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Influencing factors of using Korean Medicine services – focusing on the 2017 Korean Medicine Utilization Survey

Article information

J Korean Med. 2021;42(1):12-25
Publication date (electronic) : 2021 March 01
doi : https://doi.org/10.13048/jkm.21002
Jinwoong Lim1,2orcid_icon, Kee-Jae Lee3orcid_icon
1Department of Acupuncture and Moxibustion, Mokhuri Neck & Back Hospital
2Department of Clinical Korean Medicine, College of Korean Medicine, Graduate School, Kyung Hee University
3Department of Bioinformatics and Statistics, Graduate School, Korea National Open University

이 논문은 제1저자 임진웅의 석사학위논문의 일부를 정리한 것입니다.

Correspondence to: 이기재 서울시 종로구 대학로 86 (동숭동), 한국방송통신대학교 본관 533호 바이오정보통계학과 Tel：+82-2-3668-4690, E-mail: kjlee@knou.ac.kr
Received 2021 August 7; Revised 2021 August 13; Accepted 2021 February 18.

Abstract

Objectives

The aim of this study was to investigate influencing factors of using Korean medicine services (KMS) using the 2017 Korean Medicine Utilization Survey (KMUS).

Methods

Demographic statistics of the survey were summarized and influencing factors of the KMS experience and the intention to visit KMS were analyzed using logistic regression model with complex sample design. Influencing factors were specified based on Andersen’s behavioral model of health care utilization and factors associated with individual recognitions of KMS. Additionally, using the ordinary logistic regression model without complex sample design, the survey data were analyzed to compare the results.

Results

In the logistic regression analysis, sex, age, health condition, presence of chronic disease, a degree of knowledge about Korean Medicine, and a view about herbal medicine safety were statistically significant both in the KMS experience, and the intention to visit KMS. Marital status was statistically significant in the KMS experience, while family income, a view about the cost of KMS were statistically significant in the intention to visit KMS.

Conclusion

Individual recognitions of KMS and enabling components should be considered when establishing KMS policies. In addition, future studies analyzing KMUS need to take into account the complex sample design features of the survey to avoid statistically misleading results.

Keywords: Korean Medicine Utilization Survey; health care utilization; complex sample survey
Fig. 1

Andersen’s Behavioral Model of Health Service Utilization and Included Variables

Demographic Characteristics of the General Population Survey in 2017 KMUS

Characteristics of Variables According to the KMS Experience

Characteristics of Variables According to the Intention to Visit KMS

Results of Logistic Regression Models of Influencing Factors of the KMS Experience†

Results of Logistic Regression Models of Influencing Factors of the Intention to Visit KMS†

References

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Article information Continued

Copyright © 2021 The Society of Korean Medicine all rights reserved

Fig. 1

Fig. 1

Andersen’s Behavioral Model of Health Service Utilization and Included Variables

Table 1

Demographic Characteristics of the General Population Survey in 2017 KMUS

Variables Sample size [estimated proportion %]
Sex Male 2,467 [49.8]
Female 2,533 [50.2]
Age(y) 19–29 871 [17.8]
30–39 860 [17.8]
40–49 1,027 [20.3]
50–59 989 [19.8]
≥60 1,253 [24.2]
Marital status Single 1,078 [22.5]
Married 3,922 [77.5]
Education level Elementary school 479 [8.3]
Middle school 389 [7.7]
High school 1,964 [39.7]
> High school 2,168 [44.3]
Occupation status Employed 3,298 [66.7]
 Profession/Administration 229 [6.6]
 Office job 980 [30.9]
 Service/Sales 1,202 [37.9]
 Agriculture/forestry /fisheries 271 [7.1]
 Technician/Laborer 608 [17.1]
 Others 8 [0.3]
Not employed 1,702 [33.3]
 Student 368 [22.5]
 Homemaker 1,007 [60.0]
 Inoccupation 326 [17.4]
 Others 1 [0.0]
Monthly family income 1.5 million won 573 [9.3]
1.5 – 3 million won 989 [19.5]
3 – 4.5 million won 1,409 [29.5]
4.5 – 6 million won 1,345 [27.5]
> 6 million won 684 [14.5]

