Woorim Kim

Noorhee Son, Woo-Ri Lee, Woorim Kim. HIRA Research 2026;6:90-101. https://doi.org/10.52937/hira.26.6.1.e3

Unmet healthcare needs reflect timely access to medical care perceived to be required by an individual. This study investigated the association between the unmet healthcare needs and satisfaction with local medical services in patients with diabetes. Data from the 2023 Korea Community Health Survey were used. Descriptive statistics were measured using a chi-squared test. The association between the likelihood of unmet healthcare needs and patient satisfaction with local medical services was analyzed using a multivariable logistic regression analysis. Of the 23,822 participants diagnosed with diabetes, 1,141 (4.7%) reported unmet healthcare needs. A total of 18,198 (80.6%) individuals were satisfied with local medical services. Compared to those satisfied with local medical services, those unsatisfied were more likely to experience unmet needs (OR 1.65, 95% CI 1.41–1.94). Unmet healthcare needs were associated with patient satisfaction with local medical services. This suggests the importance of addressing this association, considering its potential correlation with health outcomes and disease burden. The online version contains supplementary material available at 10.1186/s12913-026-14276-w.

Background: Depression poses a significant burden among young adults, making it crucial to investigate factors associated with depressive symptoms. This study examined the association between unmet educational aspirations and depressive symptoms in working young adults. Methods: Data from the 2021 Seoul Young Adult Panel Study (SYPS) were used. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression (CES‐D 11) scale. The association between unmet educational aspirations and depressive symptoms was analyzed using multivariable linear regression analysis. A subgroup analysis was conducted based on job satisfaction level. Results: Of 3402 participants, 392 (11.5%) reported unmet educational aspirations for personal reasons and 412 (12.1%) for circumstantial reasons. Compared to individuals without unmet educational aspirations, those with unmet educational aspirations due to personal ( β : 0.77, p = 0.017) and circumstantial ( β : 2.17, p < 0.001) reasons had higher CES‐D 11 scores, indicating higher levels of depressive symptoms. This increase was particularly pronounced among participants who reported circumstantial unmet educational aspirations and had low job satisfaction. Conclusions: Young adults with unmet educational aspirations, whether for personal or circumstantial reasons, showed higher levels of depressive symptoms. The findings suggest the importance of considering educational aspirations in addressing the mental health of young adults.

Woorim Kim, Kyuwoong Kim, Eun Jeong Nam, Su Yeon Kye, Minju Kim, Jin Young Choi. HIRA Research 2025;5:148-61. https://doi.org/10.52937/hira.25.5.2.e1

OBJECTIVES: Breast cancer screening rates have increased since the introduction of the National Cancer Screening Program (NCSP) in Korea. However, it remains unclear whether socioeconomic inequalities have improved, particularly according to screening type. This study investigated inequalities in organized (government-led) and opportunistic (individually initiated) screening, stratified by education and income levels.METHODS: Data were obtained from the Korean National Cancer Screening Survey, conducted annually from 2009 to 2021, involving approximately 1,700 women each year except in 2009. Trends were analyzed using joinpoint regression to calculate average annual percent changes (AAPCs). Socioeconomic inequalities were assessed using the slope index of inequality (SII) and relative index of inequality (RII).RESULTS: Organized screening rates increased from 42.0% in 2009 to 60.2% in 2021 (AAPC, 1.9; 95% confidence interval [CI], 0.7 to 3.4), whereas opportunistic screening rates declined from 13.3% to 11.2% (AAPC, -5.4; 95% CI, -8.7 to -2.3). For organized screening, individuals with lower education levels exhibited higher participation, resulting in negative inequality indices (SII, -5.37%; RII, 0.80). No significant income-based inequality was found (SII, 1.60%; RII, 1.07). However, opportunistic screening demonstrated significant inequalities by both education (SII, 5.37%; RII, 1.92) and income (SII, 5.90%; RII, 1.96), with higher participation rates among more advantaged groups.CONCLUSIONS: The NCSP has improved breast cancer screening rates and reduced income-related inequality in organized screening. However, educational and income-based inequalities persist in opportunistic screening. To reduce screening inequities, policy efforts are needed to further promote the NCSP, including improving program quality and providing financial support for follow-up examinations.

Background: Hospice and palliative care play key roles in facilitating goals-of-care discussions and managing symptoms in end-of-life (EOL) care for cancer patients. In this study, the association between completion of advance care planning (ACP), which refers to decisions regarding life-sustaining treatment, and hospice utilization in patients with cancer is examined. Methods: Data from the Korea-Clinical Data Utilization Network for Research Excellence were used. The study population included individuals diagnosed with one of the five leading causes of cancer-related deaths in South Korea. The association between the completion of ACP and hospice utilization was analyzed using multivariable logistic regression analysis. Results: The study population included 50,574 patients with terminal cancer, of whom 10,530 (20.8%) had received hospice care. Self-determined ACP was completed by 9271 (18.3%) participants and non-self-determined ACP by 8654 (17.1%). Patients with ACP were more likely to receive hospice care, with the self-determined group (OR, 5.46; 95% CI: 5.13–5.81) showing a stronger association than the non-self-determined group (OR, 1.27; 95% CI: 1.18–1.37). Conclusions: Patients with cancer who completed ACP were more likely to use hospice care services. These findings indicate the potential importance of ACP decisions in providing EOL care.

