• 대한예방한의학회지
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• 제22권1호
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• pp.1-14
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• 2018

Objectives : This study aimed to analyze the characteristics of uninsured herbal medicine(UHM) users and the economic and social barriers of UHM utilization. Methods : We used the Korea Health Panel Data, representative national survey on medical utilization and cost, provided by National Health Insurance Service and Korea Institiute of Health and Social Affairs. The frequency analysis was used to identify the characteristics of the respondents, and the cross-analysis (${\chi}^2-test$) was used to verify the relationship between their characteristics and the usage of UHM. In order to analyze the determinants of using the UHM considering the individual's characteristics, logistic regression analysis and multiple regression analysis were conducted for those who used the Korean medicine (KM) outpatient service in 2015. Results : The usage of UHM was significantly lower for those (1) who's age of 20 to 65; (2) who have the university or higher education degree; (3) who live in Jeju province, and (4) who bought the herbal medicine for other health related purposes. On the other hand, the usage of UHM for those (1) who have the first quintile of household income; (2) who have the chronic respiratory disease; (3) who have been taking the medicine for health promotion purpose for more than 3 months and (4) who have purchased the food which has health promotion function was significantly higher than others. The patients who have chronic musculoskeletal diseases accounted the most among the UHM users. Conclusions : There was the considerable inequality in the usage of UHM among household income groups, which provides policy rationale for UHM to be covered by national health insurance. To facilitate the coverage expansion, restrictive covering model can be considered for children and adolescents, or for patients with muskuloskeletal diseases who have the high demand for UHM.

• 보건행정학회지
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• 제22권4호
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• pp.497-521
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• 2012

Objectives This study aimed to investigate the effect of social capital, health risk behavior and health status on medical care utilization by the elderly. The data and Research method Data were obtained from the 4th wave survey of the Korea Welfare Panel Study. 4,087 household members aged 65 years and over were subject to analysis. Descriptive statistics are used to describe the basic features of the data in a study. we performed a structural equation modeling(SEM) analysis to evaluate the effect of social capital and mediating effect of health risk behavior and health status. Results Results showed that factors related to medical care utilization of the elderly were different depending on types of service (inpatient and outpatient service) except health status. Age, higher social capital, more health-risk behavior and poorer health status were associated with increased use of inpatient service. Social capital was found to have a positive direct effect on it. Also, social capital had an indirect effect on reducing use of inpatient services by improving health status. On the other hand, lower age and higher household income tended to increase use of outpatient service, while higher social capital and higher health status were inversely related. Social capital had a direct effect and an indirect effect on reducing use of outpatient service and, at that time, health status played a mediating role. Conclusions Social capital may contribute to improve health status and indirectly reduce medical care utilization of the elderly by enhancing their health status. These results provide evidence that more policy and strategy considerations should be needed for the elderly to strengthen their social capital in order to enhance their levels of health and more efficient utilization of medical care.

• 보건의료산업학회지
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• 제9권1호
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• pp.81-93
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• 2015

This study investigated the prevalence of unmet needs for health care among Korean adults and related factors. Using data from the 2012 Korea Health Panel, 1,896 adults aged 65 and over and two age groups(Young-Old(66-74) and Old-Old($65{\leq}$)) were analyzed to identify these factors. Logistic regression analysis was used to examine the main factors associated with unmet medical needs. According to the results of this study, the factors influencing unmet medical needs with regard to economic factors were Subjective Health Status(young-old), Disability(young-old), Activity Limitation(young-old), Education Level(old) and Economic Activity(old). The factors influencing unmet medical needs were factors of attitude, information, and disease. factors were Disability(young-old), Activity Limitation(young-old), Education Level(old) and Economic Activity(old). Therefore, further research that investigates unmet needs depending on age group in the elderly would suggest helpful policy implications.

