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      Unmet healthcare needs of elderly people in Korea

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          Abstract

          Background

          Elderly people often have more complicated healthcare needs than younger adults due to additional functional decline, physical illness, and psychosocial needs. Unmet healthcare needs increase illness severity, complications, and mortality. Despite this, research on the unmet healthcare needs of elderly people is limited in Korea. This study analysed the effect of functional deterioration related to aging on unmet healthcare needs based on the Korea Health Panel Study.

          Methods

          This cross-sectional study used data from the 2011–2013 survey of 8666 baseline participants aged 65 years and older. Unmet healthcare needs were calculated using a complex weighted sample design. Group differences in categorical variables were analysed using the Rao-Scott Chi-square test. Using logistic regression analysis, the association between unmet healthcare needs and aging factors was analysed.

          Results

          The prevalence of unmet healthcare needs in Korean elderly was 17.4%. Among them, the leading reason was economic hardship (9.2%). Adjusting for sex, age, socioeconomic characteristics, and health-related characteristics, the group with depression syndrome was 1.45 times more likely to have unmet healthcare needs than that without depression syndrome (95% CI = 1.13–1.88). The group with visual impairment was 1.48 times more likely to have unmet healthcare needs than that without it (95% CI = 1.22–1.79). The group with hearing impairment was 1.40 times more likely to have unmet healthcare needs than that without it (95% CI = 1.15–1.72). The group with memory impairment was 1.74 times more likely to have unmet healthcare needs than that without it (95% CI = 1.28–2.36).

          Conclusions

          The unmet medical needs of the elderly are more diverse than those of younger adults. This is because not only socioeconomic and health-related factors but also aging factors that are important to the health of the elderly are included. All factors were linked organically; therefore, integrated care is needed to improve healthcare among the elderly. To resolve these unmet healthcare needs, it is necessary to reorganize the healthcare system in Korea to include preventive and rehabilitative services that address chronic diseases in an aged society and promote life-long health promotion.

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          Most cited references24

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          Delays and unmet need for health care among adult primary care patients in a restructured urban public health system.

          We estimated the prevalence and determinants of delayed and unmet needs for medical care among patients in a restructured public health system. We conducted a stratified cross-sectional probability sample of primary care patients in the Los Angeles County Department of Health Services. Face-to-face interviews were conducted with 1819 adult patients in 6 languages. The response rate was 80%. The study sample was racially/ethnically diverse. Thirty-three percent reported delaying needed medical care during the preceding 12 months; 25% reported an unmet need for care because of competing priorities; and 46% had either delayed or gone without care. Barriers to needed health care continue to exist among patients receiving care through a large safety net system. Competing priorities for basic necessities and lack of insurance contribute importantly to unmet health care needs.
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            Unmet health care needs of older people: prevalence and predictors in a French cross-sectional survey

            Background: Unmet health care needs are associated with negative health outcomes, yet there is a paucity of data on this problem among older people. Objective: To identify unmet health care needs and associated factors among older people in France. Methods: This is a cross-sectional population study of people aged 70 years or older in which 2350 respondents were interviewed in 2008–10. During a standardized interview, a nurse examined health problems, functional abilities and use of health care resources. Unmet health care needs were defined as situations in which a participant needed health care and did not receive it. Results: The mean age was 83.2 ± 7.4 years. Almost all participants reporting a chronic disease (98.6%) had consulted a physician in the previous 6 months. Unmet health care needs were found in 23.0% of the sample and mainly consisted of lack of dental care (prevalence of 17.7%), followed by lack of management of visual or hearing impairments (prevalence of 4.4% and 3.1%, respectively). Age was the main factor associated with unmet health care needs [compared with people aged 70–79: odds ratio80–89 years = 2.26 (1.70–3.03), odds ratio90 years and over = 3.85 (2.71–5.45)]. Other associated factors were regular smoking, homebound status, poor socioeconomic conditions, depression, limitations in instrumental activities of daily living and low medical density. Conclusion: Unmet health care needs affect almost one-quarter of older people in France. Efforts should be made to improve oral health and develop home care, especially for the oldest-olds.
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              Unmet needs as sociomedical indicators.

              This paper discusses the Meharry Medical College Study of Unmet Needs designed to measure the effectiveness of alternative health care delivery systems: (a) comprehensive care with broad outreach, (b) comprehensive care with limited outreach, and (c) traditional care. Unmet needs are defined as the differences between services judged necessary to deal appropriately with health problems and services actually received. The central hypothesis is that comprehensive health programs will be more effective than traditional care in reducing unmet needs. Unmet needs are viewed as measures of program outcome and are one of several types of sociomedical indicators which use factors other than biomedical or biological states as measures of outcome. The distinction is made between unmet needs are discussed and the relatively limited focus of these is contrasted with the more comprehensive Meharry approach. Household interviews and clinical examinations provide the data base for deriving professional judgements of unmet needs in the medical, dental, nursing, and social services areas. The Meharry work suggests several areas in which further work on unmet needs would be useful.
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                Author and article information

                Contributors
                yskim27@gmail.com
                leej@kuh.ac.kr
                20060246@kuh.ac.kr
                20170102@kuh.ac.kr
                leekonkuk@gmail.com
                82 2 2030 7683 , cjk@kuh.ac.kr
                82 2 2030 7561 , alzdoc@kuh.ac.kr
                Journal
                BMC Geriatr
                BMC Geriatr
                BMC Geriatrics
                BioMed Central (London )
                1471-2318
                20 April 2018
                20 April 2018
                2018
                : 18
                : 98
                Affiliations
                [1 ]ISNI 0000 0004 0371 843X, GRID grid.411120.7, Department of Quality Improvement, , Konkuk University Medical Center, ; 120-1 Neungdong-ro (Hwayang-dong), Gwangjin-gu, Seoul, 05030 South Korea
                [2 ]ISNI 0000 0004 0371 843X, GRID grid.411120.7, Department of Rehabilitation Medicine, , Konkuk University School of Medicine, Konkuk University Medical Center, ; 120-1 Neungdongro (Hwayang-dong), Gwangjin-gu, Chungju, 05030 South Korea
                [3 ]ISNI 0000 0004 0371 843X, GRID grid.411120.7, Department of Neurology, , Konkuk University School of Medicine, Konkuk University Medical Center, ; 120-1 Neungdong-ro (Hwayang-dong), Gwangjin-gu, Seoul, 05030 South Korea
                [4 ]ISNI 0000 0004 0371 843X, GRID grid.411120.7, Department of Family Medicine, , Konkuk University School of Medicine, Konkuk University Medical Center, ; 120-1 Neungdong-ro (Hwayang-dong), Gwangjin-gu, Seoul, 05030 South Korea
                [5 ]ISNI 0000 0004 0532 8339, GRID grid.258676.8, Department of Preventive Medicine, , Konkuk University School of Medicine, ; 268 Chungwon-daero Chungju-si Chungcheongbuk-do, Chungju, 27478 South Korea
                Author information
                http://orcid.org/0000-0002-0875-7505
                Article
                786
                10.1186/s12877-018-0786-3
                5910628
                29678164
                81f98966-e5e5-4a70-b583-4a5c57ec0ba6
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 15 August 2017
                : 10 April 2018
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100003710, Korea Health Industry Development Institute;
                Award ID: HI16C0526
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2018

                Geriatric medicine
                unmet healthcare needs,elderly,aging
                Geriatric medicine
                unmet healthcare needs, elderly, aging

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