This study investigated the relationship between fragmented care (patient care provided at multiple hospitals) and incident mood disorders in elderly colorectal cancer patients. Fragmented care was defined as a change in the medical institution providing first cancer treatment within 180 days of cancer diagnosis. The aim of this study was to investigate the impact of fragmented care on the incidence of mood disorder after cancer diagnosis in elderly colorectal cancer patients. This study used NHIS Senior cohort data between 2002 and 2019 in South Korea. The participants included individuals aged 60 to 80 years who were diagnosed with colorectal cancer between 2008 and 2014. The primary outcome measure was the incidence of mood disorders within five years after cancer diagnosis. The independent variable was fragmented care. Regression analysis was conducted using the Cox proportional hazard model, and a sensitivity analysis was performed to enhance the robustness of the study findings. Of the total 3,726 participants, 878 (23.6%) were diagnosed with mood disorders, and 328 (8.8%) experienced fragmented care. The mood disorder incidence rate per 100,000 person-days was higher among those who experienced fragmented care (18.9 cases) compared to those who did not (14.6 cases). Participants who received fragmented care had a significantly higher risk of incident mood disorders (hazard ratio 1.39, 95% confidence interval 1.10–1.77). The results of the sensitivity analysis, which extended the fragmented care observation period, remained consistent with the original findings. Additionally, subgroup analysis revealed that the effect of fragmented care on incident mood disorders was significantly associated with female sex, chronic diseases, lower economic status, and type of colon cancer (C18). Fragmented care increased the risk of incident mood disorders within the first five years of diagnosis in elderly patients with colorectal cancer. The findings highlight the potentially important role of a cohesive health system in managing the mental health of patients with colorectal cancer, which is important considering that depression is relatively commonly found in these patients.

Background: Many municipalities in rural areas of Korea are facing population decline due to the aging population phenomenon. This study examined the relationship between residing in municipalities facing population decline and satisfaction with nearby healthcare infrastructure in older aged adults. Methods: The 2021 Korea Community Health Survey (KCHS) data were used. Municipalities were classified as those not facing population decline, those at risk, and those facing population decline based on the Population Decline Index. The association between residing in municipalities facing population decline and satisfaction with nearby healthcare infrastructure was examined cross-sectionally using a multi-level logistic regression analysis. Satisfaction with available public transportation was concomitantly examined as it is related to accessing healthcare services. Results: Of the 58,568 individuals aged 65 years or above analyzed, 27,471 (46.9%) adults were residing in municipalities without population decline, 4,640 (7.9%) adults in municipalities at risk of population decline, and 26,457 (45.2%) in municipalities with population decline. Individuals living in municipalities with population decline were more likely to be dissatisfied with nearby healthcare infrastructure (OR 1.76, 95% CI 1.41–2.20). Similar tendencies were found for public transportation infrastructure (OR 1.67, 95% CI 1.38–2.03). Conclusions: Individuals residing in municipalities with declining populations are more likely to report dissatisfaction with nearby healthcare infrastructure and public transportation. These findings emphasize the importance of providing adequate medical infrastructure to reduce potential health-related disparities.

OBJECTIVES: Studies have suggested an association between hearing loss and anemia. Hearing loss has also been linked to rhinitis, which is characterized by inflammation of the nasal mucous membranes and sinus mucosa. Few studies have concurrently explored the relationships between hearing loss, anemia, and rhinitis. This study was conducted to investigate the association between hearing loss and anemia and to further analyze the potential role of rhinitis in this relationship.METHODS: Data were collected from the 2020 Korea National Health and Nutrition Examination Survey. Hearing loss was measured with an audiometer in a soundproof booth and was defined as at least moderate impairment (as indicated by a pure-tone average of ≥41 dB in the better-hearing ear). The association between hearing loss and anemia was analyzed using multivariable logistic regression. The combined effect of anemia and rhinitis on hearing loss was assessed with an interaction term.RESULTS: Among the 2,772 participants, 477 (17.2%) exhibited hearing loss. Participants with anemia were more likely to experience hearing loss than those without anemia (odds ratio [OR], 1.58; 95% confidence interval [CI], 1.07 to 2.33). Furthermore, the odds of hearing loss were greater in participants with both anemia and rhinitis (OR, 3.79; 95% CI, 1.93 to 7.43) relative to those without either condition.CONCLUSIONS: Anemia was associated with hearing loss in individuals aged 40 years and older. Based on the analysis of combined effects, participants with anemia and chronic rhinitis were more likely to experience hearing loss than individuals without these conditions.

Woorim Kim, Kyuwoong Kim, Eun Jeong Nam, Sue Hyun Kye, Jin Young Choi. HIRA Research 2024;4:63-72. https://doi.org/10.52937/hira.24.4.1.e1