Choi Seo Yeong, Yun Il, Moon Jong Youn
Department of Preventive Medicine, Gachon University College of Medicine, Incheon, Republic of Korea.
Artificial Intelligence and Big-Data Convergence Center, Gil Medical Center, Gachon University of Medicine, Incheon, Republic of Korea.
Heliyon. 2024 Dec 4;11(1):e40935. doi: 10.1016/j.heliyon.2024.e40935. eCollection 2025 Jan 15.
This study aimed to examine whether sufficient medical resources in residential areas influence individuals' unmet healthcare needs in South Korea, where overpopulation is of concern.
Two publicly available datasets were utilized: The Korean Community Health Survey at the individual-level and the Korean medical utilization statistics at the regional-level. It included 176,378 individuals. To address the clustered nature of the regional-level data, a multi-level framework was applied, containing individual-level data, incorporating demographic details and health information.
Individuals living in small cities and rural areas with sufficient medical resources were 1.26 times more likely to experience unmet healthcare needs than those living in well-resourced metropolitan cities. Additionally, the adjusted odds ratio for unmet healthcare needs was the highest at 1.32 for those living in small cities and rural areas lacking sufficient medical resources. Stratified analyses revealed the largest disparity in unmet healthcare needs between income levels in regions with sufficient resources. In these areas, those with the lowest income were 1.77 times more likely to experience unmet healthcare than those with the highest income. Similarly, in metropolitan cities, the income-based gap in unmet healthcare needs was most pronounced, with the adjusted odds ratio for the lowest-income group being 1.66.
Our findings demonstrate that living in small cities or rural areas with insufficient medical resources, as well as having a low income level even in an area with sufficient medical services, significantly increases individuals' unmet healthcare needs. This suggests then need for equitable distribution medical resources across regions and public health support policies that do not limit access to medical care for people with poor socioeconomic status.
本研究旨在探讨在韩国这样一个人口过剩令人担忧的国家，居民区充足的医疗资源是否会影响个人未满足的医疗保健需求。
使用了两个公开可用的数据集：个体层面的韩国社区健康调查和区域层面的韩国医疗利用统计数据。研究纳入了176,378名个体。为处理区域层面数据的聚类性质，应用了一个多层次框架，其中包含个体层面数据，纳入了人口统计学细节和健康信息。
生活在医疗资源充足的小城市和农村地区的个体，未满足医疗保健需求的可能性是生活在资源丰富的大城市的个体的1.26倍。此外，对于生活在缺乏充足医疗资源的小城市和农村地区的个体，未满足医疗保健需求的调整后优势比最高，为1.32。分层分析显示，在医疗资源充足的地区，不同收入水平之间未满足医疗保健需求的差距最大。在这些地区，收入最低的人群未满足医疗需求的可能性是收入最高人群的1.77倍。同样，在大城市，基于收入的未满足医疗保健需求差距最为明显，最低收入组的调整后优势比为1.66。
我们的研究结果表明，生活在医疗资源不足的小城市或农村地区，以及即使在医疗服务充足的地区收入水平较低，都会显著增加个人未满足的医疗保健需求。这表明需要在各地区公平分配医疗资源，并制定公共卫生支持政策，以确保社会经济地位低下的人群不会被限制获得医疗服务。
