Unmet Health Care Need Research Articles

HSD110 Risk Estimation and Risk Prediction of Unmet Healthcare Needs of Disaster Victims Using Machine Learning

HSD110 Risk Estimation and Risk Prediction of Unmet Healthcare Needs of Disaster Victims Using Machine Learning

Community Initiated Care: A blue-print for the practical realization of contextual behavioral science

There is a vast unmet need for mental health care and support in the United States and globally. Although expanding specialty services is needed, this is neither sufficient nor necessary to comprehensively address the current and future demand. Traditional models of care which have focused on mental disorders, while useful for many, remain out of reach, unaffordable, and not timely for helping the vast majority of individuals in need of mental health support. There is a growing movement of community-based networks and organizations which aim to fill this need by harnessing existing community resources to promote mental health and prevent mental and substance use disorders. This paper describes our effort to derive a blue-print for an approach, which we call “Community Initiated Care (CIC)”, building on these real-world experiences and the growing science on lay person delivered brief psychosocial interventions in community settings. CIC serves as a back-bone for training lay persons to support the mental health and well-being of others in their communities. CIC is envisioned as an equitable, efficient, safe, and timely form of contextualized support to promote mental health and prevent self-harm, mental health and substance use problems. CIC is not intended to replace clinical interventions; instead, we envisage the supportive encounter to use a person-centered approach to bolster existing positive coping skills, promote positive social engagement, reduce risk of future mental health problems, and encourage other forms of help seeking when appropriate. This article explores how our thinking is aligned with and responsive to the strategies and tactics of the Contextual Behavioral Science Task Force to promote programs that are multi-dimensional, process-based, prosocial, practical, and multi-level. Development, implementation, and evaluation of CIC will not only advance contextual behavioral science but also move society forward to more equitable mental health and well-being.

Unmet Needs for Healthcare Services among People in the Field Practice Area of A Rural Health and Training Centre in Goa - A Descriptive Cross-Sectional Study

BACKGROUND
 Universal Health Coverage (UHC) means that individuals and communities receive the healthcare services they need without suffering financial hardship. It includes the full spectrum of essential, quality healthcare services, from health promotion to prevention, treatment, rehabilitation and palliative care. Unmet Healthcare Needs (UHNs) are defined as the difference between the healthcare services deemed necessary to deal with a particular health problem and the actual services received. UHC is possible only if we identify the UHNs among people and plan the delivery of healthcare services accordingly. The study aimed to identify the UHNs among the people in the field practice area of a Rural Health and Training Centre (RHTC), Mandur in Goa.
 METHODS
 A community-based cross-sectional study was conducted in a rural area. A multistage sampling technique was used to include 160 study participants of 21 years of age or above. A semi-structured questionnaire was used to collect data which was later entered into Google Sheets and analysed using SPSS.
 RESULTS
 The mean age of study participants was 44 years (95% CI 41-47). The majority were males (53.13%), 65% were Hindus, and most of them (38.75%) had completed secondary school education, however, more than half (53.13%) of them were unemployed. Twenty-six percent of the study participants reported UHNs during their last visit to a healthcare facility.
 CONCLUSIONS
 The majority of the UHNs consisted of radiological investigations such as X-Ray and Ultrasound. Similarly, the most commonly perceived UHNs was also for radiological investigations followed by the unavailability of general practitioner, medicines and dentist.

UNMET NEED FOR HEALTHCARE AMONG PEOPLE WITH HYPERTENSION IN INDONESIA

Background: Hypertension is a worldwide public health problem, mainly due to its high frequency and risks leading to cardiovascular diseases. The prevalence of hypertension in the Indonesian population aged > 18 years in 2018 was 34.11%. The unmet need for healthcare has generally been explored in most empirical studies concerning people with hypertension. Aims: This study investigated the determinants of unmet needs for healthcare among people with hypertension. Methods: The design of this study was cross-sectional on data from the Indonesian Family Life Survey wave 5 (IFLS-5). The survey sample was 6,302 adults aged > 40 years stratified by rural/urban residence status. A three-level multilevel analysis was performed to estimate the individual, household, and community-level determinants of unmet needs for hypertension care. Results: As many as 78.4% of the respondents with hypertension reported unmet needs for healthcare. Age, female, single, income, having insurance, urban residence, and the number of health-integrated posts for the elderly (Posyandu Lansia) were significantly associated with umeet needs for healthcare utilization among people with hypertension, while education and employment status showed no association with these variables. Conclusion: Improvement in access to healthcare and reduction in health inequality is required to address this problem.

