• Title/Summary/Keyword: 다변수 2수준 이분형 로지스틱 회귀분석

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Why Is the Rate of Poor Subjective Health Notably High in South Korea? The Importance of Managing Healthcare Needs (한국인은 왜 주관적 건강상태가 매우 나쁠까? 의료필요 관리의 중요성)

  • Woojin Chung
    • Health Policy and Management
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    • v.34 no.3
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    • pp.334-346
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    • 2024
  • Background: Research on the link between subjective health and unmet healthcare needs is limited. This study examines whether experiences of subjective healthcare needs and unmet needs are related to subjective health in South Korea, where the rate of poor subjective health is notably high. Methods: This analysis utilized data from the Korea Health Panel (2014-2018), incorporating 68,930 observations from 16,535 adults aged 19 or older. The dependent variable, subjective health, was dichotomized into poor (bad or very bad) and non-poor (fair, good, or very good) categories. The primary variables of interest were the experiences of subjective healthcare needs and unmet needs, while control variables included 14 socio-demographic, health, and functional characteristics. The study employed population proportion analysis and multivariable two-level binary logistic regression analysis for each gender, accounting for the complex sampling design. Results: In 2018, the rate of reporting poor health was 8.7% (95% confidence interval [CI], 8.0%-9.5%) for men and 14.7% (95% CI, 13.8%-15.6%) for women. For both genders, compared to individuals whose healthcare needs were met, those without healthcare needs were less likely to report poor subjective health (adjusted odds ratio [AOR], 0.58; 95% CI, 0.39-0.86 for men; AOR, 0.59; 95% CI, 0.37-0.93 for women). Conversely, individuals whose healthcare needs were not met were more likely to report poor subjective health (AOR, 2.31; 95% CI, 2.01-2.65 for men; AOR, 2.19; 95% CI, 1.98-2.43 for women). A policy simulation indicated that reducing the experience of subjective healthcare needs would be approximately 5 times more effective in reducing poor subjective health than a policy focused on reducing the experience of unmet needs. Conclusion: South Korea must make significant efforts to reduce the deterioration of subjective health and promote appropriate healthcare utilization. To achieve this, a set of policies is recommended to address subjective healthcare needs. These policies should include (1) prompting individuals to proactively manage their own health, (2) providing primary healthcare similar to that in advanced countries, (3) ensuring the healthcare delivery system operates effectively, (4) decentralizing the healthcare management system, and (5) reducing the likelihood of people being misled into thinking they have a healthcare need.

A Study on Risk Factors of Recurrent Otitis Media (소아 재발성 중이염의 위험인자에 대한 연구)

  • Kim, Eun Jin;Kwon, Young Ran;Song, Kang Hoon;Jang, Won Nyung;Lee, Jin;Chang, Jin Keun;Cha, Sung Ho
    • Pediatric Infection and Vaccine
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    • v.17 no.2
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    • pp.91-100
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    • 2010
  • Purpose : Recurrent otitis media (ROM) is usually defined as ${\geq}$3 distinct and well-documented episodes within 6 months or ${\geq}$4 episodes within 12 months. ROM is sufficiently important to warrant consideration of chemoprophylaxis, tympanostomy tube placement. There also is evidence that children with ROM are at risk for both hearing loss and speech delay. However, studies of ROM have been notably insufficient. In addition, even though environmental, racial, and sociocultural differences can affect risk factors, few studies have been conducted with regard to recurrent otitis media in Korea. Methods : This study was conducted from July 2009 to January 2010 with infants and children who were younger than 60 months old, who visited the out-patient clinics at Han-Il General Hospital and Kyunghee University Hospital. Data were collected by interview using a pre-formed sheet. Among a total of 892 infants and children, 457 were excluded, and the remaining 435 were allocated to 104 with ROM and 331 as a control group. Results : Attendance at daycare centers (P<0.001, OR=2.85), allergic rhinitis (P=0.026, OR=2.32), past history of bronchiolitis (P=0.003, OR=2.33), and low socioeconomic status (P=0.005, OR=2.00) were found to have a close significant correlation with ROM. Risk factors such as sex, having a sibling, breast-feeding, use of pacifiers, atopy, pneumococcal vaccination, influenza vaccination, smoking of parents, and indoor smoking are not relevant. Conclusion : Attendance at daycare centers, allergic rhinitis, past history of bronchiolitis, and low socioeconomic status have been identified as risk factors for ROM.