Osong Public Health and Research Perspectives

Original Articles

Neighborhood Deprivation and Unmet Health Care Needs: A Multilevel Analysis of Older Individuals in South Korea: Seung Eun Lee, Miyeon Yeon, Chul-Woung Kim, Tae-Ho Yoon, Dongjin Kim, Jihee Choi; Osong Public Health Res Perspect. 2019;10(5):295-306. Published online October 31, 2019; DOI: https://doi.org/10.24171/j.phrp.2019.10.5.06

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Objectives

In this study the relationship between neighborhood deprivation and the unmet health care needs of elderly individuals (≥ 65 years) was examined. Some previous studies suggested that neighborhood characteristics affect access to health care, yet research on the unmet needs of older individuals is limited.

Methods

Multilevel logistic regression analysis was used to assess the relationship of neighborhood-level factors with unmet health care needs due to costs, adjusting for individual-level factors, in individuals ≥ 65 years in the 2017 Korean Community Health Survey (n = 63,388).

Results

There were 2.6% of elderly individuals who experienced unmet health care needs due to costs. Following adjustment for individual and neighborhood characteristics, the neighborhood deprivation in urban areas was found to have an inverse association with unmet needs (odds ratio = 0.50; 95% confidence interval = 0.24–1.06) for the most deprived quartile versus the least deprived quartile). However, in rural areas neighborhood deprivation was not a significant variable. Among the individual-level variables, household income was one of the strongest correlates with unmet needs in both urban and rural areas.

Conclusion

The present findings suggest that targeted policy interventions reflecting both neighborhood and individual characteristics, should be implemented to reduce the unmet health care needs of elderly individuals.

Citations

Citations to this article as recorded by

What are the factors affecting older adults’ experience of unmet healthcare needs amid the COVID-19 pandemic in Korea?
Sujin Kim, Jongnam Hwang
BMC Geriatrics.2023;[Epub] CrossRef
Linking neighbourhood safety and children's internalizing and externalizing problems: Mediating role of maternal depression
Youngmin Cho
Child & Family Social Work.2023; 28(4): 1089. CrossRef
Urban-Rural Differences in the Prevalence of Depressive Symptoms in Korean Adults
Ji-An Jeong, Sun A Kim, Jung Ho Yang, Min-Ho Shin
Chonnam Medical Journal.2023; 59(2): 128. CrossRef
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Jiayu Shang, Cheng Peng, Xubo Tang, Yanni Sun
Bioinformatics.2023; 39(Supplement): i30. CrossRef
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A. A. Zelenina, S. A. Shalnova, S. A. Maksimov
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The Older Persons' Index of Multiple Deprivation: Measuring the deprivation circumstances of older populations in Aotearoa New Zealand
Daniel J. Exeter, Michael Browne, Tommi Robinson-Chen, Jessie Colbert, Ngaire Kerse, Arier Lee
Health & Place.2022; 76: 102850. CrossRef
The Contribution of Material, Behavioral, Psychological, and Social-Relational Factors to Income-Related Disparities in Cardiovascular Risk Among Older Adults
Chiyoung Lee, Qing Yang, Eun-Ok Im, Eleanor Schildwachter McConnell, Sin-Ho Jung, Hyeoneui Kim
Journal of Cardiovascular Nursing.2021; 36(4): E38. CrossRef
Association between community deprivation and practising health behaviours among South Korean adults: a survey-based cross-sectional study
Bich Na Jang, Hin Moi Youn, Doo Woong Lee, Jae Hong Joo, Eun-Cheol Park
BMJ Open.2021; 11(6): e047244. CrossRef

Relationship Between Catastrophic Health Expenditures and Income Quintile Decline: Jeong-Hee Kang, Chul-Woung Kim; Osong Public Health Res Perspect. 2018;9(2):73-80. Published online April 30, 2018; DOI: https://doi.org/10.24171/j.phrp.2018.9.2.06

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99 Download
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Abstract PDF

Objectives

The aims of this study were to investigate the proportion of households facing catastrophic health expenditures based on household income quintiles, and to analyze the relationship between expenditures and household income quintile decline.

Methods

Study data were obtained from an annually conducted survey of the 2012–2013 Korean health panel. There were 12,909 subjects aged 20–64 years from economically active households, whose income quintile remained unchanged or declined by more than one quintile from 2012 to 2013. Logistic regression analysis was performed to determine whether catastrophic health expenditures in 2012 were related to more than one quintile income decline in 2013.

Results

Households facing catastrophic health expenditures of ≥ 40%, ≥ 30%, and ≥ 10% of a household’s capacity to pay, were 1.58 times (p < 0.003), 1.75 times (p < 0.000), and 1.23 times (p < 0.001) more likely to face a decline in income quintile, respectively.

Conclusion

Over a 1 year period, the proportion of households facing more than one quintile income decline was 16.4%, while 2.1% to 2.5% of households in Korea faced catastrophic health expenditures. Catastrophic health expenditure experienced in 2012 was significantly associated with income quintile decline 1 year later. Therefore, lowering the proportion of households with catastrophic health expenditure may reduce the proportion of households with income quintiles decline.

