소득 수준에 따른 미충족 의료: 형평성의 함의 (Income-related inequality in unmet healthcare needs: Implication of equity)

서지정보

· 발행기관 : 한국보건교육건강증진학회
· 수록지 정보 : 보건교육건강증진학회지 / 34권 / 4호 / 83 ~ 97페이지
· 저자명 : 황종남

초록

Objectives: The aim of this study was to assess whether income-related inequality in unmet healthcare needs exists under the Korea’s universal healthcare system, and to quantify each contribution from various socio-demographic factors to the observed inequality. Methods: Data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2010-2012, a nationally representative survey, was utilized. To measure income-related inequality in unmet healthcare needs, individuals over the age of 19 were included in the analyses, and the Concentration Index (CI) was calculated. To identify and quantify contribution from each socio-demographic factor, decomposition of the CI was conducted. Results: Income-related inequality in unmet healthcare needs existed as the CI indicated that unmet needs was concentrated among lower income groups. the inequality persisted even after adjusting for need factors including sex, age, and self-rated health. This suggests that the existing inequality is an inequity matter. Decomposition analysis revealed that income and educational levels were main contributors to the existing inequality with respect to unmet healthcare needs. Conclusions: The findings of this study suggest that the existing inequality in unmet healthcare need is the matter of inequality that should be eliminated to ensure equal care for equal need. In addition, income- and education-related barriers should be tackled to be eliminated at the national level to achieve “equal care for equal need” under the National Health Insurance system.

영어초록

Objectives: The aim of this study was to assess whether income-related inequality in unmet healthcare needs exists under the Korea’s universal healthcare system, and to quantify each contribution from various socio-demographic factors to the observed inequality. Methods: Data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2010-2012, a nationally representative survey, was utilized. To measure income-related inequality in unmet healthcare needs, individuals over the age of 19 were included in the analyses, and the Concentration Index (CI) was calculated. To identify and quantify contribution from each socio-demographic factor, decomposition of the CI was conducted. Results: Income-related inequality in unmet healthcare needs existed as the CI indicated that unmet needs was concentrated among lower income groups. the inequality persisted even after adjusting for need factors including sex, age, and self-rated health. This suggests that the existing inequality is an inequity matter. Decomposition analysis revealed that income and educational levels were main contributors to the existing inequality with respect to unmet healthcare needs. Conclusions: The findings of this study suggest that the existing inequality in unmet healthcare need is the matter of inequality that should be eliminated to ensure equal care for equal need. In addition, income- and education-related barriers should be tackled to be eliminated at the national level to achieve “equal care for equal need” under the National Health Insurance system.

참고자료

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