Influencing Factors of Transportation Costs regarding Healthcare Service Utilization in Korea

Jeon²

2023

Int J Public Health

Objectives: This study examines the inequality between people with and without disabilities regarding unmet healthcare needs and preventable hospitalization.Methods: We used the Korea Health Panel of 2016–2018; the final analytical observations were 43,512, including 6.95% of persons with disabilities. We examined the differences in contributors to the two dependent variables and decomposed the observed differences into explained and unexplained components using the Oaxaca-Blinder approach.Results: Unmet healthcare needs and preventable hospitalizations were 5.6% p (15.36% vs. 9.76%) and 0.68% p (1.82% vs. 0.61%), respectively, higher in people with disabilities than in those without, of which 48% and 35% were due to characteristics that the individual variables cannot explain. Decomposition of the distributional effect showed that sex, age, and chronic disease significantly increased disparities for unmet healthcare needs and preventable hospitalization. Socioeconomic factors such as income level and Medical aid significantly increased the disabled–non-disabled disparities for unmet healthcare needs.Conclusion: Socioeconomic conditions increased the disparities, but around 35%–48% of the disparities in unmet healthcare needs and preventable hospitalization were due to unexplained factors, such as environmental barriers.

Section: Dependent Variablesmentioning

confidence: 87%

Section: Data Source and Participantsmentioning

confidence: 99%

Decomposing Disability Inequality in Unmet Healthcare Needs and Preventable Hospitalizations: An Analysis of the Korea Health Panel

Jeon²

2023

Int J Public Health

“…This study examined only out-of-pocket expenses of health insurance, but receiving treatment in a different region involves additional costs for transport and the accompanying caregiver (if any) and additional time, doubling the total costs. 28 If local residents travel to other regions to receive essential medical services because there is no reliable healthcare delivery system in the residential region, such additional costs are incurred by them alone. Therefore, the total medical expenses spent in other regions can help estimate the costs that can be saved by building a local healthcare delivery system that ensures essential medical services.…”

Section: Discussionmentioning

confidence: 99%

Relevance Index Regional Variation by Each Disease and Its Essential Medical Field: A Retrospective Data Analysis From 2016-2020 in Korea

Pyo²,

Lee

et al. 2023

J Korean Med Sci

Background To precisely build a healthcare delivery system at regional levels, local patients’ healthcare service utilization patterns must be examined. Hence, this study utilized trend analysis of the relevance index of each disease of each essential medical service field at the municipal and provincial levels. Methods This study analyzed customized databases released by the National Health Insurance Service from 2016–2020. Diseases defined in the Korean National Burden of Disease (KNBD) study were categorized into the following essential medical service fields: trauma care, cardiocerebrovascular, maternal and neonatal, mental health, infection, cancer, older adults’ care and rehabilitation, and others. Relevance index, the percentage of medical service utilization in a region by the residents of that region relative to their total medical service utilization, was examined by region (17 municipal and provincial regions) and disease area. The relevance index was determined based on the number of patients and the total out-of-pocket expenses. Result Eight of the 17 regions showed over a 90.0% relevance index in the infection area. In the cancer area, 14 regions (not including Seoul, Daegu, and Busan) had a relevance index lower than 75.0%. Throughout the analysis period (2016–2020), there were no significant variations in the relevance index. Diseases such as bone and connective tissue cancer (39.0%), neural tube defects (16.7%), and autism (57.1%) had low relevance index in the essential medical service fields. In all 17 regions, the relevance index of inpatients was lower than that of outpatients, and that for out-of-pocket expenses was lower than that based on the number of patients. Conclusion The relevance index of major diseases of each essential medical service field calculated in this study can provide good indicators for monitoring the level of an independent regional healthcare delivery system.

“…Besides, the transportation cost burden on people living in rural areas and low-income populations are higher. Therefore, patients in these vulnerable groups carry a double burden from cancer [31]. Studies on treatment outcomes in settings where all patients with cancer receive equal access to treatment and supportive care confirmed that similar treatments yield similar outcomes [28,29].…”

Section: Discussionmentioning

confidence: 99%

Association between Moving to a High-Volume Hospital in the Capital Area and the Mortality among Patients with Cancer: A Large Population-Based Cohort Study

Choi

Park

2021

IJERPH

This study aimed to identify the association between moving to a high-volume hospital and the mortality of patients with cancer living in the district. The study population comprised participants diagnosed with cancer within the past nine years (2004–2012). The final sample included 8197 patients with cancer, 3939 were males (48.1%), and 4258 were females (51.9%). A Cox proportional hazard model was used to estimate the hazard ratio (HR) for death. Confounding variables including sex, age, type of social security, income level, disability, and utilization volume were incorporated into the model. Among patients with cancer living in the district, 2874 (35.1%) used healthcare services in Seoul. About 10% (n = 834) of patients died during the follow-up period. The HR for death in females (HR: 0.68, 95% CI: 0.58–0.81) was lower than that in males. Additionally, the HR for the death of patients using healthcare services in Seoul (HR: 1.30, 95% CI: 1.11–1.53) was higher than those patients who did not use healthcare services in Seoul. Among patients utilizing services in the province, wealthier patients’ survival probability was significantly higher than that of others. The cause of income differences should be identified, and accessibility to medical use of low-income families should be enhanced to prevent mortality of patients from cancer disparities.