Subjective perceptions of unmet need for health care in Europe among social groups: Findings from the European social survey (2014) special module on the social determinants of health
Subjective perceptions of unmet need for health care in Europe among social groups: Findings from the European social survey (2014) special module on the social determinants of health
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DOI：
10.1093/eurpub/ckw219
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发表时间：
2017-02-01
影响因子：
4.4
通讯作者：
Eikemo, Terje A.
中科院分区：
文献类型：
--
作者：
Fjaer, Erlend L.;Stornes, Per;Eikemo, Terje A.
背景资料：未满足的需要可以定义为个人主观认为的处理健康问题所需的服务与实际获得的服务之间的差异。这项研究探讨了与未满足需求相关的因素，以及未满足需求的原因如何在欧洲的社会经济和人口群体中分布。方法：使用第7轮欧洲社会调查的数据，对25-75岁的人采用多层次逻辑回归模型。自我报告的未满足需求衡量受访者在过去12个月内是否无法获得医疗咨询或治疗。未满足需求的原因分为三类：可提供性、可获得性和可接受性。健康状况通过自我报告的健康状况、非传染性疾病和抑郁症状来衡量。结果：三分之二的未满足的需求是由于等待名单和预约可用性。女性和年轻年龄组报告的未满足需求更多。我们没有发现教育不平等，而财政紧张被认为是欧洲所有类型的医疗保健需求未得到满足的一个重要因素。所有类型的卫生保健使用和健康状况不佳都与未满足的需求有关。低医生密度和高自付被认为是与未满足的需求，由于可用性。结论：尽管在许多欧洲福利国家，医疗保健覆盖率是普遍的，但财政压力似乎是欧洲公民获得医疗保健的主要决定因素。这可能表明，高收入群体能够绕过等候名单。因此，欧洲福利国家应加强努力，减少接受护理的障碍。
Background: Unmet need can be defined as the individually perceived subjective differences between services judged necessary to deal with health problems and the services actually received. This study examines what factors are associated with unmet need, as well as how reasons for unmet need are distributed across socioeconomic and demographic groups in Europe. Methods: Multilevel logistic regression models were employed using data from the 7th round of the European Social Survey, on people aged 25-75. Self-reported unmet need measured whether respondents had been unable to get medical consultation or treatment in the last 12 months. Reasons for unmet need were grouped into three categories: availability, accessibility and acceptability. Health status was measured by self-reported health, non-communicable diseases and depressive symptoms. Results: Two-thirds of all unmet need were due waiting lists and appointment availability. Females and young age groups reported more unmet need. We found no educational inequalities, while financial strain was found to be an important factor for all types of unmet need for health care in Europe. All types of health care use and poor health were associated with unmet need. Low physician density and high out-of-pocket payments were found to be associated with unmet need due to availability. Conclusion: Even though health care coverage is universal in many European welfare states, financial strain appeared as a major determinant for European citizens' access to health care. This may suggest that higher income groups are able to bypass waiting lists. European welfare states should, therefore, intensify their efforts in reducing barriers for receiving care.