scholarly journals How Poverty, Residence Status and Health Insurance Predict Unmet Healthcare Needs among Chinese Elders?

2021 ◽  
Vol 8 (6) ◽  
pp. 10
Author(s):  
Lili Wu ◽  
Chunyin Wang ◽  
Jiayun Kou
Keyword(s):  
Health Insurance ◽  
Social Stratification ◽  
Healthcare Access ◽  
Care Needs ◽  
Financial Barriers ◽  
Multinomial Logistic Model ◽  
Healthcare Needs ◽  
Unmet Healthcare Needs ◽  
Unmet Health Care Needs ◽  
Chinese Elders

This study focuses on the variability in unmet healthcare needs among vulnerable Chinese elders and the degree to which these unmet needs are associated with socioeconomic disadvantages. We use the 2013 wave of China Health and Retirement Longitudinal Study (CHARLS) and a multinomial logistic model to investigate how poverty, residence status and particular health insurance schemes influence unmet healthcare needs independently and in combination. Our results show that poverty and rural residence are strong predictors of unmet healthcare needs due to financial and non-financial constraints, respectively. Although health insurance can reduce financial barriers, its influence varies with different insurance schemes, thus generating unequal healthcare access among heterogeneous vulnerable subgroups of elders and putting poor rural migrants at the highest risk for unmet healthcare needs. Our findings direct attention to the differences in resources available to various subgroups of elders and the importance of social stratification in predicting unmet health care needs.

scholarly journals The Unmet Healthcare Needs: Evidence from Serbia

2020 ◽  
Author(s):  
Milos MITRASEVIC ◽  
Snezana RADOVANOVIC ◽  
Svetlana RADEVIC ◽  
Milena MARICIC ◽  
Ivana Zivanović MACUZIC ◽  
...  
Keyword(s):  
Health Care ◽  
The Elderly ◽  
Economic Factors ◽  
Health Care Needs ◽  
Care Needs ◽  
Factors Associated ◽  
Healthcare Needs ◽  
Unmet Healthcare Needs ◽  
Unmet Health Care Needs ◽  
Socio Economic Factors

Background: We aimed to determine the socio-economic factors associated with unmet healthcare needs of the population aged 20 and over in Serbia. Methods: We used data from the 2013 National Health Survey (NHS) of the population of Serbia. We focused only on the data concerning the population aged 20 and over. The final sample thus included 13,765 participants. The logistic regression was used to examine the socio-economic factors associated with unmet health care needs. Results: According to the data obtained in this study, 26.2% of the population aged 20 and over reported unmet health care needs during the previous 12 months. The multivariate analysis shows that significant indicators of unmet healthcare needs include: gender, age, marital status, level of education, financial and employment status. Conclusion: Females, the elderly and those with the lowest levels of education and household income, as well as those who are divorced and unemployed are at highest risk of unmet healthcare needs. Different policies and approaches should be taken into consideration when it comes to vulnerable population groups in order to reduce the currently existing gaps to a minimum and provide more equal opportunities for health care to all citizens.  

scholarly journals Impact of fees on access to dental care: evidence from France

2020 ◽  
Vol 30 (6) ◽  
pp. 1066-1071
Author(s):  
Anne-Charlotte Bas ◽  
Paul Dourgnon ◽  
Sylvie Azogui-Levy ◽  
Jérôme Wittwer
Keyword(s):  
Health Insurance ◽  
Dental Care ◽  
P Value ◽  
Care Needs ◽  
Enabling Factors ◽  
Healthcare Needs ◽  
Out Of Pocket Payments ◽  
Access To Dental Care ◽  
The Impact ◽  
Dental Prosthetics

