Poor People and Poor Health: Examining the Mediating Effect of Unmet Healthcare Needs in Korea / 예방의학회지

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.

Unmet Healthcare Needs Status and Trend of Korea in 2017 / 보건행정학회지

Unmet healthcare needs are being used as an important indicator of the accessibility of healthcare services worldwide. To examine current status and trends of unmet needs in Korea, we used data from four sources: the Korea National Health and Nutrition Examination Survey (KNHANES, 2007–2017); the Community Health Survey (CHS 2008–2017); the Korea Health Panel Survey (KHP 2011–2015); and the Korean Welfare Panel Study (KOWEPS 2006–2017). The proportion of individual reporting unmet healthcare needs as of 2017 was 8.8% (KNHANES), 10.6% (CHS), and 12.4% (KHP as of 2015). The proportion of households reporting unmet healthcare needs due to cost was 0.5% (KOWEPS). Annual percentage change was −19.2%, −13.3%, −5.8%, and −13.3% respectively. Low income populations had more unmet healthcare needs than high income populations. However, unlike the last two studies, the main reason for unmet medical reasons was that there was no time regardless of income level.

Unmet Healthcare Needs Status and Trend of Korea in 2016 / 보건행정학회지

Unmet healthcare needs do not end with the phenomenon itself, but lead to possibilities of increased severity of illness. Missed opportunities for treatment at the right timing increase possibilities of complications, and affect prognosis of disease. To examine current status and trends of unmet needs in Korea, we used data from four sources: the Korea National Health and Nutrition Examination Survey (KNHNES, '2007–2016); the Community Health Survey (CHS '2008–2016); the Korea Health Panel Survey (KHP '2011–2014); and the Korean Welfare Panel Study (KOWEPS '2006–2016). The proportion of individual reporting unmet healthcare needs as of 2016 was 8.8% (KNHNES), 11.5% (CHS), and 12.8% (KHP, as of 2014). Annual percentage change which characterizes trend for the follow-up period was −9.9%, −3.1%, and −1.3%, respectively. The proportion of individuals reporting unmet healthcare needs due to cost was 1.8% (KNHNES), 1.5% (CHS), and 3.0% (KHP). The proportion of households reporting unmet healthcare needs due to cost was 1.0% (KOWEPS). Annual percentage change was −10.0%, −15.2%, −5.4%, and −17.5%, respectively. Low income populations had more unmet healthcare needs than high income populations. Therefore, in order to improve unmet healthcare needs, it is necessary to focus on low income populations.

Unmet Healthcare Needs Status and Trend of Korea in 2015 / 보건행정학회지

The proportion of people who reported unmet healthcare needs is an important indicator to measure the access problem in healthcare service. To examine current status and trends of unmet needs in Korea, we used data from four sources: the Korea National Health and Nutrition Examination Survey (KNHNES, ‘2007–2015); the Community Health Survey (CHS ‘2008–2015); the Korea Health Panel Survey (KHP ‘2011–2013); the Korean Welfare Panel Study (KOWEPS ‘2006–2015). The proportion of individual reporting unmet healthcare needs as of 2015 was 12.6% (KNHNES), 11.7% (CHS), and 16.3% (KHP, as of 2013). Annual percent change which characterizes trend for follow-up period was -9.4%, -3.4%, and 7.6%, respectively. The proportion of individual reporting unmet healthcare needs due to cost was 2.8% (KNHNES), 1.7% (CHS), and 4.6% (KHP). The proportion of household reporting unmet healthcare needs due to cost was 1.2% (KOWEPS). Annual percent change was -9.0%, -14.9%, 9.4%, and -18.2%, respectively. Low income population reported about 5 times more unmet needs than high income population. Therefore for decreasing the unmet healthcare needs, strategies focusing on low income population were needed.

Necessidade de saúde insatisfeita no Brasil: uma investigação sobre a não procura de atendimento / Unmet health care needs in Brazil: an investigation about the reasons for not seeking health care

Neste trabalho, a necessidade de saúde insatisfeita, definida pelos autores como a situação em que o indivíduo sente necessidade, mas não procura atendimento de saúde, é estudada a partir dos dados do suplemento de saúde das rodadas de 1998, 2003 e 2008 da Pesquisa Nacional por Amostra de Domicílios (Pnad). Constata-se que, de 1998 a 2008, a parcela da população brasileira com necessidade de saúde durante as duas semanas anteriores à pesquisa se manteve em torno de 17 por cento, enquanto a parcela com necessidade de saúde insatisfeita caiu de 3,5 por cento para 2,9 por cento. Também mudou o perfil dos motivos que as pessoas escolhem para justificar não terem procurado atendimento de saúde. A porcentagem dos que alegavam falta de dinheiro se reduziu, embora ainda seja o motivo mais escolhido, aumentando as porcentagens dos que alegam limitações e falhas do sistema de saúde, como o tempo de espera e a falta de profissionais ou serviços. Baixa renda ou escolaridade, residência nas regiões mais pobres do país ou em área rural, ser negro, ser homem, ser adulto, estar ocupado, residir com outras pessoas com necessidade insatisfeita, não realizar consultas médicas há pelo menos um ano e não ter plano de saúde são, dentre outras, características que aumentam a propensão a não satisfazer a necessidade de saúde pela busca de atendimento.

Herein, unmet health care needs, defined by the authors as the situation when an individual feels the need but does not seek healthcare, are studied from the data of the health questionnaires of the 1998, 2003 and 2008 rounds of the National Household Sampling Survey (Pnad). From 1998 to 2008, the percentage of the population with healthcare needs during the two weeks prior to the interview did not change, remaining at around 17 percent, whilst the share with unmet healthcare needs fell from 3.5 percent to 2.9 percent. There were also changes in the reasons chosen by the interviewees to justify why they did not seek healthcare. The percentage of those who said they could not afford it decreased though it is still the reason given most frequently thereby boosting the percentages of those alleging problems with the healthcare system, such as long waiting times and a lack of professionals and services. People with less income or schooling, residing in the poorer regions of the country or in rural areas, blacks, males, adults, workers, people living with other people with unmet healthcare needs or that have not been to an appointment with a doctor in the last year, and those without health plans, are less likely to seek healthcare and therefore stand a higher chance of having unmet healthcare needs.