Skip Navigation
Skip to contents

Epidemiol Health : Epidemiology and Health


Author index

Page Path
HOME > Browse articles > Author index
Han Eol Jeong 1 Article
Socioeconomic disparities in Korea by health insurance type during the COVID-19 pandemic: a nationwide study
Han Eol Jeong, Jongseong Lee, Hyun Joon Shin, Ju-Young Shin
Epidemiol Health. 2021;43:e2021007.   Published online January 13, 2021
  • 9,217 View
  • 393 Download
  • 7 Citations
AbstractAbstract AbstractSummary PDFSupplementary Material
This study explored socioeconomic disparities in Korea using health insurance type as a proxy during the ongoing coronavirus disease 2019 (COVID-19) pandemic.
We conducted a retrospective cohort study using Korea’s nationwide healthcare database, which contained all individuals who received a diagnostic test for COVID-19 (n=232,390) as of May 15, 2020. We classified our cohort by health insurance type into beneficiaries of the National Health Insurance (NHI) or Medicaid programs. Our study outcomes were infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and COVID-19-related outcomes, a composite of all-cause death, intensive care unit admission, and mechanical ventilation use. We estimated age-, sex-, and Charlson comorbidity index score–adjusted odds ratios (aORs) with 95% confidence intervals (CIs) using a multivariable logistic regression analysis.
Of the 218,070 NHI and 14,320 Medicaid beneficiaries who received COVID-19 tests, 7,777 and 738 tested positive, respectively. The Medicaid beneficiaries were older (mean age, 57.5 vs. 47.8 years), more likely to be males (47.2 vs. 40.2%), and had a higher comorbidity burden (mean CCI, 2.0 vs. 1.7) than NHI beneficiaries. Compared to NHI beneficiaries, Medicaid beneficiaries had a 22% increased risk of SARS-CoV-2 infection (aOR, 1.22; 95% CI, 1.09 to 1.38), but had no significantly elevated risk of COVID-19-related outcomes (aOR 1.10, 95% CI 0.77 to 1.57); the individual events of the composite outcome yielded similar findings.
As socioeconomic factors, with health insurance as a proxy, could serve as determinants during the current pandemic, pre-emptive support is needed for high-risk groups to slow its spread.
Korean summary
사회경제적 수준과 코로나19 발생률 및 예후 간 연관성 등 코로나19로 인한 건강 불평등 현상은 아직 확인된 바가 없다. 건강보험 가입자 대비 의료급여 수급권자에서 SARS-CoV-2의 감염 위험이 더 높게 나타났다. 코로나19의 확산을 늦추기 위해서는, 의료급여 수급권자를 비롯한 취약계층 대상의 선제적 지원이 제공되어야 한다.
Key Message
Socioeconomic status, with health insurance as a proxy, could explain health inequalities in clinical outcomes, diverse disease incidence and prognosis, during the COVID-19 pandemic.


Citations to this article as recorded by  
  • Increased Healthcare Delays in Tuberculosis Patients During the First Wave of COVID-19 Pandemic in Korea: A Nationwide Cross-Sectional Study
    Jinsoo Min, Yousang Ko, Hyung Woo Kim, Hyeon-Kyoung Koo, Jee Youn Oh, Yun-Jeong Jeong, Hyeon Hui Kang, Kwang Joo Park, Yong Il Hwang, Jin Woo Kim, Joong Hyun Ahn, Yangjin Jegal, Ji Young Kang, Sung-Soon Lee, Jae Seuk Park, Ju Sang Kim
    Journal of Korean Medical Science.2022;[Epub]     CrossRef
  • Socioeconomic Inequalities in COVID-19 Incidence During Different Epidemic Phases in South Korea
    Dae-sung Yoo, Minji Hwang, Byung Chul Chun, Su Jin Kim, Mia Son, Nam-Kyu Seo, Myung Ki
    Frontiers in Medicine.2022;[Epub]     CrossRef
  • Neighbourhood socio-economic vulnerability and access to COVID-19 healthcare during the first two waves of the pandemic in Geneva, Switzerland: A gender perspective
    Denis Mongin, Stéphane Cullati, Michelle Kelly-Irving, Maevane Rosselet, Simon Regard, Delphine S. Courvoisier
    eClinicalMedicine.2022; 46: 101352.     CrossRef
  • Analysis of the Relationship between Socioeconomic Status and Incidence of Hysterectomy Using Data of the Korean Genome and Epidemiology Study (KoGES)
    Yung-Taek Ouh, Kyung-Jin Min, Sanghoon Lee, Jin-Hwa Hong, Jae Yun Song, Jae-Kwan Lee, Nak Woo Lee
    Healthcare.2022; 10(6): 997.     CrossRef
  • The determinants of caregiver use and its costs for elderly inpatients in Korea: a study applying Andersen’s behavioral model of health care utilization and replacement cost method
    Jennifer Ivy Kim, Sukil Kim
    BMC Health Services Research.2021;[Epub]     CrossRef
  • Dissection of non-pharmaceutical interventions implemented by Iran, South Korea, and Turkey in the fight against COVID-19 pandemic
    Mohammad Keykhaei, Sogol Koolaji, Esmaeil Mohammadi, Reyhaneh Kalantar, Sahar Saeedi Moghaddam, Arya Aminorroaya, Shaghayegh Zokaei, Sina Azadnajafabad, Negar Rezaei, Erfan Ghasemi, Nazila Rezaei, Rosa Haghshenas, Yosef Farzi, Sina Rashedi, Bagher Larijan
    Journal of Diabetes & Metabolic Disorders.2021; 20(2): 1919.     CrossRef
  • The associations of previous influenza/upper respiratory infection with COVID-19 susceptibility/morbidity/mortality: a nationwide cohort study in South Korea
    So Young Kim, Joo-Hee Kim, Miyoung Kim, Jee Hye Wee, Younghee Jung, Chanyang Min, Dae Myoung Yoo, Songyong Sim, Hyo Geun Choi
    Scientific Reports.2021;[Epub]     CrossRef

Epidemiol Health : Epidemiology and Health