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The aim of the current study is to examine the extent to which equity in the utilization of longterm care services has been achieved in the Republic of Korea (hereafter Korea), based on the Aday—Andersen Access Framework that takes into consideration a series of variables hypothesized as predictive of utilization. The current study used cross-sectional survey data collected and conducted by the Korea Labor Institute (KLI) between August 1 to December 22, 2006. The sample for this study was 5544 persons who are older than 60 years. The study was extracted from a larger nationally representative cross-sectional survey of 10,255 individuals. The stratified cluster sampling technique was used to draw the survey respondents. A self-administered questionnaire was used to collect the data from the sample. Descriptive and logistic regression analysis was performed examining the relationship between the dependent variable and the independent variables and the relative importance of factors. The results indicate that a universal health insurance system has not yielded a fully equitable distribution of services. The limitation of benefit coverage as well as disparities in consumer cost-sharing and associated patterns of utilization across plans high out-of-pocket payment can be a barrier to health care utilization, which results in inequity and differential long-term care utilization between sub-groups of older adults. Health policy reforms in Korea must continue to concentrate on expanding insurance coverage, reducing the inequities reflected in disparities in consumer cost-sharing and associated patterns of utilization across plans, and establishing a financially separate insurance system for poor older adults. The behavioral responses of physicians to the method of reimbursement, and the subsequent impact on overall rates of utilization and expenditures need to be more fully understood. In addition, further research is needed to identify the nonfinancial barriers that persist for certain demographic subgroups, i.e., those 70 and older, men, lacking social network members, those who have four or more family members, and those who have no schooling.
This study compared
persons with disabilities with those without disabilities in terms of health
services utilization and examined the factors associated with the use of
inpatient hospital services. Data on a sample of 4040 older adults (65+ years
of age) from the Korean Longitudinal Study of Ageing were used. Descriptive and
logistic regression analysis was performed examining sample characteristics
of participants with and without disabilities and factors significantly
associated with health services utilization. This study showed that the
elderly with disabilities used significantly more inpatient hospital services
than the elderly without disabilities. As expected, poor health was clearly
the most influential factor explaining the use of inpatient hospital services.
The second most influential factor in determining use of medical services is
disability. Persons with disabilities had a twofold or more increase in the
odds of using inpatient hospital services. Likewise, the person with chronic
condition had also an additional twofold increase in risk for medical services due to the chronic condition. Chronic conditions were clearly the third influential factor explaining the use of
inpatient hospital services. Finally, females were a small margin more likely
to use inpatient hospital services than males.