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Original Articles
- Poor People and Poor Health: Examining the Mediating Effect of Unmet Healthcare Needs in Korea
- Youngsoo Kim, Saerom Kim, Seungmin Jeong, Sang Guen Cho, Seung-sik Hwang
- J Prev Med Public Health. 2019;52(1):51-59. Published online January 23, 2019
- DOI: https://doi.org/10.3961/jpmph.18.162
- 6,274 View
- 189 Download
- 11 Crossref
-
Abstract
Summary
PDF
Supplementary Material - Objectives
The purpose of this study was to estimate the mediating effect of subjective unmet healthcare needs on poor health. The mediating effect of unmet needs on health outcomes was estimated.
Methods
Cross-sectional research method was used to analyze Korea Health Panel data from 2011 to 2015, investigating the mediating effect for each annual dataset and lagged dependent variables.
Results
The magnitude of the effect of low income on poor health and the mediating effect of unmet needs were estimated using age, sex, education level, employment status, healthcare insurance status, disability, and chronic disease as control variables and selfrated health as the dependent variable. The mediating effect of unmet needs due to financial reasons was between 14.7% to 32.9% of the total marginal effect, and 7.2% to 18.7% in lagged model.
Conclusions
The fixed-effect logit model demonstrated that the existence of unmet needs raised the likelihood of poor self-rated health. However, only a small proportion of the effects of low income on health was mediated by unmet needs, and the results varied annually. Further studies are necessary to search for ways to explain the varying results in the Korea Health Panel data, as well as to consider a time series analysis of the mediating effect. The results of this study present the clear implication that even though it is crucial to address the unmet needs, but it is not enough to tackle the income related health inequalities. -
SummaryKorean summary
이 연구에서는 2011년부터 2015년까지의 한국의료패널 자료를 이용하여 미충족의료과 불건강의 관련성을 살펴보고, 불건강을 매개하는 미충족의료의 크기를 추정했다. 미충족의료는 개인고정효과를 보정하였을 때 불건강에 유의한 영향 준다는 것을 확인할 수 있었고, 미충족의료가 매개하는 저소득의 건강 효과는 저소득이 불건강에 미치는 전체 효과 중 일부에 지나지 않았으며, 효과의 크기는 분석 연도 별로 일정하지 않게 나타났다. 이는 건강불평등을 줄이기 위한 정책 개입에서 미충족의료 해소가 유의미한 정책 목표로 가치가 있지만 그 한계 또한 명확하다는 것을 의미한다. -
Citations
Citations to this article as recorded by
- How did unmet care needs during the pandemic affect health outcomes of older European individuals?
Julien Bergeot, Florence Jusot
Economics & Human Biology.2024; 52: 101317. CrossRef - Unmet healthcare needs among the population aged 50+ and their association with health outcomes during the COVID-19 pandemic
Carlota Quintal, Luis Moura Ramos, Micaela Antunes, Óscar Lourenço
European Journal of Ageing.2023;[Epub] CrossRef - Factors and at-risk group associated with hypertension self-management patterns among people with physical disabilities: a latent class analysis
Hye Jin Nam, Ju Young Yoon
BMC Public Health.2022;[Epub] CrossRef - Changes in Barriers That Cause Unmet Healthcare Needs in the Life Cycle of Adulthood and Their Policy Implications: A Need-Selection Model Analysis of the Korea Health Panel Survey Data
Woojin Chung
