• Journal of Preventive Medicine and Public Health
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• v.52 no.6
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• pp.355-365
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• 2019

Objectives: In rural areas of Korea, where public transportation infrastructure is lacking and alternative systems are poor, the elderly experience inconveniences in using healthcare, although their need is high. This study aimed to analyze the association between the convenience of transportation and unmet healthcare needs among the rural elderly. Methods: The data used were collected in the 2016 Community Health Survey among rural elderly individuals aged 65 or older. Dependent variable was the unmet healthcare needs, explanatory variable was the convenience of transportation. The elderly were divided into 3 groups: with no driver in the household, with a driver, and the elderly individual was the driver (the self-driving group). Covariates were classified into predisposing, enabling, and need factors. They included gender, age, education, income, economic activity, household type, motor ability, subjective health level, number of chronic diseases, anxiety/depression, and pain/discomfort. The data were analyzed using logistic regression and stratification. Results: A significant association was found between the convenience of transportation and unmet healthcare needs. When examined unadjusted odds ratio of the group with a driver in the household, using the group with no driver as a reference, was 0.61 (95% confidence interval [CI], 0.54 to 0.68), while that of the self-driving group was 0.34 (95% CI, 0.30 to 0.38). The odds ratios adjusted for all factors were 0.69 (95% CI, 0.59 to 0.80) and 0.79 (95% CI, 0.67 to 0.91). Conclusions: We confirmed a significant association between inconvenient transportation and unmet healthcare needs among the rural elderly even after adjustment for existing known factors. This implies that policies aimed at improving healthcare accessibility must consider the means of transportation available.

• Health Policy and Management
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• v.30 no.1
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• pp.120-125
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• 2020

Unmet healthcare needs lead to increased disease severity, increased likelihood of complications, and worse disease prognosis. To examine the latest status of unmet healthcare needs in South Korea, the four different data configured with nationally representative sample of South Korean population were used: the Korea Health and Nutrition Examination Survey (KNAHANES, 2007-2018), the Community Health Survey (CHS, 2008-2018), the Korea Health Panel Survey (KHP, 2011-2016), and the Korean Welfare Panel Study (KOWEPS, 2006-2018). The proportion of individuals reporting unmet healthcare needs were 7.8% (KNHANES, 2018), 8.8% (CHS), and 10.8% (KHP, 2016). Annual percentage change which characterizes trend for the follow-up period was -9.1%, -3.2%, and -6.8%, respectively. The proportion of individuals reporting unmet healthcare needs due to cost were 1.2% (KNAHANES, 2018), 1.2% (CHS, 2018), 2.5% (KHP, 2016), and 0.5% (KOWEPS, 2018). Annual percentage change which characterizes trend for the follow-up period was -10.3%, -12.0%, -11.3%, and -18.8, respectively. The low-income population and the elderly population were vulnerable groups reporting the highest rate of unmet health care needs. The rate of unmet healthcare needs has been declining since the past decade, still, the disparity between different income groups and age groups suggests that there are many challenges to address.

• Health Policy and Management
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• v.29 no.2
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• pp.184-194
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• 2019

Background: The extent of coverage rate of the public health insurance is still insufficient to meet healthcare needs. Private health insurance (PHI) plays a role to supplement coverage level of national health insurance in Korea. It is expected that reduce unmet need healthcare. This study was aimed to identify relationship between PHI type and the unmet healthcare need and its associated factors. Methods: Data were obtained from the 2014 Korea Health Panel Survey using nationally representative sample was analyzed. Respondents were 8,667 who were adults over 20 years covered by PHI but have not changed their contract. According to the enrollment form, PHI was classified into three types: fixed-benefit, indemnity, and mixed-type. To identify factors associated with unmet needs, multiple logistic regression conducted using the Andersen model factors, which are predisposing factors, enabling factors, and need factors. Results: Our analysis found that subjects who had PHI with mixed-type were less likely to experience unmet health care needs compared than those who did not have it (odds ratio, 0.80; 95% confidence interval, 0.66-0.98). As a result of analyzing what affected their unmet healthcare needs, the significant factors associated with unmet medical need were gender, marital status, residence in a metropolitan area, low household income, economic activity participation, self-employed insured, physically disabled, low subjective health status, and health-risk factors such as current smoking and drinking. Conclusion: The results of this study suggest that having PHI may reduce experience of unmet healthcare needs. Findings unmet healthcare needs factors according to various subjects may be useful in consideration of setting policies for improving accessibility to healthcare in Korea.

