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      소득 수준에 따른 암검진 이용 형평성 연구: 집중지수와 집중지수 분해 방법을 이용하여 = Income-related Inequalities in Cancer Screening in Korea: Using Concentration Index (CI) and Decomposition of CI

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      https://www.riss.kr/link?id=A103352979

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      다국어 초록 (Multilingual Abstract) kakao i 다국어 번역

      Cancer is one of the heaviest burdens of disease in Korea. For early detection and timely treatment, regular cancer screening is suggested for all individuals over aged 40. Although the rate of cancer screening is continuously increasing in Korea, existing literature suggest that income-related inequalities in cancer screening exist regardless of type of health care system. This study aimed to assess income-related inequalities in cancer screening using a nationally representative survey data. In addition, this study quantified socio-demographic factors contributing income-related inequalities in cancer screening in the Korean population. For our analysis, Korea National Health and Nutrition Examination Survey (KNHANES) 2010-2012 were used. To measure income-related inequalities, we employed concentration index (CI) and decomposition of the CI method. Our results showed that income-related inequalities in cancer screening exist indicating a pro-rich pattern along with a pro-rich pattern of horizontal inequity index (HI). The main contributors to the existing inequities were private insurance and income levels. Our study suggests that the identified inequities and main contributors in relation to cancer screening should be considered for policy interventions. Further longitudinal studies are needed to understand impact of changes in co-payment for cancer screening in Korea.
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      Cancer is one of the heaviest burdens of disease in Korea. For early detection and timely treatment, regular cancer screening is suggested for all individuals over aged 40. Although the rate of cancer screening is continuously increasing in Korea, exi...

      Cancer is one of the heaviest burdens of disease in Korea. For early detection and timely treatment, regular cancer screening is suggested for all individuals over aged 40. Although the rate of cancer screening is continuously increasing in Korea, existing literature suggest that income-related inequalities in cancer screening exist regardless of type of health care system. This study aimed to assess income-related inequalities in cancer screening using a nationally representative survey data. In addition, this study quantified socio-demographic factors contributing income-related inequalities in cancer screening in the Korean population. For our analysis, Korea National Health and Nutrition Examination Survey (KNHANES) 2010-2012 were used. To measure income-related inequalities, we employed concentration index (CI) and decomposition of the CI method. Our results showed that income-related inequalities in cancer screening exist indicating a pro-rich pattern along with a pro-rich pattern of horizontal inequity index (HI). The main contributors to the existing inequities were private insurance and income levels. Our study suggests that the identified inequities and main contributors in relation to cancer screening should be considered for policy interventions. Further longitudinal studies are needed to understand impact of changes in co-payment for cancer screening in Korea.

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      참고문헌 (Reference)

      1 국립암센터, "통계로 본 암 현황 2014" 2014

      2 신호성, "치과의료이용의 형평성" 26 (26): 70-93, 2006

      3 임국환, "의료기관 종별 소득계층간 의료이용 불평등" 한국보건경제정책학회 16 (16): 39-56, 2010

      4 김동진, "우리나라 성인의 의료이용의 형평성" 176 : 45-54, 2011

      5 조비룡, "우리나라 국가검진체계의 실상" 대한의사협회 54 (54): 666-669, 2011

      6 채수미, "외래내원 천식환자의사 사회경제적 상태에 따른 의료이용의 형평성" 한국보건사회학회 22 (22): 183-203, 2007

      7 김도영, "소득수준별 보건의료서비스 이용 형평성 변화 분석" 사회과학연구소 23 (23): 105-125, 2012

      8 김태일, "소득계층에 따른 의료이용 격차 분석" 한국사회보장학회 24 (24): 53-75, 2008

      9 조홍준, "보건의료에서의 형평성: 우리나라의 현황" 대한의사협회 56 (56): 184-194, 2013

      10 윤희숙, "민간의료보험 가입이 의료이용에 미치는 영향" 한국개발연구원 30 (30): 99-128, 2008

      1 국립암센터, "통계로 본 암 현황 2014" 2014

      2 신호성, "치과의료이용의 형평성" 26 (26): 70-93, 2006

      3 임국환, "의료기관 종별 소득계층간 의료이용 불평등" 한국보건경제정책학회 16 (16): 39-56, 2010

      4 김동진, "우리나라 성인의 의료이용의 형평성" 176 : 45-54, 2011

      5 조비룡, "우리나라 국가검진체계의 실상" 대한의사협회 54 (54): 666-669, 2011

      6 채수미, "외래내원 천식환자의사 사회경제적 상태에 따른 의료이용의 형평성" 한국보건사회학회 22 (22): 183-203, 2007

      7 김도영, "소득수준별 보건의료서비스 이용 형평성 변화 분석" 사회과학연구소 23 (23): 105-125, 2012

      8 김태일, "소득계층에 따른 의료이용 격차 분석" 한국사회보장학회 24 (24): 53-75, 2008

      9 조홍준, "보건의료에서의 형평성: 우리나라의 현황" 대한의사협회 56 (56): 184-194, 2013

      10 윤희숙, "민간의료보험 가입이 의료이용에 미치는 영향" 한국개발연구원 30 (30): 99-128, 2008

      11 최병호, "국민의료의 형평성 분석과 정책과제" 2004

      12 이용철, "국민건강영양조사 대상자들의 민간의료보험 가입 요인 및 가입여부에 따른 건강행태․의료이용 비교" 한국콘텐츠학회 10 (10): 190-204, 2010

