Korean Journal of Family Medicine最新文献

{"title":"Smoking cessation policy gaps in South Korea: an MPOWER Framework analysis with AI-assisted multi-source evidence synthesis (2021-2026).","authors":"Sang Hyun Ahn, Yoo-Seock Cheong","doi":"10.4082/kjfm.26.0104","DOIUrl":"https://doi.org/10.4082/kjfm.26.0104","url":null,"abstract":"<p><p>Smoking remains the leading preventable cause of death in South Korea, accounting for 58,000-68,000 deaths annually and socioeconomic costs of approximately ₩15 trillion. Despite demonstrated cessation program effectiveness, participation has declined 62% since 2017, and Korea's tobacco landscape is undergoing rapid transformation-including a decade-long cigarette price freeze, one of the world's highest heated tobacco product market shares (18.4%), and the widening gap between total tobacco product use and cigarette-only prevalence. This review applies the World Health Organization Framework Convention on Tobacco Control MPOWER framework to identify policy gaps and strategic priorities for Korean smoking cessation during 2021-2026. We synthesized evidence from PubMed, Cochrane Library, Embase, KoreaMed, and RISS, supplemented by an artificial intelligence-assisted multi-source corroboration protocol using four independent platforms with primary-source verification of all cited claims. Four strategic priorities emerge, ranked by anticipated population-level impact. First, price and packaging policy reform: the 10-year price freeze at ₩4,500 (fifth lowest among Organization for Economic Cooperation and Development countries) represents the most significant modifiable barrier, with expert consensus recommending ₩8,000-10,000 with inflation indexation. Second, evidence-based novel product regulation: marked divergence among international guidelines on e-cigarettes demands a calibrated Korean approach balancing adult cessation benefits against youth initiation risks. Third, product-specific monitoring: total tobacco product use should replace cigarette-only prevalence as the primary national indicator. Fourth, pharmacotherapy optimization and digital integration: combination nicotine replacement therapy showed no clear difference versus varenicline in network meta-analysis (odds ratio, 1.06; 95% credible interval, 0.75-1.48), and digital cessation interventions (relative risk, 1.86) warrant consideration for integration into Korean cessation services. The December 2025 Tobacco Business Act amendment creates a legislative window to address these gaps comprehensively.</p>","PeriodicalId":17893,"journal":{"name":"Korean Journal of Family Medicine","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between phase angle and albuminuria in Korean adults aged 40 years or older: a cross-sectional study of the 9th Korea National Health and Nutrition Examination Survey (2022-2023).","authors":"Dong Su Park, Yohwan Yeo, Jung Jin Cho, Eunbyul Cho, Dagyeong Lee, Yoon Soo Jeong","doi":"10.4082/kjfm.25.0305","DOIUrl":"https://doi.org/10.4082/kjfm.25.0305","url":null,"abstract":"<p><strong>Background: </strong>Phase angle (PhA), derived from bioelectrical impedance analysis, reflects cellular health and membrane integrity and is reduced in chronic diseases. Albuminuria is an early marker of endothelial and microvascular injury and predicts renal and cardiovascular diseases. This study aimed to investigate the association between PhA and albuminuria in Korean adults aged 40 years or older.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of data from the 9th Korea National Health and Nutrition Examination Survey (2022-2023). After excluding participants younger than 40 years of age, those with diabetes, elevated serum creatinine levels, and those with missing data, 3,283 adults (1,495 men and 1,788 women) were included. Whole-body PhA at 50 kHz was used as the independent variable. Albuminuria was defined as a urine albumin-to-creatinine ratio of ≥30 mg/g. Survey-weighted, sex-stratified multivariate logistic regression models were adjusted for age, lifetime smoking, drinking frequency in the previous year, hypertension status, body mass index, glycated hemoglobin, low- and high-density lipoprotein cholesterol, triglycerides, serum creatinine, blood urea nitrogen, high sensitivity C-reactive protein, and skeletal muscle mass index.</p><p><strong>Results: </strong>Albuminuria was identified in 7.0% of the participants (7.2% of men and 6.9% of women). In women, each 1° increase in PhA was associated with substantially lower odds of albuminuria (adjusted odds ratio, 0.47; 95% confidence interval, 0.26-0.86). In men, the relationship showed a J-shaped pattern, with the lowest risk at mid-range PhA values and a marked increase at higher values; both linear and quadratic PhA terms were significant.