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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
  • 9,539 View
  • 42 Download
  • 3 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.

Citations

Citations to this article as recorded by  
  • 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
  • 3,741 View
  • 94 Download
  • 6 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.

Citations

Citations to this article as recorded by  
  • 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
    Ciência & Saúde Coletiva.2022; 27(1): 325.     CrossRef
  • What Policy Approaches Were Effective in Reducing Catastrophic Health Expenditure? A Systematic Review of Studies from Multiple Countries
    HyunWoo Jung, Kwang-Soo Lee
    Applied Health Economics and Health Policy.2022; 20(4): 525.     CrossRef
  • 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
  • 2,748 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.

Citations

Citations to this article as recorded by  
  • 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
  • The sociopolitical context of the COVID-19 response in South Korea
    Hani Kim
    BMJ Global Health.2020; 5(5): e002714.     CrossRef
  • Post-COVID healthcare reform in India: What to expect?
    SohamD Bhaduri
    Journal of Family Medicine and Primary Care.2020; 9(11): 5427.     CrossRef
  • The Story of Korean Health Insurance System
    Hae-Wol Cho, Chaeshin Chu
    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
  • 1,918 View
  • 18 Download
  • 27 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.

Citations

Citations to this article as recorded by  
  • Spanish Version of the Scale “Eventos Adversos Associados às Práticas de Enfermagem” (EAAPE): Validation in Nursing Students
    Antonio Martínez-Sabater, Carlos Saus-Ortega, Mónica Masiá-Navalon, Elena Chover-Sierra, María Luisa Ballestar-Tarín
    Nursing Reports.2022; 12(1): 112.     CrossRef
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    Ravenna Leite da Silva, Luiz Bueno da Silva, Aryelle Nayra Azevedo Silva
    Work.2022; 73(3): 915.     CrossRef
  • The Impact of Performance of Non-Nursing Tasks on the Attitudes of Nursing Students toward Nursing Profession
    Ibrahim Rawhi Ayasreh, Ferial Hayajneh, Rana Al Awamleh
    Nurse Media Journal of Nursing.2022; 12(2): 151.     CrossRef
  • Identification of Predictive Nursing Workload Factors: A Six Sigma Approach
    Marcos Buestan, Cinthia Perez
    Sustainability.2022; 14(20): 13169.     CrossRef
  • Association of nursing hours with cognitive function, balance, and dependency level of stroke patients
    Haneul Lee, Kyounga Lee, Seon‐Heui Lee
    Nursing Open.2022;[Epub]     CrossRef
  • Burnout and patient safety: A discriminant analysis of paediatric nurses by low to high managerial support
    Haitham Khatatbeh, Annamária Pakai, Dorina Pusztai, Szilvia Szunomár, Noémi Fullér, Gyula Kovács Szebeni, Adrienn Siket, Miklós Zrínyi, András Oláh
    Nursing Open.2021; 8(2): 982.     CrossRef
  • Major educational factors associated with nursing adverse events by nursing students undergoing clinical practice: A descriptive study
    Hui Li, Xiangping Kong, Lulu Sun, Yuanyuan Zhu, Bo Li
    Nurse Education Today.2021; 98: 104738.     CrossRef
  • Accuracy of documented administration times for intravenous antimicrobial drugs and impact on dosing decisions
    Stephanie A. Roydhouse, Jane E. Carland, Deborah S. Debono, Melissa T. Baysari, Stephanie E. Reuter, Alice J. Staciwa, Anmol P. K. Sandhu, Richard O. Day, Sophie L. Stocker
    British Journal of Clinical Pharmacology.2021; 87(11): 4273.     CrossRef
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    Leticia Alves Freitas, Alex Luís Fagundes, Patrícia Rezende Prado, Marta Cristiane Alves Pereira, Adriane Pinto Medeiros, Ligia Menezes Freitas, Thalyta Cardoso Alux Teixeira, Janine Koepp, Rhanna Emanuela Fontenele Lima Carvalho, Fernanda Raphael Escobar
    Nursing Open.2021; 8(5): 2509.     CrossRef
  • Patient safety. Factors for and perceived consequences of nursing errors by nursing staff in home care services
    Deborah Elisabeth Jachan, Ursula Müller‐Werdan, Nils Axel Lahmann
    Nursing Open.2021; 8(2): 755.     CrossRef
  • Nurses’ perception of patient safety culture and its relationship with adverse events: a national questionnaire survey in Iran
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    BMC Nursing.2021;[Epub]     CrossRef
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    International Journal of Nursing Studies.2021; 115: 103860.     CrossRef
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    Journal of Korean Academy of Nursing.2021; 51(1): 27.     CrossRef
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PHRP : Osong Public Health and Research Perspectives