• 보건행정학회지
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• 제29권3호
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• pp.288-302
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• 2019

Background: The one-person households (OPH) are rapidly increasing and vulnerable to socioeconomic and health problems. Because it is predicted to be inequitable to health care utilization, we would like to find out about the equity of health care utilization of the OPH by comparison with the multi-person households (MPH). Methods: This study followed the theoretical framework of Wagstaff and van Doorslaer (2000), O'Donnell and his colleagues (2008), where the horizontal inequity index is the difference between the concentration indices of actual health care utilization and health care needs. This study employed the 9th Korea Health Panel survey, and a total of 10,807 cases were analyzed. Health care needs were measured by age, sex, subjective health status, chronic disease count, Charlson's Comorbidity Index, limitation of activities, and disability. Results: Compared with the MPH, there were pro-poor inequities in hospitalization, emergency utilization, hospitalization out-of-pocket payments, and pro-rich inequities in outpatient out-of-pocket payments for the OPH. The decomposition of the concentration index revealed that chronic disease count made the largest contribution to socioeconomic inequality in outpatient utilization. Age, health insurance, economic activities, and subjective health status also proved more important contributors to inequality. The variables contributing to the hospitalization and emergency utilization inequity were age, education, Charlson's Comorbidity Index, marital status, and income. Conclusion: Because the OPH was more vulnerable to health problems than the MPH and there were pro-poor inequities in medical utilization, hospitalization, and emergency costs, it is necessary to develop a policy that can correct and improve the portion of high contribution to medical utilization of the OPH.

• 보건행정학회지
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• 제13권3호
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• pp.104-128
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• 2003

Equity in health care has taken priority in the Korean government's policy agenda after the government-led national health insurance achieved universal coverage in 1989 along with the final inclusion of the self-employed as beneficiary. The purpose of this study is to examine the extent to which there exists difference or inequality in the utilization of health care, especially cancer inpatient services among income classes. We analysed the utilization of cancer inpatient services of residents in Jeju Island for a year of 2000, using the national health insurance data for qualification of beneficiaries and utilization of health care. The independent variable are 10 income classes based on the national health insurance fee imposed on each household for a year of 2000. The dependent variables of this study are an amount of cancer inpatient health care utilization measured by cancer admission days and cancer treatment costs. Also, cancer inpatient health care utilization is analysed by three categories divided into utilization in medical care institutions (1) within Jeju Island, (2) outside Jeju Island, and (3) all within and outside Jeju Island. We measured concentration index of cancer inpatient health care utilization. This analysis showed negative concentration index within Jeju Island and positive outside Jeju Island, and positive in all within and outside Jeju Island. This results suggest inequality against the relatively poor income groups in utilization of cancer inpatient health care services. Especially, inequity of cancer inpatient health care would be more serious in Jeju Island of Korea, considering that lower income groups reportedly have higher incidence rates in most of cancer and thus use more health services.

• 한국치위생학회지
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• 제19권4호
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• pp.565-575
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• 2019

Objectives: In this study, both subjective and objective levels of oral health were used to identify the relationship between oral health inequalities. Methods: Korean National Health and Nutritional Examination Survey data from 2013 to 2015 were combined to create an analysis plan. Oral health questions categorized as subjective oral health conditions and oral health-related diseases used dental tissue disease status as data measured by the Community Periodical Index(CPI) and decayed, missing, filled teeth(DMFT) experience. Other data on oral health behaviors such as toothache experience, the frequency of toothbrush use, chewing problems, oral examination status, and unmet dental care needs were classified and analyzed according to the socioeconomic level. Data were analyzed using frequency and cross analyses, and the statistical significance level was set at 0.05. Results: It was found that higher the economic and educational level, better was the subjective oral health, lower the CPI, lower the experience of toothache, higher the frequency of toothbrush use, lower the number of people having chewing problems, and higher the frequency of oral checkups. Conclusions: Oral health inequality exists among social classes. It is suggested that continuous research and efforts be carried out to promote oral health while considering socioeconomic and educational levels. Further, active government efforts will be needed to address polarization by social class.