Citations

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Association of Depressive Symptoms With Health Service Use and Catastrophic Health Expenditure Among Middle-Aged and Older Chinese Adults: Analysis of Population-Based Panel Data
Rui Yan, Lifeng Li, Xiaoran Duan, Jie Zhao
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BMC Health Services Research.2023;[Epub] CrossRef
Gastos catastróficos em saúde: análise da associação com condições socioeconômicas em Minas Gerais, Brasil
Jéssica de Brito Macedo, Alexandra Crispim Boing, Juliana Mara Andrade, Helton Saulo, Rodrigo Nobre Fernandez, Fabíola Bof de Andrade
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HyunWoo Jung, Kwang-Soo Lee
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Elderly chronic diseases and catastrophic health expenditure: an important cause of Borderline Poor Families’ return to poverty in rural China
Xiaocang Xu, Haoran Yang
Humanities and Social Sciences Communications.2022;[Epub] CrossRef
Does Elderly Chronic Disease Hinder the Sustainability of Borderline Poor Families’ Wellbeing: An Investigation From Catastrophic Health Expenditure in China
Xiaocang Xu, Haoran Yang
International Journal of Public Health.2022;[Epub] CrossRef
The Relationship between Unmet Healthcare Needs Due to Financial Reasons and the Experience of Catastrophic Health Expenditures
Jeong-Hee Kang, Chul-Woung Kim
Journal of Korean Academy of Community Health Nurs.2021; 32(1): 95. CrossRef
Effect of financial stress on self-rereported health and quality of life among older adults in five developing countries: a cross sectional analysis of WHO-SAGE survey
Rui Huang, Bishwajit Ghose, Shangfeng Tang
BMC Geriatrics.2020;[Epub] CrossRef

Analyzing the Historical Development and Transition of the Korean Health Care System: Sang-Yi Lee, Chul-Woung Kim, Nam-Kyu Seo, Seung Eun Lee; Osong Public Health Res Perspect. 2017;8(4):247-254. Published online August 31, 2017; DOI: https://doi.org/10.24171/j.phrp.2017.8.4.03

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37 Download
6 Crossref

Abstract PDF

Objectives

Many economically advanced countries have attempted to minimize public expenditures and pursue privatization based on the principles of neo-liberalism. However, Korea has moved contrary to this global trend. This study examines why and how the Korean health care system was formed, developed, and transformed into an integrated, single-insurer, National Health Insurance (NHI) system.

Methods

We describe the transition in the Korean health care system using an analytical framework that incorporates such critical variables as government economic development strategies and the relationships among social forces, state autonomy, and state power. This study focuses on how the relationships among social forces can change as a nation’s economic development or governing strategy changes in response to changes in international circumstances such as globalization.

Results

The corporatist Social Health Insurance (SHI) system (multiple insurers) introduced in 1977 was transformed into the single-insurer NHI in July 2000. These changes were influenced externally by globalization and internally by political democratization, keeping Korea’s private-dominant health care provision system unchanged over several decades.

Conclusion

Major changes such as integration reform occurred, when high levels of state autonomy were ensured. The state’s power (its policy capability), based on health care infrastructures, acts to limit the direction of any change in the health care system because it is very difficult to build the infrastructure for a health care system in a short timeframe.

Citations

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Clinical and Translational Science.2024;[Epub] CrossRef
Lessons from health insurance responses in counteracting COVID-19: a qualitative comparative analysis of South Korea and three influential countries
Hey Jin Ko, Eunji Yun, Boryung Ahn, Hyejin Lee, Won Mo Jang, Jin Yong Lee
Archives of Public Health.2023;[Epub] CrossRef
Role of Primary Care and Challenges for Public–Private Cooperation during the Coronavirus Disease 2019 Pandemic: An Expert Delphi Study in South Korea
Woo-young Shin, Changsoo Kim, Sei Young Lee, Won Lee, Jung-ha Kim
Yonsei Medical Journal.2021; 62(7): 660. CrossRef
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Hani Kim
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The Story of Korean Health Insurance System
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Osong Public Health and Research Perspectives.2017; 8(4): 235. CrossRef

Nurse-Perceived Patient Adverse Events depend on Nursing Workload: Jeong-Hee Kang, Chul-Woung Kim, Sang-Yi Lee; Osong Public Health Res Perspect. 2016;7(1):56-62. Published online February 28, 2016; DOI: https://doi.org/10.1016/j.phrp.2015.10.015

2,867 View
18 Download
38 Crossref

Abstract PDF

Objectives
The purpose of this study was to investigate the correlation between nursing workload and nurse-perceived patient adverse events.
Methods
A total of 1,816 nurses working in general inpatient units of 23 tertiary general hospitals in South Korea were surveyed, and collected data were analyzed through multilevel logistic regression analysis.
Results
Among variables related to nursing workload, the non-nursing task experience had an influence on all four types of patient adverse events. Nurses with non-nursing tasks experienced patient adverse events—falls [odds ratio (OR) = 1.31], nosocomial infections (OR = 1.23), pressure sores (OR = 1.16), and medication errors (OR = 1.23)—more often than occasionally. In addition, when the bed to nurse ratio was higher, nurses experienced cases of pressure sores more often (OR = 1.35). By contrast, nurses who said the nursing workforce is sufficient were less likely than others to experience cases of pressure sores (OR = 0.78). Hospitals with a relatively high proportion of nurses who perceived the nursing workforce to be sufficient showed a low rate of medication error (OR = 0.28).
Conclusion
The study suggested that the high level of nursing workload in South Korea increases the possibility of patient adverse events.

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