) and CHE (10% and 40% of household capacity to pay) were examined using the generalized estimating equation (GEE) model. Analysis was conducted separately for MA type I and II individuals. Results: In 1,164 Medical Aid type I individuals, compared to the 'MA to MA' group, the 'MA to MA Exit' group had increased likelihoods of all-cause and financial unmet need. This group also showed higher likelihoods of CHE at the 10% standard. The 'MA Exit to MA Exit' group showed increased likelihoods at the 10% and 40% CHE standards. In 852 type II recipients, the 'MA to MA Exit' group had higher likelihoods of CHE at the 10% standard. Conclusions: Type 1 MA exit beneficiaries had higher likelihoods of all-cause and financial unmet need, along CHE at the 10% standard. Type I 'MA Exit to MA Exit' beneficiaries also showed higher likelihoods of CHE at the 10% and 40% standards. In type II recipients, MA exit beneficiaries had higher likelihoods of CHE at the 10% standard. The results infer the importance of monitoring MA exit beneficiaries as they may be vulnerable to unmet need and CHE.

• Journal of Digital Convergence
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• v.17 no.4
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• pp.203-210
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• 2019

This study analyzed the size and influence factors of annual average health expenditure according to job type. Using data from the Korea Health Panel (2012), the final analysis was conducted on adults aged 20 years or older, excluding the missing data. Data analysis was done by logistic regression analysis to analyze the factors affecting medical expenditure. As a result of the study, Model 1 showed higher expenditure on medical expenses by skilled workers in agriculture and forestry fishery than those in simple labor. Model 2 was analyzed as having a positive effect on the increase of medical expenditure by the simple worker in the sales of the occupation, statistically significant by sex, marriage, income level and chronic disease. Therefore, it would be necessary to establish social security and health care & welfare policies, in order to grasp the disease with a high frequency rate according to occupation status and activate the physical examination and preventive actions.

• Health Policy and Management
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• v.33 no.2
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• pp.194-292
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• 2023

Background: This study aimed to update 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. Methods: This study used five data sources to evaluate the trends of suicide-related indicators: Statistics Korea (1983-2021), Korean Wealth Panel Study (KOWEPS, 2012-2021), and Korea Health Panel Survey (KHP, 2010-2013, 2016-2019), Korean National Health and Nutrition Examination (KNHANES, 2007-2013, 2015-2021), Korean Community Health Survey (KCHS, 2008-2009, 2013, 2017, 2021). Results: The suicide rate per 100,000 population increased from 25.7 in 2020 to 26.0 in 2021. The rates of suicidal ideation from recently available data were 4.28% (KNHANES, 2021), 6.52% (KCHS, 2021), 1.61% (KOWEPS) and 7.10% (KHP, 2019). The suicidal attempts rates were 0.46% (KNHANES, 2021) and 0.34% (KCHS, 2021). The annual percentage change (APC) of suicide rate showed that suicide rates increased in the younger population (APC=9.02% in <19 years, APC=5.13 in 20-39 years) although the rates decreased in the older population (APC=-3.37 in 60-79 years, APC=-2.25 in >80 years). Conclusion: The suicide rate and related indicators increased in 2021 compared to 2020. Thus, continuous observation and appropriate suicide prevention policies as well as studies about the factors that affected the increase in 2021 are needed.

• Health Policy and Management
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• v.34 no.1
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• pp.87-93
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• 2024

Background: In recent years, studies have shown conflicting results regarding the benefits of dietary supplements in reducing healthcare expenditures. This study aimed to address this inconsistency by examining the association between supplement consumption and health expenditures using nationally representative data from the Korea Health Panel Survey (2019-2020). Methods: A 1:1 matched case-control dataset was established using propensity score matching technique based on supplement consumption. Then, total annual healthcare expenditures were compared between the two groups. In addition, a multivariate regression analysis (Proc Surveyreg) was performed to determine the association between the supplement consumption and medical costs. Results: The supplement user group spent about 1.72 million Korean won, while the non-user group spent about 1.43 million Korean won on medical services (p=0.0186). The results of multivariate regression showed that the costs were approximately 26.15% higher in the user group than in the non-user group (p=0.0004). Conclusion: Contrary to the previous studies that have shown the benefits of supplement use in reducing healthcare costs, this study showed that those who consistently consumed supplements spent more on medical services. This can be interpreted in the same context as previous studies suggesting that dietary supplement intake is a healthy behavior for managing one's health. However, we caution against drawing firm conclusions due to data limitations. Further analysis using patient-level epidemiologic data is needed.

