Background: Soldiers are at a higher risk of injury than people of other occupations. As most military personnel work at remote military areas, unmet medical or dental needs of individuals tend to be high. Such experience of unmet medical needs may be... Background: Soldiers are at a higher risk of injury than people of other occupations. As most military personnel work at remote military areas, unmet medical or dental needs of individuals tend to be high. Such experience of unmet medical needs may be associated with the mental health of military personnel. Therefore, this study aimed to analyze the experience of unmet need in military personnel, the effect of the introduction of military telemedicine, differences between military ranks in unmet need, and the effect of unmet need on the mental health of military personnel. Methods: This study used secondary data from the 2014-2015 Military Health Survey (MHS), conducted by the ROK School of Military Medicine. The final study population included 8,452 respondents. This study was conducted in two stages. In the first stage, logistic and multinomial logit regression analysis was carried out to examine the association between unmet medical and dental need and military characteristics. Additionally, the effect of telehealth in remote military areas was examined. Subgroup analysis was also performed by rank (E1-E4 Vs. E5-O6). In the second stage, multiple linear and logistic regression analyses was performed to investigate the association between self-ed experience and causes of unmet need and mental health and suicide ideation. Results: Among 8,452 respondents, 1,280 (15.1%) and 1,194 (14.1%) military personnel ed experience of unmet medical and dental need in the recent 12 months. The primary reasons for unmet medical and dental need were “no time to receive service,” followed by “difficult to make an appointment or long office wait,” “do not believe in doctors,” “illness not very serious,” and “no money to pay for service.” Logistic regression analysis showed that “female,” “rural area,” working overtime, “military personnel with chronic conditions,” “severe self-perceived health,” “low sleep duration,” and “severe sleep difficulty” were associated with high unmet medical and dental need. With regard to reasons for unmet medical need occurrence, position at high rank was related with high unmet medical need due to “no time to receive for service” and working in “rural area.” Shift worker had high unmet medical need due to “difficult to make an appointment or long office wait.” In addition, having additional private supplemental health insurance was related with high unmet medical need due to “do not believe in doctors.” In the subgroup analysis, the effect of telehealth in remote military area was examined. Working in “isolated military area” was related with high unmet medical need in 2014. However, the association was not found in 2015. Additionally, subgroup analyses were performed by rank (E5-O6 Vs. E1-E4). In the E5-O6 group, multinomial logit regression analysis revealed that the O4-O6 rank had high unmet medical need due to “pressure for performance appraisal.” All study population's the average K-10 Score was 14.11±3.41. The average K-10 Score significantly higher for individuals with an unmet medical and dental need and in those who had considered suicide in the past 12 months. With respect to the association between unmet need and mental health status and suicide ideation, regression analysis revealed that unmet medical and dental need was significantly related to negative mental health whereas only unmet medical need was significantly associated with increased suicide ideation. There was some difference between unmet medical or dental need and suicide ideation. Military personnel ing unmet medical need due to “pressure due to performance appraisal” were most likely to experience suicide ideation with significance. However, among military personnel ing unmet dental need, those with unmet medical need due to “no money to pay for service” were significantly more likely to experience suicide ideation. Conclusions: The results of this study infer that it is essential for the military to address factors behind the occurrence of unmet medical and dental need. Study results present that military personnel who do not have enough time or under the pressure of being evaluated about their work have higher unmet medical and dental need. In addition, causes of unmet need were significantly associated with soldiers’ mental health decline and suicide ideation, which highlights the importance of providing military personnel with timely, affordable, and sufficient medical care. 참고문헌 (Reference) |
