Nationwide Study on the Characteristics of Patients Visiting and Using Korean Medical Facilities by Sex

HaeChang Jung; HaeMo Park; Sundong Lee; Jung, HaeChang; Park, HaeMo; Lee, Sundong

doi:10.13048/jkm.14008

JKM > Volume 35(1); 2014 > Article

Jung, Park, and Lee: Nationwide Study on the Characteristics of Patients Visiting and Using Korean Medical Facilities by Sex

Original Article

The Journal of Korean Oriental Medicine 2014; 35(1): 75-87.

Published online: March 30, 2014

DOI: https://doi.org/10.13048/jkm.14008

Nationwide Study on the Characteristics of Patients Visiting and Using Korean Medical Facilities by Sex

HaeChang Jung, HaeMo Park, Sundong Lee

Dept. of Preventive medicine, School of Korean Medicine, Sangji University

Correspondence to: 이선동(Sun-dong Lee), 강원도 원주시 우산동 상지대학교 한의과대학 예방의학교실, Tel : +82-33-730-0665, Fax : +82-33-738-7825, E-mail : sdlee@sangji.ac.kr

Received February 11, 2014 Revised March 10, 2014 Accepted March 10, 2014

Abstract

Objectives

This study aimed to analyze the utilization of Korean medical clinics by sex.

Methods:

Data was based on reports about usage and consumption of Korean medicine in 2011 by the Ministry of Health and Welfare and Korea Institute for Health and Social Affairs. 171 Korean medical hospitals and more than 300 Korean medical clinics were selected after 2 rounds of extraction, from the 12,250 Korean medical institutions throughout the country. The investigation was carried out between August 25 and September 30, 2011. The study group was composed of 290 men and 813 women; Korean medical institutions including clinics and hospitals were mainly used for their health care.

Results:

For sociodemographic distribution, sex, marital status, education level, occupation status, and income level showed statistically significant differences.
Females had a lower subjective health status than did males. Muscle injury, hwa-byung, gastric disorder, lumbago, common cold, weight loss, and herbal tonics showed differences in prevalence rates between the sexes.
Arthritis, muscle injury, gastric disorder, ankle sprain, herbal tonics, and stroke showed differences in usage rates between the sexes. Likewise, major treatment methods had differences between the sexes.
There were no statistically significant differences between the sexes concerning acupuncture.

Conclusions:

Females were lower than males in several aspects of income and education level and occupation status. Males had a higher subjective health status than did females. Differences by sex of treatment methods and prevalence rates of several diseases existed.

Keywords: Korean medicine, sex, patients visiting Korean medicine facilities

Fig. 1

Flow Chart of Study

Table 1

Sociodemographic Characteristics of Research Subjects

한방의료기관 이용자 전체 및 성별빈도		전체 한방의료기관 이용자	남성 한방의료기관 이용자	여성 한방의료기관 이용자	p-value

인구사회학적 특성

전체		1,103(100.0)	217(26.3)	886(73.7)

나이¹⁾	10 대 미만	7(0.6)	4(1.4)	3(0.4)	0.1244
	10대	33(3.0)	13(4.5)	20(2.5)
	20대	112(10.2)	31(10.7)	81(10.0)
	30대	181(16.4)	47(16.2)	134(16.5)
	40대	254(23.0)	77(26.6)	177(21.8)
	50대	183(16.6)	43(14.8)	140(17.2)
	60대	185(16.8)	40(13.8)	145(17.8)
	70대	129(11.7)	32(11.0)	97(11.9)
	80대 이상	19(1.7)	3(1.0)	16(2.0)

혼인상태	미혼	150(13.6)	56(19.3)	94(11.6)	0.0001
	기혼	793(72.0)	216(74.5)	577(71.1)
	사별	139(12.6)	14(4.8)	125(15.4)
	이혼	15(1.4)	3(1.0)	12(1.5)
	별거	4(0.4)	0(0.0)	4(0.5)
	기타	1(0.1)	1(0.3)	0(0.0)

