Subjective unmet need and utilization of health care services in Canada: What are the equity implications?

Allin, Sara; Grignon, Michel; Grand, Julian Le

doi:10.1016/j.socscimed.2009.10.027

Cited by 226 publications

(263 citation statements)

References 28 publications

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“…Although selfreported measures of unmet need are clearly more subjective than assessment by an independent expert, they have the advantage of capturing participants' greater understanding of their own health and health care needs. 21 Self-reported measures of unmet need may be particularly useful in studying an adolescent population, which has relatively high perceived barriers to accessing health care 4 (consistent with the increasing focus on opportunistic health promotion during all adolescent consultations).…”

Section: Discussionmentioning

confidence: 99%

Unmet Health Care Need in US Adolescents and Adult Health Outcomes

Hargreaves¹,

Elliott

Viner³

et al. 2015

Pediatrics

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Section: Discussionmentioning

confidence: 99%

Unmet Health Care Need in US Adolescents and Adult Health Outcomes

Hargreaves¹,

Elliott

Viner³

et al. 2015

Pediatrics

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“…Koolman, 2007;Hernández-Quevedo et al, 2010), previous studies show that people who perceive unmet need tend to use health care services more than those who do not report unmet need, after controlling for health (Allin et al, 2010;Hurley et al, 2008). Hence, subjective unmet need may represent dissatisfaction with available LTC services rather than actual use (or forgone use) of these services.…”

Section: Unmet Needs Variablesmentioning

confidence: 99%

“…While both self-reported and ADL-related unmet need variables have been used in several studies (Allin et al, 2010;Kemper et al, 2008;Shea et al, 2003;Tennstedt et al, 1994), this is the first study to our knowledge that compares results for both types of unmet needs measures. The empirical analysis indicates significant differences depending on the type of care considered and between the two types of indicators of unmet needs.…”

Section: Introductionmentioning

confidence: 99%

Inequity in long-term care use and unmet need: Two sides of the same coin

García-Gómez

Hernández-Quevedo²,

Jiménez-Rubio

et al. 2015

Journal of Health Economics

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International studies have shown evidence on inequity in use of health services of different kinds, depending on the type of health care service analysed. However, equity in the access to long-term care (LTC) services has received much less attention. We investigate the determinants of several LTC services and the existence of unmet need by the disabled population using unique data from a survey conducted on the disabled population in Spain in 2008. We further measure the level of horizontal inequity using methods based on the Concentration Index, a widely used indicator of income-related inequality in health. At the time of the analysis, only those respondents with the highest dependency level were covered by the recently introduced universal LTC system, which allows us to explore whether inequities remain for this subgroup of the population. In addition, we compare results using self-reported versus a more objective indicator of unmet needs. Evidence suggests that after controlling for a wide set of need variables, there is not an equitable distribution of use and unmet need of LTC services in Spain, with socioeconomic status being an important factor in access to LTC. We find that individuals at the higher end of the income distribution utilize a relatively larger share of formal services (provided by a professional), while intensive informal care (provided by friends and family) is concentrated among the worst-off. In terms of unmet needs for LTC services, their distribution depends on the service considered as well as on whether we focus on subjective or objective measures. Interestingly, for the population covered by the new universal LTC system, inequities in most LTC services and unmet needs remain statistically significant and even increase for certain services, in particular, formal services provided by professionals. JEL classification codes: I14, 138, J14

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“…Unmet health care needs are also more pronounced among people with low income; the homeless and vulnerably housed; sexual minorities; women; people with one or more mental disorders, substance dependence or co-occurring disorders; and adults with disabilities. [2][3][4][5][6][7][8][9][10] The reasons people give for not accessing needed health care range from the cost and organization of health services to personal concerns and perceptions. 11 The most commonly reported barriers as worded in the Canadian Community Health Survey (CCHS) Cycle 1.1 are 1) "waiting time too long", 2) "service not available when needed", 3) "too busy", 4) "didn't get around to it/didn't bother", 5) "felt would be inadequate" and 6) "cost".…”

mentioning

confidence: 99%

Unmet health care needs among sex workers in five census metropolitan areas of Canada

Benoit

Ouellet

Jansson

2016

Can J Public Health

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OBJECTIVES: This paper examines unmet health care needs in one of Canada's most hard-to-reach populations, adult sex workers, and investigates whether their reasons for not accessing health care are different from those of other Canadians.METHODS: Data gathered in 2012-2013 from sex workers aged 19 and over (n = 209) in five Canadian census metropolitan areas (CMAs) were analyzed to estimate the perceived health, health care access and level of unmet health care needs of sex workers, and their principal reasons for not accessing health care. These data were collected using questions identical to those of the Canadian Community Health Survey (CCHS) Cycle 2.1, 2003. The results were compared with those of residents aged 19 and over in the same CMAs who had participated in the CCHS.RESULTS: Sex workers reported notably worse perceived mental health, poorer social determinants of health (with the exception of income) and nearly triple the prevalence of unmet health care needs (40.4% vs. 14.9%). Those with the greatest unmet health care needs in both groups were younger, unmarried or single and in poorer health, and reported lower income and a weaker sense of community belonging. Even without these within-group risk factors, sex workers were more likely to report unmet health care needs compared with CCHS respondents. Sex workers were also more likely to identify "didn't get around to it", "too busy", "cost", "transportation problems" and "dislike doctors/afraid" as reasons for eschewing care.CONCLUSION: Equity policies that reduce cost and transportation barriers may go some way in helping sex workers access needed health care. Qualitative research is needed to better understand the realities of sex workers' personal and work lives, including the degree of freedom they have in accessing health care when they need it, but also their experiences when they do manage to engage with the health care system. KEY WORDS: Social determinants of health; access to health care; sex workers; unmet health care needs; barriers La traduction du résumé se trouve à la fin de l'article.

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Subjective unmet need and utilization of health care services in Canada: What are the equity implications?

Cited by 226 publications

References 28 publications

Unmet Health Care Need in US Adolescents and Adult Health Outcomes

Unmet Health Care Need in US Adolescents and Adult Health Outcomes

Inequity in long-term care use and unmet need: Two sides of the same coin

Unmet health care needs among sex workers in five census metropolitan areas of Canada

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