https://doi.org/10.4081/gh.2025.1295
Local healthcare resources associated with unmet healthcare needs in South Korea: a spatial analysis
Submitted: 19 April 2024
Accepted: 24 December 2024
Published: 11 March 2025
Accepted: 24 December 2024
Abstract Views: 995
PDF: 115
Supplementary materials: 38
Supplementary materials: 38
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Despite national initiatives to enhance healthcare accessibility, unmet healthcare needs in South Korea remain notably high, particularly in specific regions. This study investigated the factors contributing to geographical disparities in unmet healthcare needs by employing spatial regression models to examine the spatial interactions between healthcare resources and unmet needs. Utilizing data from the 2020 Community Health Survey and Statistics Korea for 216 local government entities, excluding remote areas to ensure data consistency, we identified significant spatial clusters of unmet healthcare needs. These clusters are primarily located in non-metropolitan regions facing transportation barriers and limited healthcare infrastructure. Spatial regression analysis revealed that general hospitals and clinics are significantly associated with reduced unmet healthcare needs underscoring their critical role in mitigating regional disparities. In contrast, hospitals (≥30 beds) and convalescent hospitals did not exhibit significant effects, likely owing to their focus on specialised inpatient and long-term care services, which do not directly address immediate outpatient needs. These findings advance the understanding of how healthcare resource distribution impacts unmet needs at a regional level in South Korea and highlight the necessity for allocating general hospitals and clinics strategically to promote health equity. Based on these results, we recommend evidence- based policy interventions that optimise existing healthcare resources and strategically deploy new facilities in underserved regions. These insights provide valuable guidance for policymakers to reduce geographical health disparities and enhance overall public health outcomes.
Aday LA, Andersen R, 1974. A framework for the study of access to medical care. Health Serv Res 9:208-20.
Allin S, Grignon M, Le Grand J, 2010. Subjective unmet need and utilization of health care services in Canada: What are the equity implications? Soc Sci Med 70:465-72.
DOI: https://doi.org/10.1016/j.socscimed.2009.10.027
Alonso J, Orfila F, Ruigómez A, Ferrer M, Antó JM, 1997. Unmet health care needs and mortality among Spanish elderly. Am J Public Health 87:365-70.
DOI: https://doi.org/10.2105/AJPH.87.3.365
An S, Kim NH, Kim YN, 2019. Comparison of health status and the effectiveness of health cost between rural and urban residents. Naju: Korea Rural Economic Institute. 1-182.
Anselin L, Bera AK, 1998. Spatial dependence in linear regression models with an introduction to spatial econometrics. Stat Textbooks Monogr 155:237-90.
Anselin L, 2001. Spatial effects in econometric practice in environmental and resource economics. Am J Agric Econ 83:705-10.
DOI: https://doi.org/10.1111/0002-9092.00194
Anselin L, Syabri I, Smirnov O, 2002. Visualizing multivariate spatial correlation with dynamically linked windows. In: Proceedings, CSISS Workshop on New Tools for Spatial Data Analysis, Santa Barbara, CA.
Braveman P, Gruskin S, 2003. Defining equity in health. J Epidemiol Community Health 57:254-8.
DOI: https://doi.org/10.1136/jech.57.4.254
Centers for Disease Control and Prevention, 2018. Unmet need for health care. Internet. Available from: https://www.cdc.gov/nchs/hus/topics/unmet-need.htm.
Chen J, Hou F, 2002. Unmet needs for health care. Health Rep 13:23-34.
Cho I, 2010. A study on spatial effects in MAUP: With a focus on scale and zoning effects. Master’s thesis. Korea National University of Education.
Department of Health, 2010. Department of health and social care. Available from: https://www.gov.uk/government/publications/mortality-monitoring-bulletin-life-expectancy-and-all-age-all-cause-mortality-and-mortality-from-selected-causes-overall-and-inequalities-update-to-include-data-for-2009.
Diez-Roux AV, 1998. Bringing context back into epidemiology: Variables and fallacies in multilevel analysis. Am J Public Health 88:216-22.
