Kim Jae-Hyun, Lee Kwang Soo, Lee Yunhwan, Park Eun-Cheol
Department of Health Administration, Dankook University College of Health Science, Cheonan, Korea.
Institute of Health Promotion and Policy, Dankook University, Cheonan, Korea.
Korean J Fam Med. 2017 Nov;38(6):365-371. doi: 10.4082/kjfm.2017.38.6.365. Epub 2017 Nov 14.
To investigate the impact of indicators of occupational class on healthcare utilization by using longitudinal data from a nationally representative survey.
Data were obtained from the Korean Welfare Panel Study conducted from 2006 (wave 1) through 2014 (wave 9). A total of 5,104 individuals were selected at baseline (2006). Analysis of variance and longitudinal data analysis were used to evaluate the following dependent variables: number of outpatient visits and number of days spent in the hospital per year.
The number of annual outpatient visits was 4.298 days higher (P<0.0001) in class IV, 0.438 days higher (P=0.027) in class III, and 0.335 days higher (P=0.035) in class II than in class I. The number of days spent in the hospital per year was 0.610 days higher (P=0.001) in class IV, 0.547 days higher (P<0.0001) in class III, and 0.115 days higher (P=0.136) in class III than in class I. In addition, the number of days spent in the hospital in class IV patients with unmet healthcare needs showed an opposite trend to that predicted on the basis of socioeconomic status (estimate,-8.524; P-value=0.015).
Patients whose jobs involved manual or physical labor were significantly associated with higher healthcare utilization. Thus, the results suggest that healthcare utilization in different occupational classes should be improved by monitoring work environments and promoting health-enhancing behaviors.
利用全国代表性调查的纵向数据,研究职业阶层指标对医疗保健利用的影响。
数据取自2006年(第1波)至2014年(第9波)进行的韩国福利面板研究。在基线(2006年)时共选取了5104名个体。采用方差分析和纵向数据分析来评估以下因变量:每年的门诊就诊次数和住院天数。
IV类职业的每年门诊就诊次数比I类职业多4.298天(P<0.0001),III类职业比I类职业多0.438天(P=0.027),II类职业比I类职业多0.335天(P=0.035)。每年的住院天数IV类职业比I类职业多0.610天(P=0.001),III类职业比I类职业多0.547天(P<0.0001),II类职业比I类职业多0.115天(P=0.136)。此外,医疗需求未得到满足的IV类患者的住院天数呈现出与基于社会经济地位预测的相反趋势(估计值为-8.524;P值=0.015)。
从事体力劳动或体力工作的患者与更高的医疗保健利用率显著相关。因此,研究结果表明,应通过监测工作环境和促进健康行为来改善不同职业阶层的医疗保健利用情况。