국내 이주 노동자의 의료이용 형태 및 의료이용만족도 분석

다국어 초록 (Multilingual Abstract)

Immigrants are a growing segment of the Korean population. In 2007, there were 970,000 immigrants, accounting for 2% of the total Korean population. Rapid increase in the immigrant population has been accelerated due to an aging society, agreement of FTA or WTO. Inspite of the fact that we have already entered into a multi-ethnic, multi-cultural society, the public health system of Korea is not adequate to protect the health right of immigrants, one of the essential human rights. Recently the Government announced the policy of Emergency Service for Immigrants, who have no medical insurance or benefits, and put a law into force for an immigrants' health care system through the local public health center. Private organizations have also offered medical care to immigrants having no medical insurance or protection through free clinics. However, this is just toddler steps for immigrants' health care in Korea.Previous national studies in Korea had reported immigrants status, but there is little information about health care utilization and immigrants' satisfaction with health care services in Korea. Therefore, we aimed to evaluate the health care utilization and immigrants' satisfaction with health care services in Korea, for improving the health care system in Korea and giving basic information to create a better public health policy. A cross-sectional survey was conducted by interviewing 226 immigrants who were staying at shelters in Seoul, visiting free clinics, or attending churches in Seoul(response rate 93%). We collected the data of socio-demographics, health status, health care utilization and satisfaction of immigrant workers by questionnaire. We analyzed the factors that affect the health care utilization, and immigrants' satisfaction with health care services using t-test, chi-square, one way ANOVA and multiple regression analysis.The mean number of medical institute visits of immigrant was 5.0 in the last year. In our study, 74% of immigrants responders had no medical insurance, and the majority of immigrants had paid the total medical cost themselves, except for those who used free clinics. Only 10% used medical insurance for health care costs. The most important reasons that immigrant workers chose the medical institute were low medical costs, accessible location, and ability of medical services. The average of the aggregate score of health care satisfaction of immigrant workers was 3.5 (satisfaction was measured by a 5-point Likert scale). By multiple regression analysis, the health care satisfaction was associated with the immigrant workers choosing a main medical institute. Specifically, the immigrant workers who used the free clinics were more satisfied with their health care than the immigrant workers who used other medical institutes. In conclusion, the utilization of health care facilities by immigrants was low. The highest health care satisfaction came from the utilization of free clinics. So it appears that public immigration health care system in Korea has not properly been functioning. Thus, a further large-scale national study on heath status and health care utilization of immigrants is needed to improve immigrants' health status and to develop a proper policy for immigrant health care.