• 보건행정학회지
• /
• 제5권2호
• /
• pp.155-172
• /
• 1995

This study is an empirical analysis on the equity in the delivery of heatlh care under the Korean Medical Insurance Corporation System. The purposes of this study are to find out effects of income on the health care utiliztion and measure the income-related inequity in the distribution of health care. This study was carried out based on the fact that the health insurance program has been organized to achieve the equity objective, "equal treatment for equal needs". Of 41, 828 insured persons who had been diagnosed in the 1993 Health Screening Test and utilifzation data from 1, January 1993 through 31, December 1993 were derived from the Benefit Managment File. Inequity was measured by means of I) share approach, ii) standardization concentration curve approach, iii) inequity index, iv) test for inequity. The major findings were as follows : 1. The expenditure shares of the top two quintile groups exceeded their morbidity shares, whereas the opposite was true of the bottom three quintile groups, Which showed a positive HI$_{LG}$ inequity index, suggesting the presence of some inequity favoring the rich group. 2. Compared with other residential areas, the rural area showed the highest positive HI$_{LG}$ irrespective of need indicatior applied. 3. Standardized expenditure concentration indices adjusted by age, gender and need structure were also found to be positive, and therefore still indicated that there has been inequity favoring the rich after the standardization. 4. The Loglikelihood Ratio (LR) test for the statistical significance of income-related inequity of medical care utilization was carried out using the logistic regression model. The resulting loglikelihood ratio test statistic value was 176, which did exceed the 0.5 percent critical value of the chi-square distribution with 28 degrees of freedom, which is 50.993. Therefore, the null hypothesis of no income-related inequity of medical care utilization was rejected at the 99.5 percent confidence level. 5. The Regression based F-test has been carried out for analyzing the income-related inequity of medical expenditure in terms of age, gender, morbidity indicators as explanary variables. The hypothesis of the absence of income-relate inequity was rejected for all need indicators at the 95% confidence level.nce level.

• Nutrition Research and Practice
• /
• 제7권3호
• /
• pp.233-241
• /
• 2013

There are limited data on healthy dietary patterns protective against metabolic syndrome (MetSyn) development. We identified dietary patterns among middle-aged and older adults and investigated the associations with the incidence of MetSyn. A population-based prospective cohort study included 5,251 male and female Koreans aged 40-69 years. At baseline, all individuals were free of MetSyn, other major metabolic diseases, and known cardiovascular disease or cancer. Cases of MetSyn were ascertained over a 6-year of follow-up. Dietary patterns and their factor scores were generated by factor analysis using the data of a food frequency questionnaire. We performed pooled logistic regression analysis to estimate multivariable-adjusted relative risk (RR) and 95% confidence interval (CI) for associations between factor scores and MetSyn risk. Two dietary patterns were identified; (1) a healthy dietary pattern, which included a variety of foods such as fish, seafood, vegetables, seaweed, protein foods, fruits, dairy products, and grains; and (2) an unhealthy dietary pattern, which included a limited number of food items. After controlling for confounding factors, factor scores for the healthy dietary pattern were inversely associated with MetSyn risk (P-value for trend < 0.05) while those for the unhealthy dietary pattern had no association. Individuals in the top quintile of the healthy diet scores showed a multivariable-adjusted RR [95% CI] of 0.76 [0.60-0.97] for MetSyn risk compared with those in the bottom quintile. The beneficial effects were derived from inverse associations with abdominal obesity, low HDL-cholesterol levels, and high fasting glucose levels. Our findings suggest that a variety of healthy food choices is recommended to prevent MetSyn.