교육정도²⁾	무학	75(6.9)	11(3.8)	64(7.9)	0.0001
	초등학교	169(15.4)	23(8.0)	146(18.1)
	중학교	134(12.2)	30(10.4)	104(12.9)
	고등학교	357(32.6)	91(31.6)	266(33.0)
	대학교	358(32.7)	132(45.8)	226(28.0)

직업유무	예	554(50.6)	201(69.8)	353(43.7)	0.0001
직업유무	아니오	541(49.4)	87(30.2)	454(56.3)	0.0001

소득수준	100만원 이하	243(22.1)	47(16.3)	196(24.2)	0.0065
	101만원∼200만원	253(23.0)	61(21.1)	192(23.7)
	201만원∼300만원	213(19.4)	69(23.9)	144(17.8)
	301만원∼400 만원	156(14.2)	43(14.9)	113(14.0)
	401만원∼500만원	111(10.1)	26(9.0)	85(10.5)
	501만원 이상	123(11.2)	43(14.9)	80(9.9)

건강보험종류	지역가입	407(36.9)	117(40.3)	290(35.7)	0.1595
	사업자(직장) 가입	632(57.4)	161(55.5)	471(58.0)
	의료급여 1종	36(3.3)	10(3.5)	26(3.2)
	의료급여 2종	18(1.6)	1(0.3)	17(2.1)
	기타	9(0.8)	1(0.3)	8(1.0)

1) 항목별 무응답 건수: 혼인상태 무응답 : 1건, 교육정도 : 8건, 소득수준 : 4건, 건강보험종류 : 1건

2) 중복된 항목 제외: 미취학2건

Table 2

Health Status, Types of Frequently Visited Medical Clinics, Type of Frequently-Visited Korean Medical Clinics, and the Usage Frequently of Korean Medical Clinics When In Need of Treatment^*

단위: 명(%)

한방의료기관 이용자 전체 및성별 빈도		전체 한방의료기관 이용자	남성 한방의료기관 이용자	여성 한방의료기관 이용자	p-value¹⁾

세부항목

주관적 건강상태²⁾	매우 좋음	36(3.3)	14(4.8)	22(2.7)	0.0119
	좋음	237(21.5)	77(26.6)	160(21.5)
	보통	476(43.2)	123(42.4)	353(43.2)
	나쁨	318(28.9)	71(24.5)	247(28.9)
	매우 나쁨	35(3.2)	5(1.7)	30(3.2)

한방진료시 이용하는 진료기관³⁾	한의원	816(76.1)	199(70.3)	617(78.1)	0.0465
	한방병원	226(21.1)	74(26.2)	152(19.2)
	한약방	4(0.4)	1(0.4)	3(0.4)
	약국	4(0.4)	3(1.1)	1(0.1)
	침술원	4(0.4)	1(0.4)	3(0.4)

한방의료기관 이용환자의 주요 질환	고혈압	46(4.2)	8(2.8)	38(4.7)	0.1613
	화병	58(5.3)	5(1.7)	53(6.5)	0.0017
	불임	4(0.4)	0(0.0)	4(0.5)	0.2314
	관절염	274(24.8)	49(16.9)	225(27.7)	0.0003
	위장장애	208(18.9)	28(9.7)	180(22.1)	0.0001
	발목을 삠	189(17.1)	50(17.2)	139(17.1)	0.9554
	요통	418(37.90)	80(27.6)	338(41.6)	0.0001
	감기	156(14.1)	28(9.7)	128(15.7)	0.0106
	근육 부상	264(23.9)	94(32.4)	170(20.9)	0.0001
	당뇨병	22(2.0)	5(1.7)	17(2.1)	0.7012
	아토피	25(2.8)	5(1.7)	20(2.5)	0.4698
	허리를 삠	235(21.3)	69(23.8)	166(20.4)	0.2282
	중풍	64(5.8)	23(7.9)	41(5.0)	0.0709
	암	3(0.3)	1(0.3)	2(0.3)	0.7815
	오십견	105(9.5)	29(10.0)	76(9.4)	0.7454
	생리통	53(4.8)	-	53(6.5)	-
	천식	18(1.6)	3(1.0)	15(1.9)	0.3496
	골절	39(3.5)	11(3.8)	28(3.4)	0.7823
	다이어트(비만)	43(3.9)	2(0.7)	41(5.0)	0.0010
	피부미용	11(1.0)	2(0.7)	9(1.1)	0.5392
	체형교정	21(1.9)	2(0.7)	19(2.3)	0.0780
	체질개선	80(7.3)	15(5.2)	65(8.0)	0.1116
	보약처방	289(26.2)	51(17.6)	238(29.3)	0.0001
	키(성장)	7(0.6)	2(0.7)	5(0.6)	0.8907
	교통사고 후유증	71(6.4)	19(6.6)	52(6.4)	0.9261

