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Subjective unmet need and utilization of health care services in Canada: What are the equity implications?

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Author Info

  • Allin, Sara
  • Grignon, Michel
  • Le Grand, Julian

Abstract

This study aimed to evaluate whether subjective assessments of unmet need may complement conventional methods of measuring socioeconomic inequity in health care utilization. This study draws on the 2003 Canadian Community Health Survey to develop a conceptual framework for understanding how unmet need arises, to empirically assess the association between utilization and the different types of unmet need (due to waiting times, barriers and personal reasons), and to investigate the effect of adjusting for unmet need on estimates of income-related inequity. The study's findings suggest that a disaggregated approach to analyzing unmet need is required, since the three different subgroups of unmet need that we identify in Canada have different associations with utilization, along with different equity implications. People who report unmet need due to waiting times use more health services than would be expected based on their observable characteristics. However, there is no consistent pattern of utilization among people who report unmet need due to access barriers, or for reasons related to personal choice. Estimates of inequity remain unchanged when we incorporate information on unmet need in the analysis. Subjective assessments of unmet need, namely those that relate to barriers to access, provide additional policy-relevant information that can be used to complement conventional methods of measuring inequity, to better understand inequity, and to guide policy action.

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Bibliographic Info

Article provided by Elsevier in its journal Social Science & Medicine.

Volume (Year): 70 (2010)
Issue (Month): 3 (February)
Pages: 465-472

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Handle: RePEc:eee:socmed:v:70:y:2010:i:3:p:465-472

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Related research

Keywords: Canada Unmet need Health care utilization Equity Access barriers;

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Cited by:
  1. Dourgnon, Paul, 2013. "Evaluation des politiques publiques et inégalités sociales d'accès aux services de santé," Economics Thesis from University Paris Dauphine, Paris Dauphine University, number 123456789/12221 edited by Wittwer, Jérôme, November.
  2. Brackbill, Robert M. & Stellman, Steven D. & Perlman, Sharon E. & Walker, Deborah J. & Farfel, Mark R., 2013. "Mental health of those directly exposed to the World Trade Center disaster: Unmet mental health care need, mental health treatment service use, and quality of life," Social Science & Medicine, Elsevier, vol. 81(C), pages 110-114.
  3. Garcia-Subirats, Irene & Vargas, Ingrid & Mogollón-Pérez, Amparo Susana & De Paepe, Pierre & da Silva, Maria Rejane Ferreira & Unger, Jean Pierre & Vázquez, María Luisa, 2014. "Barriers in access to healthcare in countries with different health systems. A cross-sectional study in municipalities of central Colombia and north-eastern Brazil," Social Science & Medicine, Elsevier, vol. 106(C), pages 204-213.

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