도서지역 장애인의 미충족 의료 영향 요인:인천광역시 옹진군을 중심으로

Abstract

= Abstract = Objectives: This study aimed to identify factors influencing unmet medical needs among people with disabilities living in Ongjin County, Incheon, a representative island region in Korea. Methods: A cross-sectional survey was conducted with 108 registered individuals with disabilities in Ongjin County. Unmet medical and dental needs were defined as not receiving necessary care within the past year. Data were analyzed using chi-square tests, t-tests, and stepwise logistic regression. Results: Among the participants, 36 (33.3%) reported unmet medical needs and 43 (39.8%) reported unmet dental needs. In the final model, unmet medical needs were associated with lack of regular physical activity, depressive symptoms, and longer disability duration. Individuals without regular physical activity had a higher probability of unmet medical needs (OR = 3.42, 95% CI = 1.003–11.678), and those with depressive symptoms showed an increased risk (OR = 7.04, 95% CI = 1.994–24.850). Each additional year of disability was associated with a 13% increase in unmet medical needs (OR = 1.13, 95% CI = 1.038– 1.228). Unmet dental needs were significantly associated with unemployment (OR = 4.14, 95% CI = 1.194 –14.381) and chewing difficulty (OR = 1.88, 95% CI = 1.241–2.854). Conclusion: People with disabilities in island regions face disproportionately high levels of unmet medical and dental needs due to psychosocial, behavioral, and economic barriers. Policies that strengthen mental health support, promote physical activity, expand oral health services, and reduce financial and geographic obstacles are essential to improve healthcare equity.