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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
DOI: https://doi.org/10.3961/jpmph.16.035
  • 8,109 View
  • 208 Download
  • 14 Crossref
AbstractAbstract PDF
Objectives
The objective of this study is to investigate associations between contextual characteristics and unmet healthcare needs in South Korea after accounting for individual factors.
Methods
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.
Results
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.”
Conclusions
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.
Summary

Citations

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  • Association between area deprivation index and concerns to COVID-19: A multi-level analysis of individual and area factors
    Doo Woong Lee, Jieun Jang, Jaeyong Shin
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    BMC Public Health.2024;[Epub]     CrossRef
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    Min-Jeong Park, Mi-Young Chung, Verda Salman
    PLOS ONE.2023; 18(6): e0286425.     CrossRef
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    Myung-Jae Hwang, Shin Young Park, Tae-Ho Yoon, Jinhwa Jang, Seon-Young Lee, Myeongsu Yoo, Yoo-Yeon Kim, Hae-Kwan Cheong, Donghyok Kwon, Jong-Hun Kim
    Epidemiology and Health.2022; 44: e2022107.     CrossRef
  • Unmet Healthcare Needs and Associated Factors Among Korean Enlisted Soldiers
    Eunkyoung Bae, Jeongok Park, Eunyoung Jung
    Military Medicine.2021; 186(1-2): e186.     CrossRef
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    Journal of Korean Academy of Community Health Nursing.2021; 32(2): 131.     CrossRef
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    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
    BMC Health Services Research.2020;[Epub]     CrossRef
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    Dong-Woo Choi, Sang Ah Lee, Doo Woong Lee, Jae Hong Joo, Kyu-Tae Han, SeungJu Kim, Eun-Cheol Park
    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
    Seung Eun Lee, Miyeon Yeon, Chul-Woung Kim, Tae-Ho Yoon, Dongjin Kim, Jihee Choi
    Osong Public Health and Research Perspectives.2019; 10(5): 295.     CrossRef
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    Youngmi Kang, Heesook Son
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    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
DOI: https://doi.org/10.3961/jpmph.15.026
  • 23,866 View
  • 112 Download
  • 7 Crossref
AbstractAbstract PDF
Objectives
Receiving proper dental care plays a significant role in maintaining good oral health. We investigated the relationship between regional deprivation and dental care utilization.
Methods
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).
Results
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.
Conclusions
This study’s findings suggest that policy interventions should be considered to reduce regional variations in rates of dental care utilization for examination.
Summary

Citations

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  • Utilization of dental care among adult populations: a scoping review of applied models
    Ashkan Negintaji Zardak, Mostafa Amini-Rarani, Ibrahim Abdollahpour, Faezeh Eslamipour, Bahareh Tahani
    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
  • Relationship between Subjective Oral Discomfort and Health-Related Quality of Life in the South Korean Elderly Population
    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
    Shiho Kino, Eduardo Bernabé, Wael Sabbah
    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
Nurse-perceived Patient Adverse Events and Nursing Practice Environment
Jeong-Hee Kang, Chul-Woung Kim, Sang-Yi Lee
J Prev Med Public Health. 2014;47(5):273-280.   Published online September 12, 2014
DOI: https://doi.org/10.3961/jpmph.14.019
  • 11,863 View
  • 145 Download
  • 17 Crossref
AbstractAbstract PDF
Objectives
To evaluate the occurrence of patient adverse events in Korean hospitals as perceived by nurses and examine the correlation between patient adverse events with the nurse practice environment at nurse and hospital level. Methods: In total, 3096 nurses working in 60 general inpatient hospital units were included. A two-level logistic regression analysis was performed. Results: At the hospital level, patient adverse events included patient falls (60.5%), nosocomial infections (51.7%), pressure sores (42.6%) and medication errors (33.3%). Among the hospital-level explanatory variables associated with the nursing practice environment, ‘physician- nurse relationship’ correlated with medication errors while ‘education for improving quality of care’ affected patient falls. Conclusions: The doctor-nurse relationship and access to education that can improve the quality of care at the hospital level may help decrease the occurrence of patient adverse events.
Summary

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    Healthcare.2024; 12(4): 460.     CrossRef
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    Haitham Khatatbeh, Annamária Pakai, Dorina Pusztai, Szilvia Szunomár, Noémi Fullér, Gyula Kovács Szebeni, Adrienn Siket, Miklós Zrínyi, András Oláh
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Influence of the Nursing Practice Environment on Job Satisfaction and Turnover Intention
Sang-Yi Lee, Chul-Woung Kim, Jeong-Hee Kang, Tae-Ho Yoon, Cheoul Sin Kim
J Prev Med Public Health. 2014;47(5):258-265.   Published online September 12, 2014
DOI: https://doi.org/10.3961/jpmph.14.002
  • 12,080 View
  • 187 Download
  • 12 Crossref
AbstractAbstract PDF
Objectives
To examine whether the nursing practice environment at the hospital-level affects the job satisfaction and turnover intention of hospital nurses. Methods: Among the 11 731 nurses who participated in the Korea Health and Medical Workers’ Union’s educational program, 5654 responded to our survey. Data from 3096 nurses working in 185 general inpatient wards at 60 hospitals were analyzed using multilevel logistic regression modeling. Results: Having a standardized nursing process (odds ratio [OR], 4.21; p<0.001), adequate nurse staffing (OR, 4.21; p<0.01), and good doctor-nurse relationship (OR, 4.15; p<0.01), which are hospital-level variables based on the Korean General Inpatients Unit Nursing Work Index (KGU-NWI), were significantly related to nurses’ job satisfaction. However, no hospital-level variable from the KGU-NWI was significantly related to nurses’ turnover intention. Conclusions: Favorable nursing practice environments are associated with job satisfaction among nurses. In particular, having a standardized nursing process, adequate nurse staffing, and good doctor-nurse relationship were found to positively influence nurses’ job satisfaction. However, the nursing practice environment was not related to nurses’ turnover intention.
Summary

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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
DOI: https://doi.org/10.3961/jpmph.2014.47.2.104
  • 12,242 View
  • 169 Download
  • 29 Crossref
AbstractAbstract PDF
Objectives

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.

Methods

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.

Results

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.

Conclusions

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.

Summary

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JPMPH : Journal of Preventive Medicine and Public Health