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Seung Eun Lee 3 Articles
The Association Among Individual and Contextual Factors and Unmet Healthcare Needs in South Korea: A Multilevel Study Using National Data
Seung Eun Lee, Miyeon Yeon, Chul-Woung Kim, Tae-Ho Yoon
J Prev Med Public Health. 2016;49(5):308-322.   Published online September 7, 2016
  • 8,126 View
  • 208 Download
  • 14 Crossref
AbstractAbstract PDF
The objective of this study is to investigate associations between contextual characteristics and unmet healthcare needs in South Korea after accounting for individual factors.
The present study used data from the 2012 Korean Community Health Survey (KCHS) of 228 902 adults residing within 253 municipal districts in South Korea. A multilevel analysis was conducted to investigate how contextual characteristics, defined by variables that describe the regional deprivation, degree of urbanity, and healthcare supply, are associated with unmet needs after controlling for individual-level variables.
Of the surveyed Korean adults, 12.1% reported experiencing unmet healthcare needs in the past. This figure varied with the 253 districts surveyed, ranging from 2.6% to 26.2%. A multilevel analysis found that the association between contextual characteristics and unmet needs varied according to the factors that caused the unmet needs. The degree of urbanity was associated with unmet need due to “financial burden” (odds ratio [OR], 0.53; 95% confidence interval [CI], 0.42 to 0.66 for rural vs. metropolitan), but not unmet need due to “service not available when needed.” There were no significant associations between these unmet need measures and regional deprivation. Among individual-level variables, income level showed the highest association with unmet need due to “financial burden” (OR, 5.63; 95% CI, 4.76 to 6.66), while employment status showed a strong association with unmet need due to “service not available when needed.”
Our finding suggests that different policy interventions should be considered for each at-risk population group to address the root cause of unmet healthcare needs.


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    Epidemiology and Health.2022; 44: e2022107.     CrossRef
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  • Factors Affecting Unmet Healthcare Needs among Adults with Chronic Diseases
    Ji-Young Han, Hyeon-Sook Park
    Journal of Korean Academy of Community Health Nursing.2021; 32(2): 131.     CrossRef
  • Factors Influencing Unmet Healthcare Needs among Older Korean Women
    Jung A. Choi, Oksoo Kim
    International Journal of Environmental Research and Public Health.2021; 18(13): 6862.     CrossRef
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    Purity Njagi, Jelena Arsenijevic, Wim Groot
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  • Effect of socioeconomic deprivation on outcomes of diabetes complications in patients with type 2 diabetes mellitus: a nationwide population-based cohort study of South Korea
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    BMJ Open Diabetes Research & Care.2020; 8(1): e000729.     CrossRef
  • Neighborhood Deprivation and Unmet Health Care Needs: A Multilevel Analysis of Older Individuals in South Korea
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    Osong Public Health and Research Perspectives.2019; 10(5): 295.     CrossRef
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    Youngmi Kang, Heesook Son
    Asia Pacific Journal of Public Health.2017; 29(6): 495.     CrossRef
  • Regional Disparity and Factors Influencing Unmet Medical Needs: A Study Based on the Sixth Korea National Health and Nutrition Examination Survey (2015)
    Ji Hye Lim
    Osong Public Health and Research Perspectives.2017; 8(5): 295.     CrossRef
Dental Care Utilization for Examination and Regional Deprivation
Cheol-Sin Kim, Sun-Young Han, Seung Eun Lee, Jeong-Hee Kang, Chul-Woung Kim
J Prev Med Public Health. 2015;48(4):195-202.   Published online July 23, 2015
  • 23,889 View
  • 113 Download
  • 7 Crossref
AbstractAbstract PDF
Receiving proper dental care plays a significant role in maintaining good oral health. We investigated the relationship between regional deprivation and dental care utilization.
Multilevel logistic regression was used to identify the relationship between the regional deprivation level and dental care utilization purpose, adjusting for individual-level variables, in adults aged 19+ in the 2008 Korean Community Health Survey (n=220 258).
Among Korean adults, 12.8% used dental care to undergo examination and 21.0% visited a dentist for other reasons. In the final model, regional deprivation level was associated with significant variations in dental care utilization for examination (p<0.001). However, this relationship was not shown with dental care utilization for other reasons in the final model.
This study’s findings suggest that policy interventions should be considered to reduce regional variations in rates of dental care utilization for examination.


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    BMC Oral Health.2023;[Epub]     CrossRef
  • Dental Expenditure by Household Income in Korea over the Period 2008–2017: A Review of the National Dental Insurance Reform
    Hosung Shin, Han-A Cho, Bo-Ra Kim
    International Journal of Environmental Research and Public Health.2021; 18(8): 3859.     CrossRef
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    Kyung-Yi Do, Sook Moon
    International Journal of Environmental Research and Public Health.2020; 17(6): 1906.     CrossRef
  • Change over a period of 9 years in self-reported oral health of a middle-aged population using 4-6th KNHANES data
    Song-Yi Kim, Nam-Hee Kim
    Journal of Korean Academy of Oral Health.2019; 43(2): 50.     CrossRef
  • The role of healthcare system in dental check‐ups in 27 European countries: multilevel analysis
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    Journal of Public Health Dentistry.2017; 77(3): 244.     CrossRef
  • The Association Among Individual and Contextual Factors and Unmet Healthcare Needs in South Korea: A Multilevel Study Using National Data
    Seung Eun Lee, Miyeon Yeon, Chul-Woung Kim, Tae-Ho Yoon
    Journal of Preventive Medicine and Public Health.2016; 49(5): 308.     CrossRef
  • Dental care utilization in the west of Iran: a cross-sectional analysis of socioeconomic determinants
    Satar Rezaei, Esmail Ghahramani, Mohammad Hajizadeh, Bijan Nouri, Sheno Bayazidi, Fatemah Khezrnezhad
    International Journal of Human Rights in Healthcare.2016; 9(4): 235.     CrossRef
The Incidence of Stroke by Socioeconomic Status, Age, Sex, and Stroke Subtype: A Nationwide Study in Korea
Su Ra Seo, Su Young Kim, Sang-Yi Lee, Tae-Ho Yoon, Hyung-Geun Park, Seung Eun Lee, Chul-Woung Kim
J Prev Med Public Health. 2014;47(2):104-112.   Published online March 31, 2014
  • 12,254 View
  • 169 Download
  • 29 Crossref
AbstractAbstract PDF

To date, studies have not comprehensively demonstrated the relationship between stroke incidence and socioeconomic status. This study investigated stroke incidence by household income level in conjunction with age, sex, and stroke subtype in Korea.


Contributions by the head of household were used as the basis for income levels. Household income levels for 21 766 036 people were classified into 6 groups. The stroke incidences were calculated by household income level, both overall within income categories and further by age group, sex, and stroke subtype. To present the inequalities among the six ranked groups in a single value, the slope index of inequality and relative index of inequality were calculated.


In 2005, 57 690 people were first-time stroke patients. The incidences of total stroke for males and females increased as the income level decreased. The incidences of stroke increased as the income level decreased in those 74 years old and under, whereas there was no difference by income levels in those 75 and over. Intracerebral hemorrhage for the males represented the highest inequality among stroke subtypes. Incidences of subarachnoid hemorrhage did not differ by income levels.


The incidence of stroke increases as the income level decreases, but it differs according to sex, age, and stroke subtype. The difference in the relative incidence is large for male intracerebral hemorrhage, whereas the difference in the absolute incidence is large for male ischemic stroke.



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JPMPH : Journal of Preventive Medicine and Public Health