Healthcare.2022; 10(11): 2243. CrossRef - Intergenerational Differences in Factors Affecting Unmet Health Care Needs in South Korea: Comparison of Middle-aged and Older Adults
Eunjeong Noh
Journal of Intergenerational Relationships.2021; 19(1): 144. CrossRef - Identification of Unmet Healthcare Needs: A National Survey in Thailand
Sukanya Chongthawonsatid
Journal of Preventive Medicine and Public Health.2021; 54(2): 129. CrossRef - Factors affecting unmet healthcare needs of low-income overweight and obese women in Korea: analysis of the Korean National Health and Nutrition Examination Survey 2017
Ju-Hee Nho, Sook Kyoung Park
Korean Journal of Women Health Nursing.2021; 27(2): 93. CrossRef - Factors Affecting Unmet Healthcare Needs among Adults with Chronic Diseases
Ji-Young Han, Hyeon-Sook Park
Journal of Korean Academy of Community Health Nursing.2021; 32(2): 131. CrossRef - Association between osteoarthritis and unmet medical needs in Korea: limitations in activities as a mediator
Hooin Jo, Eun-san Kim, Boyoung Jung, Soo-Hyun Sung, In-Hyuk Ha
BMC Public Health.2020;[Epub] CrossRef - Unmet Healthcare Needs and Associated Factors in Rural and Suburban Vietnam: A Cross-Sectional Study
Ju Young Kim, Dae In Kim, Hwa Yeon Park, Yuliya Pak, Phap Ngoc Hoang Tran, Truc Thanh Thai, Mai Thi Thanh Thuy, Do Van Dung
International Journal of Environmental Research and Public Health.2020; 17(17): 6320. CrossRef - Factors Underlying Unmet Medical Needs: A Cross-Sectional Study
Young Suk Yoon, Boyoung Jung, Dongsu Kim, In-Hyuk Ha
International Journal of Environmental Research and Public Health.2019; 16(13): 2391. CrossRef
- How did unmet care needs during the pandemic affect health outcomes of older European individuals?
- Impact of Regional Cardiocerebrovascular Centers on Myocardial Infarction Patients in Korea: A Fixed-effects Model
- Sang Guen Cho, Youngsoo Kim, Youngeun Choi, Wankyo Chung
- J Prev Med Public Health. 2019;52(1):21-29. Published online November 28, 2018
- DOI: https://doi.org/10.3961/jpmph.18.154
- 6,510 View
- 163 Download
- 7 Crossref
-
Abstract
Summary
PDFSupplementary Material
- Objectives
The Regional Cardiocerebrovascular Center (RCCVC) Project designated local teaching hospitals as RCCVCs, in order to improve patient outcomes of acute cardiocerebrovascular emergencies by founding a regional system that can adequately transfer and manage patients within 3 hours. We investigated the effects of RCCVC establishment on treatment volume and 30-day mortality.
Methods
We constructed a panel dataset by extracting all acute myocardial infarction cases that occurred from 2007 to 2016 from the Health Insurance Review and Assessment Service claims data, a national and representative source. We then used a panel fixed-effect model to estimate the impacts of RCCVC establishment on patient outcomes.
Results
We found that the number of cases of acute myocardial infarction that were treated increased chronologically, but when the time effect and other related covariates were controlled for, RCCVCs only significantly increased the number of treatment cases of female in large catchment areas. There was no statistically significant impact on 30-day mortality.
