Health Policy Manag.  2019 Jun;29(2):160-171. 10.4332/KJHPA.2019.29.2.160.

Analysis of the Health Expenditure and Medical Usage Difference of the Baby Boomers between Male and Female: Depression as a Mediators

• Jeong JY
• Jeong JY
• Cha SJ
• Lee HJ

• KMID: 2453168
• DOI: http://doi.org/10.4332/KJHPA.2019.29.2.160

Abstract

BACKGROUND
This study purposed to compare the difference on medical utilization and health expenditure of baby boomer generation by depression between gender.
METHODS
Korea Welfare Panel Survey 2016, provided by the Korea Institute for Health and Social Affairs, was used for the analysis. For the research, we used the two-part model, yes or no of use (part 1), and frequency of use (part 2) for medical utilization. The dependent variables are the whether or not to use of hospitalization services, outpatient services, length of stay, outpatient service visits, and health expenditure. And the independent variables are used as the predisposing (education, spouse presence), enabling (insurance type, private insurance, economic activity, income), and need (chronic disease, self-rated health, disability) factors in the Andersen behavior model. Depression was used as intervening variables. Structural equation model and multiple group analysis by gender were used.
RESULTS
There were differences in the medical care usage and cost between men and women in baby boomer. For men, mediating effects of depression were present at the hospitalization (yes/no), length of stay, and health expenditure. On the other hand, for women, the mediating effect of depression was found only at the outpatient visits. Specially, depression was working at the medical services by the different way between gender. The size of effect (multiple group analysis) was affected by significant differences between men and women.
CONCLUSION
This study found that the mediating effect of depression is increased medical usage and health expenditure and the effect factors are different by gender. Therefore, it is necessary to establish a medical care policy considering the socio-economic characteristics of baby boomers.

Keyword

Baby boomer; Utilization; Health expenditures; Structural equation modeling; Multiple group analysis; Sex difference

MeSH Terms

Depression*
Female*
Hand
Health Expenditures*
Hospitalization
Humans
Insurance
Korea
Length of Stay
Male*
Negotiating
Outpatients
Population Growth*
Sex Characteristics
Spouses