• Journal of Nutrition and Health
• /
• 제33권3호
• /
• pp.314-324
• /
• 2000

Evaluation of nutritional status of the elderly imposes different problem from the other age groups. It is essential to use right instrument to assess food consumption. In Korea, the food frequency questionnaire has not been applied widely to elderly people. The purpose of this study is to assess the possibility of employing a semi-quantitative food frequency questionnaire(FFQ) for the Korean elderly to estimate nutrient and/or food intakes. In this study the FFQ for the elderly was developed and validated. The subjects were 144 free-living old women aged from 65 to 90. The FFQ was designed with 4 items for cereals and 86 items for other foods and with frequency of 12 intervals. Three portion sizes were given to select : 1/2 of standard amount, standard amount, and 11/2 of standard amount. ach subject was interviewed with newly developed FFQ form and same subjects were also involved to complete 3-day diet record. Nutrient intake was calculated using software program developed by our group. The nutrient intakes by the FFQ was validated by comparing the results with 3-day diet record. The FFQ estimated significantly higher mean intakes of energy, carbohydrate, protein, fats and vitamin C than did the diet reconrds(p<0.05). Pearson's correlation coefficients between two methods ranged from 0.21 for vitamin Q to 0.69 for alcohol(mean r=0.53). From 32% to 42% of the subjects were classified in the same quintile of nutrient intake by two methods, and 63% to 84% were classified in the same or adjacent quintile. On average, only 4% of the subjects were misclassified into extreme quitiles. The results indicate that the FFQ developed for the elderly in this study is useful for classifying individuals by rank and identifying groups at extremes of nutrient intakes.

• 디지털융복합연구
• /
• 제13권12호
• /
• pp.31-39
• /
• 2015

본 논문은 1990-2014년 "가계동향조사" 자료로써 소득불평등도 추이를 살피고, 1인 및 2인 가구들이 전체 소득불평등도와 소득격차에 미치는 효과를 기여도 개념으로 실증분석 하였다. 주요 분석결과를 기여도 중심으로 요약하면 다음과 같다. 첫째, 경상소득 및 가처분소득 기준으로 2인 가구의 소득불평등도에 대한 기여도는 시간이 지나면서 증가추세를 보이고 있으며, 2003년 이후부터 그 수준이 10%를 초과하는 것으로 나타났다. 1인 가구의 소득 불평등도에 대한 기여도는 2인 가구에 비해 더 컸다. 둘째, 1-2인 가구의 소득5분위 배율에 대한 기여도는 2006년 이후 증가하며, 2인 가구에 비해 1인 가구의 기여도가 더 컸다. 이상에서 소득불평등도 완화와 소득격차 확대 해소를 위해서 1-2인 가구에 대한 심층적인 조사와 분석을 수행하고, 그 결과에 기초한 정책방안들을 제시할 필요가 있다는 시사점을 도출할 수 있었다.

• Journal of Preventive Medicine and Public Health
• /
• 제53권2호
• /
• pp.117-125
• /
• 2020

Objectives: This study investigated the role of information and communication technology and women's empowerment in contraceptive discontinuation in Indonesia. Methods: The study used data from the 2017 Indonesia Demographic and Health Survey and monthly contraceptive calendar data. A Gompertz proportional hazards model was used for analysis. Results: The 12-month contraceptive discontinuation rate was higher among women who had used the Internet in the past year, women who were mobile phone owners, and women who reported having fully participated in household decision-making than among their counterparts. These factors significantly impacted the risk of contraceptive discontinuation in Indonesia, even after controlling for contraceptive method, age, parity, contraceptive intent, education, work status, place of residence, and wealth status. Conclusions: After adjustment for the control variables, a higher risk of contraceptive discontinuation was associated with having used the Internet in the past year, owning a mobile phone, and not participating in household decision-making. Higher contraceptive discontinuation risk was also associated with using contraceptive pills, older age, lower parity, intent of spacing births, more education, current unemployment, and rural residence, and the risk was also significantly higher for those in the lowest household wealth quintile than for those in the fourth household wealth quintile. The association of contraceptive discontinuation with the use of modern information and communication technology and relatively disempowerment in household decision-making may imply that information regarding family planning and contraception should be conveyed via social media as part of setting up an eHealth system. This must include a strong communication strategy to empower and educate women in contraceptive decision-making.

