Effect of socioeconomic status and national health insurance registration on the use of medical service

Many developed countries guarantee minimum amount of medical service through national health insurance programs. However, little is known about how these programs affect the individual’s utilization of medical service. This study investigates how one’s socioeconomic status affects their choices on medical service, as well as how the relationship between the two varies by whether one owns a public or private health insurance. We used Korea Health Panel from 2008 to 2011 (n=18,237). In order to identify the impact of public or private health insurance registration has on the usage of medical service, longitudinal study applied with generalized estimating equation was conducted. The subordination variable was whether or not one used medical service such as outpatient, inpatient and emergency medical service. The analysis result revealed that the use of medical service differed greatly by one’s socioeconomic status after adjusting potential confounders. The medical service usage increased as the educational level and income increased. Also, the lack of health insurance reduced the medical service usage, and the usage increased when one owned private health insurance. Thus, it is necessary to strengthen the coverage of public health insurance while using the private health insurance as a supplementary tool in order to enhance the health equity.