Understanding reasons for unmet health care needs in Korea: what are health policy implications?

BMC Health Serv Res. 2018 Jul 16;18(1):557. doi: 10.1186/s12913-018-3369-2.

Abstract

Background: To ensure equal access to necessary care regardless of an individual's socioeconomic status, it is crucial to understand the factors that act as barriers. Unmet health care needs can arise for a variety of complex reasons, including personal choice, financial barriers, or lack of services, and each of these reasons requires a different policy approach. Researchers have advocated for a more granular measure of unmet health care need for better policy implication. This study aimed to assess various factors associated with different types of unmet health care needs in Korea.

Methods: The Korean National Health and Nutrition Examination Survey (KNHANES) 2010-2012 was used to analyze responses from 17,610 individuals over age 19. To measure the unmet needs of this population, self-reported experience in the past 1 year was used, and individual's reasons for unmet need were sorted into three distinct categories - availability, acceptability, accessibility. Four different logistic regression models stratified by gender were used to examine the relationship between socioeconomic factors and unmet needs.

Results: While income was not a significant factor for men, women with lower incomes showed a higher likelihood of experiencing unmet need. In addition, women with lower incomes showed higher odds of having acceptability-related unmet needs during the past 1 year compared to men. Education and income levels were associated with accessibility-related unmet needs for both women and men.

Conclusion: As unmet health care needs are considered to be a critical indicator of a country's health care system, it is crucial to identify and eliminate any obstacles that prevent access to health care services. Under the current universal health care system in Korea, women, particularly those of lower income and lower educational levels, have limited access to necessary health care services. A gender-specific health care plan is recommended to reduce the higher rate of unmet needs experienced by this group. To reduce accessibility-related unmet needs, increasing available services for younger age groups, reflecting their needs of health services, needs to be considered.

Keywords: Acceptability; Accessibility; Availability; Korea; Unmet health care need.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Female
  • Health Policy*
  • Health Services
  • Health Services Accessibility / standards
  • Health Services Accessibility / statistics & numerical data
  • Health Services Needs and Demand / standards*
  • Healthcare Disparities / statistics & numerical data*
  • Humans
  • Income
  • Logistic Models
  • Male
  • Middle Aged
  • Nutrition Surveys
  • Poverty
  • Republic of Korea
  • Self Report
  • Social Class
  • Socioeconomic Factors
  • Young Adult