The aim of the current study is to examine the extent to which equity in the utilization of longterm care services has been achieved in the Republic of Korea (hereafter Korea), based on the Aday—Andersen Access Framework that takes into consideration a series of variables hypothesized as predictive of utilization. The current study used cross-sectional survey data collected and conducted by the Korea Labor Institute (KLI) between August 1 to December 22, 2006. The sample for this study was 5544 persons who are older than 60 years. The study was extracted from a larger nationally representative cross-sectional survey of 10,255 individuals. The stratified cluster sampling technique was used to draw the survey respondents. A self-administered questionnaire was used to collect the data from the sample. Descriptive and logistic regression analysis was performed examining the relationship between the dependent variable and the independent variables and the relative importance of factors. The results indicate that a universal health insurance system has not yielded a fully equitable distribution of services. The limitation of benefit coverage as well as disparities in consumer cost-sharing and associated patterns of utilization across plans high out-of-pocket payment can be a barrier to health care utilization, which results in inequity and differential long-term care utilization between sub-groups of older adults. Health policy reforms in Korea must continue to concentrate on expanding insurance coverage, reducing the inequities reflected in disparities in consumer cost-sharing and associated patterns of utilization across plans, and establishing a financially separate insurance system for poor older adults. The behavioral responses of physicians to the method of reimbursement, and the subsequent impact on overall rates of utilization and expenditures need to be more fully understood. In addition, further research is needed to identify the nonfinancial barriers that persist for certain demographic subgroups, i.e., those 70 and older, men, lacking social network members, those who have four or more family members, and those who have no schooling.
 Korean Statistics Office (2010) Population statistics. Korean Statistics Office, Daejeon.
 Duk, S. (2004) Long-term care policy for functionally dependent older people in The Republic of Korea. Health Affairs, 57, 47-62.
 Andersen, R.M. (1968) Behavioral model of families’ use of health services. Research Series No 25, Centre for Health Administration Studies, Chicago.
 Duk, S. (2012) The present situation and problems of the long-term care insurance in South Korea: From comparative perspectives between South Korea and Japan. Japanese Journal of Social Security Policy, 9, 49-60.
 Jo, J.G. and Choi, K. (2011) Health policy in Korea. http://www.ier.hit-u.ac.jp/pie/Japanese/discussionpaper/dp2002/
 Flynn, M.L. and Chung, Y.S. (1990) Health care financing in Korea: Private market dilemmas for a developing nation. Journal of Public Health Policy, 11, 238-253. http://dx.doi.org/10.2307/3342754
 Park, J.M. (2005) The determinants of long-term care utilization and equity of access to care among older adults in Dong-Ku of Incheon metropolitan city, South Korea. Asia-Pacific Journal of Public Health, 17, 104-109. http://dx.doi.org/10.1177/101053950501700208
 Lee, G.O. and Lee, M.J. (2001) The factors influencing the intention of using home health care among the Koran elderly. Korean Gerontologist, 21, 113-214.
 Song, D.Y. (2003) The factors influencing family caregivers’ use of in-home services. Korean Society of Social Welfare, 53, 105-128.
 Lee, Y.K. (2009) The determinants of long-term care utilization among the elderly. Health and Social Welfare Review, 29, 213-235.
 Park, J.M. (2003) Equity of access to long-term care among the American elderly. Journal of Public Health, 11, 121-130. http://dx.doi.org/10.1007/BF02956148
 Stern, S. (1997) Simulation-based estimation. Journal of Economic Literature, 35, 2006-2039.
 Beekman, A., Deeg, D., Braam, A.W., Smith, J. and Van Tilburg, W. (1997) Consequences of depression in later life: Associations of major and minor depression with disability, well-being, and service utilization. Psychosomatic Medicine, 27, 1397-1409. http://dx.doi.org/10.1017/S0033291797005734
 Folstein, M.F., Folstein, S.E. and Mchugh, P.R. (1975) Mini-mental state: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 96-98.
 Norton, E. (2000) Long-term care. In: Culyer, A.J. and Newhouse, J.P., Eds., Handbooks of Health Economics, North Holland, Amsterdam. http://dx.doi.org/10.1016/S1574-0064(00)80030-X
 Portrait, F., Lindeboom, M. and Deeg, D. (2000) The use of long-term care services by the Dutch elderly. Health Economics, 9, 13-531. http://dx.doi.org/10.1002/1099-1050(200009)9:6<513::AID-HEC534>3.0.CO;2-R
 Cohen, M.A., Weinrobe, M. and Miller, J. (2000) Multivariate analysis of patterns of informal and formal caregiving among privately insured and nonprivately insured disabled elders living in the community. Agency for Health Care Policy and Research.
 Lu, J., Leung, G., Kwon, S., Tin, K.Y., Van Doorslaer, E. and O’Donnell, O. (2007) Horizontal equity in health care utilization—Evidence from three high-income Asian economies. Social Science and Medicine, 64, 199-212. http://dx.doi.org/10.1016/j.socscimed.2006.08.033
 Jeon, H. (2007) A comparative study of Korea’s longterm care program. Thesis, Miami University, Oxford.
 Kwon, S., Kim, S.J. and Jung, Y. (2009) Introduction of long-term care insurance in South Korea. http://umdcipe.org/conferences/policy_exchanges/conf_papers/
 Kang, I.O., Park, C.Y. and Lee, Y. (2012) Role of healthcare in Korean long-term care insurance. Journal of Korean Medical Science, 27, S41-S46. http://dx.doi.org/10.3346/jkms.2012.27.S.S41