Korean Health Panel Survey Research Articles

Determinants of the concurrent use of biomedicine and Korean Medicine: A study based on the Korean Health Panel survey (2008–2014)

IntroductionThis study was conducted to analyze the factors associated with the concurrent use of biomedicine and Korean Medicine (KM) in an outpatient medical service using data from the Korean Health Panel (KHP) 2008–2014. MethodUsing the KHP, which is an ongoing longitudinal survey of a nationally representative Korean population, descriptive analysis was employed to present the frequency and percentage of concurrent use of biomedicine and KM with those who only used biomedicine. In addition, factors associated with the types of medical institutions receiving outpatient medical services were analyzed using the random effects panel probit model and the random effects panel logit model. ResultsAnalysis of the KHP data from 2008 to 2014 revealed that 16–18% of the population used both biomedicine and KM services concurrently. Moreover, concurrent users were more likely to be female, over 40 years old, have a lower confidence in healthcare services quality, have chronic disease, have used medication for more than three months and to have a high mean frequency of medical services use. ConclusionIdentifying determinants associated with concurrent use of biomedicine and KM might help medical professionals and policy makers to make wise judgments, plan treatments successfully and allocate resources efficiently.

The relationship between catastrophic health expenditure and health-related quality of life

ObjectivesThe objective of our study was to investigate the relationship between catastrophic health expenditure (CHE) and health-related quality of life (HRQoL) in general population.MethodsWe used Korean Health Panel Survey data from 2011 to 2013, which included data from 8850 baseline participants of 19 years of age or older. We defined CHE as total annual out-of-pocket health payment that was 40% greater than the household’s capacity to pay. HRQoL was measured using the EuroQol-visual analogue scale (EQ-VAS). We used generalized estimating equations to perform a longitudinal regression analysis.ResultsA total of 4.5% of the participants (n = 398) experienced CHE. Those with CHE tended to have a lower EQ-VAS index score compared with those without CHE (β: − 1.34, p = 0.013). A subgroup analysis revealed that individuals experiencing CHE had significant decreases as the number of chronic diseases increased (three or more, β: − 1.85, p = 0.014).ConclusionsCatastrophic health expenditure influences HRQoL, which was more pronounced in patient with chronic disease. The efforts should focus on people who suffer from excessive health expenditures and chronic diseases.

Emergency department utilization among people with disabilities in Korea

BackgroundAccording to prior studies, it is possible to consider the emergency care utilization due to ambulatory care sensitive conditions (ACSCs) as a proxy measure of access to primary care but there was no confirmed study among people with disabilities. Objective/HypothesisWe examined overall emergency department (ED) utilization patterns among people with disabilities compared with the general population and estimated factors affecting ED utilization. Additionally, we examined whether there were any differences in ED visits due to ACSCs according to type and severity of disability. MethodsThe nationally representative Korean Health Panel Survey was used. Data from 14,616 individuals who participated in the survey from 2008 to 2012 were analyzed. The frequency and causes of emergency visits were examined between individuals with and without disabilities. A generalized regression model with Poisson distribution was applied to identify factors that affect ED visits. ResultsIn 2012, people with disabilities were about two times as likely to visit the ED compared to people without disabilities, and people with external disability represented the largest proportion of people with disabilities. According to generalized linear model, disability was a strong predictor of ED visits, along with lower education level, being elderly, having a chronic disease, and being less healthy. Overall, ED visits due to ACSCs were about three times higher in the disabled group than in the non-disabled group. ConclusionsPublic health authorities should consider strengthening the primary care system to avoid unnecessary and preventable ED utilization among all Korean people, including people with disabilities.

Trends of Health Status and Medical Utilization Among Korean Baby Boomers: Analysis From Korean Health Panel Survey 2008-2014

Trends of Health Status and Medical Utilization Among Korean Baby Boomers: Analysis From Korean Health Panel Survey 2008-2014

Equity in the utilization of physician and inpatient hospital services: evidence from Korean health panel survey.

BackgroundLittle is known regarding equity in health care utilization among Koreans since 2008. This study examines the extent to which equity in the use of health care services has been achieved in Korea.MethodsDescriptive and logistic regression analysis was performed. The sample for this study was 17,035 individuals who participated in interviews.ResultsDifferences in need substantially account for the original differences observed between subgroups of Koreans. Need factors were important determinants of Koreans using physician and inpatient hospital services. Having income did not ameliorate the subgroup differences in the use of physician services. Nonetheless, having income remains an important predictor of physician utilization.ConclusionsThe Korean health care system does not yield a fully equitable distribution of physician and inpatient hospital services. Health care reforms in Korea should continue to concentrate on insuring effective universal health care, implying that all population groups with need receive effective coverage.

