Unmet healthcare needs and community health center utilization among the low-income population based on a nationwide community health survey.

Abstract

BACKGROUND: The Korean government has established community health centers (CHC) since the end of the 20th century to improve community public health and access to healthcare. In this study, we investigated the reasons for unmet healthcare needs and the reasons/purposes for using CHC based on income level. METHODS: We used data from the 2012 Community Health Survey, which was administered by the Korean Centers for Disease Control and Prevention (n=208,399). We performed the χ(2) test to examine differences between unmet healthcare needs and utilization of CHC based on various patient characteristics. Survey logistic regression models were used to examine unmet healthcare needs and utilization of CHC by income level. We also analyzed subgroup models to explain the reasons for the outcome variables. RESULTS: A total of 22,901 (11.0%) individuals experienced unmet healthcare needs and 75,137 (36.1%) utilized CHC. Results of the survey logistic regression analysis revealed that the lowest-income population had a higher odds ratio (OR) for experiencing unmet healthcare needs (OR=1.61) and utilized CHC more frequently (OR=1.66). Their main reasons for unmet healthcare needs were economic (OR=5.75) and difficulties in transportation (OR=2.17). The lowest-income population visited CHC because of lower costs (OR=1.76) and close proximity to home (OR=1.56). The lowest-income population visited CHC for primary care (OR=1.22) and vaccinations (OR=1.23). In contrast, the highest-income group visited CHC primarily to obtain government-issued documents (OR=0.82). CONCLUSIONS: Our results indicate different reasons/purposes for unmet healthcare needs and utilization of CHC based on income level. The government should use a management strategy to reduce unmet healthcare needs among the low-income population and redefine the roles of CHC.