scholarly journals COVID-19 and Unmet Healthcare Needs of Older People: Did Inequity Arise in Europe?

2021 ◽  
Vol 18 (17) ◽  
pp. 9177
Author(s):  
Marta González-Touya ◽  
Alexandrina Stoyanova ◽  
Rosa M. Urbanos-Garrido
Keyword(s):  
Older People ◽  
Unmet Needs ◽  
Healthcare Access ◽  
Healthcare Provision ◽  
Horizontal Inequity ◽  
Calculated Concentration ◽  
Adverse Health Outcomes ◽  
Healthcare Needs ◽  
Unmet Healthcare Needs ◽  
The Rich

Background: The disruption in healthcare provision due to the COVID-19 pandemic forced many non-urgent medical treatments and appointments to be postponed or denied, which is expected to have huge impact on non-acute health conditions, especially in vulnerable populations such as older people. Attention should be paid to equity issues related to unmet needs during the pandemic. Methods: We calculated concentration indices to identify income-related inequalities and horizontal inequity in unmet needs due to postponed and denied healthcare in people over 50 during COVID-19, using data from the Survey on Health, Ageing and Retirement in Europe (SHARE). Results: Very few countries show significant income-related inequalities in postponed, rescheduled or denied treatments and medical appointments, usually favouring the rich. Only Estonia, Italy and Romania show a significant horizontal inequity (HI) in postponed healthcare, which apparently favours the poor. Significant pro-rich inequity in denied healthcare is found in Italy, Poland and Greece. Conclusions: Although important income-related horizontal inequity in unmet needs of European older adults during the early waves of the COVID-19 pandemic is not evident for most countries, some of them have to carefully monitor barriers to healthcare access. Delays in diagnosis and treatments may ultimately translate into adverse health outcomes, reduced quality of life and, even, widen socio-economic health inequalities among older people.

scholarly journals Population’s unmet needs in relation to primary care in Romania- a pilot survey in County Brasov.

2019 ◽  
Author(s):  
Andrea Elena Neculau ◽  
Liliana Rogozea ◽  
Daniela Popa ◽  
Ioana Atudorei ◽  
Florin Leasu ◽  
...  
Keyword(s):  
Primary Care ◽  
Low Income ◽  
Unmet Needs ◽  
Family Doctor ◽  
Health Needs ◽  
Medical Services ◽  
Out Of Hours ◽  
Health Technologies ◽  
Healthcare Needs ◽  
Unmet Healthcare Needs

Abstract Background Patients’ expectations and needs for healthcare services are changing. These changes are correlated with changes in disease profiles, a higher prevalence of chronic diseases, the introduction of new and innovative treatments and health technologies, and the emergence of new social and economic contexts. National health reports on Romania show that decisions in healthcare planning are not correlated with the health needs of the population. At the same time, this report shows a high degree of unmet healthcare needs of the Romanian population (related to cost, distance and waiting times), especially for low-income populations. The objective of the study was to identify the unmet needs of the population in relation to primary care medical services in the context of actual health regulations through a pilot study in a representative county in Romania. Methods The study is survey-based, and part of a health needs assessment programme commissioned by the District Health Authority to the university. A questionnaire with 21 items was designed to gather information about the structures, processes and outcomes of primary care from the perspective of the population. A total of 877 questionnaires were returned and validated. The data were analysed with SPSS version 25. Results Access to primary care was considered to be good by most of the population. Most of the settlements have a family doctor, and 80.5% can schedule an appointment on the same or the following day. Most basic medical services are provided, except for out-of-hours primary care services and cervical cancer screening. The family doctors are considered to be a reliable health resource. Conclusions Despite limitations in the practice of family medicine in Romania and therefore a narrow spectrum of services offered by primary care in general, the level of contentment of the population with this healthcare resource is still high. Barriers to access are related to the lack of some essential services, especially preventive and out-of-hours services. Unmet needs are presumably not recognised by patients due to a lack of medical culture. Further research is needed to clarify this conclusion. Key words: unmet health needs, primary care, Romania

Tools for guiding interventions to address patient-perceived multidimensional unmet healthcare needs in palliative care: systematic literature review

