Skip to main content
Top
Published in: BMC Health Services Research 1/2018

Open Access 01-12-2018 | Research article

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

Author: Jongnam Hwang

Published in: BMC Health Services Research | Issue 1/2018

Login to get access

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.
Literature
1.
go back to reference Marmot M, Friel S, Bell R, Houweling TA, Taylor S. Commission on social determinants of health. Closing the gap in a generation: health equity through action on the social determinants of health. Lancet. 2008;372(9650):1661–9.CrossRefPubMed Marmot M, Friel S, Bell R, Houweling TA, Taylor S. Commission on social determinants of health. Closing the gap in a generation: health equity through action on the social determinants of health. Lancet. 2008;372(9650):1661–9.CrossRefPubMed
2.
go back to reference Kwon S. Thirty years of national health insurance in South Korea: lessons for achieving universal health care coverage. Health Policy Plan. 2009;24(1):63–71.CrossRefPubMed Kwon S. Thirty years of national health insurance in South Korea: lessons for achieving universal health care coverage. Health Policy Plan. 2009;24(1):63–71.CrossRefPubMed
3.
go back to reference Choi JW, Park EC, Yoo KB, Lee SG, Jang SI, Kim TH. The effect of high medical expenses on household income in South Korea: a longitudinal study using propensity score matching. BMC Health Serv Res. 2015;15:369.CrossRefPubMedPubMedCentral Choi JW, Park EC, Yoo KB, Lee SG, Jang SI, Kim TH. The effect of high medical expenses on household income in South Korea: a longitudinal study using propensity score matching. BMC Health Serv Res. 2015;15:369.CrossRefPubMedPubMedCentral
4.
go back to reference OECD. Health at a Glance 2015. Paris: OECD Publishing; 2015. ISSN:1995-3992 OECD. Health at a Glance 2015. Paris: OECD Publishing; 2015. ISSN:1995-3992
5.
go back to reference Huh SI, Kim S. Financial burden of health care expenditures and unmet needs by socioeconomic status. Korean J Health Econ Policy. 2011;17(1):47–70. Huh SI, Kim S. Financial burden of health care expenditures and unmet needs by socioeconomic status. Korean J Health Econ Policy. 2011;17(1):47–70.
6.
go back to reference Cho H-J. Equity in health care: current situation in South Korea. J Korean Med Assoc. 2013;56(3) Cho H-J. Equity in health care: current situation in South Korea. J Korean Med Assoc. 2013;56(3)
7.
go back to reference Kim J, Kim TH, Park E-C, Cho WH. Factors influencing unmet need for health Care Services in Korea. Asia Pac J Public Health. 2015;27(2):NP2555–NP69.CrossRefPubMed Kim J, Kim TH, Park E-C, Cho WH. Factors influencing unmet need for health Care Services in Korea. Asia Pac J Public Health. 2015;27(2):NP2555–NP69.CrossRefPubMed
8.
go back to reference Allin S, Grignon M, Le Grand J. Subjective unmet need and utilization of health care services in Canada: what are the equity implications? Soc Sci Med. 2010;70(3):465–72.CrossRefPubMed Allin S, Grignon M, Le Grand J. Subjective unmet need and utilization of health care services in Canada: what are the equity implications? Soc Sci Med. 2010;70(3):465–72.CrossRefPubMed
9.
go back to reference Hwang J, Guilcher SJT, McIsaac KE, Matheson FI, Glazier R, et al. An examination of perceived health care availability and unmet health care need in the City of Toronto, Ontario, Canada. Can J Public Health. 2017;108(1):7.CrossRef Hwang J, Guilcher SJT, McIsaac KE, Matheson FI, Glazier R, et al. An examination of perceived health care availability and unmet health care need in the City of Toronto, Ontario, Canada. Can J Public Health. 2017;108(1):7.CrossRef
