공적 이전소득 및 자산 소득이 은퇴 중고령 가구의 의료이용에 미치는 영향

학위논문 (석사)-- 서울대학교 보건대학원 : 보건학과 보건정책관리전공, 2016. 8. 이태진.Abstract Background Retirement brings changes in the household income level and composition. Although previous studies have suggested that the composition of retirement income is heterogeneous, the public transfer and asset income have been consistently reported as two major income sources for the retirees. Despite the changes in income, health care spending remains a major household expenditure item of the retirees. Although the characteristics of retirement income are examined in depth, studies on effects of the source of retirement income on health care utilization are limited. This study aims to estimate effects of the public transfer income and asset income on health care utilization of the retirees. In addition, determinants of health care utilization of the retirees are examined. Methods The study sample is drawn from the Korean Retirement and Income Survey data in 2011 and 2013. The sample consists of households in which the head is 50 and over and retired (n=909). Dependent variables are household health care utilization status and health care spending. Health care spending is log transformed. Independent variables include dependent income sources, share of asset income, share of pension income, share of social security income, total household income, sex, age, education level, marital status, chronic diseases status, disability status, limitations on Activities of Daily Living status, private health insurance status, and number of family members. K-means cluster analysis was used to cluster the sample into four income dependent groups (asset, private transfer, pension, social security) based on their household income composition. Two-Part Model analysis was used to estimate the effect of household characteristics on health care utilization. Results The results of the Two-Part Model analysis suggest that the dependent income source and the share of pension income and social security income are significant predictors of health care utilization of the retirees. Compared to the asset income dependent, the odds of using health services significantly decreased for the social security income dependent. In addition, the health care spending significantly decreased for the pension income dependent and the social security income dependent. Increase in the share of social security income significantly decreased the odds of using health services. Increase in the share of pension income and social security income both significantly decreased the health care spending. The Need and demographics were strong predictors of the odds of using health services. The Enabling, demographics, and Need characteristics were strong predictors of the health care spending. Conclusions The findings of this study are the following. First, the household income compositions of the retirees in Korea are heterogeneous. Although pension income and social security income were the primary source of retirement income, retirees still heavily rely on private transfers. Second, the income composition of the retirees is significant predictor of the health care utilization. Both the share of each income source and the dependent income source has strong implications on the retirees use of health care. Third, the Need characteristics and number of demographics were important predictors of the odd of using health services. The health care spending was significantly affected by household characteristics of Need, Predisposing, and Enabling in nature.I.Introduction 1 1.Background 1 2.Purpose of Research 5 3.Hypothesis 5 II. Literature review 6 1.Determinants of Health Care Utilization of the Retirees 6 2.Income Structure of the Retiree Households 8 3.Source of Households Income and Health Care Utilization 12 4.Two Part Model Analysis of Health Care Utilization 14 III.Materials and Methods 16 1.Data Source and Sample Selection 16 2.Variables and Outcomes 18 3.Statistical Analysis 23 IV.Results 27 1.Characteristics of the Study Sample 27 2.Predictors of Health Care Utilization of the Retirees 36 V.Discussion and Conclusion 43 Bibliography 47 Abstract in Korean 50Maste

그래프 분할을 위한 유전탐색

Thesis(master`s)--서울대학교 대학원 :전기·컴퓨터공학부,2007.Maste

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