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Background@#The purpose of this study is to analyze whether there is a change in patterns of medical use among those likely to be converted their health insurance qualifications when the family support rule is alleviated. There is no empirical analysis that converting health insurance qualification will affect the increase in medical use. @*Methods@#For analysis, data were extracted from the national health insurance eligibility and medical care database. To identify analysis targets similar to that of medical aids’ characteristics among health insurance coverage, we compared income, property level, and medical use patterns through basic statistical analysis and used a difference-in-difference (DID) analysis to estimate the net effect of changes in medical use following the change of qualifications. @*Results@#The main results are as follows. The results show that those who are under the 5% income group (1st income group) of health insurance coverage are the most similar to the medical aids group. DID analysis shows that changes in the medical use of people who maintain their national insurance qualification and who are not. As a results, the number of hospitalized days of converting group was reduced by 3.5 days while outpatient days were increased by 1.8 days. @*Conclusion@#As a result, there was not much difference in the patterns of medical use for the under 5% income group who are likely to be eligible for expanded medical aids when the family support rule is alleviated. In addition, more than 30% of them are in arrears with their health insurance premiums, causing inconvenience in using medical services. These findings suggest the need of abolishing the criteria obligated to support family, and great efforts should be made to contribute to non-paid poor and remove their medical blind spot.
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Background@#The out-of-pocket maximum is one of the distinctive healthcare systems which sets a ceiling on co-payment in order to reduce the burden of households from the unpredictable medical expenditure. However, this leads to an increase in the demand for healthcare services especially in long-term care hospitals (LTCHs) in Korea. @*Methods@#This study analyzed the influence factor of medical service overuse of 165,592 inpatients in LTCHs which out-of-pocket maximum is applied, by utilizing data from the National Health Insurance Service (2016). Based on Anderson Model, the medical service overuse, as a dependent variable, was defined as long-stay admission more than 180 days at the LTCHs. Independent variable was comprised of predisposing factors (gender, age), enabling factors (income level, types of out-of-pocket maximum) and need factors (illness level, patient use of tertiary hospital). @*Results@#The most powerful factor of medical service overuse in LTCHs was availability of pre-payment for the out-of-maximum (odds ratio [OR], 191.66; p<0.001). This tendency was found in high income level status (p<0.001). Furthermore, mild inpatients (OR, 1.50; p<0.001) which had no experience with the tertiary hospitals (OR, 2.06; p<0.001) were more relevant to the medical service overuse in LTCHs, compared to the severe inpatients. @*Conclusion@#It is suggested that a separate standard of out-of pocket maximum with regards to LTCHs is required to secure the beneficial functions of long-term hospitals and prevent unnecessary financial leakage to achieve sustainable and financially sound National Health Insurance.
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Background@#As the population is aging, chronic diseases and depression are becoming the main problems in a country’s healthcare system. In this study, we aimed to explore the associations between chronic diseases and depression among the elderly in South Korea. @*Methods@#We analyzed 9,975 (men, 4,147; women, 5,828) respondents obtained from the 2014 National Survey of Living Conditions and Welfare Needs of Korean Older Persons. Our dependent variable was either 1 or 0 according to whether a respondent had depression or not, where depression was defined when the Short Form of Geriatric Depression Scale score was 8 or more points. Variables of interest were 24 types of chronic diseases and covariates included various socio-demographic and health behavior characteristics. We performed Rao-Scott chi-square tests and hierarchal logistic regression analyses by gender, reflecting the characteristics of the survey. @*Results@#A significant difference was found in the proportion of having depression between genders (men 18.9% vs. women 23.4%). According to fully adjusted, multivariable analyses, for elderly men, relative to those without any chronic disease, the odds ratio of depression was 1.56 (95% confidence interval [CI], 1.10–2.22) in the stroke patients group and 1.82 (95% CI, 1.01–3.25) in the osteoporosis patients group. For elderly women, the odds ratio was 1.96 (95% CI, 1.28–3.00) in the fracture/dislocation and aftereffects patients group and 1.30 (95% CI, 1.03–1.64) in the group of patients with other diseases. @*Conclusion@#Even after being adjusted for diverse characteristics, some chronic diseases were significantly associated with depression in the elderly and the association differed between genders. Therefore, public health and medical interventions are needed to manage such chronic diseases together with curing depression symptoms.