Socio-demographic and clinical factors contributing to smoking cessation among men: a four-year follow up study of the Korean Health Panel Survey.

BackgroundTo examine factors contributing to smoking cessation among male smokers, we looked at how socio-demographic and clinical characteristics influence stopping smoking with passage of time.MethodsData from the Korea Health Panel during 2009–2012 were used. In 2009 a total of 2,941 smokers were followed up until 2012. Statistical analysis using a generalized linear mixed model was performed for all smokers, and a subgroup analysis was also performed to determine whether individual characteristics influence smoking cessation differently based on health condition.ResultsMale smokers who have married or graduated college or above were more likely to succeed in smoking cessation. Those with chronic disease(s) were also more likely to quit smoking than those without. Among those without chronic disease, higher education showed significant association with smoking cessation, however, being married or ever married showed significant association with smoking cessation among those with chronic disease.ConclusionsThe finding that higher education helped smokers without chronic disease succeed in smoking cessation suggests that a smoking cessation campaign should focus on those with lower education. In addition, quit smoking programs may be particularly helpful for male smokers with chronic disease(s) who have never married.

Understanding the Association between Social Capital and Self-Rated Health of South Korean Elderly with Disabilities

The aim of the current study is to investigate the association between social capital and self-rated health among people who are elderly with disabilities in South Korea. For this purpose, the authors analyzed the fourth wave data of the Korean Health Panel Survey (KHPS) that included a sample of 408 people who are elderly with disabilities. The authors found that the unmet health care needs were significantly associated with self-rated health of the people who are elderly with disabilities (β = − .286, p < .05). The authors also found that respect was significantly related to self-rated health (β = .393, p < .05).

The effect of subjective and objective social class on health-related quality of life: new paradigm using longitudinal analysis.

BackgroundTo investigate the impact of the gap between subjective and objective social status on health-related quality of life.MethodsWe analyzed data from 12,350 participants aged ≥18 years in the Korean Health Panel Survey. Health-related quality of life was measured by EuroQol-Visual analogue scale. Objective (income and education) and subjective social class (measured by MacArthur scale) was classified into three groups (High, Middle, Low). In terms of a gap between objective and subjective social class, social class was grouped into nine categories ranging from High–High to Low–Low. A linear mixed model was used to investigate the association between the combined social class and health-related quality of life.ResultsThe impact of the gap between objective and subjective status on Health-related quality of life varied according to the type of gap. Namely, at any given subjective social class, an individual’s quality of life declined with a decrease in the objective social class. At any given objective social class (e.g., HH, HM, HL; in terms of both education and income), an individual’s quality of life declined with a one-level decrease in subjective social class.ConclusionOur results suggest that studies of the relationship between social class and health outcomes may consider the multidimensional nature of social status.Electronic supplementary materialThe online version of this article (doi:10.1186/s12955-015-0319-0) contains supplementary material, which is available to authorized users.

Effects of the gap between socioeconomic status and perceived social class on suicidal ideation: Unique perspectives using a longitudinal analysis

PurposeWe investigate the impact of gaps between socioeconomic status (SES; household income and education) and perceived social class on suicidal ideation. Design and methodsLongitudinal data from the 2009 and 2011 Korean Health Panel Survey were used. Our sample consisted of 12,357 subjects included in the 2009 survey and 11,758 subjects included in the 2011 survey. We analyzed rates of suicidal ideation as a function of the gap between SES and perceived social class, defined as the difference between household income and education—high (H; college or higher), medium (M; high school), low (L; middle school or lower)—and perceived social class (H, M, and L). ResultsAmong respondents whose actual and perceived levels of household income (HH: odds ratio [OR]=0.611 [95% CI [confidence interval]: 0.486–0.768], LL: OR=1.829 [95% CI: 1.489–2.247]) and education (HH: OR=0.788 [95% CI: 0.622–0.998], LL: OR 1.853 [95% CI: 1.476–2.328]) were the same, suicidal ideation increased as perceived social class decreased. The adjusted effect of the association between SES and perceived social class on suicidal ideation decreased according to the same pattern. ConclusionsThis study suggests that the gap between SES and perceptions of one’s position in the social hierarchy explains a substantial part of inequalities in suicidal ideation. It is important to consider the impact of the slopes of both gaps on suicidal ideation rather than focus only on perceived social class.

The effect of cost-sharing in private health insurance on the utilization of health care services between private insurance purchasers and non-purchasers: a study of the Korean health panel survey (2008-2012).