Health Care Access and Use Among Adults With and Without Vision Impairment: Behavioral Risk Factor Surveillance System, 2018.

Adults with vision impairment may have unique needs when accessing health care to maintain good health. Our study examined the relationship between vision status and access to and use of health care. We analyzed data on adults aged 18 years or older who participated in the 2018 Behavioral Risk Factor Surveillance System. Vision impairment was identified by a yes response to the question "Are you blind or do you have serious difficulty seeing, even when wearing glasses?" Survey questions assessed health care access over the past year (having health insurance coverage, a usual health care provider, or unmet health care needs because of cost) and use of health care during that period (routine checkup and dental visit). We estimated age-adjusted prevalence of our outcomes of interest and used bivariate analyses to compare estimates of the outcomes by vision impairment status. The prevalence of self-reported vision impairment was 5.3%. Compared with adults without impaired vision, adults with vision impairment had a lower prevalence of having health insurance coverage (80.6% vs 87.6%), a usual health care provider (71.9% vs 75.7%), or a dental visit in the past year (52.9% vs 67.2%) and a higher prevalence of having an unmet health care need in the past year because of cost (29.2% vs 12.6%). Adults with vision impairment reported lower access to and use of health care than those without. Further research can better identify and understand barriers to care to improve access to and use of health care among this population.

Changes in Barriers That Cause Unmet Healthcare Needs in the Life Cycle of Adulthood and Their Policy Implications: A Need-Selection Model Analysis of the Korea Health Panel Survey Data.

Using 68,930 observations selected from 16,535 adults in the Korea Health Panel Survey (2014-2018), this study explored healthcare barriers that prevent people from meeting their healthcare needs most severely during adulthood, and the characteristics that are highly associated with the barrier. This study derived two outcome variables: a dichotomous outcome variable on whether an individual has experienced healthcare needs, and a quadchotomous outcome variable on how an individual's healthcare needs ended. An analysis was conducted using a multivariable panel multinomial probit model with sample selection. The results showed that the main cause of unmet healthcare needs was not financial difficulties but non-financial barriers, which were time constraints up to a certain age and the lack of caring and support after that age. People with functional limitations were at a high risk of experiencing unmet healthcare needs due to a lack of caring and support. To reduce unmet healthcare needs in South Korea, the government should focus on lowering non-financial barriers to healthcare, including time constraints and lack of caring and support. It seems urgent to strengthen the foundation of "primary care", which is exceptionally scarce now, and to expand it to "community-based integrated care" and "people-centered care".

Suriyeli Mülteci Krizinin Türkiye'de Sağlığa Erişim Üzerindeki Etkisi: Sentetik kontrol analizi

One of the most critical determinants of a healthy life is the level of accessibility to health services when needed. The literature defines the unmet need for healthcare services as "whether the individual (in the last twelve months) cannot apply to a doctor despite the need for medical examination or treatment." One of the main reasons to cause an unmet health care need is the expensive healthcare cost due to increased demand. Mainly, there are increases in demand due to reasons such as population growth and migration movements. Turkey experienced a large-scale migration as a consequence of the Syrian civil war. Based on the Disaster and Emergency Management Agency figures, as of 2018, Turkey is home to about 3.4 million Syrian refugees under temporary protection status. İkizler et al. (2020) point out that this large-scale migration results in a nearly 6.3% increase in unmet healthcare need at the beginning of the refugee crisis. However, the effect weakens gradually. This paper aims to support the results of İkizler et al. (2020) by exploiting the synthetic control method, and OECD's and EUROSTAT's country-level data set related to health care. Even though we control for the 2009 crisis, we observe that the synthetic values of the UHCN for Turkey do not coincide well, especially for the period 2009-2010. The results suggest that the impact of the mass influx of refugees on Turkey's UHCN ceases to exist, wiped away mostly by the government's increase in health investment. Although this makes the synthetic series slightly different from Turkey's series, the results provide intuitive information.

