Yeong n Ju

Association between reduction in copayment and gastric cancer patient concentration to the capital area in South Korea: NHI cohort 2003–2013

Since 2004, the South Korean government has introduced a policy that decreases copayment for cancer patients by strengthening public coverage in the National Health Insurance (NHI) system (first phase=copayment for outpatient care from 30% to 20%; second phase=copayment for total medical expenditures from 20% to 10%; third phase=copayment for total medical expenditures from 10% to 5%). We aimed to investigate the relationship between the policy introduction and patient visits to hospitals in the capital area. We used data from the NHI Cohort 2003-2013, which included all medical claims (7193 cases) filed for 2124 patients who visited the hospital due to stomach cancer, and performed a segmented Poisson regression analysis. Of all hospital visits, 40.6% of patients were from the capital area. After the introduction of the second phase of the policy, there was an increase in patient concentration in the capital area, although there were no significant effects on patient concentration during the first and third phases of the policy. In conclusion, our findings suggest that the introduction of a policy that reduces copayment for cancer patients had a substantial impact on patient concentration in the capital area. Therefore, health policymakers should consider effective alternatives including efficient allocation of medical resources or support for the more vulnerable population as flexible benefit plans to aid healthcare utilization by cancer patients.

The effect of childhood and current economic status on depressive symptoms in South Korean individuals: a longitudinal study

BackgroundMental health inequality along the economic strata is prominent in South Korea, particularly as intergenerational material transfer is becoming increasingly important in gaining economic status. Therefore, this study aimed to investigate the relationship between current and childhood economic status and depressive symptoms in adults aged 20 or above.MethodsThis study used data from the Korean Welfare Panel Study (KOWEPS), 2010 to 2013. A total of 9,645 individuals aged 20 years or above without depressive symptoms in 2010 were analyzed. The effect of childhood and current economic status, categorized into low, middle, and high groups, on depressive symptoms was investigated using hierarchical logistic regression models. Depressive symptoms were measured using the Center for Epidemiological Studies Depression (CES-D 11) scale. Subgroup analysis was performed based on education level.ResultsCompared to the middle current-middle childhood economic status group, the low-low group (OR: 1.88, CI: 1.61-2.20), low-middle group (OR: 1.68, CI: 1.43-1.98), and low-high group (OR: 1.64, CI: 1.34-2.01) were more likely to have depressive symptoms. The high-low group (OR: 0.68, CI: 0.55-0.84), high-middle group (OR: 0.67, CI: 0.56-0.81), and high-high group (OR: 0.45, CI: 0.27-0.75) were less likely to have depressive symptoms. This trend was generally maintained with regard to education level, but the effects were not statistically significant in the high current economic status groups among participants with a university degree or above.ConclusionLow current economic status was associated with a higher likelihood of depressive symptoms. In particular, the low current-low childhood economic status group showed the highest likelihood of depressive symptoms, suggesting the adverse mental health effects of prolonged poverty. Therefore, the findings reveal that mental health inequalities are present along the economic strata and require proper addressing of the mental health of lower income individuals.

Quality of life and national pension receipt after retirement among older adults.

As the aging population (including baby boomers) retires, its members face the problem of retirement security. Social security, including the national pension, is the most important source of retirement security and thus directly affects the well‐being of retired older adults. We investigated the relationship between national pension receipt and quality of life (QoL) among Koreans aged 60 years or older.

Sleep disorders and risk of hospitalization in patients with mood disorders: Analysis of the National Sample Cohort over 10 years

Medical utilization due to organic sleep disorders has increased remarkably in South Korea, which may contribute to the deterioration of mental health in the population. We analyzed the relationship between organic sleep disorders and risk of hospitalization due to mood disorder. We used data from the National Health Insurance Service (NHIS) National Sample Cohort 2002-2013, which included medical claims filed for the 15,537 patients who were newly diagnosed with a mood disorder in a metropolitan region, and employed Poisson regression analysis using generalized estimating equation (GEE) models. By the results, there was a 0.53% hospital admission rate among 244,257 patients with outpatient care visits. Patients previously diagnosed with an organic sleep disorder before specific outpatient care had a higher risk for hospitalization. Such associations were significant in females, patients with a longer duration of disease, or those who lived in the largest cities. In conclusion, considering that experiencing a sleep disorder by a patient with an existing mood disorder was associated with deterioration of their status, health policy makers need to consider insurance coverage for all types of sleep disorders in patients with psychological conditions.

Low socioeconomic status and suicidal ideation among elderly individuals.