* 복수 응답 허용

1) χ² 검증 검정

2) 전체 대상자 중 해당 질병의 숫자와 비율임

3) 양방병원이라고 응답한 4명 제외

Table 3

Usage Frequency of Korean Medicine by Treatment Methods

단위: 명(%)

전체 및 성별빈도	전체 한방의료기관 이용자	남성 이용자	여성 이용자	p-value

한방치료법

한약	6(0.6)	4(1.4)	2(0.3)	0.1346
한약+한약제제	10(0.9)	4(1.4)	6(0.8)
한약+침	296(27.5)	59(20.7)	237(29.9)
한약+뜸	2(0.2)	0(0.0)	2(0.3)
한약+부항	4(0.4)	0(0.0)	4(0.5)
한약+추나	5(05)	1(0.4)	4(0.5)
한약+기타	1(0.1)	0(0.0)	1(0.1)
한약제제	1(0.1)	0(0.0)	1(0.1)
한약제제+침	29(2.7)	11(3.9)	18(2.3)
한약제제+뜸	1(0.1)	1(0.4)	0(0.0)
침	19(1.8)	6(2.1)	13(1.6)
침+뜸	127(11.8)	33(11.6)	94(11.9)
침+부항	139(12.9)	43(15.1)	96(12.1)
침+추나	25(2.3)	6(2.1)	19(2.4)
침+한방 물리요법	401(37.2)	114(40.0)	287(36.2)
침+기타	3(0.3)	1(0.4)	2(0.3)
뜸+부항	1(0.1)	0(0.0)	1(0.1)
뜸+한방 물리요법	2(0.2)	0(0.0)	2(0.3)
부항+추나	1(0.1)	0(0.0)	1(0.1)
부항+한방 물리요법	1(0.1)	1(0.4)	0(0.0)

Table 4

Ten Major Symptoms and Treatment Methods that Prompted Patients to Receive Treatment at Korean Medical Facilities during the Last Three Months^*

단위: 명(%)

한방의료기관 이용자 전체및 성별 빈도		전체 한방의료기관이용자	남성 한방의료기관 이용자	여성 한방의료기관 이용자	p-value¹⁾

질병별 한방치료법

요통²⁾		338(30.6)	78(26.9)	260(32.0)	0.1069

치료법³⁾	한약	68(6.2)	13(4.5)	55(6.8)	0.1653
	한약제제	33(3.0)	9(3.1)	24(3.0)	0.8966
	침	328(29.7)	76(26.2)	252(31.0)	0.1256
	뜸	130(11.8)	25(8.6)	105(12.9)	0.0515
	부항	172(15.6)	38(13.1)	134(16.5)	0.1733
	추나	28(2.5)	4(1.4)	24(3.0)	0.1438
	한방물리요법	235(21.3)	58(20.0)	177(21.8)	0.5271
	기타	5(0.5)	1(0.3)	4(0.5)	0.7487

관절염		197(17.9)	40(13.8)	157(19.3)	0.0352

치료법	한약	40(3.6)	6(2.1)	34(4.2)	0.0984
	한약제제	16(1.5)	1(0.3)	15(1.9)	0.0666
	침	193(17.5)	40(13.8)	153(18.8)	0.0531
	뜸	80(7.3)	12(4.1)	68(8.4)	0.0172
	부항	82(7.4)	11(3.8)	71(8.7)	0.0059
	추나	7(0.6)	0(0.0)	7(0.9)	0.1129
	한방물리요법	134(12.2)	26(9.0)	108(13.3)	0.0533
	기타	3(0.3)	1(0.3)	2(0.3)	0.7815