2020 ◽  
pp. bmjspcare-2020-002495
Author(s):  
Ellie B Schmidt ◽  
David Blum ◽  
Franzisca Domeisen Benedetti ◽  
Mathias Schlögl ◽  
Florian Strasser
Keyword(s):  
Palliative Care ◽  
Clinical Practice ◽  
Unmet Needs ◽  
Advanced Disease ◽  
Unmet Need ◽  
Psychometric Validation ◽  
Complex Needs ◽  
Healthcare Needs ◽  
Unmet Healthcare Needs ◽  
Patient Reported

ContextThe unmet needs of patients with advanced disease are indicative of the patient centredness of healthcare. By tracking unmet needs in clinical practice, palliative interventions are aligned with patient priorities, and clinicians receive support in intervention delivery decisions for patients with overlapping, complex needs.ObjectiveIdentify tools used in everyday clinical practice for the purpose of identifying and addressing unmet healthcare needs for patients with advanced disease.MethodsWe conducted PubMed and Cumulative Index of Nursing and Allied Health Literature searches to include studies published between 1 January 2008 and 21 April 2020. Three concepts were used in constructing a search statement: (1) patient need, (2) validated instrument and (3) clinical practice. 2313 citations were reviewed according to predefined eligibility, exclusion and inclusion criteria. Data were collected from 17 tools in order to understand how instruments assess unmet need, who is involved in tool completion, the psychometric validation conducted, the tool’s relationship to delivering defined palliative interventions, and the number of palliative care domains covered.ResultsThe majority of the 17 tools assessed unmet healthcare needs and had been validated. However, most did not link directly to clinical intervention, nor did they facilitate interaction between clinicians and patients to ensure a patient-reported view of unmet needs. Half of the tools reviewed covered ≤3 dimensions of palliative care. Of the 17 tools evaluated, 4 were compared in depth, but all were determined to be insufficient for the specific clinical applications sought in this research.ConclusionA new, validated tool is needed to track unmet healthcare needs and guide interventions for patients with advanced disease.

scholarly journals Population’s unmet needs in relation to primary care in Romania- a pilot survey in County Brasov.

2019 ◽  
Author(s):  
Andrea Elena Neculau ◽  
Liliana Rogozea ◽  
Daniela Popa ◽  
Ioana Atudorei ◽  
Florin Leasu ◽  
...  
Keyword(s):  
Primary Care ◽  
Low Income ◽  
Unmet Needs ◽  
Family Doctor ◽  
Health Needs ◽  
Medical Services ◽  
Out Of Hours ◽  
Health Technologies ◽  
Healthcare Needs ◽  
Unmet Healthcare Needs

Abstract Background Patients’ expectations and needs for healthcare services are changing. These changes are correlated with changes in disease profiles, a higher prevalence of chronic diseases, the introduction of new and innovative treatments and health technologies, and the emergence of new social and economic contexts. National health reports on Romania show that decisions in healthcare planning are not correlated with the health needs of the population. At the same time, this report shows a high degree of unmet healthcare needs of the Romanian population (related to cost, distance and waiting times), especially for low-income populations. The objective of the study was to identify the unmet needs of the population in relation to primary care medical services in the context of actual health regulations through a pilot study in a representative county in Romania. Methods The study is survey-based, and part of a health needs assessment programme commissioned by the District Health Authority to the university. A questionnaire with 21 items was designed to gather information about the structures, processes and outcomes of primary care from the perspective of the population. A total of 877 questionnaires were returned and validated. The data were analysed with SPSS version 25. Results Access to primary care was considered to be good by most of the population. Most of the settlements have a family doctor, and 80.5% can schedule an appointment on the same or the following day. Most basic medical services are provided, except for out-of-hours primary care services and cervical cancer screening. The family doctors are considered to be a reliable health resource. Conclusions Despite limitations in the practice of family medicine in Romania and therefore a narrow spectrum of services offered by primary care in general, the level of contentment of the population with this healthcare resource is still high. Barriers to access are related to the lack of some essential services, especially preventive and out-of-hours services. Unmet needs are presumably not recognised by patients due to a lack of medical culture. Further research is needed to clarify this conclusion. Key words: unmet health needs, primary care, Romania

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.

