- Educational Differences in Health Care Utilization in the Last Year of Life among South Korean Cancer Patients.
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Soo Young Choo, Sang Yi Lee, Chul Woung Kim, Su Young Kim, Tae Ho Yoon, Hai Rim Shin, Ok Ryun Moon
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J Prev Med Public Health. 2007;40(1):36-44.
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DOI: https://doi.org/10.3961/jpmph.2007.40.1.36
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- OBJECTIVES
There have been few studies examining the differences in health care utilization across social classes during the last year of life. Therefore, in this study we analyzed the quantitative and qualitative differences in health care utilization among cancer patients across educational classes in their last year of life, and derived from it implications for policy. METHODS: To evaluate health care utilization by cancer patients in the last year of life, Death certificate data from 2004 were merged with National Health Insurance data (n=60,088). In order to use educational level as a social class index, we selected the individuals aged 40 and over as study subjects (n=57,484). We analyzed the differences in the medical expenditures, admission days, and rates of admission experience across educational classes descriptively. Multiple regression analysis was conducted to evaluate the association between medical expenditures and independent variables such as sex, age, education class, site of death and type of cancer. RESULTS: The upper educational class spent much more on medical expenditures in the last one year of life, particularly during the last month of life, than the lower educational class did. The ratio of monthly medical expenditures per capita between the college class and no education class was 2.5 in the last 6-12 months of life, but the ratio was 1.6 in the last 1 month. Also, the lower the educational class, the higher the proportion of medical expenditures during the last one month of life, compared to total medical expenditures in the last one year of life. The college educational class had a much higher rate of admission experiences in tertiary hospitals within Seoul than the other education classes did. CONCLUSIONS: This study shows that the lower educational classes had qualitative and quantitative disadvantages in utilizing health care services for cancer in the last year of life.
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Citations
Citations to this article as recorded by  - Cross-national differences in wealth inequality in health services and caregiving used near the end of life
Jennifer A. Ailshire, Cristian A. Herrera, Eunyoung Choi, Margarita Osuna, Elina Suzuki
eClinicalMedicine.2023; 58: 101911. CrossRef - Socioeconomic differences in the perception of inequalities in healthcare utilization and health in South Korea
Nayeon Kim, Hye-won Yun, Juwon Park, Fatima Nari, Hee Jin Wang, Jae Kwan Jun, Kui Son Choi, Mina Suh
Preventive Medicine Reports.2023; 36: 102445. CrossRef - Cross-National Differences in Wealth Inequality in Health Services and Caregiving Used Near the End of Life
Jennifer A. Ailshire, Cristian A. Herrera, Eunyoung Choi, Margarita Osuna, Elina M. Suzuki
SSRN Electronic Journal .2022;[Epub] CrossRef - Socioeconomic position and use of healthcare in the last year of life: A systematic review and meta-analysis
Joanna M. Davies, Katherine E. Sleeman, Javiera Leniz, Rebecca Wilson, Irene J. Higginson, Julia Verne, Matthew Maddocks, Fliss E. M. Murtagh, Holly Gwen Prigerson
PLOS Medicine.2019; 16(4): e1002782. CrossRef - Joint Symposium of Korean Cancer Association & UICC-ARO—Cross-boundary cancer studies: cancer and Universal Health Coverage (UHC) in Asia
Eun-Cheol Park, Norie Kawahara, Shinjiro Nozaki, Hasbullah Thabrany, Shunya Yoshimi, Sohee Park, Duk Hyoung Lee, Hideyuki Akaza, Jae Kyung Roh
Japanese Journal of Clinical Oncology.2017; 47(9): 889. CrossRef - Medical Costs and Healthcare Utilization among Cancer Decedents in the Last Year of Life in 2009
Inuk Hwang, Dong Wook Shin, Kyoung Hee Kang, Hyung Kook Yang, So Young Kim, Jong-Hyock Park
Cancer Research and Treatment.2016; 48(1): 365. CrossRef - Barriers to Cancer Care, Perceived Social Support, and Patient Navigation Services for Korean Breast Cancer Patients
Jung-won Lim
Social Work in Health Care.2015; 54(1): 47. CrossRef - Equity in health care: current situation in South Korea
Hong-Jun Cho
Journal of the Korean Medical Association.2013; 56(3): 184. CrossRef - Inequalities in Medical Care Utilization by South Korean Cancer Patients According to Income: A Retrospective Cohort Study
Tae Ho Yoon, Sang-Yi Lee, Chul-Woung Kim, Su Young Kim, Baek-Geun Jeong, Hyeung-Keun Park
International Journal of Health Services.2011; 41(1): 51. CrossRef - Factors Influencing Utilization of Medical Care Among Osteoarthritis Patients in Korea: Using 2005 Korean National Health and Nutrition Survey Data
Min Young Kim, Jong Ku Park, Sang Baek Koh, Chun-Bae Kim
Journal of Preventive Medicine and Public Health.2010; 43(6): 513. CrossRef
- A Study on Service Characteristics of Directors of Health Centers in Korea.
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Jae Won Yoo, Ok Ryun Moon, Sang Yi Lee, Chul Woung Kim, Sang Gu Yi
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Korean J Prev Med. 1998;31(4):786-800.
