Abstract

This study aimed to verify whether the healthcare utilization indicators developed from the user’s point of view could measure healthcare inequality more accurately than conventional unmet healthcare needs indicators. A face-to-face survey was conducted with 617 people using a measurement tool developed from the user’s point of view. Two groups were identified. The first group responded that there were no unmet healthcare needs with both the existing and developed items. The second group responded that there were no unmet healthcare needs with the existing items but with the developed item. The characteristics between the groups were analyzed. Analysis results indicated a significant difference in “in the stages of seeking healthcare,” “during utilization,” and “results of utilization” between age, self-rated health, and availability of healthcare facilities. More unmet healthcare needs were reported for tools developed in the group with people aged 50 and older (OR 3.23, 4.25, and 4.69, respectively), those in their 60s and older (OR 2.62, 10.53, 9.51, respectively), those with poor self-rated health (OR 2.22, 5.21, and 8.51, respectively), and those with poor availability of healthcare facilities (OR 3.68, 4.33, and 2.22, respectively). The study results show that the risk of underestimating unmet healthcare needs in more vulnerable groups can be prevented (and more sensitively revealed) when measured from the user’s standpoint than when measured with conventional unmet healthcare needs indicators. In the future, it is necessary to supplement the user’s point of view when measuring healthcare inequality.