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Table 1 Health service utilization and barriers experienced by respondents in North Korea (Crude and adjusted for RDS methodology)

From: Health and healthcare in North Korea: a retrospective study among defectors

  Crude Adjusted
Freq (%) % [95% CI]
HEALTH SERVICE UTILIZATIONa
 Medical costs Medical consultation 186 (62.6) 65.4 [58,74.1]
Medicine and medical supplies 228 (79.4) 82.0 [75.5,88.1]
Others (e.g., meals or heating) 162 (72.6) 75.9 [65.7,84.1]
Bribe 152 (56.7) 57.8 [49.2,66.4]
 Resource for payment Black market employment 124 (46.8) 47.3 [40.4,55.3]
Public distribution system 19 (7.2) 7.1 [3.5,11.5]
Sale of household items 89 (33.6) 39.8 [30.9,47.3]
Borrowed 38 (14.3) 17 [10.4,23.3]
Support of relatives or neighbors 57 (21.5) 19.4 [13.1,26.3]
 Location of the purchase of medicines & medical supplies Informal market (pharmacy) 179 (59.1) 60.5 [53.2,66.9]
Informal market (street stalls) 125 (41.3) 42.5 [35.8,49.9]
Hospital or clinic 39 (12.9) 10.0 [6.8,15.1]
 Type of medication Formal medicine 236 (77.6) 79.5 [73.2,84.6]
Narcotic analgesics 119 (39.1) 39.7 [32.5,49.3]
Methamphetamines 7 (2.3) 1.8 [0.4,4.1]
HEALTH SERVICE BARRIERSb
 Types of healthcare services not received No diagnosis and treatment 86 (28.7) 30.1 [23.7,36]
Self-medication without diagnosis 148 (49.3) 52.1 [44.9,58.2]
Diagnosis without treatment 60 (20) 18.2 [13.9,24]
 Reason for not receiving care Medical costs 145 (49.2) 53.8 [45.1,60.8]
Lack of medicine and medical supplies 118 (40) 39.5 [33.3,47.1]
Closed clinic and hospital 28 (9.5) 10.9 [5.7,16.1]
No trust in health professional 28 (9.5) 10 [6.5,15.5]
Physical distance to clinic 25 (8.5) 7.7 [4.3,12.9]
 Source of self-treatment No treatment 34 (11.2) 10.1 [6.3,13.4]
Informal market (pharmacy) 148 (49) 55.4 [48.4,62.9]
Informal market (street stalls) 122 (40.4) 40.8 [34.1,49.3]
Remaining medications 29 (9.6) 7.7 [4.2,11.4]
Traditional medicine 43 (14.2) 10.6 [6.7,15]
 Type of self-medication Formal medicine 184 (63) 63.5 [57.1,71]
Narcotic analgesics 163 (55.8) 53.7 [45.7,61.2]
Methamphetamines 7 (2.4) 2.7 [0.3,6.2]
  1. aMost recent case of access to healthcare within 5 years prior to displacement
  2. bMost recent case of barrier to healthcare within 5 years prior to displacement