• 대한예방한의학회지
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• 제17권3호
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• pp.1-18
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• 2013

Objectives: Korea has a dual medical system where traditional Korean Medicine (KM) and Western Medicine (WM) exist au equal terms with exclusive practice boundaries. The aim of this study was to identify complementary and substitute relationships between KM and WM in Korea. Methods: The data of 19,413 respondents were collected from the 2009 Korea Health Panel dataset. General characteristics and the medical utilization of respondents were analyzed descriptively. the Univariable Analysis was used to compare the factors that affected KM and WM utilization, and the Multivariable Analysis was applied to identify complementary or substitute relationships between the respondents' choices for KM and WM. The data were analyzed by the seven disease groups; diseases of nervous system, circulatory system, respiratory system, digestive system, skin and subcutaneous tissue, musculoskeletal system, and connective tissue, injury, poisoning and others. Results: 13.6% and 76.9% of respondents used KM and WM respectively last 12 mouths. 12.7% used both, and 0.9% used KM only. In overall, respondents who visited KM institutions used also WM. However, according to the analysis of choices of medical institutions, non-pharmacological KM treatment and WM has been used as a substitute for another in the diseases of the skin and subcutaneous tissue, diseases of the musculoskeletal system, and connective tissue, injury, poisoning and others. Conclusions: Despite some exceptional disease areas, Korean people use KM complementarily to WM, and this result can rationalize the recent Korean government policies encouraging the cooperation of KM and WM. This study can he used for the future policies development for KM service delivery.

• 보건행정학회지
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• 제26권4호
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• pp.390-398
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• 2016

Background: This study aims to analyze the impact of levels of health care coverage on the trajectory of self-rated health, comparing the near-poor which tends to be excluded in traditional health care systems with the upper middle class. Methods: The study participants were 3,687 people who sincerely responded questions regarding health care expenditures, unmet medical needs, and self-rated health in the Korea Health Panel data in 2009-2012. Results: The higher health care expenditures and the presence of unmet medical needs were significantly associated with the lower level of self-rated health. However, both factors did not significantly predict the steeper decline in the self-rated health. The results from multiple group analyses showed that health care expenditures and unmet medical needs had greater impact on the near-poor compared to their higher income counterparts. Conclusion: Public health care coverages need to be enhanced as well as reducing health care expenditures and unmet medical needs.

• Clinical Nutrition Research
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• 제11권3호
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• pp.204-213
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• 2022

Metabolic syndrome (MetS) is a multifactorial disease with its exact causes not completely clear. Micronutrients such as vitamin A, vitamin D, zinc, and magnesium have been associated with MetS components. Our objective was to investigate the association of nutrient adequacy (NA) with MetS components. The present cross-sectional study consisted of 850 adults between 18-59 years from Tehran, Iran. Dietary intake, socio-demographic data, medical history, and anthropometric indices were collected by trained personnel. NA was calculated as the mean intake ratio to the recommended amount of 16 micronutrients. MetS were defined by the consensus of National Cholesterol Education Program-Adult Treatment Panel III criteria. The association between NA and MetS was examined using linear regression analyses after controlling potential confounders. More participants in the highest quartile were obese in terms of general obesity (p = 0004) and abdominal obesity (p = 0.003) compared with subjects in the least quartile. A significant positive correlation was found between waist circumference (WC) and NA even after controlling for all potential confounders (p < 0.001). NA was positively associated with WC among adults living in Tehran.

• 한국화재소방학회논문지
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• 제29권5호
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• pp.96-103
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• 2015

본 연구에서는 한국보건사회연구원과 국민건강보험공단의 한국의료패널 2008~2011년 연간 데이터(Version 1.0)을 이용해 노인의 구급 이송 서비스 이용 특성과 관련 요인을 파악하였다. 분석 결과를 요약하면, 첫째, 119 구급차, 민간 구급차 등의 구급 이송 서비스를 이용한 노인은 전체 이용자의 46.8%를 차지하며, 응급실을 방문한 노인의 35.1%가 구급 이송 서비스를 이용했다. 둘째, 노인의 구급 이송 서비스 이용은 성별 중 남성(OR = 2.19, 95% CI = 1.51~3.17), 가구주와의 관계 중 배우자(OR = 2.19, 95% CI = 1.45~3.32), 의료 보장 형태 중 의료 급여(OR = 1.41, 95% CI = 1.10~1.82), 장애가 있는 경우(OR = 1.44, 95% CI = 1.14~1.83), 응급실 방문 이유 중 사고/중독(OR = 1.53, 95% CI = 1.20~1.97), 응급실 이용 후 조치 중 입원/전원(OR = 3.45, 95% CI = 2.80~4.25)이 통계적으로 유의한 영향 요인으로 나타났다. 따라서 고령화 시대에 노인 인구의 증가는 구급 이송 서비스의 수요 급증으로 이어질 것이며, 이에 따른 노인 맞춤형 응급의료 서비스 등의 개발이 필요하다.

