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An Analysis of Income-Related Equity in Health Services Utilization in Korea

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ꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚ

ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ

An Analysis of Income-Related Equity

in Health Services Utilization in Korea

Youngho Oh

ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ

ꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚ

This study assesses and quantifies income-related inequity in the health service utilization just after the introduction of national health insurance system. Regression-based approach was used for assessment and quantification of the equity using data from the 1989 Korean National Health Survey. The regression-based test results for income-related inequity suggested that lower income individuals have relatively less access to outpatient health service than higher income groups in terms of entry into outpatient health services market, the number of visits and the logarithm of total out-of-pocket costs. In contrast, even though there is inequity in entry into drugstore health service market, there is little evidence that there is difference in the number of drugstore visits and the logarithm of total out-of-pocket costs of drugstore health services by income. Although the reduction in the importance of money price improved accessibility to health services, there was still income-related inequity in outpatient health services, which means that outpatient health service utilization rose with an increase in income.

◎ Key Word: Equity, Health Service Utilization, Health Insurance System, Income-related Inequity

筆者: 本院 責任硏究員

(2)

요 약

ꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚ

우리나라의 醫療利用에 있어서 所得關聯

衡平性에 관한 分析

吳 泳 昊

ꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚꠚ 이 연구는 1989년 전국민 건강설문조사자료를 사용하여 우리나라의 의료이용에 있어서 소득관련 비형평성이 존재하는지를 회귀분석 접근법 을 적용하여 평가하고 그 정도를 계량화하였다. 분석결과에 의하면 외래의료시장 진입과 외래의료이용량의 관점에서 비형평성이 존재하였다. 즉 같은 건강상태하에서 하위소득계층이 상위소 득계층보다 상대적으로 낮은 의료이용을 보였다. 반면, 약국의료에서는 약국의료이용여부에 소득계층간 비형평성이 존재하였지만, 약국의료이용 량을 나타내는 약국방문횟수와 약국본인부담비에서는 소득계층간 차이 가 나지 않았다. 전국민의료보험의 도입으로 의료의 화폐가격의 중요성이 감소되었지 만, 여전히 외래의료이용에ㅔ서 소득관련 비형평성이 존재하였다. 따라 서 이러한 소득계층간 비형평성을 줄이기 위한 정책적 방안이 마련되어 야 한다.

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