      13 박용순, "국내 의료기관 암 검진 프로그램의 근거 중심 평가" 대한임상건강증진학회 9 (9): 86-96, 2009

      14 중앙암등록본부, "국가암등록사업 연례 보고서(2011년 암등록통계)" 2013

      15 국립암센터, "국가 암검진사업의 평가와 발전방향 제시" 2010

      16 김록범, "국가 암 조기검진 대상자의 암 검진 수검의도 관련 요인" 대한예방의학회 43 (43): 62-72, 2010

      17 한국건강형평성학회, "건강형평성측정방법론" 한울 2008

      18 김수진, "건강보험 암 중증질환 급여확대가 의료이용 형평성에 미친 영향" 한국보건행정학회 18 (18): 90-109, 2008

      19 Walsh, B., "The Role Of Private Medical Insurance In Socio‐Economic Inequalities In Cancer Screening Uptake In Ireland" 21 (21): 1250-1256, 2012

      20 Kakwani, N. C., "Socioeconomic inequalities in. health: measurement, computation and statistical Inference" 77 (77): 87-104, 1997

      21 Hajizadeh, M., "Socioeconomic inequalities in adult obesity risk in Canada : trends and decomposition analyses" 15 : 203-221, 2014

      22 Katz, S. J., "Socioeconomic disparities in preventive care persist despite universal coverage : breast and cervical cancer screening in Ontario and the United States" 272 (272): 530-534, 1994

      23 Hwang, J., "Socioeconomic disparities in eye care services and eye complications among diabetic patients in Canada" School of Public Health, University of Alberta 2013

      24 MacIntryre, S., "Socio-economic position, gender, and health: how do they interact?" 2 (2): 315-334, 1997

      25 Haper, S., "Selected Comparisons of Measures of Health Disparities: A review Using Database Relevant to Healthy People 2010 Cancer-Related Objectives" U. S Deparment of Health and Human Services, National Institutes of Health 2007

      26 Andersen, R. M., "Revisiting the behavioral model and access to medical care:does it matter?" 36 (36): 1-10, 1995

      27 Wagstaff, A., "On the measurement of inequalities in health" 33 (33): 545-557, 1991

      28 Koolmax, X., "On the interpretation of a concentration index of inequality" 13 (13): 649-656, 2004

      29 Wagstaff, A., "On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam" 112 (112): 207-223, 2003

      30 Haper, S., "Methods for Measuring Cancer Disparities : Using Data Relevant to Healthy people 2010 Cancer-Related Objectives" National Cancer Institute 2005

      31 Abu-Zaineh, M., "Measuring and decomposing socioeconomic inequality in healthcare delivery : A microsimulation approach with application to the Palestinian conflict-affected fragile setting" 72 (72): 133-141, 2011

      32 Kakwani, N. C., "Measurement of tax progressivity : an international comparison" 87 (87): 71-80, 1977

      33 Ramirez, M., "Measurement issues in health disparities research" 40 (40): 1640-1657, 2005

      34 Maddison, A. R., "Inequity in Access to Guideline-Recommended Colorectal Cancer Treatment in Nova Scotia, Canada" 8 (8): 71-87, 2012

      35 Kakwani, N. C., "Income Inequality and Poverty: Methods of Estimation and Policy Application" Oxford University Press 1980

      36 Wagstaff, A., "Equity in the finance and delivery of health care : some tentative cross-country comparisons" 5 (5): 89-112, 1989

      37 Lorant, V., "Equity in prevention and health care" 56 (56): 510-516, 2002

      38 Culyer, A. J., "Equity and equality in health and health care" 12 (12): 431-457, 1993

      39 Allin, S., "Does Equity in Healthcare Use Vary across Canadian Provinces?" 3 (3): 83-99, 2008

      40 McKinnon, B., "Decomposing income-related inequality in cervical screening in 67 countries" 56 (56): 139-152, 2011

      41 Solanki, G., "Cost-sharing and the utilization of clinical preventive services" 17 (17): 127-133, 1999

      42 Krieger, N., "Comparing individual-based and household-based measures of social class to assess class inequalities in women’s health : a methodological study of 684 US women" 53 (53): 612-623, 1999

      43 Zapka, J. G., "Breast cancer screening by mammography : utilization and associated factors" 79 (79): 1499-1502, 1989

      44 Carrieri, V., "Assessing inequalities in preventive care use in Europe" 113 (113): 247-257, 2013

      45 Kawachi, I., "A glossary for health inequalities" 56 (56): 647-652, 2002

      46 Aday, L. A., "A framework for the study of access to medical care" 9 (9): 208-, 1974

      47 보건복지부, "2014 국가 암 검진사업 안내" 2014

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