1인 가구의 의료이용 형평성: 다인 가구와의 비교를 통하여 = The Equity in Health Care Utilization of One-Person Households: By Comparison with Multi-Person Households

다국어 초록 (Multilingual Abstract)

Background: The one-person households (OPH) are rapidly increasing and vulnerable to socioeconomic and health problems.
Because it is predicted to be inequitable to health care utilization, we would like to find out about the equity of health care utilization of the OPH by comparison with the multi-person households (MPH).
Methods: This study followed the theoretical framework of Wagstaff and van Doorslaer (2000), O’Donnell and his colleagues (2008), where the horizontal inequity index is the difference between the concentration indices of actual health care utilization and health care needs. This study employed the 9th Korea Health Panel survey, and a total of 10,807 cases were analyzed. Health care needs were measured by age, sex, subjective health status, chronic disease count, Charlson’s Comorbidity Index, limitation of activities, and disability.
Results: Compared with the MPH, there were pro-poor inequities in hospitalization, emergency utilization, hospitalization out-of-pocket payments, and pro-rich inequities in outpatient out-of-pocket payments for the OPH. The decomposition of the concentration index revealed that chronic disease count made the largest contribution to socioeconomic inequality in outpatient utilization. Age, health insurance, economic activities, and subjective health status also proved more important contributors to inequality. The variables contributing to the hospitalization and emergency utilization inequity were age, education, Charlson’s Comorbidity Index, marital status, and income.
Conclusion: Because the OPH was more vulnerable to health problems than the MPH and there were pro-poor inequities in medical utilization, hospitalization, and emergency costs, it is necessary to develop a policy that can correct and improve the portion of high contribution to medical utilization of the OPH.

참고문헌 (Reference)

1 안은숙, "치과의료 이용의 수평적 형평성 분석" 대한예방치과·구강보건학회 39 (39): 9-16, 2015

2 김동진, "의료패널자료를 활용한 우리나라의 의료이용 불평등 측정" 한국보건사회연구원 34 (34): 33-58, 2014

3 김혜영, "유동하는 한국가족 : 1인가구를 중심으로" 한국사회연구소 15 (15): 255-292, 2014

4 김은경, "우리나라 여성 1인가구와 다인가구 여성의 건강행태 및 질병이환율 비교 : 2013년 지역사회 건강조사를 중심으로" 한국보건간호학회 30 (30): 483-494, 2016

5 조홍준, "보건의료에서의 형평성: 우리나라의 현황" 대한의사협회 56 (56): 184-194, 2013

6 사공진, "만성질환자의 의료이용과 의료비 지출의 형평성 분석" 한국보건경제정책학회 18 (18): 79-101, 2012

7 김승전, "독거노인과 배우자 동거노인의 우울증 비교" 대한생물치료정신의학회 21 (21): 192-198, 2015

8 이정찬, "당뇨병 외래환자의 상급병원 이용에 영향을 미치는 요인" 대한의사협회 55 (55): 1215-1225, 2012

9 Kim DJ, "Study on horizontal inequity in health care utilization in Korea" Korea Institute for Health and Social Affairs 2011

10 Kang EN, "Single-person households in South Korea and their policy implications" (234) : 47-56, 2016

11 Wagstaff A, "On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam" 112 (112): 207-223, 2003

12 Wagstaff A, "Measuring and testing for inequity in the delivery of health care" 35 (35): 716-733, 2000

13 Statistics Korea, "Household projections by province: 2015-2045" Statistics Korea

14 신호성, "EuroQol-5 Dimension 건강가중치를 이용한 한국인의 건강수준의 형평성 측정" 대한예방의학회 41 (41): 165-172, 2008

15 Chun SY, "Disparities in avoidable hospitalization by income in South Korea: data from the National Health Insurance cohort" 29 (29): 225-231, 2019

16 Kim DJ, "Developing health inequalities report and monitoring the status of health inequalities in Korea" Korea Institute for Health and Social Affairs 2016

17 O'Donnell O, "Analyzing health equity using household survey data: a guide to techniques and their implementation" World Bank 2008

18 Kim HY, "A survey on family consciousness and living conditions of non-married one-person households" Korean Women’s Development Institute 2007

19 Ban JH, "A study on the employment and poverty of one-person household" Korea Labor Institute 2014

20 하지경, "1인가구의 건강관련 습관적 소비, 생활시간이 주관적 건강에 미치는 영향: 비1인가구와 세대별 비교를 중심으로" 대한가정학회 55 (55): 141-152, 2017