근육부상		182(16.5)	70(24.1)	112(13.8)	0.0001

치료법	한약	25(2.3)	9(3.1)	16(2.0)	0.2647
	한약	14(1.3)	7(2.4)	7(0.9)	0.0426
	침	175(15.9)	68(23.5)	107(13.2)	0.0001
	뜸	63(5.7)	24(8.3)	39(4.8)	0.0284
	부항	89(8.1)	40(13.8)	49(6.0)	0.0001
	추나	16(1.5)	6(2.1)	10(1.2)	0.3049
	한방물리요법	118(10.7)	45(15.5)	73(9.0)	0.0020

허리삠		168(15.2)	48(16.6)	120(14.8)	0.4660

치료법	한약	39(3.5)	10(3.5)	29(3.6)	0.9251
	한약제제	15(1.4)	3(1.0)	12(1.5)	0.5773
	침	162(14.7)	47(16.2)	115(14.2)	0.3945
	뜸	66(6.0)	21(7.2)	45(5.5)	0.2929
	부항	77(7.0)	25(8.6)	52(6.4)	0.2018
	추나	23(2.1)	3(1.0)	20(2.5)	0.1447
	한방물리요법	96(8.7)	33(11.4)	63(7.8)	0.0597
	기타	1(0.1)	0.(0.0)	1(0.1)	0.5502

위장장애		153(13.9)	22(7.6)	131(16.1)	0.0003

치료법	한약	61(5.5)	12(4.1)	49(6.0)	0.2269
	한약제제	47(4.3)	9(3.1)	38(4.7)	0.2556
	침	133(12.1)	16(5.5)	117(14.4)	0.0001
	뜸	56(5.1)	5(1.7)	51(6.3)	0.0024
	부항	17(1.5)	3(1.0)	14(1.7)	0.4145
	추나	1(0.1)	0(0.0)	1(0.1)	0.5502
	한방물리요법	18(1.6)	5(1.7)	13(1.6)	0.8852
	기타	3(0.3)	1(0.3)	2(0.3)	0.7815

발목삠		117(10.6)	40(13.8)	77(9.5)	0.0402

치료법	한약	11(1.0)	6(2.1)	5(0.6)	0.0324
	한약제제	9(0.8)	3(1.0)	6(0.7)	0.6299
	침	111(10.1)	39(13.5)	72(8.9)	0.0256
	뜸	43(3.9)	14(4.8)	29(3.6)	0.3410
	부항	45(4.1)	19(6.6)	26(3.2)	0.0132
	추나	7(0.6)	0(0.0)	7(0.9)	0.1129
	한방물리요법	59(5.4)	19(6.6)	40(4.9)	0.2891
	기타	1(0.1)	0(0.0)	1(0.1)	0.5502

감기		102(9.3)	23(7.9)	79(9.7)	0.3674

치료법	한약	61(5.5)	16(5.5)	45(5.5)	0.9909
	한약제제	37(3.4)	3(1.0)	34(4.2)	0.0106
	침	41(3.7)	7(2.4)	34(4.2)	0.1718
	뜸	8(0.7)	2(0.7)	6(0.7)	0.9336
	부항	6(0.5)	1(0.3)	5(0.6)	0.5912
	추나	0(0.0)	0(0.0)	0(0.0)	-
	한방물리요법	7(0.6)	0(0.0)	7(0.9)	0.1129
	기타	1(0.1)	1(0.3)	0(0.0)	0.0939

보약		83(7.5)	13(4.5)	70(8.6)	0.0222

치료법	한약	82(7.4)	13(4.5)	69(8.5)	0.0256
	한약제제	1(0.1)	0(0.0)	1(0.1)	0.5502
	침	5(0.5)	0(0.0)	5(0.6)	0.1807
	뜸	0(0.0)	0(0.0)	0(0.0)	-
	부항	1(0.1)	0(0.0)	1(0.1)	0.5502
	추나	0(0.0)	0(0.0)	0(0.0)	-
	한방물리요법	0(0.0)	0(0.0)	0(0.0)	-