Conclusions
The establishment of RCCVCs increased the number of treatment cases of female, without increasing the mortality rate. Therefore, the RCCVCs might have prevented potential untreated deaths by increasing the preparedness and capacity of hospitals to treat acute myocardial infarction patients. -
SummaryKorean summary
권역심뇌혈관질환센터 설립 사업은 지역별로 심뇌혈관센터를 지정/육성하여, 심뇌혈관질환 발생시 3시간 이내 진료체계를 구축함으로써 급성심근경색과 뇌졸중의 급성기 응급상황에 대한 대응을 강화하고자 시행되었다. 본 연구는 권역심뇌혈관질환센터 설립 정책으로 인해 시술 건수와 30일 내 사망 등과 같은 치료 성과가 지역 수준에서 향상되었는지 살펴보기 위해 건강보험 청구자료로 지역 수준 패널자료를 구축하여 권역심뇌혈관질환센터 설립의 효과를 추정하였다. 분석 결과, 시계열적 효과와 관련 변수를 통제하였을 때 권역심뇌혈관질환센터 설립 이후 설립 지역에서 여성의 치료 사례 수가 통계적으로 유의하게 증가하였고, 사망률은 유의미한 변화가 관찰되지 않았다. 따라서 권역심뇌혈관질환센터 설립은 대비성 향상과 치료 사례 수 증가를 통해 추가적인 치료를 받은 급성심근경색 환자의 잠재적인 원외 사망을 방지하는 효과가 있는 것으로 판단된다. -
Citations
Citations to this article as recorded by- Reduced Alcohol Consumption and Major Adverse Cardiovascular Events Among Individuals With Previously High Alcohol Consumption
Dong Oh Kang, Dae-In Lee, Seung-Young Roh, Jin Oh Na, Cheol Ung Choi, Jin Won Kim, Eung Ju Kim, Seung-Woon Rha, Chang Gyu Park, Ye-Seul Kim, Yonghwan Kim, Hyo-Sun You, Hee-Taik Kang, Eunseo Jo, Jinseob Kim, Jae-woo Lee, Jin-Man Jung
JAMA Network Open.2024; 7(3): e244013. CrossRef - Relevance Index Regional Variation by Each Disease and Its Essential Medical Field: A Retrospective Data Analysis From 2016-2020 in Korea
Young-Eun Kim, Jeehee Pyo, Haneul Lee, HyeRan Jeong, Young-Kwon Park, Jeong-Wook Seo, Minsu Ock, Seok-Jun Yoon
Journal of Korean Medical Science.2023;[Epub] CrossRef - The effects of socioeconomic and geographic factors on chronic phase long-term survival after stroke in South Korea
Dougho Park, Su Yun Lee, Eunhwan Jeong, Daeyoung Hong, Mun-Chul Kim, Jun Hwa Choi, Eun Kyong Shin, Kang Ju Son, Hyoung Seop Kim
Scientific Reports.2022;[Epub] CrossRef - Comparisons of Prehospital Delay and Related Factors Between Acute Ischemic Stroke and Acute Myocardial Infarction
Cindy W. Yoon, Hoonji Oh, Juneyoung Lee, Joung‐Ho Rha, Seong‐Ill Woo, Won Kyung Lee, Han‐Young Jung, Byeolnim Ban, Jihoon Kang, Beom Joon Kim, Won‐Seok Kim, Chang‐Hwan Yoon, Heeyoung Lee, Seongheon Kim, Sung Hun Kim, Eun Kyoung Kang, Ae‐Young Her, Jae‐Kwa
Journal of the American Heart Association.2022;[Epub] CrossRef - Comparison of Factors Associated With Direct Versus Transferred-in Admission to Government-Designated Regional Centers Between Acute Ischemic Stroke and Myocardial Infarction in Korea
Dae-Hyun Kim, Seok-Joo Moon, Juneyoung Lee, Jae-Kwan Cha, Moo Hyun Kim, Jong-Sung Park, Byeolnim Ban, Jihoon Kang, Beom Joon Kim, Won-Seok Kim, Chang-Hwan Yoon, Heeyoung Lee, Seongheon Kim, Eun Kyoung Kang, Ae-Young Her, Cindy W Yoon, Joung-Ho Rha, Seong-
Journal of Korean Medical Science.2022;[Epub] CrossRef - Machine learning enhances the performance of short and long-term mortality prediction model in non-ST-segment elevation myocardial infarction
Woojoo Lee, Joongyub Lee, Seoung-Il Woo, Seong Huan Choi, Jang-Whan Bae, Seungpil Jung, Myung Ho Jeong, Won Kyung Lee
Scientific Reports.2021;[Epub] CrossRef - Presence of Thrombectomy-capable Stroke Centers Within Hospital Service Areas Explains Regional Variation in the Case Fatality Rate of Acute Ischemic Stroke in Korea
Eun Hye Park, Yong Jin Gil, Chanki Kim, Beom Joon Kim, Seung-sik Hwang
Journal of Preventive Medicine and Public Health.2021; 54(6): 385. CrossRef
- Reduced Alcohol Consumption and Major Adverse Cardiovascular Events Among Individuals With Previously High Alcohol Consumption
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