10.
go back to reference Sanmartin C. Changes in unmet health care needs. Health Rep. 2002;13(3):15.PubMed Sanmartin C. Changes in unmet health care needs. Health Rep. 2002;13(3):15.PubMed
11.
go back to reference Sibley LM, Glazier RH. Reasons for self-reported unmet health care needs in Canada: a population-based provincial comparison. Healthc Policy. 2009;5(1):87–101.PubMedPubMedCentral Sibley LM, Glazier RH. Reasons for self-reported unmet health care needs in Canada: a population-based provincial comparison. Healthc Policy. 2009;5(1):87–101.PubMedPubMedCentral
12.
go back to reference Hou F, Chen J. Unmet needs for health care. Health Rep. 2002;13(2):23.PubMed Hou F, Chen J. Unmet needs for health care. Health Rep. 2002;13(2):23.PubMed
13.
go back to reference Kweon S, Kim Y, M-j J, Kim Y, Kim K, Choi S, et al. Data resource profile: the Korea National Health and nutrition examination survey (KNHANES). Int J Epidemiol. 2014;43(1):69–77.CrossRefPubMedPubMedCentral Kweon S, Kim Y, M-j J, Kim Y, Kim K, Choi S, et al. Data resource profile: the Korea National Health and nutrition examination survey (KNHANES). Int J Epidemiol. 2014;43(1):69–77.CrossRefPubMedPubMedCentral
16.
go back to reference Heo J, Oh J, Kim J, Lee M, J-s L, Kwon S, et al. Poverty in the midst of penty: unmet needs and fistribution of health care resources in South Korea. PLoS One. 2012;7(11):e51004.CrossRefPubMedPubMedCentral Heo J, Oh J, Kim J, Lee M, J-s L, Kwon S, et al. Poverty in the midst of penty: unmet needs and fistribution of health care resources in South Korea. PLoS One. 2012;7(11):e51004.CrossRefPubMedPubMedCentral
18.
go back to reference Reeves A, McKee M, Stuckler D. The attack on universal health coverage in Europe: recession, austerity and unmet needs. Eur J Pub Health. 2015;25(3):364–5.CrossRef Reeves A, McKee M, Stuckler D. The attack on universal health coverage in Europe: recession, austerity and unmet needs. Eur J Pub Health. 2015;25(3):364–5.CrossRef
19.
go back to reference Elstad JI. Income inequality and foregone medical care in Europe during the great recession: multilevel analyses of EU-SILC surveys 2008–2013. Int J Equity Health. 2016;15:101.CrossRefPubMedPubMedCentral Elstad JI. Income inequality and foregone medical care in Europe during the great recession: multilevel analyses of EU-SILC surveys 2008–2013. Int J Equity Health. 2016;15:101.CrossRefPubMedPubMedCentral
20.
go back to reference Connolly S, Wren M-A. Unmet health care needs in Ireland: analysis using the EU-SILC survey. Health Policy. 2017;121(4):434–41.CrossRefPubMed Connolly S, Wren M-A. Unmet health care needs in Ireland: analysis using the EU-SILC survey. Health Policy. 2017;121(4):434–41.CrossRefPubMed
21.
go back to reference Lasser KE, Himmelstein DU, Woolhandler S. Access to care, health status, and health disparities in the United States and Canada: results of a cross-national population-based survey. Am J Public Health. 2006;96(7):1300–7.CrossRefPubMedPubMedCentral Lasser KE, Himmelstein DU, Woolhandler S. Access to care, health status, and health disparities in the United States and Canada: results of a cross-national population-based survey. Am J Public Health. 2006;96(7):1300–7.CrossRefPubMedPubMedCentral
22.
go back to reference de Looper M, Lafortune G. Measuring Disparities in Health Status and in Access and Use of Health Care in OECD Countries: OECD Publishing. Paris: 2009. de Looper M, Lafortune G. Measuring Disparities in Health Status and in Access and Use of Health Care in OECD Countries: OECD Publishing. Paris: 2009.