A Sick Benefit Scheme Reduces Unmet Healthcare Needs: An Natural Experiment in Seoul

Abstract South Korea experiences four times more unmet healthcare needs than OECD countries (11.6% and 2.6% respectively). Unmet healthcare needs are caused by the double burden of direct and indirect costs including income loss, and OECD countries operate a sickness benefit scheme to resolve sudden loss of pay. Seoul introduced the first sickness benefit system, Seoul-Type Paid Sick Leave Support (hereinafter Seoul Sick Leave), for self-employed national healthcare insurance subscribers to reduce the rate of unmet healthcare needs. By comparing the amount of increasing medical expenses between the beneficiary and non-beneficiary before (2018) and after (2019-2020) the introduction of the system, the study was intended to confirm the reduced unmet healthcare needs. This study used data from the National Health Information Database (NHID) and the difference in differences (DID) analytic framework. 96 and 121 patients were included in benefit and non-benefit cohorts, respectively. As a result, the beneficiary group’s expenses were smaller than those of the non-beneficiary group (coef.=-1.24, p = 0.026). However, the beneficiary group had a greater amount of increase in hospitalization expenses before and after the introduction than the non-beneficiary group did (coef.=1.66, p = 0.005). Our finding showed that the Seoul Sick Leave helped the precarious workers as they were able to use inpatient services when they needed. If it is to be scaled up to the national level, it should be applied all people to enhance universal health insurance in Korea. Key messages • Identified the effectiveness of the first sickness benefit system as it helped the precarious workers as they were able to use inpatient services when they needed. • By financially supporting them, the Seoul Sick Leave support can achieve health promotion through early detection and treatment.

8.H. Workshop: Health equity and Chronic diseases: Public health and Primary care roles

Abstract Publicly funded health systems are based on the principle of universal access to care. However, significant gaps still exist between services needed and services received (i.e. unmet need for healthcare), especially in chronic disease management and prevention, particularly affecting marginalized groups in the society. Public Health and Primary Care should be working in integrated systems, as they are crucial in addressing health needs in the community and population at large. Several international organizations and leading scholars in the field have been advocating for the integration or primary care and public health to improve population health as well as to tackle complex issues such as multimorbidity. However, these two sectors are still working in silos across several countries, with a significant negative impact in terms of efficiency of the services provided and health care costs. The aim of this workshop will be to provide a global perspective on the issue of health equity in chronic disease management and prevention, with focus on marginalized population subgroups, such as elderly, immigrants and people from low socioeconomic status. We will discuss as well the determinants of unmet health needs for access to primary care in middle-aged and older adults, and examine the reasons for unmet need. We will further discuss about the need and strategies for enhanced integration between public health and primary care in chronic disease management and prevention. Key messages • Public health systems are based on the principle of universal access to care. However, significant gaps still exist between services needed and services received (i.e. unmet need for healthcare). • Public Health and Primary Care should be working in integrated systems to tackle complex issues such as multimorbidity.

