Journal of Preventive Medicine and Public Health

Original Articles

The Impact of Public Transfer Income on Catastrophic Health Expenditures for Households With Disabilities in Korea: Eun Jee Chang, Sanggu Kang, Yeri Jeong, Sungchan Kang, Su Jin Kang; J Prev Med Public Health. 2023;56(1):67-76. Published online January 16, 2023; DOI: https://doi.org/10.3961/jpmph.22.183

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Objectives
Previous studies have reported that people with disabilities are more likely to be impoverished and affected by excessive medical costs than people without disabilities. Public transfer income (PTI) reduces financial strain in low-income households. This study examined the impact of PTI on catastrophic health expenditures (CHE), focusing on low-income households and households with Medical Aid beneficiaries that contained people with disabilities.
Methods
We constructed a panel dataset by extracting data on registered households with disabilities from the Korea Welfare Panel Study 2012-2019. We then used a generalized estimating equation model to estimate the impacts of PTI on CHE. A subgroup analysis was carried out to assess the moderating effects of family income levels and health insurance types.
Results
As PTI increased, the odds ratio (OR) of CHE in households that contained people with disabilities decreased significantly (OR, 0.92; 95% confidence interval [CI], 0.89 to 0.94; p<0.001). In particular, PTI effectively reduced the likelihood of CHE for low-income households (OR, 0.85; 95% CI, 0.81 to 0.89; p<0.001) and those who received medical benefits (OR, 0.78; 95% CI, 0.68 to 0.89; p<0.001).
Conclusions
This study highlights the positive effect of PTI on decreasing CHE. Household income and the health insurance type were significant effect modifiers, but economic barriers seemed to persist among low-income households with non-Medical Aid beneficiaries. Federal policies or programs should consider increasing the total amount of PTI targeting low-income households with disabilities that are not covered by the Medical Aid program.

Summary

Korean summary
장애인은 비장애인에 비해 소득수준이 낮고 빈곤율이 높으며, 저소득 장애인 가구일수록 소득원천 비중에서 공적이전소득 의존성이 높다. 본 연구는 공적이전소득이 장애인 가구의 재난적 의료비 발생 확률(Odds ratio)을 효과적으로 낮춘다는 점을 밝혔으며, 특히 저소득층 및 의료급여 수급 가구에서 의료비 부담 완화 효과가 큰 것을 확인하였다. 향후 의료급여 적용대상에서 제외되어 건강보험에 가입해 있는 저소득 장애인 가구를 대상으로 추가적인 맞춤형 지원 정책이 필요하다.

Citations

Citations to this article as recorded by

Prevalence and Determinants of Catastrophic Healthcare Expenditures in Iran From 2013 to 2019
Abdoreza mousavi, Farhad lotfi, Samira Alipour, Aliakbar Fazaeli, Mohsen Bayati
Journal of Preventive Medicine and Public Health.2024; 57(1): 65. CrossRef

Mediating Effect of Cognitive Function on the Relationship Between Geriatric Oral Health and Quality of Life Among Korean Seniors: Eun Jee Chang, Hyun-Jae Woo, Kyu-Hyoung Jeong; J Prev Med Public Health. 2022;55(1):106-113. Published online January 12, 2022; DOI: https://doi.org/10.3961/jpmph.21.536

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Abstract Summary PDF Supplementary Material

Objectives
Previous studies have found that the oral health of seniors can affect their physical nutrition and quality of life (QoL). Additionally, poor oral health can lead to the development of dementia, which is associated with decreased cognitive function. This study aimed to examine the impact of geriatric oral health (GOH) on the QoL of Korean seniors and the mediating effects of cognitive function.
Methods
We used data from the seventh Korean Longitudinal Study of Aging conducted in 2018. In total, 4049 seniors were included in our study. We analyzed the impact of GOH on QoL according to 5 mediating domains of cognitive function and control variables. To examine each path of mediating effects, bootstrapping with 5000 iterations was performed with 95% confidence intervals.
Results
Our findings revealed that good GOH had a positive effect on the QoL of seniors. Also, better GOH corresponded to a higher degree of cognitive function within all 5 domains: orientation, memory registration, attention/calculation, memory recall, and language and visuospatial ability. In addition, 3 domains of the 5 domains (attention/calculation, memory recall, and language and visuospatial ability) had significant mediating effects on the relationship between GOH and QoL.
Conclusions
This study suggests that adequate management of GOH is crucial for promoting a better QoL and a high degree of cognitive function among seniors. To prevent cognitive impairment, such as dementia, future studies should take a more targeted approach by examining data according to each cognitive domain and various socio-demographic factors.

