Kim Youngsoo, Kim Saerom, Jeong Seungmin, Cho Sang Guen, Hwang Seung-Sik
Department of Preventive Medicine, Graduate School of Public Health, Seoul National University, Seoul, Korea.
J Prev Med Public Health. 2019 Jan;52(1):51-59. doi: 10.3961/jpmph.18.162. Epub 2019 Jan 23.
The purpose of this study was to estimate the mediating effect of subjective unmet healthcare needs on poor health. The mediating effect of unmet needs on health outcomes was estimated.
Cross-sectional research method was used to analyze Korea Health Panel data from 2011 to 2015, investigating the mediating effect for each annual dataset and lagged dependent variables.
The magnitude of the effect of low income on poor health and the mediating effect of unmet needs were estimated using age, sex, education level, employment status, healthcare insurance status, disability, and chronic disease as control variables and selfrated health as the dependent variable. The mediating effect of unmet needs due to financial reasons was between 14.7% to 32.9% of the total marginal effect, and 7.2% to 18.7% in lagged model.
The fixed-effect logit model demonstrated that the existence of unmet needs raised the likelihood of poor self-rated health. However, only a small proportion of the effects of low income on health was mediated by unmet needs, and the results varied annually. Further studies are necessary to search for ways to explain the varying results in the Korea Health Panel data, as well as to consider a time series analysis of the mediating effect. The results of this study present the clear implication that even though it is crucial to address the unmet needs, but it is not enough to tackle the income related health inequalities.
本研究旨在评估主观未满足的医疗保健需求对健康不佳的中介作用。评估了未满足需求对健康结果的中介作用。
采用横断面研究方法分析2011年至2015年韩国健康面板数据,调查每个年度数据集和滞后因变量的中介作用。
以年龄、性别、教育程度、就业状况、医疗保险状况、残疾和慢性病作为控制变量,自评健康作为因变量,评估低收入对健康不佳的影响程度以及未满足需求的中介作用。因经济原因未满足需求的中介作用在总边际效应中占14.7%至32.9%,在滞后模型中占7.2%至18.7%。
固定效应logit模型表明,未满足需求的存在增加了自评健康不佳的可能性。然而,低收入对健康的影响中只有一小部分是由未满足需求介导的,且结果每年都有所不同。有必要进一步研究以寻找解释韩国健康面板数据中不同结果的方法,并考虑对中介作用进行时间序列分析。本研究结果明确表明,尽管满足未满足的需求至关重要,但仅解决这一问题不足以解决与收入相关的健康不平等问题。