Bae Eunkyoung, Park Jeongok, Jung Eunyoung
College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea.
Mil Med. 2021 Jan 30;186(1-2):e186-e193. doi: 10.1093/milmed/usaa235.
The purpose of this study was to explore the rate of unmet healthcare needs among Korean enlisted soldiers and to examine the factors associated with unmet healthcare needs, based on Andersen's Health Service Behavior Model.
This study employed secondary data analysis using the dataset of the military health survey for two years, 2014 and 2015, conducted by the Republic of Korea School of Military Medicine. Of all military health survey participants, 3,636 enlisted soldiers who answered the question "In the last year, have you ever been unable to go to a hospital or a clinic when you wanted to go to a hospital or a clinic?"-the dependent variable in this study-were included in this study.
The rate of unmet healthcare needs among Korean enlisted soldiers was 23.7% (n = 860) in the current study. Among the individual characteristics, on-duty stress (Odds ratio (OR) = 1.59, 95% Confidence Interval (95% CI): 1.25-2.03) and need for treatment by a mental health specialist (OR = 1.40, 95% Confidence Interval (CI): 1.00-1.95) were associated with unmet healthcare needs. Among the contextual characteristics, perception of injury-prevention effort (OR = 0.61, 95% CI: 0.52-0.71), support from superiors (OR = 0.81, 95% CI: 0.71-0.93), and possibility of accident or injury of military unit (OR = 0.73, 95% CI: 0.64-0.82) were significant factors associated with unmet healthcare needs. The subjective health condition which was a proxy of the health outcome was significantly associated with unmet healthcare needs (OR = 1.58, 95% CI: 1.13-2.22). The results indicate that the safety awareness of troops and social support of superiors were the contextual military characteristics associated with unmet healthcare needs of enlisted soldiers.
The strengthening of aspect of organizational culture, such as injury-prevention efforts at the military level, or support from superior officers, will contribute to a reduction of the unmet healthcare needs of Korean enlisted soldiers.
本研究旨在基于安德森健康服务行为模型，探究韩国现役军人未满足的医疗需求率，并考察与未满足的医疗需求相关的因素。
本研究采用二次数据分析，使用了韩国军事医学院在2014年和2015年进行的为期两年的军事健康调查数据集。在所有军事健康调查参与者中，3636名现役军人回答了“在过去一年中，当你想去医院或诊所时，是否曾无法前往？”这一问题——该问题为本研究的因变量——这些军人被纳入本研究。
在本研究中，韩国现役军人未满足的医疗需求率为23.7%（n = 860）。在个体特征中，执勤压力（优势比（OR）= 1.59，95%置信区间（95%CI）：1.25 - 2.03）和需要心理健康专家治疗（OR = 1.40，95%置信区间（CI）：1.00 - 1.95）与未满足的医疗需求相关。在环境特征中，对预防伤害努力的认知（OR = 0.61，95%CI：0.52 - 0.71）、上级的支持（OR = 0.81，95%CI：0.71 - 0.93）以及军事单位发生事故或受伤的可能性（OR = 0.73，95%CI：0.64 - 0.82）是与未满足的医疗需求相关的重要因素。作为健康结果替代指标的主观健康状况与未满足的医疗需求显著相关（OR = 1.58，95%CI：1.13 - 2.22）。结果表明，部队的安全意识和上级的社会支持是与现役军人未满足的医疗需求相关的军事环境特征。
加强组织文化方面，如军事层面的预防伤害努力或上级军官的支持，将有助于降低韩国现役军人未满足的医疗需求。
