Income-related Inequality of Health Care Utilization in Korea, 2009-2015
사회보장연구
2019, vol.35, no.2, pp.63~92(29 pages)
UCI : http://uci.or.kr/
한국사회보장학회
연구분야 : 사회과학 > 사회보장연구
김진구
(협성대학교)
초록
제4차 및 제5차「근로환경조사」자료를 활용하여 신체？정신적 건강, 근로환경, 개인특성, 직장특성 등이 취업자의 ‘일과 삶의 균형(WLB)’에 미치는 영향을 분석하였다. 전체 표본, 임금근로자 표본, 자영업자/사업주 표본을 대상으로 순서형 로짓모형을 추정하였다. OMD 추정법에 기반한 검정 결과, WLB 분석 모형이 임금근로자 표본과 자영업자/사업주 표본 간에 동질적이라는 가설은 기각되었다. 분석 결과, 신체？정신적 건강은 WLB에 긍정적인 영향을 주고, 근로시간은 길어질수록 그리고 시간외 근무는 빈번할수록 WLB를 악화시키는 것을 확인하였다. 제5차 임금근로자 표본에서는 유연근무제가 WLB에 미치는 영향이 소멸하는 것으로 나타났다. 임금근로자의 경우 일용직/임시직 근로자에 비해 상용직 근로자의 WLB가 더 높고, 자영업자/사업주의 경우 고용원이 있는 자영업자/사업주에 비해 고용원이 없는 자영업자의 WLB가 더 낮았다.
This study examined the changing trends of the income-related inequality in health cate utilization in Korea from 2009 to 2015, using Korea Health Panel Data. The Concentration Index(C) and HI index were used for measuring the equity and decomposed into their major influence factors. The main results of this study are the followings.
First, Concentration Index of health care utilization in 2009 was -.1785. but it has been gradually declined and indicated -.2083 in 2015. It means there was pro-poor inequity within given periods, and it has grown more slowly. But this trend has resulted from high demand for health care services by low-income group and this make HI Index much higher than Concentration Index. The former ranged -.005 to -.003 in that period.
Second, based on comparative analysis between the Concentration Index decomposition of 2010 and that of 2015, the aging of population in Korea, especially the growth of people aged 70 or more was a major factor in the changing trend of inequality in health care utilization.
Finally, the continued reduction in the number of Medical Aid Program recipients and the rapid expansion of private health insurance had a decisive effect on making pro-rich inequity increase. Therefore it is necessary for governments to expand the medical assistance programs for low income households including the extension of population coverage by Medical Aid Program.