</p><p><strong>Conclusion: </strong>In Korean adults, PhA showed sex-specific associations with albuminuria, with an inverse association in women and a J-shaped association in men. As a noninvasive and widely available measure, PhA could potentially serve as a supplementary tool for identifying individuals at risk for early renal microvascular injury.</p>","PeriodicalId":17893,"journal":{"name":"Korean Journal of Family Medicine","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between substance use disorder and risky behavior among students in Indonesia: a cross-sectional study.","authors":"Rachmalina Soerachman, Irfan Ardani, Oktarina Oktarina, Dwi Hapsari Tjandrarini, Setia Pranata, Tin Afifah, Betty Roosihermiatie, Diah Yunitawati, Anissa Rizkianti, Yurika Fauzia Wardhani","doi":"10.4082/kjfm.25.0237","DOIUrl":"10.4082/kjfm.25.0237","url":null,"abstract":"<p><strong>Background: </strong>Substance use is prohibited in Indonesia; however, adolescents continue to consume these substances, creating a significant public health challenge. This study examines behavioral and demographic factors associated with general drug use, including cannabis and amphetamine use, among Indonesian adolescents, using nationally representative data.</p><p><strong>Methods: </strong>A cross-sectional study used data from the 2023 Indonesia Global School-based Student Health Survey, which included 10,059 students aged 13 to 17 years. A two-stage cluster sampling was applied, and descriptive and regression analyses were conducted to identify factors associated with substance use.</p><p><strong>Results: </strong>Overall, 3.03% of students reported drug use, 1.45% reported cannabis use, and 1.33% reported amphetamine use. Age and school level were not significantly associated with substance use. However, male sex, residence outside the Java-Bali region, alcohol use, and tobacco use were consistently linked to higher odds of drug, cannabis, and amphetamine use. Alcohol consumption was the strongest predictor for all types of substance use. These findings indicate that risky behaviors tend to cluster, supporting the pattern of polysubstance use among youth.</p><p><strong>Conclusion: </strong>The study findings highlight the need for risk-specific, gender-responsive, school-based prevention programs that actively involve parents and regulate adolescents' access to alcohol and tobacco. Enhancing life skills and character education in both school and family settings may also help students avoid risky behaviors.</p>","PeriodicalId":17893,"journal":{"name":"Korean Journal of Family Medicine","volume":" ","pages":"451-459"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147474368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary care systems in South Korea and Japan: a comparative review.","authors":"Nobuo Handa, DaeHyun Kim","doi":"10.4082/kjfm.25.0375","DOIUrl":"10.4082/kjfm.25.0375","url":null,"abstract":"<p><p>The primary care system (PCS) is an essential national health infrastructure defined by the delivery of comprehensive, integrated, and accessible services that serve as the patient's first and sustained point of contact with the healthcare system. A comparative review was performed through searches of PubMed, KoreaMed, and J-STAGE databases using terms including \"primary care,\" \"general practitioner,\" \"family physician,\" \"gatekeeping,\" \"Korea,\" and \"Japan.\" Gray literature from the Japan Medical Association, Korea Medical Association, and OECD (Organisation for Economic Co-operation and Development) was also reviewed. Clinical case examples from one author's practice were included to illustrate real-world general practitioner (GP) challenges. Both Japan and South Korea feature universal health insurance but differ substantially in physician training pathways, gatekeeping enforcement, and community care integration. Japan is transitioning toward a kakaritsuke-i (registered home doctor) model with a nascent GP specialty board, whereas South Korea relies primarily on specialist-led private clinics for primary care delivery. International evidence suggests that structured, continuous family physician (FP) training is associated with improved chronic disease management, preventive care utilization, and patient satisfaction. Strengthening South Korea's PCS requires a clearly defined mandatory FP residency framework, reinforced gatekeeping mechanisms, and greater investment in community-based integrated care. Japan's ongoing reforms offer a useful regional comparator, while international FP models provide a proven evidence base for structural improvement.