BACKGROUND Suicide rates are high among elderly individuals experiencing socioeconomic insecurity. Socioeconomic security is of critical importance for elderly individuals and directly affects mental health, including suicidal behavior. Thus, we investigated the relationship between socioeconomic status and suicidal ideation in elderly individuals. METHOD We conducted a cross-sectional study using data on 58,590 individuals 65 years of age or older from the Korean Community Health Survey 2013. Logistic regression analysis was used to identify relationships between socioeconomic factors (food insecurity, household income, and living arrangement) and suicidal ideation in the elderly population. RESULTS The study included 58,590 participants (24,246 males and 34,344 females). Of those, 2,847 males and 6,418 females experienced suicidal ideation. Participants with food insecure were more likely to experience suicidal ideation than were those who were food secure (males: OR = 1.60; 95% CI, 1.34-1.90; females: OR = 1.54; 95% CI, 1.38-1.72). We found a similar pattern among participants with a low household income and those living alone. Additionally, male and female subjects who were food insecure and living alone or food insecure and had a low household income showed a marked increase in suicidal ideation. CONCLUSION Our findings suggest that low socioeconomic status is associated with an increased risk of suicidal ideation among the elderly. Furthermore, intervention programs that address the prevalence of elderly suicide, particularly among those who are socioeconomically disadvantaged, are needed.

Is one's usual dinner companion associated with greater odds of depression? Using data from the 2014 Korean National Health and Nutrition Examination Survey.

Background: Support from one’s family has been reported to have a positive effect on depression severity. Hence, family dinnertimes, when whole family can gather together, can be effective to depression by providing support from family. Aims: We investigate the association between the dinner companion and depression, and the differences in this association by gender, living arrangement and household composition. Methods: We used the Korea National Health and Nutrition Examination Survey 2014 data. A total of 4,181 individuals were included. We classified participants by their dinner companions as follows: dinner with family, dinner with others and eating alone. Depression was measured by using the 9-item Patient Health Questionnaire. Logistic regression analysis was used to investigate the association. Result: Those who ate dinner alone (odds ratio (OR): 1.53, 95% confidence interval (CI): 1.04–2.25) had higher depression rate compared to those who had dinner with family. The subgroup analysis indicated that men, those who live with others and those living in a second-generation household who ate dinner alone had greater odds of having depressive symptoms. Conclusion: Those who usually eat dinner alone have greater odds of developing depression compared to those who have dinner with their family. As such, family dinnertimes may help to alleviate depressive moods.

The impact of occupation according to income on depressive symptoms in South Korean individuals: Findings from the Korean Welfare Panel Study

Background: In South Korea, societal perceptions on occupation are distinct, with people favouring white collar jobs. Hence both occupation type and income can have mental health effects. Aim: To examine the relationship between occupational classification and depression, along with the combined effect of occupational classification and household income. Methods: Data were from the Korean Welfare Panel Study (KOWEPS), 2010–2013. A total of 4,694 economically active participants at baseline were followed. Association between occupational classification and depression, measured using the Center for Epidemiological Studies Depression (CES-D) scale 11, was investigated using the linear mixed effects model. Results: Blue collar (β: 0.3871, p = .0109) and sales and service worker groups (β: 0.3418, p = .0307) showed higher depression scores than the white collar group. Compared to the white collar high-income group, white collar low income, blue collar middle income, blue collar middle-low income, blue collar low income, sales and service middle-high income, sales and service middle-low income and sales and service low-income groups had higher depression scores. Conclusion: Occupational classification is associated with increasing depression scores. Excluding the highest income group, blue collar and sales and service worker groups exhibit higher depression scores than their white collar counterparts, implying the importance of addressing these groups.

The influence of family stress and conflict on depressive symptoms among working married women: A longitudinal study

ABSTRACT In the present study, researchers examined the association between depressive symptoms and family stress and conflict from multiple roles, along with the combined effect of family stress and family-work conflict. We used data from the 2008–2012 Korean Welfare Panel Study, consisting of 4,663 baseline participants. We measured depressive symptoms using the 11-item Center for Epidemiologic Studies Depression Scale. There was a significant relationship between depressive symptoms and family stress and conflict among working married women. With regard to the combined analysis, working married women who reported both family stress and family-work conflict exhibited the highest odds of depressive symptoms.

The association between objective income and subjective financial need and depressive symptoms in South Koreans aged 60 and older

This study aimed to investigate the effect of the gap between objective income and subjective financial need on depressive symptoms in individuals aged 60 and older.

Temporary work and depressive symptoms in South Korean workers

Background In many countries, including South Korea, labour market changes have led to an increase in unstable, temporary jobs. There is evidence that workers in such jobs may experience poorer mental health than those in more stable employment. Aims To investigate the association between temporary employment and depressive symptoms in South Korean workers. Methods We analysed data from the 2010-2014 Korean Welfare Panel Study (KOWEPS). Employment type was categorized into workers paid per day of labour (day labourers), those on short-term contracts (fixed-term workers) and permanent workers. The association between employment type and depressive symptoms, measured using the Center for Epidemiological Studies Depression scale (CES-D 11), was examined using the generalized estimating equation model. Results A total of 3756 workers aged 20-59 were included in the 2010 baseline population. Day labourers had the highest mean CES-D 11 score, followed by fixed-term workers and permanent workers. With the day labourer group as reference, fixed-term workers (β: -1.5027, P < 0.001) and permanent workers (β: -2.1848, P < 0.001) showed statistically significant decreases in depression scores. Conclusions Compared with day labourers, fixed-term workers and permanent workers had progressively lower depression scores. The findings of this study suggest that mental health inequalities based on employment type exist in South Korea.