BackgroundMoral hazard or utilization hazard refers to the phenomenon during which patients overuse medical services under national health insurance (NHI) because the services are free or the patients are required to pay only a portion of the utilization costs. The aim of this study is to investigate how NHI and private health insurance (PHI) systems influence increases in health care utilization rates.MethodsWe designed a longitudinal study to examine the utilization of healthcare services between those insured with NHI or PHI and uninsured Koreans using nationally representative four-year panel data from 13,798 participants. This study was conducted using hierarchical multivariate Poisson regression analyses in which covariates and interaction terms are applied after adjusting for the heterogeneous treatment effect.ResultsAfter adjusting covariates including disease status, lower income Koreans who were covered by medical aid were respectively 2.26 and 1.23 times more likely to receive inpatient care and outpatient care than those who were covered by NHI. When the interaction term of type of insurance was included in the model, those were covered by both medical aid and PHI were respectively 2.38 and 1.25 times more likely to receive inpatient care and outpatient care than those who were covered by only NHI.ConclusionsThe moral hazard behind insurance membership, depending on how NHI maintains policies to confer benefits, may give rise to differences in medical utilization. This phenomenon must be closely monitored to find a way to reform NHI when the rights of medical service consumers are solidified through PHI.
Despite its importance to maternal health, women’s empowerment in developing countries has yet to be adequately addressed. We investigated the effects of women’s empowerment and media use on maternal antenatal care in Southeast Asian countries. The data originate from the Demographic and Health Surveys conducted in Southeast Asia between 2011 and 2014 (n = 35,905). We conducted Poisson regression and meta-analyses to examine communication inequalities in the media use for the relationships between women’s empowerment and maternal health. Women who had decision-making authority for their own health care (incidence rate ratio [IRR] = 1.03, 95% CI = 1.01–1.05), household purchases (IRR = 1.02, 95% CI = 1.00–1.04), and visiting family or relatives (IRR = 1.05, 95% CI = 1.03–1.07) were more likely to receive health care than were study participants whose partners had the decision-making authority. When we added use of each type of media into the model, the women who read a newspaper daily (IRR = 1.10, 95% CI = 1.03–1.20), listened to the radio at least once a week (IRR = 1.02, 95% CI = 1.01–1.03), and watched television daily (IRR = 1.61, 95% CI = 1.55–1.67) were more likely to receive health care than those who did not use media at all. This study revealed that women’s empowerment and their use of media were related to better maternal health care.
There is a need to develop non-occupational intervention programs, which provide workers with training about workplace depression and improve social support, and the programs should provide time for employees to have active communication. Additionally, companies should provide employees with support to access mental healthcare thereby decreasing the occurrence of workplace depression.
Objectives: The purpose of this study is to analyze factors associated with depression among workers in South Korea by socio-economic factors, health behaviors, and working conditions. Methods: Study subjects include 4,251 adults (19 and older) who are currently working using the data from 2009 National Health and Nutrition Survey. Data were analyzed using frequency test, X 2 test, and multiple logistic regression. Results: Multiple logistic regression analysis showed that gender (OR=1.91, p<.001), age (OR=1.53, p=.030), marital status (31-39: OR=1.88, p=.029) were significantly related to depressing among socio-economic factors. Next, among health behaviors factors, perceived health status (Poor: OR=1.76, p=.049; Very poor: OR=3.46, p=.002) was statistically significant. Among characteristics of work environment, trust and respect (OR=1.34, p=.049) and working with hidden emotion (OR=1.88, p<.001) were significantly related to depression. Conclusions: In order to manage and reduce depression among workers, it is important to develop appropriate mental health promotion programs both in work places and in regulations.
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