• 한국치위생학회지
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• 제18권6호
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• pp.921-932
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• 2018

Objectives: The aim of this study was to investigate the number of existing permanent teeth and the denture usage status in elderly adults aged 65 years and above living in metropolitan cities and to confirm the degree of oral health inequality caused by the differences in oral conditions in each metropolitan city using the Lorenz curve and the Gini coefficient. Methods: The raw data for the analysis were obtained from the dataset of the sixth Korea National Health and Nutrition Examination Survey conducted between 2013 and 2015. The subjects included 1,764 people who underwent oral examination and answered questions. The complex samples general linear model was used to analyze the number of existing permanent teeth adjusted for age and monthly household income. The proportion of edentulousness and the denture status was analyzed using complex samples crosstabs. Results: The number of existing permanent teeth in the elderly adults aged 65 years and above was lowest in Ulsan (15.41) and highest in Gwangju (20.44). The proportion of edentulousness was highest in Busan (14.5%) and lowest in Daejeon (4.0%). With regard to the proportion of denture users, Busan had the highest tendency for denture usage (50.4%) and Gwangju had the lowest tendency (34.9) (p=0.172). The Gini's coefficient for the number of existing teeth was lowest in Busan (0.332). Oral health inequality was most severe in metropolitan cities. Conclusions: We found that oral health inequality exists among elderly adults living in the metropolitan cities of Korea using the Lorenz curve and Gini's coefficient.

• Journal of Preventive Medicine and Public Health
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• 제47권3호
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• pp.129-135
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• 2014

Tobacco use is the most important preventable risk factor for premature death. The World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC), the first international public health treaty, came into force in 2005. This paper reviews the present status of tobacco control policies in Korea according to the WHO FCTC recommendations. In Korea, cigarette use is high among adult males (48.2% in 2010), and cigarette prices are the lowest among the Organization for Economic Cooperation and Development countries with no tax increases since 2004. Smoke-free policies have shown incremental progress since 1995, but smoking is still permitted in many indoor public places. More than 30% of non-smoking adults and adolescents are exposed to second-hand smoke. Public education on the harmful effects of tobacco is currently insufficient and the current policies have not been adequately evaluated. There is no comprehensive ban on tobacco advertising, promotion, or sponsorship in Korea. Cigarette packages have text health warnings on only 30% of the main packaging area, and misleading terms such as "mild" and "light" are permitted. There are nationwide smoking cessation clinics and a Quitline service, but cessation services are not covered by public insurance schemes and there are no national treatment guidelines. The sale of tobacco to minors is prohibited by law, but is poorly enforced. The socioeconomic inequality of smoking prevalence has widened, although the government considers inequality reduction to be a national goal. The tobacco control policies in Korea have faltered recently and priority should be given to the development of comprehensive tobacco control policies.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 2005년도 제57차 추계 학술대회 연제집
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• pp.305-305
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• 2005

• 보건행정학회지
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• 제28권4호
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• pp.339-351
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• 2018

Background: The purpose of this study is to estimate empirically whether there is a difference in medical use among income groups, and if so, how much. This study applies econometric model to the most recent year of Korean Medical Panel, 2015. The model consists of outpatient service and inpatient service models. Methods: The probit model is applied to the model which indicate whether or not the medical care has been used. Two step estimation method using maximum likelihood estimation is applied to the models of outpatient visits, hospital days, and outpatient and inpatient out-of-pocket cost models, with disconnected selection problems. Results: The results show that there was the inequality favorable to the low income group in medical care use. However, after controlling basic medical needs, there were no inequities among income groups in the outpatient visit model and the model of probability of inpatient service use. However, there were inequities favorable to the upper income groups in the models of probability of outpatient service use and outpatient out-of-pocket cost and the models of the number of length of stay and inpatient out-of-pocket cost. In particular, it shows clearly how the difference in outpatient service and inpatient service utilizations by income groups when basic medical needs are controlled. Conclusion: This means that the income contributes significantly to the degree of inequality in outpatient and inpatient care services. Therefore, the existence of medical care use difference under the same medical needs among income groups is a problem in terms of equity of medical care use, so great efforts should be made to establish policies to improve equity among income groups.

