Unmet healthcare needs among the population aged 50+ and their association with health outcomes during the COVID-19 pandemic

Abstract

The COVID-19 pandemic led to unprecedented levels of subjective unmet healthcare needs (SUN). This study investigates the association between SUN in 2020 and three health outcomes in 2021—mortality, cancer, and self-assessed health (SAH), among adults aged 50 years and older, using data from the regular administration of the Survey of Health, Ageing and Retirement in Europe and from the two special waves administered in 2020 and 2021 regarding COVID-19. Three types of SUN were surveyed: care foregone due to fear of contracting COVID-19, pre-scheduled care postponed, and inability to get medical appointments or treatments demanded. We resort on the relative risk and the logistic specification to investigate the association between SUN and health outcomes. To avoid simultaneity, 1-year lagged SUN variables are used. We found a negative association between SUN and mortality. This result differs from the (scarce) previous evidence, suggesting that health systems prioritised life-threatening conditions, in the pandemic context. In line with previous studies, we obtained a positive association between SUN and worse health, in the case of cancer, though it is statistically significant only for the global measure of SUN (any reason). The higher chances of reporting cancer among those exposed to SUN might mean delayed cancer diagnosis, confirming that healthcare foregone was truly needed for a timely diagnosis. The association between SUN and poor or fair SAH is positive but not statistically significant, for the period analysed.

The impact of the covid-19 outbreak on unmet health care needs in istanbul

“…Among these barriers cost, transportation and long waiting times are the most prominent ones ( Byrne, 2008 , Eurostat, 2023 ). Furthermore, in literature there is evidence that unmet need is correlated to demographic factors like gender ( Kannan and Veazie, 2015 , Taber et al, 2015 ), marital status ( Tadiri et al, 2021 ), age ( Quintal et al, 2023 ), education ( Gertz et al, 2022 ), employment status ( Lee et al, 2014 , Zhao et al, 2014 , Kannan and Veazie, 2014 ), and income ( Allin et al, 2010 , Shi and Stevens, 2004 ), personal factors like fear of treatment, having chronic conditions ( Ronksley et al, 2012 , Larkey et al, 2001 , Garg et al, 2017 ), having no time to spare ( Lee et al, 2014 ) and perceived health ( Hardin et al, 2021 ), administrative factors like being uninsured ( Byrne, 2008 ) and provider issues like equitable access ( Basar et al, 2021 ).…”

Unmet Healthcare Needs among the Elderly Korean Population: Before and during the COVID-19 Pandemic

“…Besides, we speculate that the coronavirus disease (COVID-19) pandemic outbreak may have negatively affected access to healthcare services [3,25,26]. During the pandemic, social distancing and quarantine measures were enforced globally, and especially during the first wave of the pandemic, physical interaction was limited [8,25].…”

“…Humans have a myriad of healthcare needs throughout their life, but the lack of timely access to healthcare services may result in a situation of unmet healthcare needs. Furthermore, although differences between countries may exist, the prevailing view is that all healthcare needs are not necessarily adequately covered by the healthcare system in reality [1][2][3].…”

“…Unmet healthcare needs can be defined as not receiving or delaying the necessary healthcare services despite the needs being perceived by the individual or judged by the medical professional [4][5][6]. Considered a measure of healthcare access, it is the difference between the healthcare services judged necessary and those that are actually received [1,3].…”

“…UHN is an important indicator of the healthcare system globally because it worsens simple health problems, incurs huge additional treatment costs, and can develop into irreparable health conditions [1,3,[7][8][9][10][11]. The Organization for Economic Cooperation and Development (OECD) emphasizes the basic principle for all healthcare systems in each country, which is to provide high-quality healthcare to the entire population, regardless of the socio-economic conditions [12][13][14].…”