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残疾人未满足的医疗保健需求:来自2018 - 2021年韩国残疾与生活动态面板的证据

Unmet healthcare needs of people with disabilities: evidence from the 2018-2021 Korean disability and life dynamics panel.

作者信息

Park Jun Su, Kim Bomgyeol, Choi Soo Hyeok, Rajaguru Vasuki, Kim Tae Hyun

机构信息

Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.

College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea.

出版信息

BMC Public Health. 2025 Jul 2;25(1):2263. doi: 10.1186/s12889-025-23048-w.

Abstract

BACKGROUND

People with disabilities frequently have higher healthcare demands and unmet needs. This study investigated the unmet healthcare needs of people with disabilities in Korea, addressing the disparities across disability types.

METHODS

We analyzed the 2018-2021 Korean Disability and Life Dynamics Panel using the vulnerable population behavior model. The dependent variable was unmet healthcare needs among people with disabilities. Trends in unmet healthcare needs were assessed annually using frequency and percentage analyses, with statistical evaluation conducted via a trend test Multiple logistic regression analysis was conducted to identify factors associated with unmet healthcare needs.

RESULTS

Responses for each survey wave were as follows: 2018 (n = 6,121), 2019 (n = 5,527), 2020 (n = 5,259), and 2021 (n = 5,021). The proportion of unmet healthcare needs was 9.1% in 2018, decreasing to 5.8% in 2020, and slightly increasing to 6.0% by 2021(p for trend: p < 0.001). Reasons for the unmet healthcare needs of people with disabilities include a lack of money, difficulty moving, and a lack of a professional workforce. Among the reasons for unmet healthcare needs, "lack of money" significantly decreased from 70% to 60.8%. In contrast, "difficulty in moving" and "a lack of a professional workforce" increased significantly. Unmet healthcare needs were significantly higher among individuals with intellectual or autistic disabilities (aOR = 1.55, 95% CI = 1.11-2.16) and visual disabilities (aOR = 1.42, 95% CI = 1.11-1.80) compared to those with physical disabilities. People with disabilities who had a travel time of 30 min or more to a health facility were more likely to have unmet healthcare needs (aOR = 1.45, 95% CI = 1.28-4.64).

CONCLUSIONS

People with disabilities' unmet healthcare needs are primarily due to financial constraints and accessibility issues, such as travel time and mobility difficulties. Governments and policymakers must make efforts to reduce and prevent unmet healthcare needs among people with intellectual and visual disabilities.

摘要

背景

残疾人通常有更高的医疗保健需求且需求未得到满足。本研究调查了韩国残疾人未得到满足的医疗保健需求,探讨了不同残疾类型之间的差异。

方法

我们使用弱势群体行为模型分析了2018 - 2021年韩国残疾与生活动态面板数据。因变量是残疾人未得到满足的医疗保健需求。每年使用频率和百分比分析评估未得到满足的医疗保健需求趋势,并通过趋势检验进行统计评估。进行多元逻辑回归分析以确定与未得到满足的医疗保健需求相关的因素。

结果

各调查波次的回复情况如下:2018年(n = 6121),2019年(n = 5527),2020年(n = 5259)和2021年(n = 5021)。2018年未得到满足的医疗保健需求比例为9.1%,到2020年降至5.8%,到2021年略有上升至6.0%(趋势p值:p < 0.001)。残疾人未得到满足的医疗保健需求的原因包括缺钱、行动困难和缺乏专业工作人员。在未得到满足的医疗保健需求的原因中,“缺钱”从70%显著降至60.8%。相比之下,“行动困难”和“缺乏专业工作人员”显著增加。与身体残疾者相比,智力或自闭症残疾者(调整后比值比[aOR]=1.55,95%置信区间[CI]=1.11 - 2.16)和视力残疾者(aOR = 1.42,95% CI = 1.11 - 1.80)未得到满足的医疗保健需求显著更高。前往医疗机构的出行时间为30分钟或更长时间的残疾人更有可能存在未得到满足的医疗保健需求(aOR = 1.45,95% CI = 1.28 - 4.64)。

结论

残疾人未得到满足的医疗保健需求主要是由于经济限制和可及性问题,如出行时间和行动困难。政府和政策制定者必须努力减少和预防智力和视力残疾者未得到满足的医疗保健需求。

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