Potential predictors of unmet health needs among the elderly: a population-based study in Serbia

Abstract

Background This study assessed the prevalence of unmet health needs of the elderly and the associated factors regarding socioeconomic, health and functional status. Methods A secondary analysis of the 2013 National Health Survey data was conducted on a representative sample of 3540 persons aged sixty-five and older (the lowest response rate was 99.7%). Participants characteristics such as socioeconomic status, health self-perception, diagnosed chronic disease, physical functional limitations, performing essential daily activities in the home and daily personal care were explored with logistic regression analysis (Odds Ratio - OR and 95% Confidence Interval) in relation to five aspects of unmet health needs. Results 15.8% participants had unmet health needs due to the long waiting times, 16.1%, had unmet needs for medical care, 17.7% for dental care, 15.2% for drugs prescription and 96.9% participants for mental health care. Common predictors exist for medical, dental drug prescription and due to long waiting times unmet needs including older age years, middle education, rural residence, lower wealth index, single persons, with average or bad self-perceived health, chronic disease and difficult daily performance of personal care and of home activities. Unmet mental health needs by 61% less likely had participants with average wealth index, while a greater likelihood had participants with average and bad self-perceived health by 3.7 times and 8.4 times (p = 0.035, p = 0.001) respectively, by 6.2 times those with difficulties (p < 0.001) and by 5.9 times unable (p = 0.045) to perform daily activities of personal care and by 1.7 times those with difficulties (p = 0.037) to perform home activities. Conclusions Unmet health needs reported less than 20% of the elderly but almost all have unmet mental health needs. Unmet health needs are associated with negative health outcomes, age, low education level, single persons, rural settings, poorer households, and limited daily activities. Key messages Unmet mental health needs of the elderly are an extremely important problem for the health system and healthy ageing in Serbia. A strong association of unmet health needs of old, low educated elderly without partners, from rural settings and poor households with health and functional outcomes, requires responsive policies.

Socioeconomic inequality as a predictor of unmet health needs in the older adult population of Serbia

“…Demographic changes have led to an increase in the older adult population globally, with individuals of older age at greater risk of inequality in healthcare system accessibility ( 5–7 ). Research results on unmet health needs in Europe suggest that material status and social support are important predictors influencing the realization of health needs ( 7–11 ). Older adult individuals often have multiple chronic diseases and comorbidities, which can significantly worsen due to unmet health needs ( 8–11 ).…”