Association of occupational class with healthcare utilization among economically active Korean adults from 2006 to 2014: A repeated cross- sectional study of Koreans aged 19 years and older

Background: To investigate the impact of indicators of occupational class on healthcare utilization by using longitudinal data from a nationally representative survey. Methods: Data were obtained from the Korean Welfare Panel Study conducted from 2006 (wave 1) through 2014 (wave 9). A total of 5,104 individuals were selected at baseline (2006). Analysis of variance and longitudinal data analysis were used to evaluate the following dependent variables: number of outpatient visits and number of days spent in the hospital per year. Results: The number of annual outpatient visits was 4.298 days higher (P < 0.0001) in class IV, 0.438 days higher (P=0.027) in class III, and 0.335 days higher (P=0.035) in class II than in class I. The number of days spent in the hospital per year was 0.610 days higher (P=0.001) in class IV, 0.547 days higher (P < 0.0001) in class III, and 0.115 days higher (P=0.136) in class III than in class I. In addition, the number of days spent in the hospital in class IV patients with unmet healthcare needs showed an opposite trend to that predicted on the basis of socioeconomic status (estimate, -8.524; P-value=0.015). Conclusion: Patients whose jobs involved manual or physical labor were significantly associated with higher healthcare utilization. Thus, the results suggest that healthcare utilization in different occupational classes should be improved by monitoring work environments and promoting health-enhancing behaviors.