오십견		55(5.0)	17(5.9)	38(4.7)	0.4249

치료법	한약	13(1.2)	3(1.0)	10(1.2)	0.7911
	한약제제	7(0.6)	1(0.3)	6(0.7)	0.4691
	침	54(4.9)	17(5.9)	37(4.6)	0.3744
	뜸	18(1.6)	3(1.0)	15(1.9)	0.3496
	부항	26(2.4)	11(3.8)	15(1.9)	0.0605
	추나	8(0.7)	1(0.3)	7(0.9)	0.3738
	한방물리요법	24(2.2)	10(3.5)	14(1.7)	0.0836

중풍		48(4.4)	20(6.9)	28(3.4)	0.0134

치료법	한약	19(1.7)	6(2.1)	13(1.6)	0.5975
	한약제제	3(0.3)	2(0.7)	1(0.1)	0.1117
	침	47(4.3)	20(6.9)	27(3.3)	0.0096
	뜸	21(1.9)	10(3.5)	11(1.4)	0.0250
	부항	15(1.4)	7(2.4)	8(1.0)	0.0711
	추나	1(0.1)	0(0.0)	1(0.1)	0.5502
	한방물리요법	30(2.7)	13(4.5)	17(2.1)	0.0316
	기타	1(0.1)	1(0.3)	0(0.0)	0.0939

* 복수 응답 허용

1) χ² 검증 검정

2) 전체 대상자 중 해당 질병의 숫자와 비율임

3) 치료법은 해당질병의 유병자 중에서 치료법을 사용하고 있는 환자의 수와 비율을 나타내고 있음

Table 5

Treatment Effectiveness by Each Method

단위: 명(%)

한방의료기관 이용자 전체 및 성별 빈도		전체 한방의료기관 이용자	남성 한방의료기관 이용자	여성 한방의료기관이용자	p-value

한방치료방법별 치료효과

한약 (탕약)	매우 효과 좋음	239(56.5)	47(49.0)	192(58.3)	0.1496
	약간 효과 있음	139(32.9)	34(35.4)	105(32.2)
	보통	27(6.4)	11(11.5)	16(4.9)
	거의 효과 없음	6(1.4)	1(1.0)	5(1.5)
	잘 모름	11(2.6)	3(3.1)	8(2.5)

한약제제	매우 효과 좋음	73(37.4)	14(30.4)	59(39.6)	0.1036
	약간 효과 있음	92(47.2)	22(47.8)	70(47.0)
	보통	24(12.3)	7(15.2)	17(11.4)
	거의 효과 없음	2(1.0)	0(0.0)	2(1.3)
	잘 모름	4(2.1)	3(6.5)	1(0.7)

침	매우 효과 좋음	601(56.1)	141(50.0)	460(58.2)	0.0443
	약간 효과 있음	376(35.1)	108(38.3)	268(33.9)
	보통	79(7.4)	29(10.3)	50(6.3)
	거의 효과 없음	7(0.7)	1(0.4)	6(0.8)
	전혀 효과 없음	1(0.1)	1(0.4)	0(0.0)
	잘 모름	8(0.8)	2(0.7)	6(0.8)

뜸	매우 효과 좋음	198(43.6)	46(43.0)	152(43.8)	0.7632
	약간 효과 있음	188(41.4)	44(41.1)	144(41.5)
	보통	58(12.8)	13(12.2)	45(13.0)
	거의 효과 없음	2(0.4)	1(0.9)	1(0.3)
	전혀 효과 없음	1(0.2)	0(0.0)	1(0.3)
	잘 모름	2(1.5)	3(2.8)	4(1.2)

부항	매우 효과 좋음	215(46.7)	60(47.6)	155(46.4)	0.7528
	약간 효과 있음	182(39.6)	50(39.7)	132(39.5)
	보통	53(11.5)	15(11.9)	38(11.4)
	거의 효과 없음	6(1.3)	1(0.8)	5(1.5)
	잘 모름	4(0.9)	0(0.0)	4(1.2)