• Health Policy and Management
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• v.32 no.2
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• pp.237-243
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• 2022

Unmet healthcare is an important indicator to measure accessibility of healthcare services. To examine the latest status of unmet healthcare needs in South Korea, four different data which is composed of nationally representative sample of South Korean population were used; the Korea National Health and Nutrition Examination Survey (KNHANES, 2007-2020), the Community Health Survey (CHS, 2008-2020), the Korea Health Panel Survey (KHP, 2011-2018), and the Korean Welfare Panel Study (KOWEPS, 2006-2020). The proportion of individuals reporting unmet healthcare needs were 6.4% (KNHANES), 5.4% (CHS), and 12.2% (KHP). Annual percentage change (APC) which identifies trend for the follow-up period was -9.9%, -9.1%, and -5.5%, respectively. The proportion of individuals reporting unmet healthcare needs due to cost were 1.0% (KNHANES), 0.4% (CHS), 2.2% (KHP), and 0.4% (KOWEPS). The APC was -11.3%, -17.0%, -12.2%, and -21.2%, respectively. Overall, the low-income and the elderly population reported a higher rate of unmet health care needs. Although the overall experience rate of unmet medical care due to cost decreased over the past decade, the disparity between the lowest and highest income groups still remained in 2020. Disparity between income levels and age groups is a challenge to address in healthcare system, and these results suggest the need for adequate health coverage for the low-income and the elderly populations.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.12
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• pp.306-313
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• 2019

This study endeavors to provide basic data for healthcare policy development by identifying factors that influence the unmet healthcare needs of the elderly with chronic diseases. The study utilized data from the 2017 Korean National Survey on the Elderly, and analyzed 9,117 elders afflicted with more than 1 chronic disease. We determined that 851 (9.3%) elders experienced unmet healthcare needs from hospital & clinical treatment, and 1,469 (16.1%) elders experienced unmet dental treatment. 'Economic difficulty' was the most common reason expressed by 425 (49.9%) elders for unmet healthcare needs from hospital and clinical treatment, and by 1,066 (72.6%) elders for dental treatment. Furthermore, unmet healthcare needs in hospital and clinical treatment were affected by various factors, including spouse, education, self-rated health status and exercise, whereas unmet healthcare needs in dental treatment were affected by factors such as spouse, education, medical aids, self-rated health status, smoking, and exercise. Based on the research results achieved, we propose a necessity to establish healthcare policies that consider the influencing factors, and help resolve the unmet healthcare needs of the elderly with chronic diseases.

• Journal of Korea Entertainment Industry Association
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• v.14 no.2
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• pp.225-235
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• 2020

Purpose: This study is a descriptive and secondary analytical study that uses panel data to analysis of unmet healthcare needs and risk factors for improving life care of osteoporosis patients. Methods: The subjects of this study were 941 patients who were diagnosed with osteoporosis using Korea Medical Panel 2015 data(β-version 1.0). Data analysis was performed using Chi-Square and logistic regression using SPSS/win 22.0. Results: The unmet healthcare needs of osteoporosis patients were 22.6%. The factors of unmet healthcare needs were education level and age in Model I of demographic factors, and eating problems, memory problems, activity limitation, and disability in Model II. In Model III, which added socio-psychological factors, eating problems, memory problems, Total family income, and pain/Discomfort were identified. Conclusion: Based on the results of this study, it should be considered in the planning of medical policies to improve the life care of osteoporosis patients, and it is necessary to improve access to medical services and to prevent and mediate realistically to reduce unmet healthcare needs.