• Health Policy and Management
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• v.33 no.3
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• pp.363-369
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• 2023

The term "catastrophic health expenditure" means assessing the extent to which medical costs cause financial hardship for households. The aim of this research is to analyze the percentage of households that faced severe financial strain due to medical expenses from 2006 to 2021. This was achieved by utilizing data obtained from the National Survey of Tax and Benefit (NaSTaB), Korea Health Panel (KHP), and Households Income and Expenditure Survey (HIES). A trend analysis was conducted to examine the percentage of households that experienced catastrophic healthcare expenses. The households that experienced the catastrophic health expenditure was 2.49% in 2021 using the NaSTaB data. The trend analysis yielded a statistically significant result, indicating a decreasing trend (annual percent change [APC], -4.79; p<0.0001) in the proportion of households facing catastrophic health expenditures. Also, the results of the 2019 KHP and the 2021 HIES showed 1.09% and 2.44% for the households that experienced catastrophic health expenditure. The trend was increased according to the KHP (APC, 0.55; p=0.0004) and the HIES (APC, 7.04; p<0.0001). As a result, this study proposes that sustained attention and further interventions are necessary to ease the economic pressure caused by catastrophic health expenses, particularly for low-income households.

• Fire Science and Engineering
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• v.33 no.6
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• pp.152-158
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• 2019

This study examined the socio-economic and clinical characteristics associated with the use of ambulance services among pregnant, childbearing, and postpartum women based on data from the 2008-2016 Korea Health Panel. The analysis revealed that among the pregnant, childbearing, and postpartum women, the proportion using all ambulance services was 18.9% whereas 12.0% used private and 119 ambulances. Moreover, among those using ambulance services, delivery was the most common reason (38.7%) followed by complications of labor and delivery (20.0%) and pregnancy with abortive outcome (17.3%). There were statistically significant differences between the users and non-users of ambulance services in terms of the average annual household income, emergency arrival time, and delayed arrival at the emergency room. As childbirth becomes more complicated due to low fertility and elderly mothers, the expansion and improvement of ambulance services as a social safety net for pregnant, childbearing, and postpartum women will become increasingly important.

• 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.

• Journal of The Korean Society of Integrative Medicine
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• v.11 no.3
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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.

• Physical Therapy Rehabilitation Science
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• v.12 no.2
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• pp.80-91
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• 2023

Objective: The purpose of this study is to identify factors that affect the incidence of hypertension using logistic regression and decision tree analysis, and to build and compare predictive models. Design: Secondary data analysis study Methods: We analyzed 9,859 subjects from the Korean health panel annual 2019 data provided by the Korea Institute for Health and Social Affairs and National Health Insurance Service. Frequency analysis, chi-square test, binary logistic regression, and decision tree analysis were performed on the data. Results: In logistic regression analysis, those who were 60 years of age or older (Odds ratio, OR=68.801, p<0.001), those who were divorced/widowhood/separated (OR=1.377, p<0.001), those who graduated from middle school or younger (OR=1, reference), those who did not walk at all (OR=1, reference), those who were obese (OR=5.109, p<0.001), and those who had poor subjective health status (OR=2.163, p<0.001) were more likely to develop hypertension. In the decision tree, those over 60 years of age, overweight or obese, and those who graduated from middle school or younger had the highest probability of developing hypertension at 83.3%. Logistic regression analysis showed a specificity of 85.3% and sensitivity of 47.9%; while decision tree analysis showed a specificity of 81.9% and sensitivity of 52.9%. In classification accuracy, logistic regression and decision tree analysis showed 73.6% and 72.6% prediction, respectively. Conclusions: Both logistic regression and decision tree analysis were adequate to explain the predictive model. It is thought that both analysis methods can be used as useful data for constructing a predictive model for hypertension.