Burden of illness, medication adherence, and unmet medical needs in Japanese patients with atopic dermatitis: A retrospective analysis of a cross‐sectional questionnaire survey

Abstract Background Forgoing healthcare is associated with unfavorable health-related outcomes, a higher risk of hospitalization, and a decreased quality of life. Relatively to its neighboring countries, forgoing healthcare for economic reasons is high in Switzerland, primarily because of the high out of pocket expenditures that characterize the Swiss healthcare system. The purpose of this study was to investigate the determinants of forgoing healthcare, and to examine the long term health-related consequences of unmet medical needs. Methods We used data from “Bus Santé”, a cross-sectional study conducted in the city of Geneva (CH). Socioeconomic factors were self-reported by participants at baseline (N = 5032, 2007-2011), including income, education, receiving subsidies, and insurance deductibles (mandatory out of pocket expenditures). Forgoing healthcare for economic reasons was self-reported by study participants, including details about the frequency and the type of forgone care. Prospectively, a subset of participants came for a follow-up visit (2014-2015) in order to assess objective (glycemia, blood pressure, plasma lipids) and subjective health-outcomes (self-reported physical and mental health) resulting from forgone healthcare at baseline. Results At baseline, adverse socioeconomic circumstances (lower income, education, receiving subsidies, and high deductibles) were associated with a higher risk of forgoing healthcare (OR range 1.51-5.49, p < 0.015). Four years later, participants who reported forgoing healthcare at baseline were at a higher risk of having lower HDL-cholesterol (β=-0.08 [-0.14;-0.03]), and adverse physical and mental self-reported health outcomes when compared to controls (p < 0.017). Conclusions Forgoing healthcare is driven by adverse socioeconomic circumstances, subsequently leading to adverse lipid profiles and poor self-reported health outcomes. Unmet medical needs may constitute a pathway through which socioeconomic status affects health. Key messages Adverse socioeconomic circumstances lead to unmet medical needs, even in wealthy countries. Unmet medical needs lead to poor objective and subjective health-related outcomes.

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Review for "Unmet medical needs in the treatment of atopic dermatitis in infants: An Expert consensus on safety and efficacy of pimecrolimus"

10.1111/pai.13422/v2/review1 ◽

2020 ◽

Keyword(s):

Atopic Dermatitis ◽

Expert Consensus ◽

Safety And Efficacy ◽

Medical Needs ◽

Unmet Medical Needs

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Factors Underlying Unmet Medical Needs: A Cross-Sectional Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16132391 ◽

2019 ◽

Vol 16 (13) ◽

pp. 2391 ◽

Cited By ~ 4

Author(s):

Young Suk Yoon ◽

Boyoung Jung ◽

Dongsu Kim ◽

In-Hyuk Ha

Keyword(s):

Low Income ◽

Severe Depression ◽

Behavioral Model ◽

Cross Sectional Study ◽

Vulnerable Groups ◽

Service Needs ◽

Health Services Use ◽

Cross Sectional ◽

Medical Needs ◽

Unmet Medical Needs

Unmet medical needs refer to the state where a patient’s medical care or service is insufficient, inadequate, or lacking. Numerous factors influence unmet medical needs. We used a multi-pronged approach to explore the factors influencing unmet medical needs in the Korean health care system according to Anderson’s Behavioral Model of Health Services Use. To this end, we used data from 11,378 adults over 19 years old in the 2016 Korea Health Panel Survey and performed multiple logistic regression analyses. The odds of experiencing unmet medical needs were significantly greater among older participants (odds ratio (OR) = 2.51, 95% confidence interval (CI) = 1.78–3.56); low-income participants (OR = 1.41, 95% CI = 1.14–1.75); non-workers (OR = 1.24, 95% CI = 1.06–1.46); those who had received non-covered treatment (OR = 1.24, 95% CI = 1.08–1.42); those who did not regularly exercise (OR = 1.23, 95% CI = 1.02–1.48); and those experiencing pain (OR = 2.29, 95% CI = 1.97–2.66), worse self-rated health status (OR = 2.29, 95% CI = 1.89–2.79), and severe depression (OR = 2.46, 95% CI = 1.39–4.35). About one in ten Korean citizens (11.60%) have unmet medical service needs. Policies that strengthen coverage for physically and economically vulnerable groups are needed.

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