Multimorbidity, low income and unmet need for healthcare: a national study of 41,135 older adults

Abstract The aims of this study were: (1) to identify the determinants of unmet need for access to primary care in middle-aged and older adults; and (2) to examine the reasons for unmet need. We used data from the Canadian Longitudinal Study on Aging (CLSA), a nationally representative survey of adults aged 45 to 85 years. Respondents were asked if they ‘needed health care during the last 12 months but did not receive it’. For those who replied ‘Yes’, the survey asked for the reason(s) for not receiving the needed care. Out of 41,135 respondents, 3,468 had unmet need for healthcare in the last 12 months. Among respondents with 0, 1, 2 and ≥3 morbidities, the proportion reporting unmet need was 2.5%, 5.3%, 5.1% and 9.1% respectively. After adjusting for covariates, the odds ratios (ORs) for unmet need for 1, 2 and ≥3 morbidities (compared to no morbidity) were 1.25 (95% CI: 0.87 to 1.78; p = 0.23), 1.57 (95% CI: 1.13 to 2.17; p < 0.05) and 2.03 (95% CI: 1.51 to 2.73; p < 0.05), respectively. For income groups, the ORs for unmet need (compared to >$150,000/year) were 0.94 (95% CI: 0.79 to 1.12) for $100,000-$150,000, 1.02 (95% CI: 0.87 to 1.20;) for $50,000-$100,000, 1.30 (95% CI: 1.09 to 1.55) for $20,000-$50,000, and 1.39 (95% CI: 1.08 to 1.78) for < $20,000. Other statistically significant determinants of unmet need included age (older adults were less likely to have unmet need), sex (females were more likely), having a family physician (less likely) and perceived physical and mental health (poor health more likely to be associated with unmet need). The most common reasons for unmet need were: ‘long wait time’ (52.1%) and ‘doctor did not think it was necessary’ (16.7%). Multimorbidity and low-income are associated with higher odds of unmet need among older adults. This disparity is partly due to not having a regular family physician and long wait time to see a doctor. Reducing these barriers are critical to reducing inequalities in health outcomes.

Screening for eating disorders across genders in college students: Initial validation of the brief assessment of stress and eating.

The purpose of the current study was to validate a brief, 10-item screening tool for the identification of EDs-the brief assessment of stress and eating (BASE). Participants were college students (N=596; 68.2% cisgender women) from a large Midwestern university who completed the BASE and SCOFF. The Eating Disorders Diagnostic Survey was used to generate DSM-5 ED diagnoses. We evaluated area under the curve (AUC) for both receiver operating curves (ROC) and precision-recall curves (PRC). Both the BASE and SCOFF performed significantly better than chance at identifying probable EDs in cisgender women (BASE AUC: ROC=.787, PRC=.633, sensitivity=.733, specificity=.697; SCOFF AUC: ROC=.810, PRC=.684, sensitivity=.793, specificity=.701). However, the BASE (AUC: ROC=.821, PRC=.605, sensitivity=.966, specificity=.495) significantly outperformed the SCOFF (AUC: ROC=.710, PRC=.354, sensitivity=.828, specificity=.514) for identifying probable EDs in cisgender college men. The BASE is appropriate for student healthcare and college research settings. Because the BASE outperforms the SCOFF in college men, results from the current study are expected to contribute to improved identification of EDs on college campuses. The BASE is a new screening tool to identify eating disorders. The BASE performed as well as, if not better than, the SCOFF (particularly in men). Given the need for brief, psychometrically strong, and unbiased ED screening tools in college students, the current study helps address an unmet student healthcare need that we expect will contribute to improved identification of EDs on college campuses.

Lifestyle, Demographic and Socio-Economic Determinants of Mental Health Disorders of Employees in the European Countries.

Ensuring the health and well-being of workers should be a top priority for employers and governments. The aim of the article is to evaluate and rank the importance of mental health determinants: lifestyle, demographic factors and socio-economic status. The research study is based on EHIS 2013–2015 data for a sample of N = 140,791 employees from 30 European countries. The results obtained using machine learning techniques such as gradient-boosted trees and SHAPley values show that the mental health of European employees is strongly determined by the BMI, age and social support from close people. The next vital features are alcohol consumption, an unmet need for health care and sports activity, followed by the affordability of medicine or treatment, income and occupation. The wide range of variables clearly indicates that there is an important role for governments to play in order to minimize the risk of mental disorders across various socio-economic groups. It is also a signal for businesses to help boost the mental health of their employees by creating holistic, mentally friendly working conditions, such as offering time-management training, implementing morning briefings, offering quiet areas, making employees feel valued, educating them about depression and burnout symptoms, and promoting a healthy lifestyle.

