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Exploring unmet healthcare needs and associated inequalities among middle-aged and older adults in Eastern China during the progression toward universal health coverage

Author

Listed:
  • Yunhan Wang

    (Nanjing Medical University)

  • Nan Jiang

    (Nanjing Medical University)

  • Haiya Shao

    (Nanjing Medical University)

  • Zhonghua Wang

    (Nanjing Medical University
    Nanjing Medical University
    Nanjing Medical University)

Abstract

Background Given the rapid population aging in China, achieving universal health coverage (UHC) presents a primary challenge in addressing unmet healthcare needs and associated inequalities among middle-aged and older adults. Several studies have focused on healthcare utilization and its inequalities, but little attention has been paid to the inequality in unmet healthcare needs. This study aimed to analyze the inequalities in unmet the healthcare needs of middle-aged and older adults in eastern China during the progression toward UHC. Methods Data were obtained from the fourth, fifth, and sixth National Health Service Survey (NHSS) of Jiangsu Province, located in eastern China, during the years 2008, 2013, and 2018, respectively. Logistic regression models were used to assess the associated factors of unmet healthcare needs. The inequality was measured according to the concentration index (CI) and its decomposition. Results In this study, we found that 12.86%, 2.22%, and 48.89% of middle-aged and older adults reported unmet needs for outpatient and inpatient services and physical examinations, respectively. The prevalence of unmet outpatient needs increased from 2008 to 2018, while the prevalence of unmet inpatient services was lower but maintained. The prevalence of unmet needs for physical examinations among middle-aged and older adults markedly decreased since 2008. Rural areas had a higher prevalence of unmet needs for inpatient services and physical examinations than urban areas. Unmet healthcare needs were more prevalent among the poor. The pro-poor inequalities of unmet healthcare needs have been mitigated during the progression toward UHC; however, they remain predominant among rural middle-aged and older adults for outpatient and inpatient services. Socioeconomic factors significantly influenced unmet healthcare needs and contributed to their inequalities. Conclusions The findings characterize the prevalence and inequality of unmet healthcare need among middle-aged and older adults in eastern China during the progression toward UHC. Policy interventions should be actively advocated to effectively mitigate the unmet healthcare needs and address the associated inequalities.

Suggested Citation

  • Yunhan Wang & Nan Jiang & Haiya Shao & Zhonghua Wang, 2024. "Exploring unmet healthcare needs and associated inequalities among middle-aged and older adults in Eastern China during the progression toward universal health coverage," Health Economics Review, Springer, vol. 14(1), pages 1-12, December.
    • Handle: RePEc:spr:hecrev:v:14:y:2024:i:1:d:10.1186_s13561-024-00521-7
    DOI: 10.1186/s13561-024-00521-7
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    References listed on IDEAS

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    1. Liping Fu & Ya’nan Fang & Yongqing Dong, 2022. "The healthcare inequality among middle-aged and older adults in China: a comparative analysis between the full samples and the homogeneous population," Health Economics Review, Springer, vol. 12(1), pages 1-17, December.
    2. Chaofan Li & Lei Dou & Haipeng Wang & Shanshan Jing & Aitian Yin, 2017. "Horizontal Inequity in Health Care Utilization among the Middle-Aged and Elderly in China," IJERPH, MDPI, vol. 14(8), pages 1-13, July.
    3. Adam Wagstaff & Eddy van Doorslaer, 2003. "Catastrophe and impoverishment in paying for health care: with applications to Vietnam 1993–1998," Health Economics, John Wiley & Sons, Ltd., vol. 12(11), pages 921-933, November.
    4. Jens Hoebel & Alexander Rommel & Sara Lena Schröder & Judith Fuchs & Enno Nowossadeck & Thomas Lampert, 2017. "Socioeconomic Inequalities in Health and Perceived Unmet Needs for Healthcare among the Elderly in Germany," IJERPH, MDPI, vol. 14(10), pages 1-18, September.
    5. Röttger, Julia & Blümel, Miriam & Köppen, Julia & Busse, Reinhard, 2016. "Forgone care among chronically ill patients in Germany—Results from a cross-sectional survey with 15,565 individuals," Health Policy, Elsevier, vol. 120(2), pages 170-178.
    6. Jonas Eimontas & Goda Gegieckaitė & Olga Zamalijeva & Vilmantė Pakalniškienė, 2022. "Unmet Healthcare Needs Predict Depression Symptoms among Older Adults," IJERPH, MDPI, vol. 19(15), pages 1-13, July.
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