BackgroundPrivate health insurance in South Korea mainly functions as supplementary and complementary health insurance that compensates for insufficient coverage by National Health Insurance. However, full private coverage of public sector cost-sharing led to the problem of encouraging moral hazard–induced utilization, resulting in a policy change that occurred in October 2009. At that time, the Korean government introduced a minimum cost-sharing policy for indemnity health insurance. The purpose of this study was to analyze the effect of cost-sharing in private health insurance on health care utilization.MethodsWe analyzed data collected from the Korean Health Panel Survey from October 2008 to December 2011. We restricted the two groups to 803 purchasers with indemnity health insurance and 7023 non-purchasers who did not obtain any private health insurance. A difference-in-difference analysis was used to evaluate the effect of the 2009 policy.ResultsAfter the policy change, the utilization of outpatient visits by purchasers gradually decreased more than non-purchasers (0.015 in 2009 [p = 0.758], −0.117 in 2010 [p < 0.016], and −0.140 in 2011 [p = 0.004]). However, utilization of inpatient services was not statistically significant. Notably, the magnitude of the cost-sharing effect in indemnity health insurance was stronger for those receiving medical aid. Among this group, utilization of outpatient services (after the policy change in 2009) decreased more so than non-purchasers. Patients with three or more chronic diseases have not changed their health care utilization.ConclusionsOur results implied meaningful lessons for decision-makers and future health insurance policies in Korea and other countries in terms of cost-sharing in medical care. When policy makers intend to implement the cost-sharing, a different copayment scheme is needed according to the socioeconomic status or disease severity.

Impact of perceived cancer risk on the cancer screening rate in the general Korean population: results from the Korean health panel survey data.

To investigate the relationship between the perception of cancer risk and likelihood of having undergone cancer screening. We used data from the Korean Health Panel Survey from December 2011 onward. Of 3,390 patients who visited a hospital during the previous year, we included data from 2,466 individuals; 924 samples were excluded due to missing data. Logistic regression analysis and the chi square test were used to investigate the association between perceived cancer risk and the likelihood of having undergone cancer screening. For patients who perceived their risk of developing cancer during the next 10 years to be 30-40%, the odds ratio was increased 1.65 fold (95%CI: 1.223, 2.234) compared with those who perceived their risk to be almost zero. Although the difference was not statistically significant, perceiving cancer risk as either extremely low or extremely high appears to be associated with a reduced likelihood of having undergone cancer screening, resulting in an inverted U-shaped relationship. Physicians and researchers should be aware of the importance of the affective component of risk perception. Policies addressing the influence of cancer risk perception should be implemented in South Korea and worldwide.

The Comparison of Health Behaviors, Use of Health Services, and Health Expenditures among Diabetic Patients according to the Practice of Exercise

Purpose: The purpose of this study was to compare the use of health services and health expenditures between non-exercise and exercise groups of diabetic patients and among three groups divided according to exercise intensity. Methods: Data were obtained from the Korean Health Panel Survey of 2011. The participants of this study were 864 diabetic patients who did exercise (walk, moderate exercise, or vigorous exercise) or not. Data were subsequently analyzed using the SPSS 21 Program. Results: The exercise group showed higher percentages of medication compliance, non-smokers, and regular diet than the non-exercise group. The hospitalization percentage, the number of outpatient hospital visits, and health expenditures were higher in the non-exercise group than in the exercise group. There was no difference among the three groups divided according to exercise intensity in the use of health services and health expenditures. Conclusion: These results show that exercise is a way to reduce diabetic patients’ use of health services and their health expenditures.

Impact of the gap between socioeconomic stratum and subjective social class on depressive symptoms: Unique insights from a longitudinal analysis

Our objective was to investigate whether gaps between socioeconomic stratum and subjective social class affect the prevalence of depressive symptoms. We collected data from the Korean Health Panel Survey, years 2009 and 2011, and performed a longitudinal analysis of 12,357 individuals at baseline (2009), estimating the prevalence of depressive symptoms among individuals with disparate socioeconomic stratum (High, Middle, or Low household income and education level, respectively) and subjective social class (High, Middle, or Low). The odds ratio for depressive symptoms among individuals with High household income and High social class, or Low household income and Low social class, was 0.537 and 1.877, respectively (p < 0.0001), and that among individuals with High education level and High social class, or Low education and Low social class, was 0.700 and 1.597, respectively (p: 0.001, p < 0.0001, respectively). The likelihood of having depressive symptoms increased within each level of income and education, as the subjective social class decreased from High to Low. The adjusted effect of the gap between socioeconomic stratum and subjective social class on depressive symptoms deteriorated, as a whole, across the socioeconomic spectrum. The gap between socioeconomic stratum and perceived position in the social hierarchy explains a substantial part of inequalities in the prevalence of depressive symptoms. It is important to consider the impact of discrepancies between different measures of socioeconomic well-being on depressive symptoms rather than looking at the subjective social class alone.