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

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.

Keywords: Behavior model; Disability; Financial burden; Health service use; Needs assessment; Unmet needs.