Summary

Korean summary
본 연구는 2018년도 7차 한국고령화연구패널조사(KLoSA) 자료를 이용하여 65세 이상 노인4,049명을 대상으로 노인 구강건강 수준(GOHAI, Geriatric Oral Health Assessment Index)이 삶의 질에 미치는 영향을 확인하였다. 또한 K-MMSE(Korean Mini-Mental State Examination) 점수를 매개변수로 활용하여 인지기능을 시간 및 장소 지남력, 기억등록, 주의집중 및 계산력, 기억회상, 언어 및 시공간 구성력의 5가지 하위영역의 다중매개효과를 분석하였다. 그 결과, 노인의 구강건강은 삶의 질과 인지기능의 모든 하위영역에 영향을 미치는 것으로 나타났으며, 특히 인지기능 하위영역 중 주의집중 및 계산력, 기억회상, 언어 및 시공간 구성력이 구강건강과 삶의 질의 관계에서 유의한 매개효과를 보였다. 향후 노인의 삶의 질을 악화하는 주요 질환인 치주질환 및 구강건조증 등을 예방할 수 있도록 국가 차원의 구강보건사업을 확대하고, 인지기능 하위영역별 저하 양상에 따라 세분화된 약물적/비약물적 중재를 시행해야 한다.

Citations

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Association of Denture Use and Chewing Ability with Cognitive Function Analysed Using Panel Data from Korea Longitudinal Study of Aging (2006–2018)
Nu-Ri Jun, Jae-Hyun Kim, Jong-Hwa Jang
Healthcare.2023; 11(18): 2505. CrossRef

Regional Differences in the Effects of Social Relations on Depression Among Korean Elderly and the Moderating Effect of Living Alone: Chanki Kim, Eun Jee Chang, Chang-yup Kim; J Prev Med Public Health. 2021;54(6):441-450. Published online October 22, 2021; DOI: https://doi.org/10.3961/jpmph.21.337

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Abstract Summary PDF Supplementary Material

Objectives
Socioeconomic disadvantages interact with numerous factors which affect geriatric mental health. One of the main factors is the social relations of the elderly. The elderly have different experiences and meanings in their social lives depending on their socio-cultural environment. In this study, we compared the effects of social relations on depression among the elderly according to their living arrangement (living alone or living with others) and residential area.
Methods
We defined social relations as “meetings with neighbors” (MN). We then analyzed the impact of MN on depression using data from the Korean Longitudinal Study of Aging Panel with the generalized estimating equation model. We also examined the moderating effect of living alone and performed subgroup analysis by dividing the sample according to which area they lived in.
Results
MN was associated with a reduced risk of depressive symptoms among elderlies. The size of the effect was larger in rural areas than in large cities. However, elderly those who lived alone in rural areas had a smaller protective impact of MN on depression, comparing to those who lived with others. The moderating effect of living alone was significant only in rural areas.
Conclusions
The social relations among elderlies had a positive effect on their mental health: The more frequent MN were held, the less risk of depressive symptoms occurred. However, the effect may vary depending on their living arrangement and environment. Thus, policies or programs targeting to enhance geriatric mental health should consider different socio-cultural backgrounds among elderlies.

Summary

Korean summary
본 연구는 사회적 관계가 노인의 우울에 미치는 영향이 독거 상태 및 거주 지역에 따라 달라지는지 확인하였다. 사회적 관계를 이웃과의 만남 빈도로 정의하고 고령화연구패널자료를 분석한 결과 사회적 관계의 효과 크기는 대도시에서 가장 작었고 독거의 조절효과는 농어촌에서만 유의하였다.

Citations

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Association between area deprivation index and concerns to COVID-19: A multi-level analysis of individual and area factors
Doo Woong Lee, Jieun Jang, Jaeyong Shin
SSM - Population Health.2024; 25: 101580. CrossRef
Nutritional Risk, Depression, and Physical Function in Older People Living Alone
Jeong-Hye Park, Se-Won Kang
Healthcare.2024; 12(2): 164. CrossRef
Urban-Rural Differences in Prevalence of Depressive Symptoms and Its Related Factors Among Older Adults: Findings from the Korean Longitudinal Study of Aging
Bongjeong Kim, Jinseub Hwang, Dohyang Kim, Soo Jin Kang
Research in Community and Public Health Nursing.2024; 35: 51. CrossRef
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Alzheimer's & Dementia.2023; 19(9): 4204. CrossRef
Living alone and the risk of depressive symptoms: a cross-sectional and cohort analysis based on the China Health and Retirement Longitudinal Study
Guangjun Zheng, Biying Zhou, Zhenger Fang, Chunxia Jing, Sui Zhu, Mingliang Liu, Xia Chen, Lei Zuo, Haiyan Chen, Guang Hao
BMC Psychiatry.2023;[Epub] CrossRef
Assessment of the relationship between living alone and the risk of depression based on longitudinal studies: A systematic review and meta-analysis
Daolin Wu, Fuwei Liu, Shan Huang
Frontiers in Psychiatry.2022;[Epub] CrossRef
Effects of Serious Games on Depression in Older Adults: Systematic Review and Meta-analysis of Randomized Controlled Trials
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Journal of Medical Internet Research.2022; 24(9): e37753. CrossRef

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