J Prev Med Public Health.  2011 Nov;44(6):267-274. 10.3961/jpmph.2011.44.6.267.

Disparities in Health Care Utilization Among Urban Homeless in South Korea: A Cross-Sectional Study

• Yoon C
• Ju YS
• Kim CY

• KMID: 1031142
• DOI: http://doi.org/10.3961/jpmph.2011.44.6.267

Abstract

OBJECTIVES
We examined health care disparities in Korean urban homeless people and individual characteristics associated with the utilization of health care.
METHODS
We selected a sample of 203 homeless individuals at streets, shelters, and drop-in centers in Seoul and Daejeon by a quota sampling method. We surveyed demographic information, information related to using health care, and health status with a questionnaire. Logistic regression analysis was adopted to identify factors associated with using health care and to reveal health care disparities within the Korean urban homeless population.
RESULTS
Among 203 respondents, 89 reported that they had visited health care providers at least once in the past 6 months. Twenty persons (22.5%) in the group that used health care (n = 89) reported feeling discriminated against. After adjustment for age, sex, marital status, educational level, monthly income, perceived health status, Beck Depression Inventory score, homeless period, and other covariates, three factors were significantly associated with medical utilization: female sex (adjusted odds ratio [aOR, 15.95; 95% CI, 3.97 to 64.04], having three or more diseases (aOR, 24.58; 95% CI, 4.23 to 142.78), and non-street residency (aOR, 11.39; 95% CI, 3.58 to 36.24).
CONCLUSIONS
Health care disparities in Seoul and Daejeon homeless exist in terms of the main place to stay, physical illnesses, and gender. Under the current homeless support system in South Korea, street homeless have poorer accessibility to health care versus non-street homeless. To provide equitable medical aid for homeless people, strategies to overcome barriers against health care for the street homeless are needed.

Keyword

Health care; Health care disparity; Health status; Homeless persons

MeSH Terms

Adult
Aged
Confidence Intervals
Cross-Sectional Studies
Female
Health Services/statistics & numerical data/*utilization
*Health Status Disparities
Homeless Persons/*statistics & numerical data
Humans
Logistic Models
Male
Middle Aged
Odds Ratio
Psychometrics
Questionnaires
Republic of Korea/epidemiology
Urban Population/*statistics & numerical data
Young Adult