Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea.
J Korean Med Sci. 2020 Sep 7;35(35):e290. doi: 10.3346/jkms.2020.35.e290.
Transportation costs can be a barrier to healthcare services, especially for low-income, disabled, elderly, and geographically isolated populations. This study aimed to estimate the transportation costs of healthcare service utilization and related influencing factors in Korea in 2016.
Transportation costs were calculated using data from the 2016 Korea Health Panel Study. A total of 14,845 participants were included (males, 45.07%; females, 54.93%), among which 2,148 participants used inpatient and 14,787 used outpatient care services. Transportation costs were estimated by healthcare types, transportation modes, and all disease and injury groups that caused healthcare service utilization. The influencing factors of higher transportation costs were analyzed using multivariable regression analysis.
In 2016, the average transportation costs were United States dollars (USD) 43.70 (purchasing power parity [PPP], USD 32.35) per year and USD 27.67 (PPP, USD 20.48) per visit for inpatient care; for outpatient case, costs were USD 41.43 (PPP, USD 30.67) per year and USD 2.09 (PPP, USD 1.55) per visit. Among disease and injury groups, those with neoplasms incurred the highest transportation costs of USD 9.73 (PPP, USD 7.20). Both inpatient and outpatient annual transportation costs were higher among severely disabled individuals (inpatient, +USD 44.71; outpatient, +USD 23.73) and rural residents (inpatient, +USD 20.40; outpatient, +USD 28.66). Transportation costs per healthcare visit were influenced by healthcare coverage and residential area. Sex, age, and income were influencing factors of higher transportation costs for outpatient care.
Transportation cost burden was especially high among those with major non-communicable diseases (e.g., cancer) or living in rural areas, as well as elderly, severely disabled, and low-income populations. Thus, there is a need to address the socioeconomic disparities related to healthcare transportation costs in Korea by implementing targeted interventions in populations with restricted access to healthcare.
交通成本可能成为医疗服务的障碍，尤其是对于低收入、残疾、老年和地理位置偏远的人群。本研究旨在估计 2016 年韩国医疗服务利用的交通成本及其相关影响因素。
使用 2016 年韩国健康面板研究的数据来计算交通成本。共纳入 14845 名参与者（男性占 45.07%，女性占 54.93%），其中 2148 名参与者使用住院服务，14787 名参与者使用门诊服务。按医疗类型、交通方式和导致医疗服务利用的所有疾病和伤害群体来估算交通成本。使用多变量回归分析来分析交通成本较高的影响因素。
2016 年，住院治疗的平均交通成本为每年 43.70 美元（购买力平价为 32.35 美元），每次就诊 27.67 美元（购买力平价为 20.48 美元）；门诊治疗的年交通成本为 41.43 美元（购买力平价为 30.67 美元），每次就诊 2.09 美元（购买力平价为 1.55 美元）。在疾病和伤害群体中，肿瘤患者的交通成本最高，为 9.73 美元（购买力平价为 7.20 美元）。严重残疾人和农村居民的住院和门诊年交通成本均较高（住院治疗，分别增加 44.71 美元和 20.40 美元；门诊治疗，分别增加 23.73 美元和 28.66 美元）。每次医疗就诊的交通成本受医疗保障和居住地区的影响。性别、年龄和收入是门诊交通成本较高的影响因素。
交通成本负担在患有主要非传染性疾病（如癌症）或居住在农村地区的人群、老年人、严重残疾人和低收入人群中尤其高。因此，需要通过在获得医疗服务受限的人群中实施有针对性的干预措施，解决与医疗交通成本相关的社会经济差距问题。