23.
go back to reference Bryant T, Leaver C, Dunn J. Unmet health care need, gender, and health inequalities in Canada. Health Policy. 2009;91(1):24–32.CrossRefPubMed Bryant T, Leaver C, Dunn J. Unmet health care need, gender, and health inequalities in Canada. Health Policy. 2009;91(1):24–32.CrossRefPubMed
24.
go back to reference Chun H, Chung J. A review on gender and health for gender-sensitive health policy. Kor J Health Policy Admin. 2008;18(2):130–56.CrossRef Chun H, Chung J. A review on gender and health for gender-sensitive health policy. Kor J Health Policy Admin. 2008;18(2):130–56.CrossRef
25.
go back to reference Lu JF, Leung GM, Kwon S, Tin KYK, Van Doorslaer E, O’Donnell O. Horizontal equity in health care utilization evidence from three high-income Asian economies. Soc Sci Med. 2007;64(1):199–212.CrossRefPubMed Lu JF, Leung GM, Kwon S, Tin KYK, Van Doorslaer E, O’Donnell O. Horizontal equity in health care utilization evidence from three high-income Asian economies. Soc Sci Med. 2007;64(1):199–212.CrossRefPubMed
26.
go back to reference Lee SY, Kim CW, Kang JH, Seo NK. Unmet health care needs depending on employment status. Health Policy. 2015;119(7):899–906.CrossRefPubMed Lee SY, Kim CW, Kang JH, Seo NK. Unmet health care needs depending on employment status. Health Policy. 2015;119(7):899–906.CrossRefPubMed
27.
go back to reference Ko H. Unmet health care needs and health status: panel evidence from Korea. Health Policy. 2016;120(6):646–53.CrossRefPubMed Ko H. Unmet health care needs and health status: panel evidence from Korea. Health Policy. 2016;120(6):646–53.CrossRefPubMed
28.
go back to reference Mollborn S, Stepanikova I, Cook KS. Delayed care and unmet needs among health care system users: when does fiduciary trust in a physician matter? Health Serv Res. 2005;40(6p1):1898–917.CrossRefPubMedPubMedCentral Mollborn S, Stepanikova I, Cook KS. Delayed care and unmet needs among health care system users: when does fiduciary trust in a physician matter? Health Serv Res. 2005;40(6p1):1898–917.CrossRefPubMedPubMedCentral
29.
go back to reference Kim S, Kwon S. The effect of extension of benefit coverage for cancer patients on health care utilization across different income groups in South Korea. Int J Health Care Finance Econ. 2014;14(2):161–77.CrossRefPubMed Kim S, Kwon S. The effect of extension of benefit coverage for cancer patients on health care utilization across different income groups in South Korea. Int J Health Care Finance Econ. 2014;14(2):161–77.CrossRefPubMed
30.
go back to reference Park JM. Equity in the utilization of physician and inpatient hospital services: evidence from Korean health panel survey. Int J Equity Health. 2016;15(1):159.CrossRefPubMedPubMedCentral Park JM. Equity in the utilization of physician and inpatient hospital services: evidence from Korean health panel survey. Int J Equity Health. 2016;15(1):159.CrossRefPubMedPubMedCentral
31.
go back to reference Jeong H-S. Korea’s National Health Insurance—Lessons from the past three decades. Health Aff. 2011;30(1):136–44.CrossRef Jeong H-S. Korea’s National Health Insurance—Lessons from the past three decades. Health Aff. 2011;30(1):136–44.CrossRef
32.
go back to reference Kim S, Kwon S. Has the National Health Insurance improved the inequality in the use of tertiary-care hospitals in Korea? Health Policy. 2014;118(3):377–85.CrossRefPubMed Kim S, Kwon S. Has the National Health Insurance improved the inequality in the use of tertiary-care hospitals in Korea? Health Policy. 2014;118(3):377–85.CrossRefPubMed