KMUS: Korean Medicine Utilization Survey; KMS: Korean medicine services

Table 2

Characteristics of Variables According to the KMS Experience

Categorical variables Sample size Yes(%) No(%)
Sex Male 2,467 68.4 31.6
Female 2,533 79.1 20.9
Rao-Scott (p-value) 54.266(<0.001)
Age(y) 19–29 871 43.1 56.9
30–39 860 63.4 36.6
40–49 1,027 77.7 22.3
50–59 989 86.1 13.9
≥60 1,253 90.6 9.4
Rao-Scott (p-value) 139.63(<0.001)
Marital status Single 1,078 45.2 54.8
Married 3,922 82.1 17.9
Rao-Scott (p-value) 431.53(<0.001)
Education level Elementary school 479 91.5 8.5
Middle school 389 89.4 10.6
High school 1,964 73.8 26.2
> High school 2,168 67.7 32.3
Rao-Scott (p-value) 41.905(<0.001)
Occupation status Not employed 1,702 75.0 25.0
Employed 3,298 73.2 26.8
Rao-Scott (p-value) 1.3272(0.2494)
Monthly family income 1.5 million won 573 84.7 15.3
1.5 – 3 million won 989 77.4 22.6
3 – 4.5 million won 1,409 70.9 29.1
4.5 – 6 million won 1,345 72.1 27.9
> 6 million won 684 70.9 29.1
Rao-Scott (p-value) 8.8292(<0.001)
Type of national insurance Local subscriber 1,717 78.9 21.1
Employee subscriber 3,246 70.8 29.2
Medical aid 37 86.2 13.8
Rao-Scott (p-value) 19.443(<0.001)
Private insurance No 1,324 75.9 24.1
Yes 3,676 73.1 26.9
Rao-Scott (p-value) 2.9906(0.0838)
Presence of chronic disease None 3950 69.1 30.9
Yes 1050 92.1 7.9
Rao-Scott (p-value) 124.84(<0.001)
Disability grade None 4884 73.5 26.5
Yes 116 87.6 12.4
Rao-Scott (p-value) 6.4885(0.0109)
Ordinal variables Yes(Mean±SE) No(Mean±SE)
Health condition 2.403±0.017 1.884±0.026
Design-based t test(p-value) 16.588(<0.001)
A degree of knowledge about KM 3.232±0.018 2.359±0.024
Design-based t test(p-value) 27.878(<0.001)
A view about the cost of KMS 2.441±0.015 2.520±0.226
Design-based t test(p-value) −2.8393(0.0045)
A view about herbal medicine safety 3.227±0.017 3.054±0.028
Design-based t test(p-value) 5.1374(<0.001)

KMS: Korean medicine services; KM: Korean medicine; SE: standard error

Table 3

Characteristics of Variables According to the Intention to Visit KMS

Categorical variables Sample size Yes(%) No(%)
Sex Male 2467 81.2 18.8
Female 2533 87.2 12.8
Rao-Scott (p-value) 26.121(<0.001)
Age(y) 19–29 871 67.3 32.7
30–39 860 80.0 20.0
40–49 1,027 88.2 11.8
50–59 989 91.0 9.0
≥60 1,253 90.9 9.1
Rao-Scott (p-value) 58.316(<0.001)
Marital status Single 1,078 69.5 30.5
Married 3,922 88.5 11.5
Rao-Scott (p-value) 171.59(<0.001)
Education level Elementary school 479 88.5 11.5
Middle school 389 90.8 9.2
High school 1,964 84.7 15.3
> High school 2,168 81.8 18.2
Rao-Scott (p-value) 8.367(<0.001)
Occupation status Not employed 1,702 82.4 17.6
Employed 3,298 85.1 14.9
Rao-Scott (p-value) 4.8277(0.0280)
Monthly family income 1.5 million won 573 83.4 16.6
1.5 – 3 million won 989 87.1 12.9
3 – 4.5 million won 1,409 83.6 16.4
4.5 – 6 million won 1,345 83.8 16.2
> 6 million won 684 83.0 17.0
Rao-Scott (p-value) 1.5105(0.197)
Type of national insurance Local subscriber 1,717 86.8 13.2
Employee subscriber 3,246 82.8 17.2
Medical aid 37 79.7 20.3
Rao-Scott (p-value) 6.7361(0.0016)
Private insurance None 1,324 82.9 17.1
Yes 3,676 84.7 15.3
Rao-Scott (p-value) 1.7974(0.1801)
Presence of chronic disease None 3950 82.1 17.9
Yes 1050 92.4 7.6
Rao-Scott (p-value) 56.476(<0.001)
Disability grade None 4884 84.1 15.9
Yes 116 89.3 10.7
Rao-Scott (p-value) 2.3643(0.1242)
Ordinal variables Yes(Mean±SE) No(Mean±SE)
Health condition 2.312±0.016 2.027±0.033
Design-based t test(p-value) 7.6002(<0.001)
A degree of knowledge about KM 3.131±0.017 2.323±0.029
Design-based t test(p-value) 19.693(<0.001)
A view about the cost of KMS 2.467±0.014 2.434±0.031
Design-based t test(p-value) 0.96143(0.3364)
A view about herbal medicine safety 3.237±0.016 2.885±0.034
Design-based t test(p-value) 8.7909(<0.001)

KMS: Korean medicine services; KM: Korean medicine; SE: standard error

Table 4

Results of Logistic Regression Models of Influencing Factors of the KMS Experience†