• 한국융합학회논문지
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• 제8권9호
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• pp.49-57
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• 2017

본 연구는 제6기 국민건강영양조사 자료를 이용하여 사회경제적 요인, 치주질환 및 영구치 우식경험에 따른 구강건강의 격차를 확인하고, 구강건강 관련 삶의 질에 영향을 미치는 융합적 요인을 분석하여 정책 계획의 기초자료를 제시하고자 실시하였다. 연구 대상은 본인이 인지하는 구강상태에 응답한 7,639명으로 하였고, 분석방법은 복합 표본 교차분석과 로지스틱 회귀분석으로 시행하였다. 결과는 연령이 높고, 가구 소득과 교육수준이 낮을수록 주관적 구강건강이 나쁘고, 구강검사를 한 대상자는 구강건강을 좋게, 치주질환이나 영구치우식경험자는 구강건강을 나쁘게 인식하였다. 사회경제적 취약계층, 치주질환 경험자, 영구치우식경험자 등이 구강건강에 부정적임을 확인할 수 있었다. 따라서 이러한 구강건강의 불평등을 근본적으로 해결하기 위한 정책개발이 필요할 것으로 사료된다.

• 한국병원경영학회지
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• 제27권1호
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• pp.1-10
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• 2022

Background: This study aims to empirically compare and evaluate the current status of medical accessibility and health inequality between people with disabilities and without. We calculated the ACSC hospitalization rate, which is a medical accessibility index, for hypertension, a major risk factor for cardiovascular disease that accounts for more than 20% of deaths among people with disabilities using the 2016 National Health Insurance Big Data. Methods: The subjects of the study were a total of 601,520, including 64,018 people with disabilities and 537,501 people without. Logistic regression was performed to analyze the differences in hypertension hospitalization rates adjusted for demographic and sociological characteristics and disease characteristics using SAS 9.4 program. Results: Before adjusting for the characteristics, the hypertension hospitalization rate of people with disabilities was 1.55%, and the people without disabilities were 0.49%. After adjusting, it was found that people with disabilities were 2.11 times higher than people without disabilities, and it was statistically significant. Conclusion: The preventable hospitalization rate of people with disabilities is higher than that of people without, suggesting that the disabled have problems with access to medical care and health inequality. Therefore, the government's policy improvement is required to close the medical gap for the disabled.

• 한국학교보건학회지
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• 제21권2호
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• pp.47-60
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• 2008

Objectives: The purpose of this study was to compare Fast foods and Soft drinks consumption of Korean adolescents in a large city, a medium city, and a rural area. Methods: This was a descriptive comparative survey using a convenience sample of 2,261 8th and 11th grade students. The data were analyzed by X2-test and ANOVA using SPSS 10.0 statistical program. Results: For fast food consumptions, the higher in a large city than in a medium city and a rural area(p=.000). For soft drinks in a school, cafeteria or vending machines was higher in a large city and a medium city then in a rural area(p=.000). For eating snacks including cookies and popcorns was higher among students in a rural area than those in a medium city and large city(p=.008). Conclusions: 1. Overall, the health information among rural students is lower than those among other areas, as well as taking a health education course among rural students is also lower. Thus, the health inequality by regional differences should be considered. To decrease health inequality among different regions, health professionals who can systematically teach a health education course for middle and high school students and undertake students' health are needed. 2. Soft drinks sold in schools are higher in a large city and medium city than in a rural area. Therefore, there is a need of strong regulations and policies about the restriction of soft drinks sold in vending machines or school cafeterias.