J Korean Acad Community Health Nurs.  2019 Dec;30(4):484-493. 10.12799/jkachn.2019.30.4.484.

The Effect of Health Literacy and Self-care Performance on Health Care Utilization of Medicaid Elderly

  • 1Medical Aid Manager, JungGu-Office, Busan, Korea.
  • 2Professor, College of Nursing, Dong-A University, Busan, Korea. gelee@dau.ac.kr


The purpose of this study was to examine the effect of health literacy and self-care performance on health care utilization of medicaid elderly.
A total of 203 medicaid elderly over 65 and living in B-metropolitan city were interviewed. Data were analyzed with descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients and Hierarchical Multiple regression.
The average score of the health literacy was 7.88±2.84 out of 12. The average score of self-care was 3.26±0.77 points on the 5 point scale. The frequency of health care utilization by the subjects was 6.65±5.25 a month. The health literacy and self-care performance showed a statistically significant positive correlation. The health literacy and self-care performance showed a statistically significant negative correlation with health care utilization. The factors affecting health care utilization of the subjects were self-care performance, health literacy, and religion, and the explanatory power was 25%.
The results indicate that the self-care performance, health literacy, religion are significant factors of health care utilization in medicaid elderly. Therefore, it is necessary to develop strategies to improve their self-care performance and health literacy for reasonable health care utilization. Also, it is necessary to provide the elderly with correct information about medical use from accessible religious institutions, senior community center, and welfare centers.


Medicaid; Health literacy; Self care; Patient acceptance of health care
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