Lee Seung Eun, Yeon Miyeon, Kim Chul-Woung, Yoon Tae-Ho, Kim Dongjin, Choi Jihee
Graduate School of Public Health, Seoul National University, Seoul, Korea.
Department of Statistics, Florida State University, Tallahassee, Florida, United States.
Osong Public Health Res Perspect. 2019 Oct;10(5):295-306. doi: 10.24171/j.phrp.2019.10.5.06.
In this study the relationship between neighborhood deprivation and the unmet health care needs of elderly individuals (≥ 65 years) was examined. Some previous studies suggested that neighborhood characteristics affect access to health care, yet research on the unmet needs of older individuals is limited.
Multilevel logistic regression analysis was used to assess the relationship of neighborhood-level factors with unmet health care needs due to costs, adjusting for individual-level factors, in individuals ≥ 65 years in the 2017 Korean Community Health Survey ( = 63,388).
There were 2.6% of elderly individuals who experienced unmet health care needs due to costs. Following adjustment for individual and neighborhood characteristics, the neighborhood deprivation in urban areas was found to have an inverse association with unmet needs (odds ratio = 0.50; 95% confidence interval = 0.24-1.06) for the most deprived quartile versus the least deprived quartile). However, in rural areas neighborhood deprivation was not a significant variable. Among the individual-level variables, household income was one of the strongest correlates with unmet needs in both urban and rural areas.
The present findings suggest that targeted policy interventions reflecting both neighborhood and individual characteristics, should be implemented to reduce the unmet health care needs of elderly individuals.
本研究探讨社区贫困与老年个体(≥65岁)未满足的医疗保健需求之间的关系。先前的一些研究表明社区特征会影响医疗保健的可及性,但针对老年人未满足需求的研究有限。
采用多水平逻辑回归分析,在2017年韩国社区健康调查中对≥65岁的个体(n = 63,388)进行分析,评估社区层面因素与因费用导致的未满足医疗保健需求之间的关系,并对个体层面因素进行校正。
有2.6%的老年个体因费用问题存在未满足的医疗保健需求。在对个体和社区特征进行校正后,发现城市地区的社区贫困程度与未满足需求呈负相关(比值比 = 0.50;95%置信区间 = 0.24 - 1.06,最贫困四分位数与最不贫困四分位数相比)。然而,在农村地区,社区贫困不是一个显著变量。在个体层面变量中,家庭收入是城乡地区与未满足需求相关性最强的因素之一。
目前的研究结果表明,应实施反映社区和个体特征的针对性政策干预措施,以减少老年个体未满足的医疗保健需求。