• The Korean Journal of Pain
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• 제30권2호
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• pp.142-150
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• 2017

Background: There have been few studies about pain using a big data. The purpose of this study was to identify the prevalence of pain, and trends of pain associated with chronic diseases and personal out-of-pocket medical expenditures over time. Methods: Subjects were 58,151 individuals, using the Korea Health Panel from 2009 to 2013. Chi-square and multinomial logistic regression were conducted to identify the prevalence and odds ratios (ORs) of pain. Repeated measures ANOVA was used to find the trend over these 5 years. Results: Prevalence of mild and severe pain was 28.1% and 1.7% respectively. The ORs of mild and severe pain were 1.6 and 1.4 in females compared with males. From 2009 to 2013, numbers of chronic diseases producing mild pain were 2.1, 2.4, 2.8, 2.9, and 3.1 and those producing severe pain were 3.0, 3.4, 3.9, 4.2, and 4.4, respectively. After applying the average South Korean inflation rate by year over 5 years, the annual, personal out-of-pocket medical expenditures (unit: ￦1,000) for mild pain were 322, 349, 379, 420, and 461, and those for severe pain were 331, 399, 504, 546, and 569, respectively (P < 0.0001). Conclusions: The pain prevalence was 29.8%. The numbers of chronic diseases and the personal out-of-pocket medical expenditures revealed increasing trends annually, especially in those with pain. Therefore, to eliminate and alleviate the pain, there needs to be further study for developing a systemic approach.

• 보건의료산업학회지
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• 제11권1호
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• pp.117-130
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• 2017

Objectives : In this study, 3,107 patients were used to evaluate the impact based on raw data of 2014 and the health status and medical expenses income quintile was collected and data was analyzed. Methods : Analysis method was the average comparison, ANOVA, subjected to a multiple logistic regression analysis, the statistical test was the t-test and the scheffe post verification. Results : Gender(p<.000), age(p<.000), marital status(p<.000) educational status (p<.000), easement(p<.000), medication(p<.000), subjective health status(p<.005) were analyzed. First quintile identified that the highest amount was spent in the Chungcheong region, the 2nd quintile showed that the highest output was in the Gyeongsang region. The 3rd and 4th quintiles indicated that the highest expenditure was in the Seoul metropolitan region. The 5th quintile showed that the Chungcheong was the highest once again and the Jeolla region was the lowest in terms of expediture. Conclusions : Future medical research on income will require the government's Big Data collection to create the primary basis for policy making in order to improve the efficiency, effectiveness and equity of medicine spending.

• Asian Pacific Journal of Cancer Prevention
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• 제15권6호
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• pp.2713-2717
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• 2014

Background: Cancer imposes significant economic challenges for individuals, families, and society. Households of cancer patients often experience income loss due to change in job status and/or excessive medical expenses. Thus, we examined whether changes in economic status for such households is affected by catastrophic health expenditures. Materials and Methods: We used the Korea Health Panel Survey (KHPS) Panel $1^{st}-4^{th}$ (2008-2011 subjects) data and extracted records from 211 out of 5,332 households in the database for this study. To identify factors associated with catastrophic health expenditures and, in particular, to examine the relationship between change in economic status and catastrophic health expenditures, we conducted a generalized linear model analysis. Results: Among 211 households with cancer patients, 84 (39.8%) experienced catastrophic health expenditures, while 127 (40.2%) did not show evidence of catastrophic medical costs. If a change in economic status results from a change in job status for head of household (job loss), these households are more likely to incur catastrophic health expenditure than households who have not experienced a change in job status (odds ratios (ORs)=2.17, 2.63, respectively). A comparison between households with a newly-diagnosed patient versus households with patients having lived with cancer for one or two years, showed the longer patients had cancer, the more likely their households incurred catastrophic medical costs (OR=1.78, 1.36, respectively). Conclusions: Change in economic status of households in which the cancer patient was the head of household was associated with a greater likelihood that the household would incur catastrophic health costs. It is imperative that the Korean government connect health and labor policies in order to develop economic programs to assist households with cancer patients.