• Health Policy and Management
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• v.24 no.1
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• pp.24-34
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• 2014

Background: Bankrupted households have recently been increased due to excessive medical expenditure in Korea. They have not been protected from economic risk when household's member has severe diseases that need a lot of money for treatment. Purpose of this study examines policy effect by comparing unmet needs' change of policy object households and non-object groups. Methods: We used Korea Health panel 2nd 4th data collected by Korea Institute for Health and Social Affairs and National Health Insurance Service. Analysis subjects were 381 households (pre-policy) and 393 households (post-policy) that had cancer and cardiovascular and cerebrovascular diseases. Since it was major concern that estimates benefit strengthening policy started by certain time, we setup comparing households which had diabetes, hypertension disease. Comparison subjects were 393,247 households, respectively and we evaluated policy effect using difference in difference (DID) model. Results: Although unmet needs of policy object households were higher than non-object groups, policy execution variable affected negative direction. But interaction-term which shows pure effect of policy was not statistically significant. We utilized multi-DID model to examine factors affecting unmet needs causes. Copayment assistance policy did not significantly affect households that responded to 'economic reason,' and 'no have time to visit' for unmet needs causes. Conclusion: The second copayment assistance policy did not significantly give positive effect to beneficiary households than non-beneficiary groups. When we consider that primary purpose of public insurance guarantee high medical expenditure occurred by unexpected events, it needs to deliberate on switch of benefit strengthening policy that can assist vulnerable people. Also, we suggest that government forward a policy covering non-reimbursable medical expenses as well as switch of benefit strengthening direction because benefit policy do not affect non-covered medical cost which accounts for quarter of total health expenditure.

• Research in Community and Public Health Nursing
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• v.32 no.1
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• pp.95-106
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• 2021

Purpose: The purpose of this study is to investigate the association between unmet healthcare needs due to financial reasons and catastrophic health expenditures. Methods: This study used secondary data from the 2014~2015 Korean Health Panel survey. The subjects of this study were 21,495 people aged 20 or older, and of them, there were 16,227 people aged 20 to 64 and 5,268 people aged 65 or older, which were surveyed between 2014 and 2015. The association between unmet healthcare needs due to financial reasons and catastrophic health expenditures was analyzed through logistic regression. Results: In 2015, 1.7% of people aged 20~64 years and 7.9% of those aged 65 or older experienced unmet healthcare needs due to financial reasons. In the 20~64 age group, people who repeatedly experienced catastrophic health expenditures (=10%,=20%) were less likely to experience unmet healthcare needs due to financial reasons than those who did not experience catastrophic health expenditures for two years (OR=0.50, OR=0.41). However, in the 65-or-older group, people who repeatedly experienced catastrophic health expenditures (=20%) were more likely to experience unmet healthcare needs due to financial reasons than those who did not experience catastrophic health expenditures for two years (OR=1.68). Conclusion: A greater percentage of the elderly repeatedly faced both catastrophic health expenditures and unmet healthcare needs due to financial reasons compared to the non-elderly.

• 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.

• Journal of agricultural medicine and community health
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• v.35 no.2
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• pp.151-164
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• 2010

Objective:Korea has 3,170 islands with about 188,000 inhabitants. These inhabitants' needs for health services might go unmet because of geographic isolation, slimmer availability of health services, and higher proportion of the elderly compared with the mainland population. Unmet health service needs might result in serious health problems for these island residents. Therefore, the purpose of this study was to investigate their unmet health service needs and related factors from population of Nowha island. Methods: The survey was conducted from July 30 to August 1 by trained interviewers. Target population were residents in Nohwa island and the sampling method was incomplete quota sampling. General characteristics, socioeconomic status, utilization of health service, and unmet medical service needs were investigated. First univariate and then multivariate logistic analyses were done for the statistical analysis. Results: 324 residents were surveyed and the proportion of unmet health services needs was 26.5%. People living alone and of female sex had increased health services needs based on univariable analysis. From the multivariate analysis, those living alone increased the health services needs. Self-determined low socioeconomic status and medical aid increased the proportion of unmet medical needs, but these were not statistically significant. Conclusion:In Nowha island, those who are elder, and of lower socioeconomic status had much higher unmet medical needs. The results suggest the need for more social support by qualified health services to solve this unmet medical needs problem.

