An Integrative Path Model of Healthcare Utilization Determinants in Traditional Korean Medicine and Western Medicine Based on the Anderson Behavioral Model

Background: This study aimed to elucidate the determinants of healthcare utilization in South Korea’s dual healthcare system, encompassing both Western medicine and Korean medicine, through the Andersen Model. An integrative non-recursive path model of healthcare utilization determinants was proposed and analyzed. Methods: A path analysis using structural equation modeling, followed by mediation analysis, was conducted to determine the magnitude of the effect for each pathway. The 2020 data from the Korea Health Panel were used. Results: Structural equation modeling revealed that need factors, such as chronic diseases, disability, and self-rated health status, were the most significant drivers of both WM and KM utilization, while enabling factors significantly impacted WM utilization. Interestingly, WM and KM utilization were found to positively influence each other, contradicting the assumption of substitutional healthcare use. Mediation analysis further highlighted the interconnected nature of healthcare utilization pathways, with enabling and need factors showing significant indirect effects on utilization via the counterpart system. These findings underscore the importance of considering mutual influences in healthcare policy and resource allocation to enhance accessibility and efficiency. While the cross-sectional nature of the data limits causal inference, this study offers a robust theoretical framework and practical insights for addressing the complexities of healthcare utilization in dual-system contexts. Conclusion: The findings reveal that when traditional medicine functions within the national healthcare system, both Western medicine and traditional medicine are influenced by similar determinants in the same environment. Future research should explore longitudinal data to confirm these findings and investigate potential moderating effects of predisposing and enabling factors on WM and KM interactions.