• Journal of Preventive Medicine and Public Health
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• v.49 no.5
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• pp.308-322
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• 2016

Objectives: The objective of this study is to investigate associations between contextual characteristics and unmet healthcare needs in South Korea after accounting for individual factors. Methods: The present study used data from the 2012 Korean Community Health Survey (KCHS) of 228 902 adults residing within 253 municipal districts in South Korea. A multilevel analysis was conducted to investigate how contextual characteristics, defined by variables that describe the regional deprivation, degree of urbanity, and healthcare supply, are associated with unmet needs after controlling for individual-level variables. Results: Of the surveyed Korean adults, 12.1% reported experiencing unmet healthcare needs in the past. This figure varied with the 253 districts surveyed, ranging from 2.6% to 26.2%. A multilevel analysis found that the association between contextual characteristics and unmet needs varied according to the factors that caused the unmet needs. The degree of urbanity was associated with unmet need due to "financial burden" (odds ratio [OR], 0.53; 95% confidence interval [CI], 0.42 to 0.66 for rural vs. metropolitan), but not unmet need due to "service not available when needed." There were no significant associations between these unmet need measures and regional deprivation. Among individual-level variables, income level showed the highest association with unmet need due to "financial burden" (OR, 5.63; 95% CI, 4.76 to 6.66), while employment status showed a strong association with unmet need due to "service not available when needed." Conclusions: Our finding suggests that different policy interventions should be considered for each at-risk population group to address the root cause of unmet healthcare needs.

• Safety and Health at Work
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• v.13 no.1
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• pp.17-22
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• 2022

Background: This study aimed to identify work-related risk factors, including long working hours and night/shift work, for unmet health care need using data of a representative panel of Korean adults. Methods: Associations between work-related factors and unmet health care need were analyzed using data of 3,440 participants (10,320 observations) from the 2011-2013 Korean Health Panel Study. A generalized estimating equation was used for the analysis of repeated measures. Results: The prevalence of unmet health care was 16.6%. After adjusting sex, age, socioeconomic status, work characteristics, and working more than 60 hours per week (odds ratio [OR]: 1.43, 95% confidence interval [CI]: 1.23-1.65) or 50-59 hours per week (OR: 1.26, 95% CI: 1.08-1.46) instead of 40-49 hours per week and night/shift work (OR: 1.27, 95% CI: 1.06-1.51) were associated with unmet health care need. Conclusion: Long working hours and night/shift work are risk factors for unmet health care need among the Korean working population.

• Health Policy and Management
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• v.24 no.4
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• pp.357-366
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• 2014

Background: The objective of this study was to evaluate the efficiency of an emergency ambulance system and to investigate socio-economic and clinical characteristics associated with emergency ambulance service. Methods: Based on 2011 Korea health panel, unmet need and inappropriate use of emergency ambulance service were measured by Gibson in 1977. Furthermore, the factors associated with unmet need and inappropriate use of emergency ambulance service were identified by Fisher's exact tests and multiple logistic regression models. Results: Unmet need, defined as the proportion of emergency patients who clinically need ambulance transportation but do not receive it, was found to be 59.8%. Inappropriate use, defined as the proportion of emergency patient receiving ambulance care who did not clinically need it, was found to be 37.2%. There were statistically significant differences between appropriate and inappropriate groups in overall variables of socio-economic and clinical characteristics. Specifically, gender, age, relationship to household, and reasons of visiting emergency department (accident/disease) were statistically significant factors associated with appropriate use of emergency ambulance service. Conclusion: Unmet ambulance need is a useful measure for patients needs assessment, and inappropriate ambulance use is a valid criteria in judging the efficiency of emergency ambulance system. To improve and understand emergency ambulance system, unmet need and inappropriate use of emergency ambulance service should be more concerned.

• 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.30 no.1
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• pp.37-49
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• 2020

Background: Unmet healthcare needs have many advantages for measuring inequalities in healthcare use. However, the existing indicator is difficult to capture the reality of unmet healthcare needs sufficiently and is not quite appropriate in comparing regional inequality. The purpose of this study is to critically analyze the utilization of the unmet healthcare need indicator for regional healthcare inequalities research. Methods: We used the level of healthcare accessibility and healthcare need to categorize the regions that are known to cause differences in healthcare utilization between regions and verified how existing unmet healthcare need indicator is distributed at the regional level. Results: Four types of regions were classified according to the high and low levels of healthcare needs and accessibility. The hypothesis about the regional type expected to have the highest unmet healthcare need was not proved. The hypothesis about the lowest expected regional type was proved, but the difference in the average rate of unmet healthcare needs among regional types was not significant. The standard deviation of the rate of unmet healthcare needs among regions within the same type was also higher than the overall regional variation, which also disproved the whole frame of hypothesis. Conclusion: Failure to prove the hypothesis means the gap between the supposed meaning of the indicator and the reality. In order to understand the current state of healthcare utilization of people in various regions of Korea and to resolve inequality, fundamental research on the in-depth structure and mechanisms of healthcare utilization is needed.

• Journal of Korean society of Dental Hygiene
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• v.20 no.5
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• pp.571-580
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• 2020

Objectives: This study aimed to investigate the factors associated with unmet dental needs among adults with activity limitations. Methods: Data were obtained from the seventh Korean National Health and Nutrition Examination Survey (KNHANES). The final sample consisted of 945 adults aged 20 years or older with limited activity. Logistic regression analysis was used to examine the influence of predisposing, enabling, and need factors on unmet dental needs. Results: The proportion of adults with unmet dental needs during the last year was 52.2% in the middle-aged group and 45.5% in the older adult group. Higher household income was associated with fewer unmet dental needs in both groups. In the older adult group, married people were less likely to have unmet dental needs. In the middle-aged group, adults who perceived their oral health as poor were more likely to have unmet dental needs. Conclusions: All three factors (predisposing, enabling, and need) were found to be associated with unmet dental needs among adults with activity limitations. Special efforts should be made to improve access to dental care services for middle-aged adults with activity limitations.