Abstract Background For financial reasons, dental prosthetics is one of the major unmet dental healthcare needs [Financial-SUN (F-SUN)]. Private fees for dental prosthetics result in significant out-of-pocket payments for users. This study analyzes the impact of geo-variations in protheses fees on dental F-SUN. Methods Using a nationwide French declarative survey and French National Health Insurance administrative data, we empirically tested the impact of prosthetic fees on dental F-SUN, taking into account several other enabling factors. Our empirical strategy was built on the homogeneous quality of the dental prosthesis selected and used to compute our price index. Results Unmet dental care needs due to financial issues concern not only the poorest but also people with middle incomes. The major finding is the positive association between dental fees and difficulty in gaining access to dental care when other enabling factors are taken into account (median fee in the highest quintile: OR = 1.35; P value = 0.024; 95% CI 1.04–1.76). People with dental F-SUN are those who have to make a greater financial effort due to a low/middle income or a lack of complementary health insurance. For identical financial reasons, the tendency to give up on healthcare increases as health deteriorates. Conclusions The results underscore the need for fee regulation regarding dental prosthetics. This is in line with the current French government dental care reform.

scholarly journals Unmet Healthcare Needs, Catastrophic Health Expenditure, and Health in South Korea’s Universal Healthcare System: Progression Towards Improving Equity by NHI Type and Income Level

Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 408 ◽  
Author(s):  
Minsung Sohn ◽  
Xianhua Che ◽  
Hee-Jung Park
Keyword(s):  
Health Insurance ◽  
Health Status ◽  
Low Income ◽  
Health Expenditure ◽  
Income Level ◽  
Catastrophic Health Expenditure ◽  
Poor Health ◽  
Medical Aid ◽  
Healthcare Needs ◽  
Unmet Healthcare Needs

This study examined the effects of healthcare inequality on personal health. It aimed to determine how health insurance type and income level influence catastrophic health expenditure and unmet healthcare needs among South Koreans. Unbalanced Korean Health Panel data from 2011 to 2015, including 33,374 adults, were used. A time-trend and panel regression analysis were performed. The first to identify changes in the main variables and, the second, mediating effects of unmet healthcare needs and catastrophic health expenditure on the relationship between health insurance type, income level, and health status. The independent variables were: high-, middle-, low-income employee insured, high-, middle-, low-income self-employed insured, and medical aid. The dependent variable was health status, and the mediators were unmet needs and catastrophic health expenditure. The medical aid beneficiaries and low-income self-employed insured groups demonstrated a higher probability of reporting poor health status than the high-income, insured group (15.6%, 2.2%, and 2.3%, respectively). Participants who experienced unmet healthcare needs or catastrophic health expenditure were 10.7% and 5.6% higher probability of reporting poor health, respectively (Sobel test: p < 0.001). National policy reforms could improve healthcare equality by integrating insurance premiums based on income among private-sector employees and self-employed individuals within the health insurance network.

scholarly journals Non-communicable diseases among refugees claimants in Greek refugee camps—are their care needs met?

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
S S Jervelund ◽  
O Nordheim ◽  
T Stathopoulou ◽  
T A Eikemo
Keyword(s):  
Medical Care ◽  
Communicable Diseases ◽  
Refugee Camps ◽  
Care Needs ◽  
Non Communicable Diseases ◽  
Medical Needs ◽  
Healthcare Needs ◽  
Unmet Healthcare Needs ◽  
Refugee Claimants ◽  
Unmet Medical Needs

Abstract Background Little is known about the prevalence of non-communicable diseases (NCDs) among newly arrived refugees in Europe and whether their medical needs are met. The objective of this study was to investigate patterns of NCDs as refugee claimants migrate, whether refugee claimants experience unmet healthcare needs before, during and after flight when living in Greek refugee camps and to elucidate sociodemographic determinants for unmet medical care needs in the Greek refugee camps. Methods Survey data collected in 2016 among 267 newly arrived adult asylum-seekers staying at six refugee camps in Greece was used. The survey was available in English, Arabic and Farsi. We inspected frequency distributions of NCDs and unmet medical care needs, and using multiple logistic regression analysis, we estimated determinants for unmet medical needs in Greece. Results The majority had a good or fair self-reported health; yet, 17.1% suffered from 1 NCD, while 42.1% suffered from 2 or more NCDs. The most prevalent reported NCDs in Greece were: back or neck pain (26.6%) and severe headache (24.7%). The prevalence of most NCDs in the migration phases followed a U- or J-shaped pattern: decreased during migration and increased after migration to Greece. Unmet medical care needs were reported by 41.3% with one NCD after arrival in Greece. Compared with young adults, adults aged 51+ years were in increased risk of reporting unmet medical needs in Greece [odds ratio = 7.59; p = 0.015]. Conclusions The high number of persons who report NCDs underscore the need for availability of diagnostic tools and agents to ensure that the refugee claimants receive the right healthcare assistance. Tools and guidelines to provide continuity of NCD care when people migrate are likewise important. Many European countries that receive this group of refugees should take the disease patterns, including multi-morbidity, into consideration when planning for health reception and the organization of healthcare. Key messages The prevalence of NCDs among refugee claimants decreased during migration and increased after migration to Greece. Unmet medical care needs were reported by 41.3% with one NCD after arrival in Greece.