• 보건교육건강증진학회지
• /
• 제15권1호
• /
• pp.195-204
• /
• 1998

The purpose of this study was to develop cardiovascular health related percent body-fat standards that may be applied to epidemiologic investigations of the prevalence and incidence of obesity in adolescents, pediatric health screenings, and youth fitness tests. The subjects included 102 males and 80 females aged 19～22years. All subject were Honam University Students Total body fat was derived from body density which was estimated from age and the triceps and subscapular skinfold thickness measured with Lang calipers to the nearst l.0mm. Serum total cholesterol and lipoprotein cholesterol fraction(HDL-CLDL-C) were measured from blood obtained from fore arm vein after blood pressure measurement. In analyses to determine critical fat levels associated with elevated CDD(Chronic Degenerative Disease) risk factors;male and female were grouped by level of percent fat as follows: male, 〈 10%, 10-14.9%, 15-19.9%, 20-24.9%, and $\geq$ 25%;female, 〈 20%, 20-24.9%, 25-29.9%, 30-34.9%, and $\geq$ 35%. As the results of the data, the conclusions were as follows: 1. A dose respones effect was observed between blood pressure and percent body fat in males and females; in contrast, total cholesterol and lipoprotein ratios were relatively independant of percent fat among the lower four fatness group in males and the lower three fatness groups in females. 2. The percentage of subjects in the uppermost quintile for S-Bp, D-Bp, TC, LDL/H was significantly(P〈.05) greater than expected by change alone(20%) in males with $\geq$ 25% fat and in females with $\geq$ 30% fat females with $\geq$35% had even greater representation in the uppermost quintile of all CDD risk factors compared to females with 30-34.9% fat.

• 문화경제연구
• /
• 제21권2호
• /
• pp.3-28
• /
• 2018

본 연구의 목적은 RIF 무조건 분위회귀에 Oaxaca-Blinder 분해기법을 적용한 분위회귀임금분해를 통해 문화예술분야에 유리천장 현상이 존재하는지를 규명하는 것이다. 문화예술전문인력들이 종사하는 산업의 특성을 고려하여 "문화콘텐츠" 분야(대분류 J산업) 전문인력과"순수예술" 분야(대분류 R산업) 전문인력으로 구분하였고, 분석을 위해 "고용형태별 임금근로조사" 자료에서 2009년부터 2016년까지의 풀링자료를 이용하였다. 주요결과를 요약하면 다음과 같다. 첫째, OLS 임금분해 결과 순수예술 전문인력의 임금격차의 크기는 문화콘텐츠전문인력에 비해 낮게 나타났으나 이를 구성하는 차별부분의 비중은 오히려 더 크게 나타났다. 둘째, 분위회귀 임금분해 결과에서는 문화예술영역의 전문인력에 대한 유리천장효과가 서로 상이한 것으로 나타났다. 문화콘텐츠 전문인력에서는 중위부분 이후로 임금소득의 상위분위로 이동함에 따라 꾸준히 차별부분이 증가하는 지속적인 유리천장효과가 관찰되었고, 순수예술 전문인력에서는 70분위까지 감소하던 차별부분이 80분위와 90분위에서 급격히 상승하여 제한적인 유리천장효과가 고위영역에 집중되는 것이 관찰되었다.