33.
go back to reference Kim S, Hwang J. Assessment of trends in socioeconomic inequalities in cancer screening services in Korea, 1998–2012. Int J Equity Health. 2016;15:30.CrossRefPubMedPubMedCentral Kim S, Hwang J. Assessment of trends in socioeconomic inequalities in cancer screening services in Korea, 1998–2012. Int J Equity Health. 2016;15:30.CrossRefPubMedPubMedCentral
34.
go back to reference Nelson CH, Park J. The nature and correlates of unmet health care needs in Ontario, Canada. Soc Sci Med. 2006;62(9):2291–300.CrossRefPubMed Nelson CH, Park J. The nature and correlates of unmet health care needs in Ontario, Canada. Soc Sci Med. 2006;62(9):2291–300.CrossRefPubMed
35.
36.
37.
go back to reference Moret L, Nguyen J-M, Volteau C, Falissard B, Lombrail P, Gasquet I. Evidence of a non-linear influence of patient age on satisfaction with hospital care. Int J Qual Health Care. 2007;19(6):382–9.CrossRefPubMed Moret L, Nguyen J-M, Volteau C, Falissard B, Lombrail P, Gasquet I. Evidence of a non-linear influence of patient age on satisfaction with hospital care. Int J Qual Health Care. 2007;19(6):382–9.CrossRefPubMed
38.
go back to reference Peck BM, Ubel PA, Roter DL, Goold SD, Asch DA, Jeffreys AS, et al. Do unmet expectations for specific tests, referrals, and new medications reduce patients’ satisfaction? J Gen Intern Med. 2004;19(11):1080–7.CrossRefPubMedPubMedCentral Peck BM, Ubel PA, Roter DL, Goold SD, Asch DA, Jeffreys AS, et al. Do unmet expectations for specific tests, referrals, and new medications reduce patients’ satisfaction? J Gen Intern Med. 2004;19(11):1080–7.CrossRefPubMedPubMedCentral
39.
go back to reference Baiden P, den Dunnen W, Arku G, Mkandawire P. The role of sense of community belonging on unmet health care needs in Ontario, Canada: findings from the 2012 Canadian community health survey. J Public Health. 2014;22(5):467–78.CrossRef Baiden P, den Dunnen W, Arku G, Mkandawire P. The role of sense of community belonging on unmet health care needs in Ontario, Canada: findings from the 2012 Canadian community health survey. J Public Health. 2014;22(5):467–78.CrossRef
40.
go back to reference Hargreaves DS, Elliott MN, Viner RM, Richmond TK, Schuster MA. Unmet health care need in US adolescents and adult health outcomes. Pediatrics. 2015;136(3):513–20.CrossRefPubMed Hargreaves DS, Elliott MN, Viner RM, Richmond TK, Schuster MA. Unmet health care need in US adolescents and adult health outcomes. Pediatrics. 2015;136(3):513–20.CrossRefPubMed
42.
go back to reference Kelley E, Hurst J. Health care quality indicators project. Paris: OECD Health Working Papers; 2006.CrossRef Kelley E, Hurst J. Health care quality indicators project. Paris: OECD Health Working Papers; 2006.CrossRef
43.
go back to reference Park K. A study on regional inequality in health care utilization. Kor Policy Studies Rev. 2012;21(3):388–415. Park K. A study on regional inequality in health care utilization. Kor Policy Studies Rev. 2012;21(3):388–415.
44.
go back to reference Yoon TH. Regional health inequalities in Korea: the statues and policy tasks. J Crit Soc Policy. 2010;30(8):49–77. Yoon TH. Regional health inequalities in Korea: the statues and policy tasks. J Crit Soc Policy. 2010;30(8):49–77.
Metadata
Title
Understanding reasons for unmet health care needs in Korea: what are health policy implications?
Author
Jongnam Hwang
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2018
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-018-3369-2

Other articles of this Issue 1/2018

BMC Health Services Research 1/2018 Go to the issue