• Journal of Convergence for Information Technology
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• v.10 no.9
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• pp.229-236
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• 2020

The purpose of this study was to investigate the current status of unmet medical need using data from the Korea Health Panel study from 2009 to 2013 (excluding 2010), and to analyze the trends of unmet medical need and related factors. The subjects of this study were 11,598 in 2009, 11,035 in 2011, 10,584 in 2012, 10,099 in 2013, and 7,144 people in panel data, and conducted frequency analysis, chi-square test and generalized estimating equation. As a result of the analysis by year, it was found that women, under middle school graduation, medical aid, the lowest household income and low subjective health status experienced more unmet medical need. As a result of analysis using generalized estimating equation, women, under 40 years of age, under elementary school graduation, lowest quartile household income, subjective health status of less than 20 points, and activity restrictions are more likely to experience unmet medical need. Based on these results, we intend to provide basic data for establishing policies on the use of medical services.

• Quality Improvement in Health Care
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• v.25 no.2
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• pp.44-55
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• 2019

Purpose: To investigate whether changes in Medical Aid (MA) status are associated with unmet need and catastrophic health expenditure (CHE). Methods: Data from the 2010 to 2014 Korea Health Panel (KHP) were used. The impact of changes in annual MA status ('MA to MA,' 'MA to MA Exit,' 'MA Exit to MA,' and 'MA Exit to MA Exit') on unmet need (all-cause and financial) and CHE (10% and 40% of household capacity to pay) were examined using the generalized estimating equation (GEE) model. Analysis was conducted separately for MA type I and II individuals. Results: In 1,164 Medical Aid type I individuals, compared to the 'MA to MA' group, the 'MA to MA Exit' group had increased likelihoods of all-cause and financial unmet need. This group also showed higher likelihoods of CHE at the 10% standard. The 'MA Exit to MA Exit' group showed increased likelihoods at the 10% and 40% CHE standards. In 852 type II recipients, the 'MA to MA Exit' group had higher likelihoods of CHE at the 10% standard. Conclusions: Type 1 MA exit beneficiaries had higher likelihoods of all-cause and financial unmet need, along CHE at the 10% standard. Type I 'MA Exit to MA Exit' beneficiaries also showed higher likelihoods of CHE at the 10% and 40% standards. In type II recipients, MA exit beneficiaries had higher likelihoods of CHE at the 10% standard. The results infer the importance of monitoring MA exit beneficiaries as they may be vulnerable to unmet need and CHE.

• Research in Community and Public Health Nursing
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• v.29 no.1
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• pp.41-53
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• 2018

Purpose: This study was conducted to identify the factors affecting on unmet healthcare needs of married immigrant women, especially who are working in South Korea. Methods: It is designed as a cross-sectional descriptive study. We analyzed data from 8,142 working married immigrant women to the 'National Survey of Multicultural Families 2015.' Based on Andersen's health behavior model, logistic regression was conducted to determine the predictors of unmet healthcare need. Results: The prevalence of unmet healthcare needs among the subjects was 11.6%. In multivariate analysis, significant predictors of unmet needs included existence of preschooler, country of origin, period of residence in predisposing factors, monthly household income, helpful social relationship, social discrimination, Korean proficiency, working hour per week in enabling factors, and self-rated health, experience of grief or desperation in need factors. Conclusion: The association between labor-related factors and unmet healthcare needs of marriage immigrant women currently working was found from nationally representative sample. Support policies for immigrant women working more than legally defined hours and having preschooler should be supplemented to reduce unmet healthcare needs. In addition, eradicating discrimination in workplace, enlarging social relationship, and developing culturally competent nursing services tailored to health problems caused by labor are needed.

• Korea Journal of Hospital Management
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• v.28 no.4
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• pp.62-72
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• 2023

Based on the basic ideology of health care, this study realized the seriousness of annual unmet medical need and conducted a study to confirm the relationship between the subjective perception of regional healthcare environment and unmet medical needs. The independent variable was classified into attitude 'satisfaction' and 'unsatisfaction' toward regional healthcare, and the dependent variable was classified as whether unmet medical needs occurred annually. Based on previous studies, the control variables were selected as demographic and socioeconomic characteristics that can affect the occurrence of unmet medical care annually and characteristics related to health behavior. Descriptive statistics were conducted for each variable on the extracted sample, and multivariate survey logistic regression analysis was conducted to confirm the association between variables. As a result, more unmet medical needs occurred annually than those who were satisfied with the medical services in the area where they lived. In addition, more unmet medical need occurred annually in "unsatisfied" households compared to households "satisfied" with local medical services. In residential areas, women live in "metropolis" and "rural areas" compared to "urban," women live in men, lower education levels, and poor subjective health levels, and less satisfied with local medical services. As such, the impact of environmental factors in the community on the use of health and medical services is one of the major areas of interest in the field of health science, such as health policy and social dynamics. Therefore, hospitals in each region need to make efforts in terms of hospital management to increase the overall satisfaction of medical services in the region by continuously monitoring the attitude of residents to achieve universal health security, and policymakers should also be interested and propose new policies.