의료서비스와 의약품 이용에 대한 코로나바이러스감염증-19의 영향과 정책과제: 미충족 의료를 중심으로

Abstract

코로나바이러스감염증-19(COVID-19) 유행이 2020년부터 2년 이상 지속됨에 따라 코로나19 유행이 보건의료에 미치는 영향을 다양한 측면에서 평가할 필요가 있다. 이 연구는 코로나19 대유행 기간 미충족 의료 경험과 미충족 의료 발생에 취약한 집단의 특성을 파악하여 만성질환 관리 및 미충족 의료 감소를 위한 정책과제를 도출하고자 하였다. 코로나19 유행 기간 동안 미충족 의료 경험률이 뚜렷하게 증가하지는 않았으나 코로나19 감염에 대한 우려가 미충족 의료 발생에 영향을 미쳤다. 미충족 의료에 취약한 인구는 여성, 만성질환자, 코로나19 대유행 기간 중 소득이 감소한 사람이었다. 또한 보건소의 방역 업무 증가는 보건소를 주로 이용하는 취약계층의 만성질환 관리에 영향을 미쳤다. 이러한 주요 연구 결과를 바탕으로 감염병 대유행 기간 중 미충족 의료 감소를 위한 정책 과제를 제시하였다.

The objective of this study was to examine the unmet need during COVID-19 pandemic and to identify the vulnerable population for it. The cause of unmet need in healthcare is classified into availability, accessibility, and acceptability for medical service. Although most of clinics and hospitals were normally operated in South Korea, income reduction and concern for COVID-19 virus infection may influence the accessibility and acceptance for healthcare service. We conducted telephone survey on August 2021. The unmet need rate for medical service was 15.2% and that for dental service was 18.5%. The unmet need was especially high among women, chronic disease patients, and persons who reported the decrease in household income during COVID-19 pandemic. In addition to telephone survey, we conducted FGI(Focused Group Interview) where ten chronic disease patients who had used medical service in public health center before COVID-19 pandemic. Because medical service in public health center stopped for the COVID-19 control, the study participants were forced to search for other private medical institutions to continue their chronic disease such hypertension. They did not enough information or support for it, and paid more money in private clinics. Some persons expressed satisfaction for physicians in the changed clinics, but others felt discomfort in medical service in private medical clinics. Study participants hoped that medical services in public health centers would be reoperated as soon as possible. This study showed that unmet need did not increase during COVID-19 pandemic, but we can not exclude the possibility that unchanged unmet need may be the results from decreased need for medical service due to decreased prevalence for respiratory disease including common cold. Because COVID-19 pandemic is going on, more detailed monitoring and support is needed for vulnerable population including chronic disease patients and persons with reduced income.