The Gendered Pathways Through Which Intimate Partner Violence Affects Health: Exploring the Role of Unmet Healthcare Needs.

The aim of this study was to examine the relationships between intimate partner violence (IPV), gender, unmet healthcare needs, and health. Specifically, this study identified how unmet healthcare needs mediate the relationship between IPV and health, and how this mediation is moderated by gender. Using data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) (N = 15,425), we first estimated ordinary least squares regression models to investigate the association between IPV and self-rated health. Then, we used structural equation models to examine how unmet healthcare needs mediate this relationship. Lastly, we conducted a moderated mediation model to investigate whether gender moderates these mediation patterns. The results of this study showed that experiencing IPV was associated with a decrease in self-rated health and an increase in the unmet need for medical care (but not in unmet need for routine health check-ups). Unmet need for medical care explained about one-quarter of the negative association between IPV and self-rated health. A moderated mediation model revealed that indirect effects of IPV on health via unmet medical care needs were more pronounced among victimized women than victimized men. This study filled knowledge gaps about the mechanisms underlying the association between IPV and poor health status. Unmet healthcare needs partially mediated the relationship between IPV victimization and health. This mechanism was more salient for the health of victimized women than victimized men. Interventions designed to improve the health of IPV victims may focus on addressing unmet healthcare needs and could be tailored according to the gender of patients.

Children's unmet need for mental health care within and outside metropolitan areas.

Rural communities experience a lack of pediatric mental health providers. It is unclear if this leads to greater unmet needs for specialty mental health services among rural children. Data from the 2016-2019 National Survey of Children's Health were used to identify children aged 6-17 years with a mental health condition. Caregiver-reported need and receipt of specialty mental health care for their child (met need, unmet need, or no need) was compared according to residence in a Metropolitan Statistical Area (MSA). The analysis included 13,021 children (14% living outside MSAs). Unmet need for mental health services was reported for 9% of children, with no difference by rural-urban residence (p=0.940). Multivariable analysis confirmed this finding and identified urban children as less likely to have no need for mental health services, compared to rural children (relative risk ratio of no need vs. met need: 0.79; 95% confidence interval: 0.65, 0.95; p=0.015). Children with mental health conditions living in rural areas (outside MSAs) did not have higher rates of unmet needs for specialty mental health services, but they had lower rates of any caregiver-reported needs for such services. Further work is needed to examine caregivers' demand for pediatric specialty mental health services.

Chronic Care for All? The Intersecting Roles of Race and Immigration in Shaping Multimorbidity, Primary Care Coordination, and Unmet Health Care Needs Among Older Canadians.

Despite the predominance of chronic disease clustering, primary care delivery for multimorbid patients tends to be less effective and often uncoordinated. This study aims to quantify racial-nativity inequalities in multimorbidity prevalence ≥3 chronic conditions), access to primary care, and relations to past-year subjective unmet health care needs (SUN) among older Canadians. Population-based data were drawn from the Canadian Community Health Survey (2015-2018). Multivariable logistic regression was performed to estimate the likelihood of multimorbidity, sites of usual source of primary care (USOC), primary care coordination, and multidimensional aspects of SUN. The Classification and Regression Tree (CART) was applied to identify intersecting determinants of SUN. The overall sample (n = 19,020) were predominantly (69.4%) Canadian-born (CB) Whites (1% CB non-Whites, 18.1% White immigrants, and 11.5% racialized immigrants). Compared with CB Whites, racialized immigrants were more likely to have multimorbidity (adjusted odds ratio [AOR] = 1.35, 99% confidence interval [CI]: 1.13-1.61), lack a USOC (AOR = 1.41, 99% CI: 1.07-1.84), and report higher SUN (AOR = 1.47, 99% CI: 1.02-2.11). Racialized immigrants' greater SUN was driven by heightened affordability barriers (AOR = 4.31, 99% CI: 2.02-9.16), acceptability barriers (AOR = 3.11, 99% CI: 1.90-5.10), and unmet needs for chronic care (AOR = 2.71, 99% CI: 1.53-4.80) than CB Whites. The CART analysis found that the racial-nativity gap in SUN perception was still evident even among those who had access to nonpoorly coordinated care. To achieve an equitable chronic care system, efforts need to tackle affordability barriers, improve service acceptability, minimize service fragmentation, and reallocate treatment resources to underserved older racialized immigrants in Canada.

