title: Disparities in health care utilization among urban homeless in South Korea: a cross-sectional study.
abstract: OBJECTIVE
  We examined health care disparities in Korean urban homeless people and individual characteristics associated with the utilization of health care.
  
  
  METHODS
  We selected a sample of 203 homeless individuals at streets, shelters, and drop-in centers in Seoul and Daejeon by a quota sampling method. We surveyed demographic information, information related to using health care, and health status with a questionnaire. Logistic regression analysis was adopted to identify factors associated with using health care and to reveal health care disparities within the Korean urban homeless population.
  
  
  RESULTS
  Among 203 respondents, 89 reported that they had visited health care providers at least once in the past 6 months. Twenty persons (22.5%) in the group that used health care (n = 89) reported feeling discriminated against. After adjustment for age, sex, marital status, educational level, monthly income, perceived health status, Beck Depression Inventory score, homeless period, and other covariates, three factors were significantly associated with medical utilization: female sex (adjusted odds ratio [aOR, 15.95; 95% CI, 3.97 to 64.04], having three or more diseases (aOR, 24.58; 95% CI, 4.23 to 142.78), and non-street residency (aOR, 11.39; 95% CI, 3.58 to 36.24).
  
  
  CONCLUSIONS
  Health care disparities in Seoul and Daejeon homeless exist in terms of the main place to stay, physical illnesses, and gender. Under the current homeless support system in South Korea, street homeless have poorer accessibility to health care versus non-street homeless. To provide equitable medical aid for homeless people, strategies to overcome barriers against health care for the street homeless are needed.
authors.affiliation: Preventive Medicine Program, Graduate School of Public Health, Seoul National University, Seoul, Korea.
authors.forename: Changgyo
authors.initials: C
authors.lastname: Yoon
authors.forename: Young Su
authors.initials: YS
authors.lastname: Ju
authors.forename: Chang Yup
authors.initials: CY
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D054624:Health Status Disparities; D006703:Ill-Housed Persons / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011594:Psychometrics; D056910:Republic of Korea / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data*; D055815:Young Adult