DOI: https://doi.org/10.2105/AJPH.88.2.216
Dong E, Sun X, Xu T, Zhang S, Wang T, Zhang L, Gao W, 2023. Measuring the inequalities in healthcare resource in facility and workforce: A longitudinal study in China. Front Public Health11:1074417.
DOI: https://doi.org/10.3389/fpubh.2023.1074417
Heo J, Oh J, Kim J, Lee M, Lee JS, Kwon S, 2012. Poverty during plenty: Unmet needs and distribution of health care resources in South Korea. PLoS One 7:e51004.
DOI: https://doi.org/10.1371/journal.pone.0051004
Hutcheson GD. Ordinary least-squares regression. In: Moutinho L, Hutcheson GD, editors. The SAGE dictionary of quantitative management research, SAGE Publications; 2011. pp. 224-8.
DOI: https://doi.org/10.4135/9781446251119.n67
Jeon BY, Choi SM, Kim CY, 2012. Socioeconomic equity in regional distribution of health care resources in Korea. Health Policy Manag 22:85-108.
DOI: https://doi.org/10.4332/KJHPA.2012.22.1.085
Ji S, Kwon YG, Lee H, Shin C, Sohn M, Choi M, 2024. Regional disparities in health literacy for chronic diseases: focusing on healthcare resources and local extinction index. Front Public Health 12:1423645.
DOI: https://doi.org/10.3389/fpubh.2024.1423645
Joo HJ, Jang BN, Joo JH, Park EC, Jang SI, 2022. Unmet healthcare needs status and trend of South Korea in 2020. Health Policy Manag 32:237-43.
Kim HS, Jeong DW, 2010. Characteristics of spatial distribution of medical services in Seoul. Korean Urban Manag Assoc 23:27-45.
Kim JE, Lee H, Nam EW, 2021. Unmet healthcare needs among adults in Rural area, Paraguay: A cross-sectional study. J Reg Stud Develop 30:135-56.
Kim YM, 2018. Care: Strategies and Challenges. Public Health Aff 2:17-27.
DOI: https://doi.org/10.29339/pha.2.1.17
Kitchen P, Williams A, Pong RW, Wilson D, 2011. Socio-spatial patterns of home care use in Ontario, Canada: A case study. Health Place 17:195-206.
DOI: https://doi.org/10.1016/j.healthplace.2010.09.014
Le Grand J, 1982. The Strategy of Equality: Redistribution and Social Services, 1st ed. Routledge.
Litaker D, Love TE, 2005. Health care resource allocation and individuals’ health care needs: Examining the degree of fit. Health Policy 73:183-93.
DOI: https://doi.org/10.1016/j.healthpol.2004.11.010
Mohammadi A, Mollalo A, Bergquist R, Kiani B, 2021. Measuring COVID-19 vaccination coverage: an enhanced age-adjusted two-step floating catchment area model. Infect Dis Poverty 10:1-13.
DOI: https://doi.org/10.1186/s40249-021-00904-6
Mollalo A, Vahedi B, Rivera KM, 2020. GIS-based spatial modeling of COVID-19 incidence rate in the continental United States. Sci Total Environ 728:138884.
DOI: https://doi.org/10.1016/j.scitotenv.2020.138884
Mooney G, Hall J, Donaldson C, Gerard K, 1991. Utilisation as a measure of equity: Weighing heat? J Health Econ 10:475-80.
DOI: https://doi.org/10.1016/0167-6296(91)90026-J
Moran PA, 1950. Notes on continuous stochastic phenomena. Biometrika 37:17-23.
DOI: https://doi.org/10.1093/biomet/37.1-2.17
National Health Service, 2015. A guide to community-centred approaches for health and wellbeing. NHS England, Public Health England.
Nelson CH, Park J, 2006. The nature and correlates of unmet health care needs in Ontario, Canada. Soc Sci Med 62:2291-300.
DOI: https://doi.org/10.1016/j.socscimed.2005.10.014
Oliver A, Mossialos E, 2004. Equity of access to health care: Outlining the foundations for action. J Epidemiol Community Health 58:655-8.
DOI: https://doi.org/10.1136/jech.2003.017731
Park KD, 2012. Study on regional disparities in healthcare utilization: Using spatial dependence. Korean Policy Stud Rev 21:388-416.