• Journal of Preventive Medicine and Public Health
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• v.52 no.1
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• pp.51-59
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• 2019

Objectives: The purpose of this study was to estimate the mediating effect of subjective unmet healthcare needs on poor health. The mediating effect of unmet needs on health outcomes was estimated. Methods: Cross-sectional research method was used to analyze Korea Health Panel data from 2011 to 2015, investigating the mediating effect for each annual dataset and lagged dependent variables. Results: The magnitude of the effect of low income on poor health and the mediating effect of unmet needs were estimated using age, sex, education level, employment status, healthcare insurance status, disability, and chronic disease as control variables and self-rated health as the dependent variable. The mediating effect of unmet needs due to financial reasons was between 14.7% to 32.9% of the total marginal effect, and 7.2% to 18.7% in lagged model. Conclusions: The fixed-effect logit model demonstrated that the existence of unmet needs raised the likelihood of poor self-rated health. However, only a small proportion of the effects of low income on health was mediated by unmet needs, and the results varied annually. Further studies are necessary to search for ways to explain the varying results in the Korea Health Panel data, as well as to consider a time series analysis of the mediating effect. The results of this study present the clear implication that even though it is crucial to address the unmet needs, but it is not enough to tackle the income related health inequalities.

• Korea Journal of Hospital Management
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• v.24 no.4
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• pp.1-12
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• 2019

Purposes: The purpose of this study, was to identify similar factors between reasons for unscreening and unmet health care needs through prior research, and based on this, we wanted to figure out the relevance between the medical screening and unmet health care needs. Methodology: The analysis was conducted using data from 9,640 adults aged 19 or older who don't have a missing value from 16,277 participants in the 7th, 1st&2nd Year (2016&2017) of the National Health and Nutrition Examination Survey (KNHANES). Unmet health care needs were investigated as a self-reported questionnaire of whether medical service was required but not received. And the analysis was performed through the Chi-Square Test and Multi-logistic Regression analysis. Findings: As a result of the analysis, unmet healthcare needs were higher who received only one type of screening comparative to who screened both. and were highest who screened neither. Practical Implications: Unmet health care needs are the center of a vicious cycle, such as morbidity and mortality, which is detrimental to the quality of life, and continues to increase. Therefore, it is necessary to find ways of realizing health care that guarantees the health rights of all citizens by policy guarantee and support for the subjects to recognize the importance of thorough education of screenings rather than only health screening or cancer screening.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.9
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• pp.283-290
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• 2020

The purpose of this study was to investigate the potential causal relationship between unmet healthcare needs and metrics related to quality of life. To examine the relationships between these variables, the study conducted an analysis by processing additional irradiated raw materials of the Korean Medical Panel. The metrics related to quality of life included six variables: athletic ability, self-care, daily activities, pain/trouble, uneasiness/depression, and subjective health conditions. Linear regression analysis revealed that the unmet healthcare needs had statistically significant negative effects on all six quality of life variables. A review of the magnitude of the linear regression β values for those variables showed that the relative level of influence on the quality of life variables decreased in the following order: pain/trouble, subjective health conditions, uneasiness/depression, daily activities, athletic ability, and self-care. Based on the results, practical applications related to strengthening working-level links between health and welfare is considered an effective policy response to the continued presence of unmet healthcare needs; such applications could contribute to improving the quality of life of those with unmet healthcare needs.

• Journal of Family Resource Management and Policy Review
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• v.26 no.3
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• pp.49-64
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• 2022

This study aims to investigate unmet healthcare needs due to economic or non-economic difficulties among the elderly aged 65 or older. Using Korea Health Panel Survey (KHPS) data from 2018, the elderly are classified into one of four groups (health insurance subscribers, non-take-up, lower income relief, and medical aid recipients) based on their level of medical vulnerability. For hospital or dental care, the prevalence rates of unmet healthcare needs due to economic and non-economic difficulties are 12.6% and 10.6%, respectively. The prevalence rate of unmet healthcare needs due to economic difficulty in the medically vulnerable group was much higher than that of the non-vulnerable group-that is, health insurance subscribers. After controlling for other influential factors, medical vulnerability has a great impact on the prevalence rates of unmet healthcare needs due to economic difficulties. Compared to health insurance subscribers, the non-take-up, the lower relief, and the medical aid recipients are 1.4 times, 3.3 times, and 2.4 times more likely to experience unmet healthcare needs due to economic difficulty, respectively. The results of this study can provide important policy implications for securing essential healthcare resources for the elderly.