Factors affecting unmet healthcare needs of older people in Korea

2013 ◽  
Vol 60 (4) ◽  
pp. 510-519 ◽  
Author(s):  
Y.H. Ahn ◽  
N.H. Kim ◽  
C.B. Kim ◽  
O.K. Ham
Keyword(s):  
Older People ◽  
Factors Affecting ◽  
Healthcare Needs ◽  
Unmet Healthcare Needs

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

scholarly journals Development and Initial Evaluation of a Nurse-Led Healthcare Clinic for Homeless and At-Risk Populations in Tasmania, Australia: A Collaborative Initiative

2021 ◽  
Vol 18 (23) ◽  
pp. 12770
Author(s):  
Grace Bennett-Daly ◽  
Maria Unwin ◽  
Ha Dinh ◽  
Michele Dowlman ◽  
Leigh Harkness ◽  
...  
Keyword(s):  
Healthcare Access ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Public Healthcare ◽  
Staff Perceptions ◽  
Healthcare Needs ◽  
Unmet Healthcare Needs ◽  
At Risk Populations ◽  
Barriers To Healthcare Access ◽  
Primary Healthcare Providers

People who are homeless experience significantly poorer health than the general population and often face multifaceted challenges engaging with public healthcare services. Mission Health Nurse-led Clinic (MHNC) was established in 2019 to meet the healthcare needs of this marginalised population in Launceston, Tasmania. This study examines barriers to healthcare access amongst individuals who experience homelessness, client and staff perceptions of the MHNC services and explored opportunities for service expansion. Descriptive statistics were drawn from administrative data, and all interviews were thematically analysed. A total of 426 presentations were reported for 174 individuals experiencing homelessness over 26 months. The median client age was 42 years and 60.9% were male; A total of 38.5% were homeless or lived in a supported accommodation. The predominant reasons for clinic visits included prescription requests (25.3%) and immunisations (20.1%). A total of 10 clients and 5 City Mission staff were interviewed with three themes emerging from the findings: personal vulnerability, disconnectedness and acceptability of the MHNC. The MHNC services were reported to be highly appreciated by all clients. Mental health and allied health, extra operating hours and maintaining the flexibility of walk-in appointments were suggested as expansion areas for the service and were highlighted as ways to increase engagement for improved health outcomes. Continued partnerships with interprofessional primary healthcare providers would contribute to addressing unmet healthcare needs in this vulnerable population.

scholarly journals Unmet Healthcare Needs and Healthcare Access Gaps Among Uninsured U.S. Adults Aged 50–64

2020 ◽  
Vol 17 (8) ◽  
pp. 2711
Author(s):  
Namkee G. Choi ◽  
Diana M. DiNitto ◽  
Bryan Y. Choi
Keyword(s):  
Healthcare Access ◽  
Age Groups ◽  
Age Group ◽  
Older Americans ◽  
Healthcare Needs ◽  
Younger Age ◽  
Unmet Healthcare Needs ◽  
Increased Risk ◽  
Interview Survey

Lack of health insurance (HI) is a particular problem for near-older Americans aged 50–64 because they tend to have more chronic health conditions than younger age groups and are at increased risk of disability; however, little recent research has focused on HI coverage and healthcare access among this age group. Using the U.S. National Health Interview Survey data for the years 2013 to 2018, we compared HI coverage and healthcare access between the 50–64 and 65+ age groups. Using logistic regression analysis, we then examined the sociodemographic and health characteristics of past-year healthcare access of near-older Americans without HI to those with private HI or public HI (Medicare without Medicaid, Medicaid without Medicare, Medicare and Medicaid, and VA/military HI). We estimated the odds of healthcare access among those without HI compared to those with private or public HI. Near-older Americans without HI were at least seven times more likely to have postponed or foregone needed healthcare due to costs, and only 15% to 23% as likely to have had contact with any healthcare professional in the preceding 12 months. Expanding HI to near-older adults would increase healthcare access and likely result in reduced morbidity and mortality and higher quality of life for them.

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