Assessment of subjective unmet needs of South Korea: Focusing on availability, accessibility, and acceptability

Background:

Subjective unmet needs is critical indicator of barrier to access. The process of categorization of the type of unmet needs is clarify the existing barriers include recognition or awareness of obstacles to access.

Objective:

This study aimed to evaluate subjective unmet need and analyze access to care by three categorization (availability, accessibility, and acceptability). This process may redeem methods of measuring socioeconomic inequality in healthcare utilization in South Korea.

Method:

We analyzed the data are from the Korea Health Panel Survey (KHPS) in 2012. Participants were aged over 18 years and experienced unmet healthcare needs (n=11,946). Multivariate logistic regression was used to estimate the association of risk factor with the type of unmet needs.

Results:

Overall, 15.4% reported having had unmet needs in previous 12 months in 2012. Among those perceived unmet needs, the leading reason was attributable to acceptability (too busy, felt it would be inadequate) for personal reasons (55.3%). In 35.6% of unmet needs were due to accessibility for cost (too expensive). Especially, household income (AOR=12.11, 95% CI=7.37-19.88) was significantly associated with accessibility. Otherwise, the problem of availability (too far, not available to reserve) accounted for about 2% of unmet needs.

Conclusion:

Massive out-of-pocket spending for healthcare utilization is a deep-seated social malady. Except the individual reasons, the major problem was burden of medical cost. It is different result from Canada and other European countries with availability problem. Thus, multi-dimensional approach to unmet needs could be provide more insight into the equity implication of insurance coverage evaluation.