Health Policy Manag.  2016 Dec;26(4):390-398. 10.4332/KJHPA.2016.26.4.390.

The Impact of Health Care Coverage on Changes in Self-Rated Health: Comparison between the Near Poor and the Upper Middle Class

  • 1Department of Social Welfare, Pusan National University, Busan, Korea.


This study aims to analyze the impact of levels of health care coverage on the trajectory of self-rated health, comparing the near-poor which tends to be excluded in traditional health care systems with the upper middle class.
The study participants were 3,687 people who sincerely responded questions regarding health care expenditures, unmet medical needs, and self-rated health in the Korea Health Panel data in 2009-2012.
The higher health care expenditures and the presence of unmet medical needs were significantly associated with the lower level of self-rated health. However, both factors did not significantly predict the steeper decline in the self-rated health. The results from multiple group analyses showed that health care expenditures and unmet medical needs had greater impact on the near-poor compared to their higher income counterparts.
Public health care coverages need to be enhanced as well as reducing health care expenditures and unmet medical needs.


Health care coverage; Health care expenditures; Unmet medical needs; Self-rated health
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