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Background@#The purpose of this study is to analyze whether there is a change in patterns of medical use among those likely to be converted their health insurance qualifications when the family support rule is alleviated. There is no empirical analysis that converting health insurance qualification will affect the increase in medical use. @*Methods@#For analysis, data were extracted from the national health insurance eligibility and medical care database. To identify analysis targets similar to that of medical aids’ characteristics among health insurance coverage, we compared income, property level, and medical use patterns through basic statistical analysis and used a difference-in-difference (DID) analysis to estimate the net effect of changes in medical use following the change of qualifications. @*Results@#The main results are as follows. The results show that those who are under the 5% income group (1st income group) of health insurance coverage are the most similar to the medical aids group. DID analysis shows that changes in the medical use of people who maintain their national insurance qualification and who are not. As a results, the number of hospitalized days of converting group was reduced by 3.5 days while outpatient days were increased by 1.8 days. @*Conclusion@#As a result, there was not much difference in the patterns of medical use for the under 5% income group who are likely to be eligible for expanded medical aids when the family support rule is alleviated. In addition, more than 30% of them are in arrears with their health insurance premiums, causing inconvenience in using medical services. These findings suggest the need of abolishing the criteria obligated to support family, and great efforts should be made to contribute to non-paid poor and remove their medical blind spot.
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BACKGROUND: Family values of a married woman may be related to her own depressive mood. Since depressive mood of a married woman is likely to exert a negative influence, in terms of mental health, on her, her family members, and the whole society's, it may be very important to explore the relationship between family values in married women and their depressive mood. METHODS: In this study, we analyzed nationally representative 5,818 married women aged 20 years or older from the 4th panel data of 2012 Korean Longitudinal Survey of Women and Families. As for variables of interest, we constructed three family values variables: family-oriented view of marriage, individualistic view of marriage, and traditional view of marital roles. Then we employed multivariate logistic regression analyses to explore the relationship between family values and depressive mood, adjusting for family and socio-demographic factors. RESULTS: In total, 804 married women (18.4%) had experienced depressive mood. All of the three family values variables were significant in their relationships with depressive mood. The women categorized as ‘very weak’ in family-oriented view of marriage were more likely to experience depressive mood than the women categorized as ‘very strong’ (odds ratio [OR], 1.98; 95% confidence interval [CI], 1.53–2.55). By contrast, the women categorized as ‘very weak’ in individualistic view of marriage (OR, 0.43; 95% CI, 0.33–0.55) and in traditional view of marital roles (OR, 0.68; 95% CI, 0.51–0.92) were less likely to experience depressive mood than their respective counterpart women categorized as ‘very strong.’ CONCLUSION: In Korea, married women's values towards marriage itself and roles between wives and husbands had significant associations with their depressive mood. This suggests that in order to improve mental health in married women, we need to take social and cultural dimensions into consideration along with public health interventions.
Subject(s)
Female , Humans , Depression , Korea , Logistic Models , Longitudinal Studies , Marriage , Mental Health , Public Health , SpousesABSTRACT
BACKGROUND: Glycemic control is an effective way to reduce the cardiovascular complications of diabetes, but more than half of the adults with diabetes in Korea are improperly controlling their glycemic levels. The purpose of this study is to identify the factors associated with poor glycemic control in type 2 diabetes patients. METHODS: This study analyzed 1,261 subjects ≥30 years old diagnosed with type 2 diabetes who participated in the fifth Korean National Health and Nutrition Examination Survey (2010-2012). Poor glycemic control rates were defined as hemoglobin A1c (HbA1c) level ≥7%. To shed light on the causes of poor glycemic control, socio-demographics, diabetes severity, health status, and health behavior factors were adjusted and logistic regression was done. RESULTS: Of the total 1,261 patients, 53.0% of patients with type 2 diabetes had HbA1c ≥7%. After running a logistic regression model, the odds ratio of poor glycemic control was higher in high school graduates than elementary school graduates; in people living in Chungcheong and Jeolla/Jeju than those living in Seoul; in the group with diabetes for over 5 years had diabetes less than 5 years; in a group with insulin and oral hypoglycemic agent treatment than non-treatment; in a group with hypertriglyceridemia than without hypertriglyceridemia; and in the group with slept less than 6 hours slept 7-8 hours. CONCLUSION: We need a comprehensive public health policy to reduce the poor glycemic control rates in type 2 diabetes patients. We should recognize the education levels, duration of diabetes, diabetes treatment, hypertriglyceridemia, and sleep duration were associated with poor glycemic control.
