The aim of the current study is to examine the extent to which equity in the utilization of longterm care services has been achieved in the Republic of Korea (hereafter Korea), based on the Aday—Andersen Access Frame...The aim of the current study is to examine the extent to which equity in the utilization of longterm care services has been achieved in the Republic of Korea (hereafter Korea), based on the Aday—Andersen Access Framework that takes into consideration a series of variables hypothesized as predictive of utilization. The current study used cross-sectional survey data collected and conducted by the Korea Labor Institute (KLI) between August 1 to December 22, 2006. The sample for this study was 5544 persons who are older than 60 years. The study was extracted from a larger nationally representative cross-sectional survey of 10,255 individuals. The stratified cluster sampling technique was used to draw the survey respondents. A self-administered questionnaire was used to collect the data from the sample. Descriptive and logistic regression analysis was performed examining the relationship between the dependent variable and the independent variables and the relative importance of factors. The results indicate that a universal health insurance system has not yielded a fully equitable distribution of services. The limitation of benefit coverage as well as disparities in consumer cost-sharing and associated patterns of utilization across plans high out-of-pocket payment can be a barrier to health care utilization, which results in inequity and differential long-term care utilization between sub-groups of older adults. Health policy reforms in Korea must continue to concentrate on expanding insurance coverage, reducing the inequities reflected in disparities in consumer cost-sharing and associated patterns of utilization across plans, and establishing a financially separate insurance system for poor older adults. The behavioral responses of physicians to the method of reimbursement, and the subsequent impact on overall rates of utilization and expenditures need to be more fully understood. In addition, further research is needed to identify the nonfinancial barriers that persist for certain demographic subgroups, i.e., those 70 and older, men, lacking social network members, those who have four or more family members, and those who have no schooling.展开更多
This study described the self-reported chronic diseases and health status and examined the factors that are associated with effective health service utilization. Descriptive and logistic regression analysis was perfor...This study described the self-reported chronic diseases and health status and examined the factors that are associated with effective health service utilization. Descriptive and logistic regression analysis was performed to determine the factors significantly associated with self-rated health, in-patient and out-patient utilization. Self-rated health status was ranked lower among rural residents, lower-income families, married persons, and those with chronic diseases. Chronic diseases such as hypertension, arthritis, melancholy, and diabetes were common and they are associated with poor health of Koreans. The presence of chronic diseases was significant in predicting the likelihood of poor health while socio-economic factors, rather than health-related need factors, had more predictive power of the use of health services. This study provides a unique contribution to the knowledge base of the Korean population. The study findings show that Koreans in poor health status were married, living in rural areas, having chronic diseases and lower income, with a high likelihood of health care utilization among employed individuals, which could significantly help in the public health policy required to address this issue.展开更多
文摘The aim of the current study is to examine the extent to which equity in the utilization of longterm care services has been achieved in the Republic of Korea (hereafter Korea), based on the Aday—Andersen Access Framework that takes into consideration a series of variables hypothesized as predictive of utilization. The current study used cross-sectional survey data collected and conducted by the Korea Labor Institute (KLI) between August 1 to December 22, 2006. The sample for this study was 5544 persons who are older than 60 years. The study was extracted from a larger nationally representative cross-sectional survey of 10,255 individuals. The stratified cluster sampling technique was used to draw the survey respondents. A self-administered questionnaire was used to collect the data from the sample. Descriptive and logistic regression analysis was performed examining the relationship between the dependent variable and the independent variables and the relative importance of factors. The results indicate that a universal health insurance system has not yielded a fully equitable distribution of services. The limitation of benefit coverage as well as disparities in consumer cost-sharing and associated patterns of utilization across plans high out-of-pocket payment can be a barrier to health care utilization, which results in inequity and differential long-term care utilization between sub-groups of older adults. Health policy reforms in Korea must continue to concentrate on expanding insurance coverage, reducing the inequities reflected in disparities in consumer cost-sharing and associated patterns of utilization across plans, and establishing a financially separate insurance system for poor older adults. The behavioral responses of physicians to the method of reimbursement, and the subsequent impact on overall rates of utilization and expenditures need to be more fully understood. In addition, further research is needed to identify the nonfinancial barriers that persist for certain demographic subgroups, i.e., those 70 and older, men, lacking social network members, those who have four or more family members, and those who have no schooling.
文摘This study described the self-reported chronic diseases and health status and examined the factors that are associated with effective health service utilization. Descriptive and logistic regression analysis was performed to determine the factors significantly associated with self-rated health, in-patient and out-patient utilization. Self-rated health status was ranked lower among rural residents, lower-income families, married persons, and those with chronic diseases. Chronic diseases such as hypertension, arthritis, melancholy, and diabetes were common and they are associated with poor health of Koreans. The presence of chronic diseases was significant in predicting the likelihood of poor health while socio-economic factors, rather than health-related need factors, had more predictive power of the use of health services. This study provides a unique contribution to the knowledge base of the Korean population. The study findings show that Koreans in poor health status were married, living in rural areas, having chronic diseases and lower income, with a high likelihood of health care utilization among employed individuals, which could significantly help in the public health policy required to address this issue.