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- This study has attempted to show general characteristics of health centre directors who have served the post of directorship during the last 40 years. Of 3,000 such health centre directors, information on about 2,500 directors was collected. While average length of service for health center directors has increased, that of vacancy period has decreased. Rural areas have a shorter average length of service than the urban area. Rural areas have twice longer length of vacancy period per health center. Kangwon-do has the longest average length of vacancy period since 1980(2.79 months/year), and Daejeon has the shortest length of vacancy period(0.21 months/year). Chung-buk has no physician directors. The civil servant's rank for the directorship has promoted from the fifth level to the fourth level since 1990. A comparison between the physician director and non-physician director was made as follows : First, the proportion of physician directors had maintained rather high before 1980s ; 62.5% in 1963, 78.3% in 1970, 70.4% in 1980. It decreased to 44.1% in 1990 and 47.6% in 1997. Instead, non-physician directors has abruptly increased since 1980s(12.4% in 1980, 55.4% in 1990 and 50.8% in 1997). Second, physician directors mainly locate in the urban area(58.0% in 1997), but non-physician directors mainly in the rural area(67.2% in 1997). Third, since 1980, the average length of service for physician directors and for non-physician directors has become similar. Fourth, the mean age of physician directors is 45.1 years, and that of non-physician directors 55.7 years. The latter is 10 years older than the former.
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Summary
- A Study on Estimation of Caring Demand for Extended Care Facilities by Activities of Daily Living.
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Chul Woung Kim, Ok Ryun Moon, Sang Yi Lee, Jae Won Yoo, Sang Gu Yi
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Korean J Prev Med. 1998;31(3):564-578.
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- Most extended care facilities have admitted both the healthy and unhealthy elderly, among which members' average caring demand vary. The Aged Welfare Law, however, currently provides no reasonable basis on the staffing policy for extended care facilities. It just reflects the admitted number of the elderly rather than differences in members' average caring demand among facilities. This study is designed to estimate the need for caring staff on the basis of the correlation between the individual health status measured by various tools including Activities of Daily Living and caring demand by actual service time for each one. The sample included all of the admitted elderly(187 persons) in 4 extended care facilities, two in Seoul and the other two in KangWon-Do over the survey period October 5 through October 20, 1996. The survey process consisted of 3 stages. (1) The current staffing information was collected through self-completed written questionnaires left for head official in each facility. (2) Six graduate students at School of Public Health interviewed all residents to collect information on their health status and sociodemographics. The response rate for the interview was relatively high(85%). (3) Information on direct and indirect caring time consumed for each residents came from self-completed written questionnaires given to nurses and helpers in each target facilities. Analysis of the data was made using Pearson's correlation and multiple regression technique through SAS program. Based on this procedure, the following was found. 1. No facility meet the staffing standard in the Aged Welfare Law completely. 2. It is actual service time that is most correlated with ADL(Activities of daily living). 3. When all of the elderly are divided by four groups based on the level of ADL, the mean values of needed caring time in each group are 15, 21, 36 and 88 minutes respectively. 4. There is no significant difference among facilities in distribution of elderly person by group. 5. No facility meets the estimated number of nurses and helpers which reflects health status of the admitted elderly. Therefore, it is required that severity of the admitted elderly be considered in establishing staffing standard for extended care facility.
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- The Possibility of Regional Health Insurance Data in Blueprinting the Local Community Health Plan.
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Sang Yi Lee, Chul Woung Kim, Ok Ryun Moon
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Korean J Prev Med. 1997;30(4):870-883.
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- The health center has to play an important role in promoting community health and satisfying a variety of community health needs and demands in the decentralized Korea. The nearly enacted Community Health Act compels every health center to make its own health plans which intend to deal with local health problems and plan its future health care. This obligation is obviously a big burden to most health centers. They do not have experiences in and abilities of making local health care plans. In order to establish a systematic community health plan, health centers have to concentrate their efforts on enhancing the ability of making health care plan through gathering and analysing the local health informations. However, it is very difficult in reality. This is simply because it will take long time to accomplish these activities. It seems natural that various professionals and researchers participate in carrying out the process of making community health plan in the initial stage. No standardized methodology and analysing framework exist even in the health professional society. Nonetheless, it is common to introduce survey research methodologies in analysing consumer's health care utilization and cost, and in identifying factors influencing health behaviors. Many researchers and professionals have applied social survey methodologies in obtaining information on providers and health policy makers as well. The authors have found that few studies have ever utilized local health data stored at the self-employed medical insurance society as the data source of planning activities. The purpose of this study is to illustrate the usefulness of the data stored at the Sung-Dong Gu Self-employed Medical Insurance Society in establishing the community health plan. The major contents of this study are as follows ; 1. Frequency of utilization by age, area, sex, type of medical care institutions, and some major diseases 2. Medical treatment by type of medical care institutions, by classification of 21 diseases, by frequency of three-character categories 3. Medical treatment of major neoplasm and some chronic diseases by age, sex, and area. The conclusion of this study is that it is of great potentiality to find out the local health problems and to use them in blueprinting the community health plan through comparing the frequency of medical utilization analyzed by a variety of variables with NHI health data or the health data from survey research.
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