</p>","PeriodicalId":17893,"journal":{"name":"Korean Journal of Family Medicine","volume":" ","pages":"391-396"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148712872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonarteritic anterior ischemic optic neuropathy after rapid weight loss during semaglutide therapy: a case report.","authors":"Chan-Ho Cho, Won Jae Kim","doi":"10.4082/kjfm.26.0135","DOIUrl":"10.4082/kjfm.26.0135","url":null,"abstract":"<p><p>Semaglutide, a glucagon-like peptide-1 receptor agonist, is increasingly used for obesity management; however, concerns have recently emerged regarding potential ocular adverse events, including nonarteritic anterior ischemic optic neuropathy (NAION). Herein, we report a case of NAION that developed after marked, rapid weight loss during semaglutide therapy in a young man with multiple vascular risk factors. A 42-year-old man presented with acute visual disturbance in the right eye after losing approximately 40 kg over 2 months while receiving semaglutide (Wegovy) for obesity treatment. The patient's medical history included diabetes mellitus, hypertension, dyslipidemia, and a history of smoking. Ophthalmic examination revealed right optic disc edema and a corresponding inferior visual field defect. Magnetic resonance imaging and laboratory investigations revealed no other definite causes of optic neuropathy. He was diagnosed with NAION, which was temporally associated with semaglutide therapy and rapid weight reduction. Semaglutide was discontinued, and high-dose intravenous methylprednisolone was administered. At 6 months, the optic disc edema had resolved, leaving mild disc pallor, though the visual field defect persisted. Although causality cannot be established from a single case, this report highlights the need for clinical vigilance regarding optic neuropathy in patients receiving semaglutide, particularly in the setting of rapid weight loss.</p>","PeriodicalId":17893,"journal":{"name":"Korean Journal of Family Medicine","volume":"47 5","pages":"460-464"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential role of regular physicians in improving health literacy in patients with chronic diseases: a retrospective cross-sectional study in Korea.","authors":"Hye Sook Min, Kyung-Shin Lee, Dong-Hee Ryu, Jeehye Lee","doi":"10.4082/kjfm.25.0212","DOIUrl":"10.4082/kjfm.25.0212","url":null,"abstract":"<p><strong>Background: </strong>The availability of health information through media has raised public awareness of health literacy (HL). HL is essential for medication adherence and self-management in individuals with chronic diseases, and for those without chronic conditions, HL is important for promoting health and engaging in preventive behaviors. This study examined the role of having a regular physician in improving HL among Korean adults, both with and without chronic diseases.</p><p><strong>Methods: </strong>We conducted a retrospective, cross-sectional analysis using data from 8,322 participants in the 2021 Korea Health Panel Study. HL was measured with the 16-item European Health Literacy Survey Questionnaire. To identify factors associated with HL categories and to calculate adjusted mean HL scores, we used multiple logistic regression and weighted linear regression.</p><p><strong>Results: </strong>Among participants with chronic diseases (n=4,627), 56.6% reported having a regular physician, with the largest group (42.7%) showing inadequate HL. After adjustment, age 75 years or older and lower education were significantly linked to lower HL levels, regardless of chronic disease status. Having a regular physician was significantly associated with higher HL levels in participants with chronic diseases (adjusted odds ratio, 1.94; 95% confidence interval, 1.42-2.63), but not in those without chronic diseases. Participants with chronic diseases who had a regular physician showed higher mean HL scores across all HL competencies and domains.</p><p><strong>Conclusion: </strong>Although access to health information has increased, the risk of encountering conflicting or misleading content has grown. These findings emphasize the importance of regular physicians in guiding patients and improving HL, especially among individuals with chronic diseases.