도시 및 농·어촌지역 미충족 의료서비스 경험 영향요인 : 2019년과 2020년 비교

Abstract

COVID-19 has changed our lives overall and has brought particularly many changes in the area of medicine. There have been many changes in the provision of medicine and modes of using medical services, too. In research to identify and reduce the inequality and imbalance of medical systems and services between regions, it is necessary to consider how things have been changed due to COVID-19. Therefore, this study is aimed to identify the current status of urban and rural unmet healthcare before and after COVID-19, provide data to check related factors, and present basic data to make policies in consideration of the causes of unmet healthcare. This study utilized data from the Korean National Health and Nutrition Survey conducted in 2019 and 2020 before and after the outbreak of COVID-19. Cross-tabulation analysis and dichotomous logistic regression analysis were done on 426 and 368 respondents in 2019 and 2020 respectively, who said they had experienced unmet healthcare. According to the findings, both urban and rural local insurance subscribers indicated increase in the experience of unmet healthcare, and the increase rate was greater in rural local insurance subscribers, and the experience of unmet healthcare decreased in the group with low income. Also, regarding patients with chronic diseases, the experience of unmet healthcare decreased more in rural areas than in urban areas. However, the analysis showed that the group that said they had depression had twice more experience of unmet healthcare after COVID-19 than before. This implies that it is needed to consider such situations as the reduced income of self-employed people and the deepening depression of people resulted from social sanctions, for instance, restrictions on business hours or refraining from private gatherings. Also, aside from regional differences between urban and rural areas, expanding medical support with emergent medical aid or non-face-to-face treatment did reduce the factors of unmet healthcare in the low-income group during the pandemic situation. In addition, political efforts involving medical reservation services, tele-medicine care, or the roles of health centers and health clinics strengthened seem to have influenced the modes of using medical services. The limitation of this study is that the survey was done simply by asking questions about whether they had visited hospital or not without considering various situations like social foundations or policies. However, it is meaningful in that it examined the differences in the experience of unmet healthcare between urban and rural areas before and after the COVID-19 pandemic. This study attempted to identify politically whether unmet healthcare is caused not by individual differences but by regional, particularly, urban-rural differences. This author also suggests that follow-up research will have to be done to complement the environment and conditions for medical use as well as quantitative and qualitative differences in the medical infrastructure.