scholarly journals Determinants of perceived health and unmet healthcare needs in universal healthcare systems with high gender equality

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Christina P. Tadiri ◽  
Teresa Gisinger ◽  
Alexandra Kautzky-Willer ◽  
Karolina Kublickiene ◽  
Maria Trinidad Herrero ◽  
...  
Keyword(s):  
Marital Status ◽  
Gender Equality ◽  
Social Factors ◽  
Negative Impact ◽  
Perceived Health ◽  
Healthcare Systems ◽  
Care Needs ◽  
Universal Healthcare ◽  
Healthcare Needs ◽  
Unmet Healthcare Needs

Abstract Background Patient attitudes about health and healthcare have emerged as important outcomes to assess in clinical studies. Gender is increasingly recognized as an intersectional social construct that may influence health. Our objective was to determine potential sex differences in self-reported overall health and access to healthcare and whether those differences are influenced by individual social factors in two relatively similar countries. Methods Two public health surveys from countries with high gender equality (measured by UN GII) and universal healthcare systems, Canada (CCHS2014, n = 57,041) and Austria (AT-HIS2014, n = 15,212), were analysed. Perceived health was assessed on a scale of 1 (very bad) to 4 (very good) and perceived unmet healthcare needs was reported as a dichotomous variable (yes/no). Interactions between sex and social determinants (i.e. employment, education level, immigration and marital status) on outcomes were analysed. Results Individuals in both countries reported high perceived health (Scoring > 2, 85.0% in Canada, 79.9% in Austria) and a low percentage reported unmet healthcare needs (4.6% in Canada, 10.7% in Austria). In both countries, sex and several social factors were associated with high perceived health, and a sex-by-marital status interaction was observed, with a greater negative impact of divorce for men. Female sex was positively associated with unmet care needs in both countries, and sex-by-social factors interactions were only detected in Canada. Conclusions The intersection of sex and social factors in influencing patient-relevant outcomes varies even among countries with similar healthcare and high gender equality.

scholarly journals Does Universal Health Insurance Coverage Reduce Unmet Healthcare Needs in China? Evidence from the National Health Service Survey

2020 ◽  
Author(s):  
Shenping Zhou ◽  
Tianyu Huang ◽  
Anqi Li ◽  
Zhonghua Wang
Keyword(s):  
Health Insurance ◽  
Insurance Coverage ◽  
Early Discharge ◽  
Health Insurance Coverage ◽  
Universal Health Insurance ◽  
Outpatient Services ◽  
Healthcare Needs ◽  
Universal Health Insurance Coverage ◽  
Unmet Healthcare Needs ◽  
Universal Health