• 보건행정학회지
• /
• 제30권4호
• /
• pp.467-478
• /
• 2020

Background: The purpose of this study is to explain the factors influencing the incurrence of catastrophic health expenditure of national health insurance households using panel data observed over a long period. Methods: The study targeted 3,652 households who had no censoring during the 11-year survey period (2007-2017) and householders whose insurance type was consistently maintained as national health insurance. Generalized estimating equations were adopted to identify factors affecting the occurrence of catastrophic health expenditure at 20%, 30%, and 40% threshold levels. A subgroup analysis was conducted by categorizing groups depending on the existence of the elderly in the household. Results: For the last 11 years, the incidence of catastrophic health expenditure in the households without the elderly decreased slightly at all threshold levels, but the households with the elderly seemed to be increased. At baseline, household type showed a statistically significant relationship with all other variables. The results of generalized estimating equations analyses show that household income was not significant at all threshold levels in the households without elderly. On the other hand, in the households with the elderly, the 2nd (odds ratio [OR], 1.33-2.05) and 3rd quintile groups (OR, 1.25-2.55) were more likely to have catastrophic health expenditure compared to the 1st quintile of household income group. Conclusion: As the amount of health expenditures relative to the ability to pay is increasing in households with the elderly, the application of an intervention followed by consistent monitoring is needed. This study found that there were differences in influencing factors according to the presence of the elderly in the households. In particular, in households with the elderly, interesting results have been drawn regarding the occurrence of catastrophic health expenditure in the near-poor, so additional research is required.

• Journal of Preventive Medicine and Public Health
• /
• 제55권4호
• /
• pp.389-397
• /
• 2022

Objectives: This study examined the effect of out-of-pocket (OOP) payment reduction on the potential utilization of low-value magnetic resonance imaging (MRI) across income groups. Methods: We conducted an experimental vignette survey using a proportional quota-based sample of individuals in Korea (n=1229). In two hypothetical vignettes, participants were asked whether they would be willing to use MRI if they had uncomplicated headache and non-specific low back pain, each before and after OOP payment reduction. To account for the possible role of physician inducement, half of the participants were initially presented with vignettes that included a physician recommendation for low-value care. The predicted probability, slope index of inequality (SII), and relative index of inequality (RII) were calculated using logistic regression. Results: Before OOP payment reduction, the lowest income quintile was least likely to use low-value MRI regardless of physician inducement (36.7-49.6% for low back pain; 30.5-39.3% for headache). After OOP payment reduction, almost all individuals in each income quintile were willing to use low-value MRI (89.8-98.0% for low back pain; 78.1-90.3% for headache). Absolute and relative inequalities concerning potential low-value MRI utilization decreased after OOP payments were reduced, even without physician inducement (SII: from 8.15 to 5.37%, RII: from 1.20 to 1.06 for low back pain; SII: from 6.99 to 0.83%, RII: from 1.20 to 1.01 for headache). Conclusions: OOP payment reduction for MRI has the potential to increase low-value care utilization among all income groups while decreasing inequality in low-value care utilization.

• 농촌지도와개발
• /
• 제30권4호
• /
• pp.229-241
• /
• 2023

This study aims to examine the farm household income and consumption structure change as well as farm income inequality. Data from the Agricultural Household Survey for the years 2016, 2021, and 2022 were hired to analyze farm income inequality by the Gini coefficient decomposition method. Results show that from 2016 to 2021, all income quintiles exhibited an increasing trend, but in 2022, income decreased across all quintiles. As a result of analyzing farm household consumption expenditure, consumption expenditure increased in all income quintiles in 2021 and 2022 compared to 2016, but consumption of optional goods decreased in the fifth quintile. In addition, it was found that farmers in the first quartile had higher consumption expenditures and expenditures on options than those in the second quartile. The analysis of farm income by region show that public subsidies increased significantly for general rural farmers than for farmers in special and metropolitan areas in all income quintiles during the period. In the case of the first quintile, farm household income in rural areas in special and metropolitan cities increased compared to general rural areas. In the fifth quartile, agricultural income and sideline income in general rural areas increased compared to rural areas in special and metropolitan cities, while rural areas in special and metropolitan cities increased non-business income compared to rural areas. Results of farming income inequality by income type show a steady decline in inequality from 2016 to 2022, indicating that the decreasing gini coefficinet of public subsidies is contributing to the decline in farm income inequality. Private subsidies and side income are shown to increase inequality.