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KMID : 0904520070220010183
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Health and Medical Sociology
2007 Volume.22 No. 1 p.183 ~ p.203
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Impact of Socio-economic status on Equity in Health care Utilization: Cases of Asthma patients
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Chae Su-Mi
Kim Chang-Yup
Ko Su-Kyoung
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Abstract
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This study was performed to investigate the relationship between socioeconomic status (SES) and health care utilization. SES may affect on the prevalence, the morbidity and the mortality in certain diseases. This study mainly focused on the utilization of asthma patients because it is well known that asthma is more prevalent and severe in low socioeconomic groups.
Equity was defined "same amount of utilization for same amount of medical needs". The amount of utilization was measured using health care expenditure. Per capita household income was used as a proxy variable representing SES. Standardized health care expenditure concentration curve and index according to income level was analyzed to show the relationship between SES and the amount of utilization after adjusting sex, age, and medical needs. 660 responses from nationwide sample patients were used for the analysis.
Concentration indexes (CI) of expenditure of outpatient, pharmacy, inpatient, emergency, oriental medicine and alternative treatment, when medical needs were adjusted using disease severity, were -0.023, 0.016, -0.020, -0.002, 0.115, 0.120, respectively. The expenditures of pharmacy, oriental medicine, and alternative medicine were concentrated in high SES. The expenditures of outpatient, inpatient, and emergency were concentrated in low SES.
These results implied that the asthma patients in lower SES receive less regular medication which makes patients severe. Consequently, the patients in lower SES are more likely to be admitted and to spend more money (i. e. more economic burden). It should be noted that inappropriate regular treatment due to low SES makes disease severity and economic condition of patients worse.
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KEYWORD
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asthma, socio-economic status, equity, health care utilization
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