EQ‐5D로 측정된 소득 계층별 건강집중지수의 분해 = Decomposition of the Health Concentration Index by Health Dimensions Applied on EQ‐5D

다국어 초록 (Multilingual Abstract)

The concentration index has been widely used as a measure of income
related inequality in health. The purpose of the study is to measure income
related health inequality in the overall index of the EQ-5D which is one of
health-related quality of life measures as well as the contributions from each
of its 6 dimensions included dimension of dysfunction. The study used
data(N=24,169) collected from the Korean version of the EQ-5D survey of the
general Korean population, as a part of the Korea National Health & Nutrition
Examination Survey in 2005 and a health value set for the 243 health status
of EQ-5D which estimated by Kang et al.(2006).
Regarding income related inequality in health, the overall health concentration
index was 0.035, indicating that health is concentrated among higher income
groups. The concentration indices for 6 dimensions of the EQ-5D scales
varied with each dimension, which was ranged from 0.0106 for dysfunction to
0.0014 for mobility. The result showed that each dimension of the EQ-5D
scales did not contribute equally to the overall health inequality. Pain/
discomfort and dysfunction contributed 29.8% and 30.3%, respectively, to the
total health inequality, which are contrasted with small contributions of
mobility(3.9%) or self-care(4.4%).
The study implied that these results should be taking into account in policy
deliberation process in order to reduce income related health inequality
among South Korean.

국문 초록 (Abstract)

집중지수는 소득계층별 건강불평등을 측정하는 지표로 많이 이용되어 왔다. 본 연구의 목적은 건강관련 삶의 질을 측정하는 종합지표인 EQ-5D를 이용한 소득계층별 건강불평등을 측정하고, EQ-5D의 6개 건강영역별(기능악화 영역 포함)로 건강불평등에의 기여도를 알아보는 것이다. 연구 자료는 “2005 국민건강영양조사”의 EQ-5D 자료와 EQ-5D를 이용한 243개 건강상태에 대한 건강가치 추계 자료(강은정 등, 2006)이며, 연구 대상자는 19세 이상의 성인 24,169명이다. 소득계층별 건강집중지수의 크기는 0.035이었다. 이는 건강이 고소득층에 집중되어 있음을 의
미한다. EQ-5D의 6개 건강영역별 집중지수의 크기는 0.0106(기능악화 영역)에서 0.0014(운동능력)까지 건강영역별로 차이가 있었다. 이는 EQ-5D의 6개 개별 건강영역이 소득계층별 전체 건강 불평등에의 기여정도가 다르다는 것을 의미한다. EQ-5D의 개별 건강영역별 건강불평등에의 기여 도를 보았을 때, 기능악화 영역(30.3%)과 통증/불편감(29.8%)의 기여도가 가장 컸으며, 그 다음 으로 불안/우울 17.2%, 일상활동이 14.4% 기여하고 있는 것으로 나타났다. 한편 운동능력과 자
기관리의 건강불평등 기여도는 각각 3.9%, 4.4%에 지나지 않았다. 소득계층별 건강불평등을 줄이기 위한 정책 시행시 개별 건강영역별 건강불평등의 기여 정도가 다르다는 점이 고려되어, 건강불평등이 큰 건강영역 중심으로 건강불평등 해소방안이 강구되어야 할 것이다.

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