국내 미충족 의료 현황 및 영향요인 연구에 관한 체계적 문헌고찰

초록

The aim of this study is to identify the current status of, and factors associated with, unmet medical needs in Korea, and to suggest a direction for future public health policy decision-making. A systematic review of forty-five studies published before 15th December 2017 in domestic databases was completed. The content of the analysis is the definition of, the status of, and factors associated with unmet medical needs. Unmet medical needs were defined into three types: general unmet needs and unmet needs due to financial reasons and temporal reasons. The majority of the studies used the secondary data sets including Korea Health Panel Survey (15 articles, 33.3%), National Health and Nutrition Examination Survey (11 articles, 24.4%), Korea Welfare panel Study (6 articles, 13.3%). The subjects of studies were adults (17 articles, 37.8%), households (13 articles, 28.8%), elderly (9 articles, 20.0%), disabled (3 articles, 6.7%), female gender (2 articles, 4.4%) and adolescents (1 article, 2.2%). It showed increasing trends for experiencing general unmet medical needs of adults and elderly (14.89% in 2011, 16.38% in 2012 and 17.64% in 2013; 13.5% in 2011, 16.9% in 2012 and 18.9% in 2013, respectively). The experiences of unmet needs due to financial reasons were increased in adults group (27.98% in 2011, 36.35% in 2012 and 35.67% in 2013) but were varied in elderly (55.9% in 2011, 36.6% in 2012 and 42.8% in 2013). The experiences of unmet needs due to temporal reasons were increased in adults group (30.03% in 2011, 34.38% in 2012 and 35.59% in 2013) but were varied in elderly (10.0% in 2011, 29.4% in 2012 and 14.3% in 2013). The factors associated with unmet needs included: sex, age, education level, presence of spouse, household income, national health insurance, subjective health status, chronic disease, depression, and limitation to daily routine. Previous studies showed different outcomes depends on periods, subjects and source data. We need segmentation and standardization with a clear definition as well as systematic monitoring based on the completed research design about unmet medical needs. Moreover, the political countermeasures are needed which would consider the characteristics of the subjects.

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