• Journal of Preventive Medicine and Public Health
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• v.46 no.5
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• pp.282-290
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• 2013

Objectives: This study aimed to develop a health needs assessment (HNA) tool for persons with brain disorders and to assess the unmet needs of persons with brain disorders using the developed tool. Methods: The authors used consensus methods to develop a HNA tool. Using a randomized stratified systematic sampling method adjusted for sex, age, and districts, 57 registered persons (27 severe and 30 mild cases) with brain disorders dwelling in Seoul, South Korea were chosen and medical specialists investigated all of the subjects with the developed tools. Results: The HNA tool for brain disorders we developed included four categories: 1) medical interventions and operations, 2) assistive devices, 3) rehabilitation therapy, and 4) regular follow-up. This study also found that 71.9% of the subjects did not receive appropriate medical care, which implies that the severity of their disability is likely to be exacerbated and permanent, and the loss irrecoverable. Conclusions: Our results showed that the HNA tool for persons with brain disorders based on unmet needs defined by physicians can be a useful method for evaluating the appropriateness and necessity of medical services offered to the disabled, and it can serve as the norm for providing health care services for disabled persons. Further studies should be undertaken to increase validity and reliability of the tool. Fundamental research investigating the factors generating or affecting the unmet needs is necessary; its results could serve as basis for developing policies to eliminate or alleviate these factors.

• Journal of dental hygiene science
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• v.18 no.3
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• pp.182-187
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• 2018

As the elderly population increases, they are increasingly affected by oral health problems. Therefore, efforts are being made to improve the oral health of older people, alleviate mental discomfort, and reduce unmet dental needs. This study was conducted to confirm the relationship between the National Health Insurance Elderly Denture Coverage and the unmet dental need for the edentulous elderly, as part of the protection policy. We analyzed the 2011 and 2013 Community Health Survey data of the edentulous elderly, aged 75 years or older, before 2012. In order to more precisely confirm the effects of the denture donation policy on unmet dental care, basic life recipients who were subject to the free elderly prosthetic project were excluded from the analysis. The final analysis included 20,400 subjects. According to our investigation of the factors that affect the unmet dental needs of the elderly, the National Health Insurance Elderly Denture Coverage did not affect unmet dental needs. The statistically significant variables that affected the unmet dental needs of the elderly were education and income levels, which are representative socioeconomic status variables. The lower the level of education, the unhealthier the dental care experience, and income levels showed a similar tendency. The elderly who have a low socioeconomic status are more likely to experience unmet dental needs because they lack the knowledge and socioeconomic ability to pay for dental care. Therefore, the policy for health protection of the entire elderly population should be continuously expanded. In addition, the socioeconomically vulnerable groups may have health problems due to the restriction of medical use, which may lead to quality of life deterioration.

• 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.

• Journal of Korean society of Dental Hygiene
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• v.22 no.2
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• pp.117-124
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• 2022

Objectives: It is crucial to detect and prevent oral problems early. Older adults, in particular, should go for regular dental checkups to maintain a healthy oral environment. This study identified the factors affecting regular dental examinations and unmet dental needs in older adults. Methods: This study analyzed 3,362 older adults aged 65 or over using the data from the 7th Korean National Health and Nutrition Examination Survey (KNHANES). Frequency analysis was performed on general characteristics. In addition, chi-square tests were done to determine differences in regular dental checkups and unmet dental needs according to general characteristics. Logistic regression analysis was performed on factors influencing regular dental checkups and unmet dental needs. Results: Factors influencing regular dental checkups were statistically significant according to residential areas, level of education, household income, and levels of physical activity (p<0.05). Factors influencing unmet dental needs were statistically significant according to residential areas, level of education, private medical insurance, and levels of dental pain (p<0.05). Conclusions: National level policy strategies should be implemented to improve the oral health of older adults. These strategies should encourage regular dental checkups to effectively lower the rate of unmet dental needs.

• 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 Korean society of Dental Hygiene
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• v.20 no.3
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• pp.243-256
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• 2020

Objectives: This study aimed to determine and facilitate provisions for the unmet dental needs of Koreans, stratified by time, influencing factors, and research trends, through a systematic review of related published studies since 2006. Methods: this review focused on previous studies published between January 2006 and November 2019 that analyzed influencing the factors underlying the unmet dental needs of koreans. We followed the guidelines set for each phase of research and selected the final 32 studies that met the selection criteria for the analysis. Results: The number of studies has rapidly increased since 2015 (22 studies, 68.7%). the were 68.9% in 2006, 25.9% in 2009, 41.3% in 2010- 2012, and 33.3% in 2013-2015 for adults and 27.9% in 2010, 24.6% in 2015, and 16.1% in 2017 for the rates of older adults. the rates of unmet dental needs related to economic factors, were 38.6% in 2006, 41.4% in 2007-2009, and 35.9% in 2013-2015 for adults and 50.5% in 2010 and 41.2% in 2015 for the older adults. There were common influencing factors for unmet dental needs. the rate of unmet dental needs was increased by with female gender, younger age, single marital status, low family income, low educational level, worsened subjective health condition, and the presence of chronic diseases. Conclusions: Standardized studies with more accurate definitions and assessment tools are required. however, our study emphasizes the need for a policy intervention that accounts for the characteristics of subjects to reduce unmet dental needs.