Penchansky R, Thomas JW, 1981. The concept of access: Definition and relationship to consumer satisfaction. Med Care 19:127-140.
DOI: https://doi.org/10.1097/00005650-198102000-00001
Perucca G, Piacenza M, Turati G, 2019. Spatial inequality in access to healthcare: Evidence from an Italian Alpine region. Reg Stud 53:478-89.
DOI: https://doi.org/10.1080/00343404.2018.1462481
Peterson LE, Litaker DG, 2010. County‐level poverty is equally associated with unmet health care needs in rural and urban settings. J Rural Health 26:373-82.
DOI: https://doi.org/10.1111/j.1748-0361.2010.00309.x
Pyle GF, Lauer BM, 1975. Comparing spatial configurations: Hospital service areas and disease rates. Econ Geogr 51:50-68.
DOI: https://doi.org/10.2307/142702
Raeesi A, Kiani B, Hesami A, Goshayeshi L, Firouraghi N, MohammadEbrahimi S, Hashtarkhani S, 2022. Access to the COVID-19 services during the pandemic-a scoping review. Geospat Health 17:1079
DOI: https://doi.org/10.4081/gh.2022.1079
Raeesi A, Tara M, &Kiani B, 2023. Spatial accessibility to hospitals in Southeast Iran: an enhanced two-step floating catchment area method. GeoJournal 88:5427-43.
DOI: https://doi.org/10.1007/s10708-023-10925-3
Rho BI, Kwak HK, 2005. A study on the effect of neighborhood-level contextual characteristics on mental health of community residents. Health Med Sociol 17:5-31.
Rossi R, Murari A, Gaudio P, Gelfusa M, 2020. Upgrading model selection criteria with goodness of fit tests for practical applications. Entropy 22:447.
DOI: https://doi.org/10.3390/e22040447
Schwartz SH, 1994. Are there universal aspects in the structure and contents of human values? J Soc Issues 50:19-45.
DOI: https://doi.org/10.1111/j.1540-4560.1994.tb01196.x
Sibley LM, Glazier RH, 2009. Reasons for self-reported unmet healthcare needs in Canada: A population-based provincial comparison. Healthc Policy 5:87-101.
DOI: https://doi.org/10.12927/hcpol.2009.20934
Shin HR, Lim YG, Han KM, 2014. The influence of medical expenditure on unmet needs for health care: Focused on the moderating effect of private health insurance. J Reg Stud 22:25-48.
Shin HS, Lee SH, 2011. Factors affecting spatial distance to outpatient health services. Health Policy Manag 21:23-43.
DOI: https://doi.org/10.4332/KJHPA.2011.21.1.023
Tidikis F, Strasen L, 1994. Patient-focused care units improve service and financial outcomes. J HealthcFinancManag 48:38-40.
Vrieze SI, 2012. Model selection and psychological theory: a discussion of the differences between the Akaike information criterion (AIC) and the Bayesian information criterion (BIC). Psychol Methods 17:228.
DOI: https://doi.org/10.1037/a0027127
Ward MD, Gleditsch KS, 2018. Spatial regression models, 2nd ed. Sage Publications.
DOI: https://doi.org/10.4135/9781071802588
Yim J, 2022. Measures for strengthening public health care. Korea Institute for Health and Social Affairs. doi: 10.23062/2022.09.2
Yun GJ, Kim DJ, Lee HN, Park EH, 2021. Utilization of information for health protection of vulnerable populations in public health crisis situations. Korea Institute for Health and Social Affairs. Available from: https://repository.kihasa.re.kr/handle/201002/39082
Yun GJ, Song ES, Ko SJ, Kim JH, Jeong HS, Bae JY, 2022. A study on restructuring of the regional health systems for coping with public health crises: Centering on health centers. Korea Institute for Health and Social Affairs. Available from: http://repository.kihasa.re.kr/handle/201002/41538
How to Cite
Lee, S. M., Huh, D. W., & Kwon, Y. G. (2025). Local healthcare resources associated with unmet healthcare needs in South Korea: a spatial analysis. Geospatial Health, 20(1). https://doi.org/10.4081/gh.2025.1295
Copyright (c) 2025 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
