Factors influencing health care use by health insurance subscribers and medical aid beneficiaries: a study based on data from the Korea welfare panel study database

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Abstract

Background

The use of health care services is influenced by various factors, including demographic, social, economic, and health status factors. This study aimed to identify the factors that influence health care use in health insurance subscribers and medical aid beneficiaries in Korea.

Methods

A total of 11,793 subjects were identified, including 10,838 health insurance subscribers and 955 medical aid beneficiaries, using the Korea Welfare Panel Study database. The data were analysed by percentage, t-test, and multiple regression using SPSS 20.0.

Results

Medical aid beneficiaries had 13.51 more days of outpatient visits and 8.38 more days of hospitalization compared with health insurance subscribers. Factors affecting the frequency of outpatient visits for health insurance subscribers were gender, age, household type, education level, income level, administrative district, perceived health status, chronic disease, and disability. These factors accounted for 19.8% of explanation ( p < .001). Whereas, gender, household type, administrative district, perceived health status, and chronic disease were identified as factors influencing outpatient frequency for medical aid beneficiaries. These factors accounted for 11.2% of explanation ( p < .001). For health insurance subscribers, factors affecting the length of hospitalization were gender, public pension status, place of residence, administrative district, economic activity, income level, perceived health status, and disability status. These factors accounted for 7.2% of explanation ( p < .001). While, factors affecting the length of hospitalization for medical aid beneficiaries were accounted for by 3.4% ( p < .001). Gender and perceived health status were identified as factors influencing the length of hospitalization of medical aid beneficiaries.

Conclusions

There were differences between medical aid beneficiaries and health insurance subscribers in health care use and influencing factors. Future management programs should take into consideration the specific factors that influence the use of health care services in health insurance subscribers and medical aid beneficiaries.

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Most cited references 9

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The association between living alone and health care utilisation in older adults: a retrospective cohort study of electronic health records from a London general practice

Kathryn Dreyer, Adam Steventon, Rebecca Fisher … (2018)

Background In 2016, one in three older people in the UK were living alone. These patients often have complex health needs and require additional clinical and non-clinical support. This study aimed to analyse the association between living alone and health care utilisation in older patients. Methods We conducted a retrospective cohort study of 1447 patients over the age of 64, living in 1275 households who were registered at a large general practice in South East London. The utilisation of four different types of health care provision were examined in order to explore the impact of older patients living alone on health care utilisation. Results After adjusting for patient demographics and clinical characteristics, living alone was significantly associated with a higher probability of utilising emergency department and general practitioner services, with odds ratios of 1.50 (95% confidence interval [CI] 1.16 to 1.93) and 1.40 (95% CI 1.04 to 1.88) respectively. Conclusions Living alone has an impact on health care service utilisation for older patients. We show that general practice data can be used to identify older patients who are living alone, and general practitioners are in a unique position to identify those who could benefit from additional clinical and non-clinical support. Further research is needed to understand the mechanism driving higher utilisation for those patients who live alone. Electronic supplementary material The online version of this article (10.1186/s12877-018-0939-4) contains supplementary material, which is available to authorized users.

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Socioeconomic status and self-reported health among middle-aged Japanese men: results from a nationwide longitudinal study

Koji Wada, Yoshiyuki Higuchi, Derek Smith (2015)

