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- 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
- 12,274 View
- 66 Download
- 8 Crossref
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Abstract
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.
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Citations
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- 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
- 4,054 View
- 37 Download
- 6 Crossref
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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.
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