Worry about unmet medical care as a sensitive proxy indicator for medically vulnerable area

BACKGROUND: Unmet medical care needs affect health outcomes and measure medical care inequality. However, understanding demand in vulnerable areas solely based on experience might be insufficient. This study aims to explore whether a ‘worry about unmet medical care’ indicator could be a sensitive item to identify medically vulnerable areas along with ‘unmet medical experience'. METHODS: We surveyed 1,916 in a region of Korea after allocating them proportionally by age and gender. The same participants were surveyed on unmet medical care experience & worry. Chi-square & t-tests confirmed differences. Logistic regression was used to identify factors influencing on unmet needs. RESULTS: While the experience of unmet medical care was 3.4%, the worry about unmet medical care was 79.9%, The rate of worry about unmet medical care increased with age (19-39, 40-69, 70+ years old, 71.0%, 82.3%, 86.8%, respectively), and it was high among all age groups in medically vulnerable areas (19 -39, 40-69, 70+ years old, 92.3%, 94.3%, 98.2%, respectively, p<.0001). Unmet medical care experiences were high in medically vulnerable area ‘level 2’ (aOR=4.37; 95% [CI] 2.13-8.98), and worry about unmet medical care was high in lower education level (middle or elementary school) (aOR=1.81; [CI] 1.02-3.20), interest in health ‘yes’ (aOR=2.58; [CI] 1.89-3.51), medically vulnerable area ‘level 2'(aOR=2.67; [CI] 1.91-3.73). ‘level3’ area (aOR=11.81; [CI] 7.74-18.03) was found to be more likely to have worry about unmet medical care. CONCLUSIONS: Significant differences were observed between the experience of unmet medical care and worry about unmet medical care in the participants living in medically vulnerable area. To better predict actual vulnerable areas and establish approaches to address them, both unmet medical care experiences and worries need to be monitored. KEY MESSAGES: • Significant differences were observed between the experience of unmet medical care and worry about unmet medical care in the participants living in medically vulnerable area. • To better predict actual vulnerable areas and establish approaches to address them, both unmet medical care experiences and worries need to be monitored.