Subjective Satisfaction with Medical Care among Older People: Comprehensiveness, General Satisfaction and Accessibility / 예방의학회지

OBJECTIVES: The changing population age structure and rapidly increasing medical costs make providing high-quality, effective medical care for the elderly a challenge. This study assessed the satisfaction with medical care in terms of comprehensiveness, general satisfaction, and accessibility among community-dwelling Korean elders. METHODS: Data were obtained from a nationwide representative sample of the older adults(aged 65 years old or older) living in the community, who participated in a 2006 telephone survey conducted using random digit dialing (n=881). General satisfaction, comprehensiveness and accessibility were measured using a 10-item satisfaction survey questionnaire. Descriptive analysis was used to assess the distribution of each of three components of subjective satisfaction. Analysis of covariance (ANCOVA) was used to examine the association of each of the three components with socioeconomic variables. RESULTS: Comprehensiveness and general satisfaction were low among older people with a high socioeconomic status. Accessibility was evaluated as low among older people of low socioeconomic status, those living in rural areas and those who were medical aid beneficiaries. CONCLUSIONS: Urgent interventions should be considered in order to improve accessibility to medical care for elders of low socioeconomic status and those living in rural communities. Given the rapid aging of the population, we need to develop a monitoring system to improve the quality of geriatric care.

Disparities in Participation in Health Examination by Socio-economic Position among Adult Seoul Residents / 예방의학회지

OBJECTIVES: To determine the disparity in the rate people undergo health examinations according to socioeconomic position (SEP) and the changes in this disparity with time. METHODS: Seoul citizens}health profile data from 1997 to 2005 were analyzed. The study subjects were 40 years old and over, and the total number of subjects was 6,601 in 1997, 8,994 in 2001, and 8,819 in 2005. Those aged 60 years and over were eliminated from the analysis of subjects}occupation. We used education, family income and occupation as indicators of SEP. The age-standardized health examination attendance rate for each year was calculated according to the education, family income and occupation. The odds ratios (ORs) from multiple logistic regressions were adjusted for age. RESULTS: The disparity in the rate of attendance according to the SEP decreased from 1997 to 2005 but still existed. Even though the disparities among the subgroups according to education, family income and occupation were not that high, the disparity between the group with the highest SEP and the other groups was considerable. CONCLUSIONS: Our findings suggest that unequal access to health examination services according to socioeconomic position still exists. This disparity has decreased recently but the disparity according to level of education was the greatest.