</p>","PeriodicalId":17893,"journal":{"name":"Korean Journal of Family Medicine","volume":" ","pages":"416-425"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146011006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between parental consanguineous marriage and the incidence, age of onset, and severity of coronary artery disease: a cross-sectional study in Iran.","authors":"Hamid Khederlou, Arash Jalali, Vanoushe Azimi Pirsaraei, Fatemeh Shokoeizadeh, Nasrin Hamidabadi, Somayeh Yadangi, Saeed Sadeghian","doi":"10.4082/kjfm.25.0224","DOIUrl":"10.4082/kjfm.25.0224","url":null,"abstract":"<p><strong>Background: </strong>The relationship of consanguineous marriage (CM) with cardiovascular conditions, particularly structural congenital heart diseases, has been well established. Although CM may influence genetic predisposition by increasing oligogenicity and genetic homogeneity, its association with coronary artery disease (CAD) remains uncertain. This study aimed to investigate the relationship between parental CM and the prevalence, age of onset, and severity of CAD.</p><p><strong>Methods: </strong>In this cross-sectional study conducted between May 2021 and August 2022, a total of 13,151 patients undergoing coronary angiography at the Tehran Heart Center were enrolled. A structured questionnaire was used to collect demographic and anthropometric data, medical history, cardiovascular risk factors, previous angiographic findings, and parental kinship information. Analyses were performed using IBM SPSS ver. 23.0.</p><p><strong>Results: </strong>Among 11,986 participants, 66.0% were male, with a mean age of 58.9±10.7 years. CAD was diagnosed in 9,083 individuals (75.8%). In total, 1,515 participants (12.6%) reported a history of parental CM. The prevalence of CAD was 3.2 percentage points higher in individuals with parental CM (P<0.001). Additionally, parental CM was associated with an earlier CAD by 2.4 years. However, no significant correlation was observed between parental CM and CAD severity.</p><p><strong>Conclusion: </strong>Parental consanguinity is associated with a higher prevalence and earlier onset of CAD. These findings suggest that parental CM may be relevant in the context of CAD risk and should be considered in comprehensive CAD risk assessments, particularly in regions where consanguinity is common.</p>","PeriodicalId":17893,"journal":{"name":"Korean Journal of Family Medicine","volume":" ","pages":"397-404"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the association between mortality and economic status in patients with metabolic syndrome in Korea: a retrospective cohort study using the National Health Screening cohort.","authors":"Hyo-Sun You, Yong-Hoon Kim, Joungyoun Kim, Hee-Taik Kang","doi":"10.4082/kjfm.25.0172","DOIUrl":"10.4082/kjfm.25.0172","url":null,"abstract":"<p><strong>Background: </strong>The disease burden of metabolic syndrome (MetS) is increasing with increasing prevalence. Economic deprivation is a risk factor for MetS and contributes to the overall mortality. Therefore, this study aimed to investigate the association between economic status and mortality in patients with MetS.</p><p><strong>Methods: </strong>Overall, 83,786 patients with MetS were included from the Korean National Health Insurance Service-Health Screening Database. They were divided into three economic levels (low, medium, and high) based on the health insurance premiums charged according to the annual household income. Adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) for all-cause mortality were calculated using Cox proportional hazards regression models.</p><p><strong>Results: </strong>The median follow-up duration was 10.0 years. Kaplan-Meier plots showed that the mortality rate was highest in males with a low economic status (P<0.001, log-rank test). Compared with that of the high economic status group, unadjusted HRs (95% CIs) of the middle and low economic status groups for all-cause mortality were 1.44 (1.32-1.57) and 1.88 (1.72-2.06), respectively, in males, and 0.84 (0.76-0.93) and 0.99 (0.89-1.10), respectively, in females. However, in the fully adjusted model, the corresponding HRs (95% CIs) were 1.23 (1.13-1.48) and 1.35 (1.23-1.48), respectively, in males and 1.17 (1.06-1.30) and 1.25 (1.12-1.39), respectively, in females.</p><p><strong>Conclusion: </strong>Among South Korean adults with MetS, the economically deprived population was significantly associated with higher mortality rates than those of wealthier groups.