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Decomposing socioeconomic inequalities in the use of preventive eye screening services among individuals with diabetes in Korea


  • Jongnam Hwang

    () (Daegu University)


Abstract Objectives The aim of this study was to assess the socioeconomic inequalities in the use of preventive eye screening services among individuals with diabetes in Korea. Methods Using nationally representative survey data, the concentration index (CI) and decomposition of the CI were used to capture and quantify income-related inequalities. Results The results show income-related inequality in the use of eye screening services among individuals with diabetes, suggesting that services were concentrated among individuals with higher incomes. After adjusting for need factors, such as sex, age and self-rated health, the inequality still persisted as observed horizontal inequity in the services, indicating that unequal care was provided for equal need. The decomposition approach revealed that the largest contributions to the observed inequality were higher education and higher income levels. Having private insurance and residing in non-Seoul metro areas also contributed to the observed pro-rich inequality. Conclusions These findings suggest that income- and education-related barriers to the use of preventive eye screening services for individuals with diabetes should be targeted for removal at the national level to achieve the goal of equal care for equal need in diabetes management.

Suggested Citation

  • Jongnam Hwang, 2016. "Decomposing socioeconomic inequalities in the use of preventive eye screening services among individuals with diabetes in Korea," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 61(5), pages 613-620, June.
  • Handle: RePEc:spr:ijphth:v:61:y:2016:i:5:d:10.1007_s00038-016-0804-1
    DOI: 10.1007/s00038-016-0804-1

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    References listed on IDEAS

    1. Lu, Jui-fen R. & Leung, Gabriel M. & Kwon, Soonman & Tin, Keith Y.K. & Van Doorslaer, Eddy & O'Donnell, Owen, 2007. "Horizontal equity in health care utilization evidence from three high-income Asian economies," Social Science & Medicine, Elsevier, vol. 64(1), pages 199-212, January.
    2. Owen O'Donnell & Eddy van Doorslaer & Adam Wagstaff & Magnus Lindelow, 2008. "Analyzing Health Equity Using Household Survey Data : A Guide to Techniques and Their Implementation," World Bank Publications, The World Bank, number 6896, March.
    3. Dunlop, Sheryl & Coyte, Peter C. & McIsaac, Warren, 2000. "Socio-economic status and the utilisation of physicians' services: results from the Canadian National Population Health Survey," Social Science & Medicine, Elsevier, vol. 51(1), pages 123-133, July.
    4. Morris, Stephen & Sutton, Matthew & Gravelle, Hugh, 2005. "Inequity and inequality in the use of health care in England: an empirical investigation," Social Science & Medicine, Elsevier, vol. 60(6), pages 1251-1266, March.
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