The sociodemographic characteristics and social determinants of visual impairment in a homeless population in the Montreal area.

ObjectiveHomelessness is a serious social and public health concern in Canada. Individuals experiencing homelessness face numerous health problems and barriers in accessing health services. Visual impairment can exacerbate the lower quality of life experienced by people who are homeless, but its incidence among this population has been poorly documented in the literature. Our study aimed to describe health and sociodemographic characteristics and determine their association with visual impairment, ocular pathology and uncorrected refractive errors in a homeless population in Montreal, Canada.MethodsThis cross-sectional study was conducted between May 2019 and September 2020 in eight homeless shelters selected using a stratified random sampling approach on the island of Montreal. An eye examination was performed on all participants, who were also administered a survey on social determinants of health. Descriptive analysis was used to analyze survey data, and logistic regression was used for each of the three study outcomes.ResultsA total of 124 individuals experiencing homelessness (93 men, 31 women) were recruited. Participants were mostly Caucasian (> 70%) with an average age of 48 years (standard deviation = 13 years). Our sample reported a high level of education (68% had a high school diploma or higher), a high level of health insurance coverage (77%), social assistance benefits (71%), and social support (over 50%). There was a high prevalence of chronic conditions including diabetes (14%), hypertension (25%), and HIV/AIDS (3%). Results from eye examinations showed a high prevalence of visual impairment (22%), ocular pathology (23%), and uncorrected refractive error (75%). Age was statistically significantly associated with each outcome variable.ConclusionDespite a high level of social and health support, individuals experiencing homelessness in Montreal, Canada, experience high levels of chronic conditions and visual impairment. Our study highlights the unmet need for eye healthcare among homeless populations, and that eye health can be a unique entry point for intervening with homeless populations.Supplementary InformationThe online version contains supplementary material available at 10.17269/s41997-022-00676-y.

Characteristics Associated with Good Self-Perceived Mental Health among United States Adults with Arthritis.

Mental health disorders are prevalent among United States (US) adults with arthritis. Yet, little is known about characteristics associated with mental health among US adults with arthritis. This retrospective cross-sectional study used 2019 Medical Expenditures Panel Survey data to assess the association between multiple personal characteristics and mental health status among US adults with arthritis. Hierarchical logistic regression models modeled associations between personal characteristics and mental health status. Model 1 included predisposing factors, model 2 included predisposing and enabling factors, while model 3 included predisposing, enabling, and need factors. The a priori alpha level was 0.05. Analyses accounted for the complex survey design and were weighted to produce national estimates. Among 28,512 individuals, 4984 met the inclusion criteria. Of these, 4181 had good mental health (85.5%, 95% confidence interval (CI) = 84.3%, 86.7%). The following characteristics were associated with good mental health status in the final adjusted model: age 18–64 vs. ≥65 (adjusted odds ratio (AOR) = 0.29, 95% CI = 0.12, 0.71), Midwest vs. West census region (AOR = 5.17, 95% CI = 1.63, 16.46), no degree vs. higher than high school education (AOR = 0.34, 95% CI = 0.12, 0.92), and high school diploma vs. higher than high school education (AOR = 0.40, 95% CI = 0.18, 0.86). In conclusion, this study suggests such characteristics may be targeted to help improve mental health among this population. Additional efforts are needed to help satisfy the unmet need for mental healthcare among this population.

Unmet Healthcare Needs Predict Depression Symptoms among Older Adults.

