Unmet Healthcare Needs Among Elderly Malaysians

Abstract

Purpose: Older people often have chronic diseases which require a continuity of care over the long term. Countries undergoing population aging need to ensure that older people are receiving the care they need. This study assesses the prevalence of, reasons for, and factors associated with unmet healthcare needs among older people individuals in Malaysia. Patients and Methods: This cross-sectional study used data collected during 2018-2020 from 1204 older adults aged 60 and older selected from Selangor state, Malaysia. A comprehensive face-to-face interview based on the Bahasa Malaysia version of the Japan Gerontological Evaluation Study (JAGES-BM) questionnaire was administered to gain information on unmet healthcare needs, socioeconomic factors, health-related factors, and measures of function (activities of daily living, depression, visual impairment, hearing impairment, memory impairment, and walking impairment). Multivariate logistic regression was used to analyze factors associated with their unmet healthcare needs. Results: Overall, the percentage of older people respondents with unmet healthcare needs is 6.6%. The most reported reasons for forgoing or delaying healthcare were lack of knowledge about healthcare and financial barriers to care. The inability to travel alone (adjusted odds ratio [aOR] 2.51), being overweight (aOR 1.88), and having self-reported depression (aOR 2.23) were each associated with a higher likelihood of having unmet healthcare needs in their daily life. Conclusion:The prevalence of unmet healthcare needs among older people in this part of Malaysia is lower than that reported in some other countries. However, it is possible to further reduce unmet healthcare needs by improving people's knowledge and attitudes about appropriate healthcare utilization, strengthening financial protection measures and providing support to people at high risk of having unmet healthcare needs.

Unmet Healthcare Needs Predict Depression Symptoms among Older Adults

“…Among South Korean adults aged 65 years and older, the group with depression was 1.45 times more likely to have unmet healthcare needs than those without depression [ 17 ]. Gao et al found that middle-aged and older adults in China having depressive symptoms had increased odds of having unmet healthcare needs [ 19 ] and the same were found among older Malaysian adults [ 18 ]. Only a few studies investigated the association between unmet medical service needs and depression, and there is a lack of these studies in European countries’ settings.…”

“…Unmet healthcare needs can be defined as not receiving an appropriate level of care for the area of significant difficulties [ 12 ]. However, in older adult studies unmet healthcare needs are measured in significantly different ways, with some studies measuring a wide range of unmet needs in environmental, physical, psychological, and social areas of functioning [ 12 , 13 , 14 , 15 ], while others measured a more specific inability to use needed medical services [ 16 , 17 , 18 , 19 ]. Across international surveys and studies of unmet needs of older adults, the cost of the services or the financial situation emerged as one of the most common reasons for unmet healthcare needs [ 17 , 19 , 20 ].…”

“…Finally, depression might also have an effect on unmet healthcare needs and reinforce a vicious cycle. For example, depression’s negative effect on physical health might increase healthcare needs and in turn unmet needs and it has been also suggested that depression-caused sense of helplessness, reduced motivation, and lower cognitive abilities might interfere with the ability to effectively seek needed healthcare services [ 17 , 18 ].…”

Symptoms of depression and anxiety, and unmet healthcare needs in adults during the COVID-19 pandemic: a cross-sectional study from the Canadian Longitudinal Study on Aging

“…Prior to the pandemic, research has found interconnections between depression, anxiety and unmet healthcare needs. Multiple studies have found that experiencing symptoms of depression is associated with elevated unmet needs and vice versa [13][14][15][16]. In a crosssectional study of 845 older adults in Germany, the odds of experiencing depressive symptoms were 82% higher in the group that had unmet needs [17].…”

Levels of Perceived Need for Mental Health Care among High School Students with Depression: A Study in the East Gonja Municipality, Ghana

“…Prior studies have found an association between mental disorders and unmet need for mental health care. Available evidence indicates that experiencing symptoms of depression is associated with high unmet needs for care and vice versa (Park et al, 2017;Jung & Ha, 2021;Shah et al, 2021;Zhou et al, 2021). In a study among German adults, Stein et al (2019) reported that the odds of experiencing depressive symptoms were 82% higher in the group that had unmet needs.…”