</p>","PeriodicalId":17893,"journal":{"name":"Korean Journal of Family Medicine","volume":" ","pages":"442-450"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147307250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The cutoff value of serum triglyceride/high-density lipoprotein cholesterol ratio of high pericardial adipose tissue in Korean: a retrospective study.","authors":"Da Eun Choung, Beom Hee Choi, Jisoon Im, Yoojung Choi, Nam Seok Joo","doi":"10.4082/kjfm.25.0236","DOIUrl":"10.4082/kjfm.25.0236","url":null,"abstract":"<p><strong>Background: </strong>Recently, the triglyceride/high-density lipoprotein cholesterol (TG/HDL) ratio and pericardial adipose tissue (PAT) have emerged as important indicators of metabolic syndrome (MS). We aimed to evaluate the relationship between the TG/HDL ratio and PAT.</p><p><strong>Methods: </strong>We retrospectively analyzed the data of 627 patients who underwent coronary multidetector computed tomography to assess metabolic parameters. Subjects were stratified into two groups based on the PAT volume cutoff associated with MS, specifically 142.2 cm3, and metabolic parameters were compared between these groups. The TG/HDL ratio was divided into tertiles according to the logarithm of TG/HDL, and differences in PAT-related parameters among the tertiles were assessed using analysis of variance. Logistic regression was performed to estimate the odds ratios (ORs) for high PAT (≥142.2 cm3) across tertiles and receiver operating characteristic (ROC) analysis was performed to determine the optimal TG/HDL ratio cutoff for linking with high PAT.</p><p><strong>Results: </strong>The mean TG/HDL ratio in the high PAT group was 3.6. The TG/HDL ratio demonstrated a strong positive correlation with several metabolic parameters. Individuals in the higher log (TG/HDL) tertiles exhibited a greater prevalence of metabolic disturbances, including increased PAT, and displayed higher ORs for high PAT (second tertile OR, 3.51; third tertile OR, 3.26) after adjusting for age, sex, smoking, hypertension, type 2 diabetes, and dyslipidemia status. ROC analysis identified a TG/HDL ratio of 1.918 (P<0.001) as the threshold for elevated PAT levels.</p><p><strong>Conclusion: </strong>The TG/HDL ratio was positively correlated with high PAT volume, and the TG/HDL ratio cutoff for association with high PAT was determined to be 1.918.</p>","PeriodicalId":17893,"journal":{"name":"Korean Journal of Family Medicine","volume":" ","pages":"434-441"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147355532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urban-rural disparities in primary health care utilization in Indonesia: a cross-sectional study.","authors":"Asep Kusnali, Wahyu Pudji Nugraheni, Rofingatul Mubasyiroh, Leny Latifah, Agung Dwi Laksono, Tati Suryati Warouw, Tety Rachmawati, Irfan Ardani, Diah Yunitawati","doi":"10.4082/kjfm.25.0092","DOIUrl":"10.4082/kjfm.25.0092","url":null,"abstract":"<p><strong>Background: </strong>This study investigates disparities in the utilization of primary health care (PHC) between urban and rural populations in Indonesia, focusing on socioeconomic and demographic determinants. Understanding these patterns is essential for promoting equity under the National Health Insurance (Jaminan Kesehatan Nasional, JKN) program.</p><p><strong>Methods: </strong>Data were obtained from the 2023 National Socioeconomic Survey, which included 334,887 individuals. Binary logistic regression was used to examine the association between individual characteristics and PHC utilization.</p><p><strong>Results: </strong>Overall utilization rates were similar across urban and rural areas, but significant disparities were observed. Women were more likely to use PHC than men (odds ratio [OR], 1.12; 95% confidence interval [CI], 1.10-1.13). The association between higher education and PHC utilization was negative (OR, 0.78; 95% CI, 0.75-0.81), while access to information technology slightly reduced utilization (OR, 0.98; 95% CI, 0.96-0.99). Wealth effects diverged sharply: affluent urban residents were less likely to use PHC (OR, 0.84; 95% CI, 0.81-0.87), whereas wealthier rural residents were more likely to utilize PHC (OR, 1.09; 95% CI, 1.05-1.13). Dual insurance ownership had a strong positive effect in rural areas (OR, 1.56; 95% CI, 1.25-1.94).</p><p><strong>Conclusion: </strong>These findings highlight structural inequalities in PHC utilization. Policy efforts must prioritize enhancing the quality and attractiveness of PHC in urban areas, improving financial protection and infrastructure in rural areas, and addressing the digital divide. Such targeted measures are essential for achieving equitable and inclusive health coverage under JKN.</p>","PeriodicalId":17893,"journal":{"name":"Korean Journal of Family Medicine","volume":" ","pages":"426-433"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146227060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}