Model 1 Model 2 Model 3
Intercept −1.619(0.310)*** −4.438(0.443)*** −4.591(0.380)***
Sex Male Ref Ref Ref
Female 0.474(0.090)*** 0.408(0.097)*** 0.442(0.084)***
Age(y) 19–29 Ref Ref Ref
30–39 0.371(0.152)* 0.115(0.158) 0.183(0.141)
40–49 0.860(0.169)*** 0.409(0.181)* 0.488(0.158)**
50–59 1.311(0.184)*** 0.841(0.197)*** 0.749(0.175)***
≥60 1.581(0.214)*** 1.056(0.230)*** 0.930(0.206)***
Marital status Single Ref Ref Ref
Married 0.650(0.137)*** 0.575(0.142)*** 0.604(0.128)***
Education level Elementary school Ref Ref Ref
Middle school −0.031(0.282) 0.068(0.296) 0.009(0.262)
High school −0.039(0.263) −0.119(0.269) −0.220(0.237)
> High school 0.123(0.274) −0.001(0.282) −0.100(0.248)
Occupation status Not employed Ref Ref Ref
Employed −0.049(0.102) −0.084(0.114) 0.043(0.099)
Monthly family income <1.5 million won Ref Ref Ref
1.5 – 3 million won 0.380(0.215) 0.285(0.222) 0.214(0.189)
3 – 4.5 million won 0.316(0.215) 0.202(0.223) 0.195(0.189)
4.5 – 6 million won 0.526(0.214)* 0.330(0.220) 0.218(0.192)
> 6 million won 0.460(0.243) 0.227(0.251) 0.143(0.205)
Type of national insurance Local subscriber Ref Ref Ref
Employee subscriber −0.133(0.097) −0.190(0.107) −0.270(0.090)**
Medical aid −0.022(0.672) −0.648(0.658) −1.040(0.530)*
Private insurance No Ref Ref Ref
Yes 0.084(0.105) −0.015(0.115) 0.050(0.102)
Health condition 0.351(0.062)*** 0.454(0.071)*** 0.463(0.057)***
Presence of chronic disease None Ref Ref Ref
Yes 0.654(0.181)*** 0.550(0.189)** 0.723(0.153)***
Disability grade None Ref Ref Ref
Yes −0.146(0.464) 0.171(0.492) 0.238(0.351)
A degree of knowledge about Korean medicine 1.055(0.056)*** 1.058(0.049)***
A view about the cost of KMS −0.017(0.056) 0.025(0.052)
A view about herbal medicine safety 0.161(0.056)** 0.168(0.048)***
AIC 5052 4426 4167.5
†

Data shown as coefficient(standard error)

***

p<0.001,

**

p<0.01,

*

p<0.05

KMS: Korean medicine services

Table 5

Results of Logistic Regression Models of Influencing Factors of the Intention to Visit KMS†

Model 1 Model 2 Model 3
Intercept −0.768(0.307)* −4.517(0.429)*** −3.845(0.373)***
Sex Male Ref Ref Ref
Female 0.473(0.101)*** 0.414(0.104)*** 0.375(0.091)***
Age(y) 19–29 Ref Ref Ref
30–39 0.351(0.176)* 0.169(0.180) 0.065(0.155)
40–49 0.859(0.203)*** 0.490(0.212)* 0.379(0.180)*
50–59 1.078(0.215)*** 0.619(0.224)** 0.450(0.197)*
≥60 1.282(0.239)*** 0.762(0.254)** 0.387(0.223)
Marital status Single Ref Ref Ref
Married 0.326(0.165)* 0.235(0.166) 0.225(0.144)
Education level Elementary school Ref Ref Ref
Middle school 0.206(0.246) 0.301(0.259) 0.231(0.235)
High school 0.346(0.241) 0.341(0.249) 0.181(0.217)
> High school 0.389(0.258) 0.341(0.266) 0.145(0.232)
Occupation status Not employed Ref Ref Ref
Employed 0.220(0.109)* 0.228(0.119) 0.237(0.103)*
Monthly family income <1.5 million won Ref Ref Ref
1.5 – 3 million won 0.680(0.200)*** 0.583(0.205)** 0.276(0.181)
3 – 4.5 million won 0.569(0.208)** 0.451(0.213)* 0.243(0.184)
4.5 – 6 million won 0.689(0.206)*** 0.519(0.212)* 0.240(0.187)
> 6 million won 0.631(0.231)** 0.470(0.235)* 0.214(0.204)
Type of national insurance Local subscriber Ref Ref Ref
Employee subscriber −0.167(0.105) −0.208(0.112) −0.172(0.096)
Medical aid −0.407(0.453) −0.953(0.427)* −0.880(0.464)
Private insurance No Ref Ref Ref
Yes 0.125(0.112) 0.023(0.119) 0.152(0.106)
Health condition 0.098(0.064) 0.139(0.069)* 0.118(0.059)*
Presence of chronic disease None Ref Ref Ref
Yes 0.553(0.167)** 0.468(0.178)** 0.408(0.150)**
Disability grade None Ref Ref Ref
Yes 0.078(0.329) 0.455(0.362) −0.007(0.302)
A degree of knowledge about Korean medicine 0.933(0.064)*** 0.902(0.055)***
A view about the cost of KMS 0.192(0.063)** 0.104(0.055)
A view about herbal medicine safety 0.424(0.055)*** 0.442(0.051)***
AIC 4253 3813 3707
†

Data shown as coefficient(standard error)

***

p<0.001,

**

p<0.01,

*

p<0.05

KMS: Korean medicine services