Abstract Background: China has nearly achieved universal health insurance coverage, but considerable unmet healthcare needs still exist. Although this topic has attracted great attention, there have been few studies examining the relationship between universal health insurance coverage and unmet healthcare needs. This study aimed to clarify the impact of universal health insurance coverage and other associated factors on Chinese residents’ unmet healthcare needs.Methods: Data was derived from the fourth, fifth, and sixth National Health Service Survey of Jiangsu Province, which were conducted in 2008, 2013, and 2018, respectively. Descriptive statistics were used to analyze the prevalence of unmet healthcare needs. Binary multivariate logistic regression was used to estimate the association between unmet healthcare needs and universal health insurance coverage, along with other socioeconomic factors.Results: 8.99%, 1.37%, 53.37%, and 13.16% of the respondents in Jiangsu Province reported non-use of outpatient services, inpatient services, physical examinations, and early discharge from hospital, respectively. The trend in the prevalence of unmet healthcare needs showed a decline from 2008 to 2018. Health insurance had a significant reducing effect on non-use of outpatient services, inpatient services, or early discharge from hospital. People having health insurance in 2013 and 2018 were significantly less likely to report unmet healthcare needs compared to those in 2008. The effect of health insurance and its universal coverage on reducing unmet healthcare needs was greater in rural than in urban areas. Other socioeconomic factors, such as age, marital status, educational level, income level, or health status, also significantly affected unmet healthcare needs.Conclusions: Universal health insurance coverage has significantly reduced Chinese residents’ unmet healthcare needs. Policy efforts should pay more attention to the benefits of health insurances in rural areas and optimize urban-rural health resources to promote effective utilization of healthcare.

scholarly journals Medical crowdfunding in a healthcare system with universal coverage: an exploratory study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ágnes Lublóy
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Universal Coverage ◽  
Insurance Fund ◽  
Health Care Needs ◽  
Health Coverage ◽  
Health Insurance Fund ◽  
Care Needs ◽  
Unmet Health Care Needs ◽  
Universal Health

Abstract Background In recent years, crowdfunding for medical expenses has gained popularity, especially in countries without universal health coverage. Nevertheless, universal coverage does not imply covering all medical costs for everyone. In countries with universal coverage unmet health care needs typically emerge due to financial reasons: the inability to pay the patient co-payments, and additional and experimental therapies not financed by the health insurance fund. This study aims at mapping unmet health care needs manifested in medical crowdfunding campaigns in a country with universal health coverage. Methods In this exploratory study we assess unmet health care needs in Germany by investigating 380 medical crowdfunding campaigns launched on Leetchi.com. We combine manual data extraction with text mining tools to identify the most common conditions, diseases and disorders which prompted individuals to launch medical crowdfunding campaigns in Germany. We also assess the type and size of health-related expenses that individuals aim to finance from donations. Results We find that several conditions frequently listed in crowdfunding campaigns overlap with the most disabling conditions: cancer, mental disorders, musculoskeletal disorders, and neurological disorders. Nevertheless, there is no strong association between the disease burden and the condition which prompted individuals to ask for donations. Although oral health, lipoedema, and genetic disorders and rare diseases are not listed among leading causes of disability worldwide, these conditions frequently prompted individuals to turn to crowdfunding. Unmet needs are the highest for various therapies not financed by the health insurance fund; additional, complementary, and animal-assisted therapies are high on the wish list. Numerous people sought funds to cover the cost of scientifically poorly supported or unsupported therapies. In line with the social drift hypothesis, disability and bad health status being associated with poor socioeconomic status, affected individuals frequently collected donations for their living expenses. Conclusions In universal healthcare systems, medical crowdfunding is a viable option to finance alternative, complementary, experimental and scientifically poorly supported therapies not financed by the health insurance fund. Further analysis of the most common diseases and disorders listed in crowdfunding campaigns might provide guidance for national health insurance funds in extending their list of funded medical interventions. The fact of numerous individuals launching crowdfunding campaigns with the same diseases and disorders signals high unmet needs for available but not yet financed treatment. One prominent example of such treatment is liposuction for patients suffering from lipoedema; these treatments were frequently listed in crowdfunding campaigns and might soon be available for patients at the expense of statutory health insurance in Germany.

scholarly journals The risk typology of healthcare access and its association with unmet healthcare needs in Asian Americans

2017 ◽  
Vol 26 (1) ◽  
pp. 72-79 ◽  
Author(s):  
Yuri Jang ◽  
Nan Sook Park ◽  
Hyunwoo Yoon ◽  
Ya-Ching Huang ◽  
Min-Kyoung Rhee ◽  
...  
Keyword(s):  
Asian Americans ◽  
Healthcare Access ◽  
Healthcare Needs ◽  
Unmet Healthcare Needs
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