Objective To examine potential associations between socioeconomic factors and self-rated health among a national sample of Japanese men aged 50–59 years between 2005 and 2010, including the 2008 global financial crisis. Design Prospective cohort study. Setting Randomly selected 2515 census areas from a total of 1.8 million census areas in Japan. Participants This study utilised data from a national, longitudinal survey conducted by the Ministry of Health, Labour and Welfare. Starting in 2005, 16 738 Japanese men aged 50–59 years were recruited and sent a questionnaire each year. We analysed data for the 6-year period (2005–2010) from participants who had worked for over 20 years in the same industry (n=9727). Main outcome measures We focused on worsening self-rated health status by occupation, education and employment contract. Results Working in the manufacturing industry was associated with worsening self-rated health scores when compared to those working in management (HR=1.19; 95% CI 1.04 to 1.37). A relationship between education level and worsening self-rated health was also identified as follows: junior high school (HR=1.49; 95% CI 1.31 to 1.69), high school (HR=1.29; 95% CI 1.17 to 1.42), and vocational college (HR=1.25; 95% CI 1.07 to 1.46), when compared with those holding university-level qualifications. Precarious employment (HR=1.17; 95% CI 1.00 to 1.37) was also associated with worsening self-rated health status in the current study. Conclusions This study suggests that working in manufacturing for more than 20 years and having lower education levels may have a significant impact on the self-rated health of middle-aged Japanese men. This may reflect a progressive decline in Japanese working conditions following the global financial crisis and/or the impact of lower socioeconomic status.

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Subjective health in older people

Thomas Gunzelmann, Andreas Hinz, Elmar Brähler (2006)

The Nottingham Health Profile (NHP [1]) is a widely used instrument to measure subjective health in clinical research. However, there are no age-specific norms for older adults in Germany. The present study was conducted to analyze the psychometric properties of the German version of the Nottingham Health Profile (NHP) in older people. Age-specific reference values for the elderly are presented. Subjects were drawn from the general population of older German people aged 61 to 95 years (n=630; mean age 69.5 years; 55.7% female). Five of the six NHP scales revealed a good internal consistency (.70≤α≤.92). The subscales (with the exception of the subscale social isolation) showed moderate relations with instruments measuring somatization disorders and subjective body complaints (Screening for Somatoform Disorders SOMS [2]); Giessen Subjective Complaints List GBB-24 [3]). Compared to younger subjects, subjective health decreases with age. Therefore age-specific reference data for older people are necessary. Differential reference data are reported for four age groups above 60 years of age and for male and female older people. The outcome confirms that the NHP is a reliable, valid instrument to measure subjective health in older people.

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Author and article information

Contributors

Dong Hee Kim:

ORCID: http://orcid.org/0000-0003-2571-8900

dongheekim@pusan.ac.kr

Journal

Journal ID (nlm-ta): BMC Public Health

Journal ID (iso-abbrev): BMC Public Health

Title: BMC Public Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2458

Publication date (Electronic): 20 July 2020

Publication date PMC-release: 20 July 2020

Publication date Collection: 2020

Volume: 20

Electronic Location Identifier: 1133

Affiliations

[1 ]GRID grid.467842.b, ISNI 0000 0004 0647 5429, Health Insurance Review & Assessment Service, ; Wonju, Republic of Korea

[2 ]GRID grid.262229.f, ISNI 0000 0001 0719 8572, College of Nursing, , Pusan National University, ; Beomeo-ri, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do 626–870 Republic of Korea

Author information

Dong Hee Kim http://orcid.org/0000-0003-2571-8900

Article

Publisher ID: 9073

DOI: 10.1186/s12889-020-09073-x

PMC ID: 7370477

PubMed ID: 31898494

SO-VID: a6578558-c973-4b37-a104-6ac57c1e70c6

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 2 December 2019

Date accepted : 8 June 2020

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ScienceOpen disciplines: Public health

Keywords: health care,health care use,health care services,health insurance,medical aid

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ScienceOpen disciplines: Public health

Keywords: health care, health care use, health care services, health insurance, medical aid

Factors influencing health care use by health insurance subscribers and medical aid beneficiaries: a study based on data from the Korea welfare panel study database

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Chinese Journal of School Health

Most cited references 9

The association between living alone and health care utilisation in older adults: a retrospective cohort study of electronic health records from a London general practice

Socioeconomic status and self-reported health among middle-aged Japanese men: results from a nationwide longitudinal study

Subjective health in older people

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