Subject(s)
Adult , Humans , Diabetes Mellitus, Type 2 , Education , Health Behavior , Hypertriglyceridemia , Insulin , Korea , Logistic Models , Nutrition Surveys , Odds Ratio , Public Health , Running , SeoulABSTRACT
OBJECTIVES: The study is investigated socioeconomic variations in self-rated health status and contribution of health behavioral factors in Korea. METHODS: A nationally representative sample (2,800 men and 3,230 women aged 20-64 years) from the 2005 Korea National Health and Nutrition Surveys was analyzed using logistic regression. RESULTS: Self-rated health was lower among lower socioeconomic groups compared with higher socioeconomic groups, with gender being irrelevant. This association was attenuated when health behavioral and socio-demographic factors were adjusted. When each health behavioral factor was considered separately, mediators such as smoking in men, and stress or exercise in women explained a large part of the decreased socioeconomic health inequalities. CONCLUSIONS: In Korea, subjective health inequalities arise from different socioeconomic status, but this difference is decreased by health behavioral factors. Therefore, socioeconomic inequity in self-rated health status can be corrected more effectively by promotional health behaviors.
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OBJECTIVES: The purpose of this study was to estimate the willingness to quit cigarette price among Korean male adults, and to examine he factors affecting the willingness to quit cigarette price. METHODS: The data was collected by a random digit dial telephone survey. 702 samples were analyzed by using ttests, ANOVA and OLS regression analysis. To estimate the willingness to quit cigarette price, smokers were asked dichotomous questions with open-ended follow-up and the starting point of the price was randomized by one of 5 bid prices elicited from a pilot study. RESULTS: The mean of the willingness to quit cigarette price was 4,287 Won per package, which was about 2,000 Won higher than the mean of the actual price the smokers now paid. About 41% of respondents were willing to quit smoking if the price of cigarette would be increased by 3,000 Won, and if the price would be increased by 20,000 Won, all respondents were willing to quit smoking. The factors associated with the willingness to quit cigarette price were the place of residence, the amount of smoking and the degree of exposure to smoking through the mass media. CONCLUSIONS: The results showed that to get people to quit smoking, increasing the cigarette price would obviously be effective and much higher prices have a greater effect. Furthermore, to enlarge the effect of increased cigarette prices, providing more cessation programs to small towns, reducing the amount of smoking and decreasing or prohibiting advertisements of cigarettes and smoking in the mass media will be efficient.
Subject(s)
Adult , Humans , Male , Middle Aged , Commerce , Interviews as Topic , Korea , Motivation , Smoking/economics , Smoking Cessation/ethnologyABSTRACT
OBJECTIVES: To determine the impact of cigarette prices on the decision to initiate and quit smoking by taking into account the interdependence of smoking and other behavioral risk factors. METHODS: The study population consisted of 3,000 male Koreans aged > or =20. A survey by telephone interview was undertaken to collect information on cigarette price, smoking and other behavioral risk factors. A two-part model was used to examine separately the effect of price on the decision to be a smoker, and on the amount of cigarettes smoked. RESULTS: The overall price elasticity of cigarettes was estimated at -0.66, with a price elasticity of -0.02 for smoking participation and -0.64 for the amount of cigarettes consumed by smokers. The inclusion of other behavioral risk factors reduced the estimated price elasticity for smoking participation substantially, but had no effect on the conditional price elasticity for the quantity of cigarettes smoked. CONCLUSIONS: From the public health and financial perspectives, an increase in cigarette price would significantly reduce smoking prevalence as well as cigarette consumption by smokers in Korea.