Department of Preventive Medicine, Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, Korea.
J Korean Med Sci. 2018 Mar 12;33(11):e84. doi: 10.3346/jkms.2018.33.e84.
The aim of this study was to investigate whether generalized trust and/or social participation at an individual level have negative associations with unmet healthcare needs.
Door-to-door interviews were conducted by trained interviewers to collect information. The 8,800 study participants included 220 adults sampled systematically using the resident registration database from 40 sub-municipal-level administrative units in Korea. Unmet healthcare needs were measured subjectively by the following question: "During the past 12 months, was there ever a time when you felt that you needed healthcare (excluding dental care) but did not receive it?" The responses were classified as either "yes" or "no."
The adjusted odds ratios (ORs) for unmet healthcare needs based on one positive response, two positive responses, and three positive responses to the three items of generalized trust compared to no positive responses were 0.92 (95% confidence interval [CI], 0.77-1.09), 0.90 (95% CI, 0.74-1.09), and 0.73 (95% CI, 0.61-0.87), respectively. The adjusted ORs for unmet healthcare needs based on social participation only in informal organizations, only in formal organizations, and in both informal and formal organizations compared to no social participation were 0.83 (95% CI, 0.71-0.98), 0.97 (95% CI, 0.77-1.21), and 0.97 (95% CI, 0.82-1.15), respectively. The covariates included in the multiple logistic regression were sociodemographic variables (gender, age, marital status, educational level, occupation, food security, and administrative unit), self-rated health, and perceived stress.
Therefore, generalized trust and social participation in informal organizations can decrease the incidence of unmet healthcare needs.
本研究旨在探讨个体层面的普遍信任和/或社会参与是否与未满足的医疗保健需求呈负相关。
通过培训过的调查员进行入户访谈收集信息。研究的 8800 名参与者包括 220 名成年人，他们是从韩国 40 个次级市行政单位的居民登记数据库中系统抽取的。未满足的医疗保健需求通过以下问题进行主观测量：“在过去 12 个月中，是否有过您感到需要医疗保健（不包括牙科保健）但未得到满足的情况？”回答分为“是”或“否”。
与没有积极回应相比，对普遍信任的三个项目中的一个积极回应、两个积极回应和三个积极回应的未满足医疗保健需求的调整后比值比（OR）分别为 0.92（95%置信区间 [CI]，0.77-1.09）、0.90（95% CI，0.74-1.09）和 0.73（95% CI，0.61-0.87）。仅参加非正式组织、仅参加正式组织以及同时参加非正式组织和正式组织的社会参与与没有社会参与相比，未满足医疗保健需求的调整后 OR 分别为 0.83（95% CI，0.71-0.98）、0.97（95% CI，0.77-1.21）和 0.97（95% CI，0.82-1.15）。多逻辑回归中纳入的协变量包括社会人口统计学变量（性别、年龄、婚姻状况、教育水平、职业、粮食安全和行政单位）、自我评估健康状况和感知压力。
因此，普遍信任和非正式组织中的社会参与可以降低未满足的医疗保健需求的发生率。
