The Effect of Distribution of Regional Health Care Institutions on Subjective Well-being of the Elderly in Seoul: A Multi-level Analysis Considering the Moderating Effect of Subjective Economic Status

This study analyzes the effect of the distribution of local health institutions on the elderly's wellbeing in Seoul dividing into private and public centers. This study analyzes the direct effect of the distribution and the moderating effect of personal economic status using a multi-level model. Data from the 2018 Seoul Elderly Survey and Seoul Statistics 2018 were used. Not only distribution of public health centers but local clinics increased, elderly's wellbeing increased significantly. However, the influence of the distribution of clinics was different according to the economic status. The local effect of clinics and hospitals appears to decrease as the economic status increases. In other words, the influence of the hospitals and clinics generates more psychological utility with low economic status. Therefore, the distribution effect of private hospitals can partially contribute to narrowing the well-being gap due to economic status. However, the distribution of public centers did not differ. It is challenging for the preconceived notion that local public health centers are useful only to economically vulnerable people. This study revealed that, regardless of the type, a considerable number of health institutions is positive to the elderly, and it can be more beneficial to the economically vulnerable. Also, many public centers are positive to the wealthy, too. This study makes pay attention to the role of public medical institutions for the elderly in metropolitan cities.