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

Jinwoong Lim; Kee-Jae Lee; Lim, Jinwoong; Lee, Kee-Jae

doi:10.13048/jkm.21002

JKM > Volume 42(1); 2021 > Article

Lim and Lee: Influencing factors of using Korean Medicine services – focusing on the 2017 Korean Medicine Utilization Survey

Original Article

The Journal of Korean Medicine 2021; 42(1): 12-25.

Published online: March 01, 2021

DOI: https://doi.org/10.13048/jkm.21002

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

Jinwoong Lim¹^{, 2}

, Kee-Jae Lee³

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 August 7, 2021 Revised August 13, 2021 Accepted February 18, 2021

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

Table 1

Demographic Characteristics of the General Population Survey in 2017 KMUS

Variables		Sample size [estimated proportion %]
Sex	Male	2,467 [49.8]
Sex	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]
Marital status	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
Sex	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
Marital status	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
Occupation status	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
Private insurance	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
Presence of chronic disease	Yes	1050	92.1	7.9

Rao-Scott (p-value)			124.84(<0.001)

Disability grade	None	4884	73.5	26.5
Disability grade	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
Sex	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
Marital status	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
Occupation status	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
Private insurance	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
Presence of chronic disease	Yes	1050	92.4	7.6

Rao-Scott (p-value)			56.476(<0.001)

Disability grade	None	4884	84.1	15.9
Disability grade	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
Sex	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
Marital status	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
Occupation status	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
Private insurance	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
Presence of chronic disease	Yes	0.654(0.181)***	0.550(0.189)**	0.723(0.153)***

Disability grade	None	Ref	Ref	Ref
Disability grade	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
Sex	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
Marital status	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
Occupation status	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
Private insurance	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
Presence of chronic disease	Yes	0.553(0.167)**	0.468(0.178)**	0.408(0.150)**

Disability grade	None	Ref	Ref	Ref
Disability grade	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

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