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KMID : 1170320180240010111
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Korean Journal of Health Economics and Policy
2018 Volume.24 No. 1 p.111 ~ p.141
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A Multilevel Analysis on Unmet Healthcare Need and Regional Contextual Effects: A Case Study of Seoul
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Kim Hee-Un
Kang Min-Ah
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Abstract
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This study aims to investigate both the individual- and regional-level determinants of disparities in healthcare access in Seoul metropolitan city. Using 2013 Community Health Survey, unmet healthcare need was classified into three categories: unmet healthcare need due to inaccessibility, unavailability, and unacceptability of healthcare service. Three logistic regression models were tested to find out individual-level risk factors of each type of unmet healthcare need. Additionally, multilevel model tested the individual and contextual risk factors of unmet healthcare need due to the inaccessibility of healthcare service. The results suggested that the most frequent type of unmet healthcare need in metropolitan areas is the unavailability of healthcare services, and its variance stems mostly from individual-level differences. In contrast, unmet healthcare need due to the inaccessibility of healthcare services shows the highest regional variance. Regional level factors, such as regional deprivation and behavioral social capital have significant effect on the unmet healthcare need due to the inaccessibility of healthcare service; furthermore, higher income group's risk of unmet healthcare need due to inaccessibility increased more rapidly than the lower-income groups’. Lastly, Unmet healthcare need due to the unacceptability of healthcare services was determined by individuals’ predisposing factors and health status. The results imply that community health policies based on its regional characteristics be established to elevate the accessibility of healthcare, and healthcare delivery systems and health promotion programs should be improved.
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KEYWORD
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Unmet Healthcare Need, Access to Healthcare, Contextual Effect, Multilevel Analysis, Community Health Survey(CHS)
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