Risk factors for depression in older adults include significant interpersonal losses, increasing social isolation, and deteriorating physical abilities and health that require healthcare. The effects of unmet healthcare needs on depression in older adults are understudied. This study aimed to analyze the association between unmet healthcare needs and symptoms of depression, sleep, and antidepressant medication while controlling for other significant factors among older adults. For this study, we used a multinational database from The Survey of Health, Ageing and Retirement in Europe (SHARE), containing data of individuals aged 50 and older. The final sample used in this research consisted of 39,484 individuals from 50 to 100 years (mean − 71.15, SD ± 9.19), 42.0 percent of whom were male. Three path models exploring relationships between symptoms of depression at an older age and unmet healthcare needs were produced and had a good model fit. We found that unmet healthcare needs were directly related to depression, activity limitations were related to depression directly and through unmet healthcare needs, whereas financial situation mostly indirectly through unmet healthcare needs. We discuss how depression itself could increase unmet healthcare needs.

Unmet Healthcare Needs among College Students during the COVID-19 Pandemic: Implications for System-Wide and Structural Changes for Service Delivery.

Background: During the COVID-19 pandemic, college students faced health disparities in addition to a negative burden on academic performance; however, little is reported in the literature regarding healthcare utilization. Methods: A cross-sectional survey was conducted among consenting college student participants aged 18 or older from a Hispanic-serving institution. Descriptive and bivariate statistics were used to analyze demographic characteristics and the types of healthcare services needed by such characteristics. Logistic regression was used to adjust for noted sex differences in associations between reporting limited healthcare services and types of healthcare services. Results: The study population of 223 participants was mostly Hispanic/Latino (65%) and female (73%). Of the population, 11% reported they could not obtain needed healthcare services, with time being reported as the most common reason. Significant associations were found between seeking general healthcare services/routine screening, seeking mental health services, and seeking sexual health services with reporting limited healthcare services, with sex-adjusted odds ratios and 95% confidence intervals of 1.90 (95% CI: 1.08, 3.36), 3.21 (95% CI: 1.44, 4.15), and 2.58 (95% CI: 1.05, 6.35), respectively. Conclusions: Availability and inability to obtain health services may exacerbate college student health disparities. Targeted interventions are needed in the population to mitigate the potential burdens of unmet healthcare needs, particularly among minority college students.

"Factors Affecting Unmet Healthcare Needs of Elderly Woman: Based on the Anderson’s Behavioral Model"

본 연구는 여성노인의 미충족 의료 현황과 영향요인을 분석하기 위해 수행되었다. 이를 위해 2019년 한국 지역사회 건강 조사 자료를 활용하였으며, 앤더슨의 의료이용 행동모형을 기반으로 한 이차분석 연구이다. 2019년 지역사회건강조사에 참여한 총 대상자는 22만 9,099명이었고 이 중 만 65세 이상 여성노인 43,564명을 연구대상으로 하였다. 분석결과 65세 여성노인 중 6.5%가 미충족 의료를 경험한 것으로 나타났다. 소인요인 중 연령이 증가할수록 1.05배(CI=1.04-1.05), 배우자가 없는 경우 1.12배(CI=1.03-1.22), 혼자 사는 경우 1.15배(CI=1.06-1.26)로 미충족 의료를 더 많이 경험하는 것으로 나타났고 가능요인에서는 농어촌에 사는 경우 1.28배(CI=1.20-1.36), 기초생활수급자인 경우 1.34배(CI=1.19-1.51), 필요요인에서는 스트레스가 높은 경우 2.57배(CI= 2.46-2.68), 주관적 건강상태가 나쁠수록 미충족 의료를 경험할 위험이 1.45배(CI=0.47-0.51)높은 것으로 나타났다. 본 연구결과는 여성노인에 대한 사회적 관심의 필요성, 이들의 의료접근성 향상을 위한 충분한 지원 및 사회적 지지에 대한 보완 등의 건강관리 지원의 중요성을 시사한다.