추나	매우 효과 좋음	59(58.4)	11(52.4)	48(60.0)	0.6902
	약간 효과 있음	28(27.7)	8(38.1)	20(25.0)
	보통	10(9.9)	2(9.5)	8(10.0)
	거의 효과 없음	2(2.0)	0(0.0)	2(2.5)
	잘 모름	2(2.0)	0(0.0)	2(2.5)

물리요법	매우 효과 좋음	281(41.6)	66(36.3)	215(43.6)	0.0758
	약간 효과 있음	301(44.6)	87(47.8)	214(43.4)
	보통	83(12.3)	24(13.2)	59(12.0)
	거의 효과 없음	5(0.7)	1(0.6)	4(0.8)
	전혀 효과 없음	1(0.2)	1(0.6)	0(0.0)
	잘 모름	4(0.6)	3(1.7)	1(0.2)

Table 6

Treatment Satisfaction, Rates of Patients Experiencing Side Effects and the Types of Side Effects

단위: 명(%)

한방의료기관 이용자 전체 및 성별 빈도		전체 한방의료기관 이용자	남성 한방의료기관 이용자	여성 한방의료기관 이용자	p-value

진료만족도, 부작용 경험률 및 종류
진료 만족도	매우 만족	399(36.2)	90(31.0)	309(38.1)	0.0194
	만족	574(52.1)	152(52.4)	422(52.0)
	보통	113(10.3)	42(14.5)	71(8.8)
	불만족	6(0.5)	3(1.0)	3(0.4)
	잘 모름	9(0.8)	3(1.0)	6(0.7)
부작용 경험률		22(2.0)	3(1.0)	19(2.3)	0.1751
부작용 종류	배탈ㆍ설사 등 소화기 질환	5(22.7)	0(0.0)	5(26.3)	0.3837
	두드러기, 가려움증 등 피부질환	5(22.7)	0(0.0)	5(26.3)
	마비 등 신경계질환	1(4.6)	0(0.0)	1(5.3)
	신장기능 이상(예: 얼굴 및 손발 부종)	1(4.6)	0(0.0)	1(5.3)
	기타	10(45.5)	3(100.0)	7(36.8)

참고문헌

1. Texbook of preventive Korean medicine compilation committee. Preventive Korean Medicine and Public Health. Seoul: GyeChukmunhwasa;2013.

2. Jeon GS, Choi ES, Lee HY. Gender-related Difference in the Utilization of Health Care Services by Korean Adults. Journal of Korean public health nursing. 2010; 24:2. 182–196.

3. Denton M, Prus S, Walters V. Gender differences in health: Canadian study of the psychosocial, structural and behavioural determinants of health. Social Science & Medicine. 2004; 58:12. 2585–2600.

4. Lee G, Cafferta . Marital status, living arrangements, and the use of health services access and use among elderly persons. Journal of Gerontology. 1987; 42:6. 613–618.

5. Lee IS. Study on medical operation in the shape of man and women based in gender difference. Kor. J. Oriental Medical Classics. 2006; 19:1. 47–109.

6. Jun Heo. Donguibogam. Seoul: Yeogang Publisher;2001. p. 1283

7. Sung MK, Lim BM. A Study on Health Seeking Behaviors of Local Residents-Focused on Shopping Around Phenomenon in Yangsan City, Korea. Kor. J. Oriental Preventive Medical Society. 2012; 16:2. 83–94.

8. Seo YJ, Kang SH, Kim YH, Choi DB, Shin HK. Systematic Review on the Customers’ Use of and Satisfaction with Oriental Medical Services. J Korean Oriental Med. 2010; 31:1. 69–80.

9. Yoo WK, Ryu KA. Utilization patterns and Determinants of Oriental Medical Services: Focused on the Residents of Taegu City. Kor. J. Oriental Preventive Medical Society. 2000; 4:2. 1–24.

10. Lee SD, Jo JG, Kim HD, Park HM, Y JM, Choi SY. Nationwide Study on the Usage and Characteristics of Patients Visiting Korean Medical Facilities-Based on the Treatment of Major Disorders, Effectiveness, Satisfaction and Occurrence Rate of Side Effects From the Ministry of Welfares Report on Usage and Consumption of Korean Medicine in 2011. Kor. J. Oriental Preventive Medical Society. 2013; 17:2. 29–46.

