한국 미충족 의료 니즈 수준 및 발생 사유의 거주지역 간 격차 분석과 정책적 시사점

Abstract

Background: Most developed countries are working to improve their universal health coverage systems. This study investigatesregional disparities in unmet healthcare needs and their causes in South Korea. Additionally, it compares the unmet healthcare needsrate in South Korea with that of 33 European countries. Methods: The analysis incorporates information from 13,359 adults aged 19 or older, using data from the Korea Health Panel. Thedependent variables encompass the experience of unmet healthcare needs and the three causes of occurrence: “burden of medicalexpenses,” “time constraints,” and “lack of care.” The primary variable of interest is the region of residence, while control variablesencompass 14 socio-demographic, health, and functional characteristics. Multivariable binary logistic regression analysis, accountingfor the sampling design, is conducted. Results: The rate of unmet healthcare needs in Korea is 11.7% (95% confidence interval [CI], 11.0%–13.3%), which is approximately30 times higher than that of Austria (0.4%). The causes of unmet healthcare needs, ranked in descending order, are “lack of care,”“time constraints,” and “burden of medical expenses.” Predictive probabilities for experiencing unmet healthcare needs and eachcause differ significantly between regions. For instance, the probability of experiencing unmet healthcare needs due to “lack of care”is approximately 10 times higher in Gangwon-do (13.5%; 95% CI, 13.0%–14.1%) than in Busan (1.3%; 95% CI, 1.3%–1.4%). Theprobability due to “burden of medical expenses” is approximately 14 times higher in Seoul (4.1%; 95% CI, 3.6%–4.6%) compared toJeollanam-do (0.3%; 95% CI, 0.2%–0.4%). Conclusion: Amid rapid sociodemographic transitions, South Korea must make significant efforts to alleviate unmet healthcare needsand the associated regional disparities. To effectively achieve this, it is recommended that South Korea involves the NationalAssembly in healthcare policy-making, while maintaining a centralized financing model and delegating healthcare planning andimplementation to regional authorities for their local residents—similar to the approaches of the United Kingdom and France.