Determinants of Korean Medicine Utilization Based on the Andersen Model: A Scoping Review of Secondary Data Analyses

In South Korea, understanding the determinants of Korean medicine (KM) utilization is important for evidence-based policy. Although numerous studies using secondary data have been published, the findings have not been systematically synthesized. Using Andersen Behavioral Model, this scoping review aimed to identify KM use determinants and evidence gaps. The protocol was preregistered in the Open Science Framework. Studies which used major secondary healthcare datasets to analyze KM utilization (use, frequency, or expenditure) in South Korea, were included. The search was conducted across 6 databases (including PubMed and Embase). Variables, categorized via Andersen Behavioral Model (predisposing, enabling, need, and health behavior factors), were synthesized. Of 3,043 records, 29 studies met the inclusion criteria. Predisposing and enabling factors were the most frequently examined factors, whereas health behavior factors were less frequently represented. Across 14 regression-based studies contributing 19 outcome-specific results, need and predisposing factors were more often associated with use and frequency, whereas enabling factors were more often associated with expenditure. Determinants of KM utilization varied by outcome measure. Socioeconomic resources may be related to the frequency and financial burden of KM use, but this interpretation requires caution (expenditure-related evidence was limited and noncovered KM services were incompletely measured in secondary datasets).