Health Policy Manag.  2023 Sep;33(3):273-294. 10.4332/KJHPA.2023.33.3.273.

Exploring Regional Disparities in Unmet Healthcare Needs and Their Causes in South Korea: A Policy-Oriented Study

• Chung W

• KMID: 2549114
• DOI: http://doi.org/10.4332/KJHPA.2023.33.3.273

Abstract

Background
Most developed countries are working to improve their universal health coverage systems. This study investigates regional disparities in unmet healthcare needs and their causes in South Korea. Additionally, it compares the unmet healthcare needs rate in South Korea with that of 33 European countries.
Methods
The analysis incorporates information from 13,359 adults aged 19 or older, using data from the Korea Health Panel. The dependent variables encompass the experience of unmet healthcare needs and the three causes of occurrence: “burden of medical expenses,” “time constraints,” and “lack of care.” The primary variable of interest is the region of residence, while control variables encompass 14 socio-demographic, health, and functional characteristics. Multivariable binary logistic regression analysis, accounting for the sampling design, is conducted.
Results
The rate of unmet healthcare needs in Korea is 11.7% (95% confidence interval [CI], 11.0%–13.3%), which is approximately 30 times higher than that of Austria (0.4%). The causes of unmet healthcare needs, ranked in descending order, are “lack of care,” “time constraints,” and “burden of medical expenses.” Predictive probabilities for experiencing unmet healthcare needs and each cause differ significantly between regions. For instance, the probability of experiencing unmet healthcare needs due to “lack of care” is approximately 10 times higher in Gangwon-do (13.5%; 95% CI, 13.0%–14.1%) than in Busan (1.3%; 95% CI, 1.3%–1.4%). The probability due to “burden of medical expenses” is approximately 14 times higher in Seoul (4.1%; 95% CI, 3.6%–4.6%) compared to Jeollanam-do (0.3%; 95% CI, 0.2%–0.4%).
Conclusion
Amid rapid sociodemographic transitions, South Korea must make significant efforts to alleviate unmet healthcare needs and the associated regional disparities. To effectively achieve this, it is recommended that South Korea involves the National Assembly in healthcare policy-making, while maintaining a centralized financing model and delegating healthcare planning and implementation to regional authorities for their local residents—similar to the approaches of the United Kingdom and France.

Keyword

Healthcare disparities; Unmet healthcare needs; Place of residence; Universal health coverage; Republic of Korea