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Determinants of Self-Reported Unmet Healthcare Needs by Disability Status: A Secondary Cross-Sectional Analysis of
1National Rehabilitation Center, Seoul 01022, Republic of Korea.
Background/Objectives:
People with disabilities face a disproportionately higher disease burden alongside reduced healthcare accessibility, resulting in elevated unmet healthcare needs (UHN). Understanding the factors that drive UHN-and whether these factors differ by disability status-is critical for developing targeted public health interventions.
Methods:
A secondary cross-sectional analysis was conducted using linked national survey and administrative data-specifically the Korea National Health and Nutrition Examination Survey (KNHANES) cycles VI to VIII (2013-2021) linked with National Health Insurance Service (NHIS) administrative records-to examine determinants of healthcare access and utilization barriers by disability status. Independent variables were selected based on Andersen's Behavioral Model of Health Services Use for vulnerable populations, encompassing predisposing factors, enabling factors, and need factors (including functional status indicators). Interaction terms between disability status and sex, and between disability status and household income level, were introduced to identify effect modification by disability status.
Results:
People with registered disabilities had significantly higher UHN compared to those without disabilities. The contributing factors to UHN differed between the two groups, with sex and household income showing statistically significant interaction effects with disability status, indicating that their associations with UHN vary depending on whether an individual has a registered disability.
Conclusions:
UHN in people with disabilities is shaped by a distinct set of determinants compared to the general population. The overall pattern of contributing factors differed between people with and without disabilities across multiple dimensions. These findings highlight the need for tailored healthcare policies that account for the unique vulnerabilities of people with disabilities, rather than applying uniform strategies across all population groups.