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The association between perceived unmet medical need and mental health among the Republic of Korea Armed Forces

Authors
 Tae Kyung Kim  ;  S G Lee  ;  K-T Han  ;  Y Choi  ;  S Y Lee  ;  E-C Park 
Citation
 Journal of the Royal Army Medical Corps, Vol.163(3) : 184-192, 2017 
Journal Title
 Journal of the Royal Army Medical Corps 
ISSN
 0035-8665 
Issue Date
2017
MeSH
Adolescent ; Adult ; Age Factors ; Female ; Geography ; Health Care Costs ; Health Services Needs and Demand* ; Health Status ; Health Surveys ; Humans ; Linear Models ; Logistic Models ; Male ; Mental Health* ; Middle Aged ; Military Medicine* ; Military Personnel/psychology* ; Needs Assessment ; Republic of Korea ; Stress, Psychological/psychology* ; Suicidal Ideation* ; Time Factors ; Trust ; Young Adult
Keywords
HEALTH SERVICES ADMINISTRATION & MANAGEMENT ; MENTAL HEALTH ; unmet medical need
Abstract
INTRODUCTION: We investigated the effect of unmet medical need on the mental health of Republic of Korea (ROK) Armed Forces personnel, as most of the service members work in remote areas and often experience such unmet needs. METHODS: This study used secondary data from the 2014 Military Health Survey (MHS), conducted by the ROK School of Military Medicine and designed to collect military health determinants. Descriptive statistics showed the general characteristics of the study populations by variable. We specifically compared the population after stratifying participants by suicide ideation. An analysis of variance was also carried out to compare Kessler Psychological Distress Scale 10 Scores. Additionally, dependent spouses and children of both active-duty service members and retirees are included among those entitled to Military Health System healthcare. RESULTS: Among the 4967 military personnel, 681 (13.7%) individuals reported an experience of unmet medical need within the past 12 months and gave reasons of 'no time (5.15%)', 'long office wait (2.6%)', 'no money (0.22%)', 'long distance from base (1.19%)', 'illness but not very serious (1.65%)', 'mistrust in doctors (1.95%)' and 'pressure due to performance appraisal (0.95%)'. Regression analysis revealed that unmet medical need was significantly associated with negative mental health (β=1.753, p<0.0001) and increased suicide ideation (OR=2.649, 95% CI 1.84 to 3.82). Also, soldiers reporting unmet medical need due to 'no money', 'no time' or 'pressure due to performance appraisal' were significantly more likely to experience similar negative mental health effects. CONCLUSIONS: Our study indicates that unmet medical need is significantly associated with soldiers' mental health decline and suicide ideation, highlighting the importance of providing military personnel with timely, affordable and sufficient medical care.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/160829
DOI
10.1136/jramc-2016-000625
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실)
1. Journal Papers (연구논문) > 4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원)
Yonsei Authors
박은철(Park, Eun-Cheol) ; 이상규(Lee, Sang Gyu)
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Full Text
http://jramc.bmj.com/content/163/3/184.long
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