Unmet Healthcare Needs and Associated Factors Among Korean Enlisted Soldiers

Abstract

Introduction: The purpose of this study was to explore the rate of unmet healthcare needs among Korean enlisted soldiers and to examine the factors associated with unmet healthcare needs, based on Andersen's Health Service Behavior Model.

Method: This study employed secondary data analysis using the dataset of the military health survey for two years, 2014 and 2015, conducted by the Republic of Korea School of Military Medicine. Of all military health survey participants, 3,636 enlisted soldiers who answered the question "In the last year, have you ever been unable to go to a hospital or a clinic when you wanted to go to a hospital or a clinic?"-the dependent variable in this study-were included in this study.

Result: The rate of unmet healthcare needs among Korean enlisted soldiers was 23.7% (n = 860) in the current study. Among the individual characteristics, on-duty stress (Odds ratio (OR) = 1.59, 95% Confidence Interval (95% CI): 1.25-2.03) and need for treatment by a mental health specialist (OR = 1.40, 95% Confidence Interval (CI): 1.00-1.95) were associated with unmet healthcare needs. Among the contextual characteristics, perception of injury-prevention effort (OR = 0.61, 95% CI: 0.52-0.71), support from superiors (OR = 0.81, 95% CI: 0.71-0.93), and possibility of accident or injury of military unit (OR = 0.73, 95% CI: 0.64-0.82) were significant factors associated with unmet healthcare needs. The subjective health condition which was a proxy of the health outcome was significantly associated with unmet healthcare needs (OR = 1.58, 95% CI: 1.13-2.22). The results indicate that the safety awareness of troops and social support of superiors were the contextual military characteristics associated with unmet healthcare needs of enlisted soldiers.

Conclusions: The strengthening of aspect of organizational culture, such as injury-prevention efforts at the military level, or support from superior officers, will contribute to a reduction of the unmet healthcare needs of Korean enlisted soldiers.