• 한국병원경영학회지
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• 제28권4호
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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.

• 융합정보논문지
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• 제10권9호
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• pp.229-236
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• 2020

본 연구는 2009년부터 2013년까지(2010년 제외)의 한국 의료패널 자료를 활용하여 미충족 의료의 추세 및 현황을 알아보고, 미충족 의료와 관련된 요인을 분석하고자 하였다. 연구 대상자는 2009년 11,598명, 2011년 11,035명, 2012년 10,584명, 2013년 10,099명 그리고 7,144명의 패널 자료를 활용하여 빈도분석, 교차분석, 일반화 추정방정식 모형을 시행하였다. 연도별로 교차분석 결과, 여성, 중학교 졸업 이하의 학력, 의료보장 형태가 의료급여인 경우, 최저 분위의 가구소득, 주관적 건강상태 점수가 낮을 때 미충족 의료 경험률이 높은 것으로 나타났다. 일반화 추정방정식 모형을 통한 분석 결과, 여성, 40세 미만 연령대, 초등학교 졸업 이하, 최저 분위의 가구소득, 주관적 건강상태 20점 미만, 활동 제한이 있는 경우 미충족 의료를 경험할 가능성이 높은 것으로 나타났다. 이 결과를 바탕으로, 의료서비스 이용의 정책을 수립하는데 기초자료를 제공하고자 한다.

• 한국의료질향상학회지
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• 제25권2호
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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.

• 보건행정학회지
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• 제24권4호
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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.

• 보건의료산업학회지
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• 제10권1호
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• pp.117-129
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• 2016

Objectives : This study investigated the prevalence of unmet health care needs among Korean adults and related factors. Methods : The study participants were adults over the age of 20 mental health experience from the Korea Health Panel in 2012(n=4,730). Statistical analysis methods used in this study were the ${\chi}^2$-test, Logistic Regression Analysis and other basic statistics such frequency-and percentage using SPSS version 22.0. Results : (1)Significant variables of stress: Factors were age, economic activity, subjective health status, and activity limitation. (2)Significant variables of depression: Factors were age, income class(low) and activity limitation. (3)Significant variables of suicidal impulse: Factors were age, chronic diseases, income class, and activity limitation. Conclusions : Stress, depression, and suicidal impulse can be unmet medical factors; therefore improvement measures and mental health counseling programs in response to suicide impulses, should be developed. Thus there is a need for a health sciences approach.

• 보건의료산업학회지
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• 제9권1호
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• pp.81-93
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• 2015

This study investigated the prevalence of unmet needs for health care among Korean adults and related factors. Using data from the 2012 Korea Health Panel, 1,896 adults aged 65 and over and two age groups(Young-Old(66-74) and Old-Old($65{\leq}$)) were analyzed to identify these factors. Logistic regression analysis was used to examine the main factors associated with unmet medical needs. According to the results of this study, the factors influencing unmet medical needs with regard to economic factors were Subjective Health Status(young-old), Disability(young-old), Activity Limitation(young-old), Education Level(old) and Economic Activity(old). The factors influencing unmet medical needs were factors of attitude, information, and disease. factors were Disability(young-old), Activity Limitation(young-old), Education Level(old) and Economic Activity(old). Therefore, further research that investigates unmet needs depending on age group in the elderly would suggest helpful policy implications.

• 보건행정학회지
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• 제29권2호
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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.

• 보건행정학회지
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• 제26권4호
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• pp.390-398
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• 2016

Background: This study aims to analyze the impact of levels of health care coverage on the trajectory of self-rated health, comparing the near-poor which tends to be excluded in traditional health care systems with the upper middle class. Methods: The study participants were 3,687 people who sincerely responded questions regarding health care expenditures, unmet medical needs, and self-rated health in the Korea Health Panel data in 2009-2012. Results: The higher health care expenditures and the presence of unmet medical needs were significantly associated with the lower level of self-rated health. However, both factors did not significantly predict the steeper decline in the self-rated health. The results from multiple group analyses showed that health care expenditures and unmet medical needs had greater impact on the near-poor compared to their higher income counterparts. Conclusion: Public health care coverages need to be enhanced as well as reducing health care expenditures and unmet medical needs.

• 보건행정학회지
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• 제33권4호
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• pp.389-399
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• 2023

Background: The purpose of this study is to analyze the factors affecting the unmet healthcare needs of older people with chronic diseases in Korea and provide a basic research report to strengthen their access to medical care. Methods: In the 2020 older people survey data, 8,182 older people aged 65 or older who were diagnosed with one or more chronic diseases were the final subjects of the study. According to Andersen's behavioral model used in unmet healthcare needs, independent variables were composed of predisposing factors, possible factors, and necessary factors, and whether or not unmet healthcare needs was set as dependent variable. Results: Of the older people with chronic diseases, 1.6% experienced unmet healthcare needs, of which 55.9% experienced unmet healthcare needs for reasons related to economic burden, 31.6% physical constraints, and 12.5% time constraints. As a result of the analysis, older people with chronic diseases were more likely to experience unmet healthcare needs if they were relatively low in age, low in education level, no spouse, low in household income, poor subjective health, complex chronic diseases, and functional restrictions. However, by major reasons for experiencing unmet healthcare needs, living in rural areas were more likely to experience unmet healthcare needs due to physical constraints, and those who participated in economic activities and who had were more likely to experience unmet healthcare needs due to time burden. These results were not derived when only unmet healthcare needs was set as the dependent variable. Conclusion: This study emphasizes the need for an approach by cause of unmet medical occurrence by suggesting that there are differences in influencing factors by reason for experiencing unmet healthcare needs.

• 한국병원경영학회지
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• 제29권1호
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• pp.46-55
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• 2024

Objective: This study was conducted to provide basic data for the establishment of effective health policies for the unmet medical experience that may occur among the elderly depending on whether they live in a singleperson household or not. Methodology: This study used data from the 8th National Health and Nutrition Examination Survey (2019-2020) and excluded cases with missing values in variables for the total number of respondent participants of 15,469. Finally, 2,850 subjects aged 65 or older were selected for final analysis. This study examined the relationship between experiences of unmet medical needs, attempting to confirm the relationship between single-person households and unmet medical needs through subgroup analysis considering gender, age, and household income. Results: According to the results, in the case of single-person households, the odds ratio (OR) for unmet medical needs was significantly higher at 1.60 times (95% CI: 1.16-2.21). Upon conducting subgroup analyses for gender, age, and household income quintiles, the OR was significantly higher at 2.24 times (95% CI: 1.14-4.41) for males and 1.48 times (95% CI: 1.02-2.14) for females, statistically significant in both cases. For individuals aged 65-69, the OR was significantly higher at 1.90 times (95% CI: 1.04-3.47), but for those aged 70-74 and over 75, it was not statistically significant. In the case of households with 'low' income, the OR was higher at 1.62 times (95% CI: 1.16-2.26), and for 'middle' income, it was significantly higher at 3.21 times (95% CI: 1.08-9.51). Conclusion: This study confirmed that the experience of unmet medical care is high among men who make up single-person households and low-income seniors. Therefore, this study suggests that policies to expand medical services and support welfare for single-person households should be established to resolve these problems, showing that health policies that take into account individual and regional characteristics are needed to improve medical accessibility for single-person households.