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4 "Chul-Woung Kim"
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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
  • 8,604 View
  • 38 Download
  • 2 Citations
AbstractAbstract PDF
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.

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
  • 2,881 View
  • 93 Download
  • 4 Citations
AbstractAbstract 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.

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
  • 2,078 View
  • 25 Download
  • 4 Citations
AbstractAbstract 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.

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
  • 1,345 View
  • 17 Download
  • 23 Citations
AbstractAbstract 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.

PHRP : Osong Public Health and Research Perspectives