11. Choi SY, Shin HK, Park HM, Lee SD. A Analysis of Patients Using Korean Medicine Clinics-Analysis of Outpatients and Inpatients by Age, Sex and Regions. Kor. J. Oriental Preventive Medical Society. 2012; 16:2. 67–81.

12. Ministry of Health and Welfare and Korea Institute for Health and Social Affairs. Reports about usage and consumption of Korean medicine. 2011.

13. Andersen R, Newman JF. Societal and individual determinants of medical care utilization in the United States, The Milbank Memorial Fund Quarterly. Health and Society. 1973; 51:1. 95–124.

14. Park TS, Lee SY. Introduction to categorical data analysis. Seoul: JaYu Academy;1999.

15. Byun JS, Lee SD, Kim JH. Determinants of Utilization of Oriental Medical Services and Policy Implications. Kor. J. Oriental Preventive Medical Society. 1999; 3:2. 1–23.

16. Jeon MS. Traditional Korean Oriental Medical Tourism Development. Journal of Korean Photo-Geographers. 2012; 22:4. 111–120.

17. Lee HR, Kang HS, Kim GB, Kim WO, Song MS, Wang MJ, et al. An Attitudinal Study on Oriental Medicine: Q methodological approach. The Seoul Journal of Nursing. 1992; 6:1. 25–41.

18. Lee SD, Park KS. KAP Study on Oriental Traditional Doctor, Hospital and Medicine in Korea. Kor. J. Oriental Preventive Medical Society. 1997; 1:1. 27–41.

19. Blazer DG, Landerman LR, Fillenbaum G, Horner R. Health services access and use among older adults in North Carolina; Urban vs rural residents. American Journal of Public Health. 1995; 85:10. 1384–139.

20. Jang YR, Kim GY, Chiriboga DA. Health, health care utilization, and satisfaction with service: Barriers and facilitators for older Korean Americans. Journal of the American Geriatrics Society. 2005; 53:9. 1613–1617.

21. Kim YG. The study of socioeconomic status and health service use. Soc Sci Stud. 1995; 21:9–24.

22. Lee HJ, Lee TJ, Jeon BY, Jung YG. Factors Related to Health Care Utilization in the Poor and the General Populations. The Korean Journal of Health Economics and Policy. 2009; 15:1. 79–106.

23. Prus SG, Gee E. Gender Differences in the Influence of Economic, Lifestyle, and Psychosocial factors on Later-life Health. Canadian Journal of Public Health. 2003; 99:4. 306–309.

24. Park JE, Kwon SM. Determinants of the Utilization of Oriental Medical Services by the Elderly. J Korean Oriental Med. 2011; 32:1. 97–108.

25. Denton M, Walters V. Gender differences in structural and behavioral determinants of health: an analysis of the social production of health. Social Science & Medicine. 1999; 48:1221–35.

26. Bang YS, Ryu SY, Kim HY. The relationship between the components of ICF and self-rated health status in the elderly who use senior citizen center. The research of local community. 2011; 19:4. 95–113.

27. Yeom JH, Park JS, Kim DH. A Study of Factors Affecting Self-Rated Health among Korean Elderly: Focusing on Gender Differences. Journal of the Korean Gerontological Society. 2012; 32:4. 1101–1118.

28. National statistical office. Coinsurance rate in Korean medical institutions including clinics and hospitals. 1999–2010.

29. Rhim KH, Lee JH. Income-related inequality in medical care utilization by provider types. The Korean Journal of Health Economics and Policy. 2010; 16:2. 39–56.

30. Parslow R, Jorm A, Christensen H, Jacomb P, Rodgers B. Gender differences in factors affecting use of health services: an analysis of a community study of middle-aged and older Australians. Social Science & Medicine. 2004; 59:2121–2129.

31. Park YE. Study on the determinants of Korean medical demand. DongSeo Medical Book Publisher. 1992; 17:1. 16–42.

32. Oriental medical dictionary compilation committee. The New Dictionary of Oriental Medicine. Seoul: DongBang Medical Book Publisher;2001. p. 274