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Health system characteristics and unmet care needs in Europe: an analysis based on EU-SILC data

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  • Sabine Chaupain-Guillot
  • Olivier Guillot

Abstract

Using survey data from the 2009 wave of the European Union Statistics on Income and Living Conditions, this study examines the determinants of unmet needs for medical and dental care in European countries. Special emphasis is put on the impact of health system characteristics. Four factors are taken into account: the density of doctors or dentists, the rules governing access to practitioners, the method of paying primary care physicians, and the amount of out-of-pocket payments. The analysis is carried out using multilevel logistic regression models. Separate regressions are estimated for medical and dental services. The dependent variable is whether respondents reported that, at least once in the last 12 months, they needed care but did not receive it. The estimation results show that the probability of experiencing unmet medical or dental needs varies noticeably across countries. This inter-country variability seems to be partly explained by the differences in the financing of health care. Indeed, a positive link is found between the share of households’ out-of-pocket payments in total health expenditure and the probability of unmet needs. The other contextual factors do not seem to play a significant role. Copyright Springer-Verlag Berlin Heidelberg 2015

Suggested Citation

  • Sabine Chaupain-Guillot & Olivier Guillot, 2015. "Health system characteristics and unmet care needs in Europe: an analysis based on EU-SILC data," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(7), pages 781-796, September.
    • Handle: RePEc:spr:eujhec:v:16:y:2015:i:7:p:781-796
    DOI: 10.1007/s10198-014-0629-x
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    1. Robert G. Evans, 1974. "Supplier-Induced Demand: Some Empirical Evidence and Implications," International Economic Association Series, in: Mark Perlman (ed.), The Economics of Health and Medical Care, chapter 10, pages 162-173, Palgrave Macmillan.
    2. repec:dau:papers:123456789/9221 is not listed on IDEAS
    3. repec:dau:papers:123456789/458 is not listed on IDEAS
    4. Baggett, T.P. & O'Connell, J.J. & Singer, D.E. & Rigotti, N.A., 2010. "The unmet health care needs of homeless adults: A national study," American Journal of Public Health, American Public Health Association, vol. 100(7), pages 1326-1333.
    5. repec:dau:papers:123456789/447 is not listed on IDEAS
    6. Lise Rochaix & Stéphane Jacobzone, 1997. "L'hypothèse de demande induite : un bilan économique," Économie et Prévision, Programme National Persée, vol. 129(3), pages 25-36.
    7. Marcus, M. & Freed, J.R. & Coulter, I.D. & Der-Martirosian, C. & Cunningham, W. & Andersen, R. & Garcia, I. & Schneider, D.A. & Maas, W.R. & Bozzette, S.A. & Shapiro, M.F., 2000. "Perceived unmet need for oral treatment among a national population of HIV-positive medical patients: Social and clinical correlates," American Journal of Public Health, American Public Health Association, vol. 90(7), pages 1059-1063.
    8. Zeynep Or & Florence Jusot & Engin Yilmaz, 2009. "Inégalités de recours aux soins en Europe. Quel rôle attribuable aux systèmes de santé ?," Revue économique, Presses de Sciences-Po, vol. 60(2), pages 521-543.
    9. Litaker, David & Love, Thomas Ezra, 2005. "Health care resource allocation and individuals' health care needs: examining the degree of fit," Health Policy, Elsevier, vol. 73(2), pages 183-193, August.
    10. repec:dau:papers:123456789/9219 is not listed on IDEAS
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    Cited by:

    1. Connolly, Sheelah & Wren, Maev-Ann, 2017. "Unmet healthcare needs in Ireland: Analysis using the EU-SILC survey," Health Policy, Elsevier, vol. 121(4), pages 434-441.
    2. Pengfei Sheng & Tingting Yang & Tengfei Zhang, 2021. "The Unmet Medical Demand among China’s Urban Residents," IJERPH, MDPI, vol. 18(21), pages 1-13, November.
    3. Allin, Sara & Farmer, Julie & Quiñonez, Carlos & Peckham, Allie & Marchildon, Gregory & Panteli, Dimitra & Henschke, Cornelia & Fattore, Giovanni & Lamloum, Demetrio & Holden, Alexander C.L. & Rice, T, 2020. "Do health systems cover the mouth? Comparing dental care coverage for older adults in eight jurisdictions," Health Policy, Elsevier, vol. 124(9), pages 998-1007.
    4. Damiano Fiorillo, 2020. "Reasons for unmet needs for health care: the role of social capital and social support in some western EU countries," International Journal of Health Economics and Management, Springer, vol. 20(1), pages 79-98, March.
    5. Başar, Dilek & Dikmen, Fatih Hakan & Öztürk, Selcen, 2021. "The prevalence and determinants of unmet health care needs in Turkey," Health Policy, Elsevier, vol. 125(6), pages 786-792.
    6. Erik Schokkaert & Jonas Steel & Carine Van de Voorde, 2017. "Out-of-Pocket Payments and Subjective Unmet Need of Healthcare," Applied Health Economics and Health Policy, Springer, vol. 15(5), pages 545-555, October.
    7. Monika Karasiewicz & Ewelina Chawłowska & Agnieszka Lipiak & Barbara Więckowska, 2021. "A Step towards Understanding and Tackling Health Inequalities: The Use of Secondary Prevention Services and the Need for Health Promotion in a Rural Setting," IJERPH, MDPI, vol. 18(16), pages 1-18, August.
    8. Carnazza, Giovanni & Liberati, Paolo & Resce, Giuliano, 2023. "Income-related unmet needs in the European countries," Socio-Economic Planning Sciences, Elsevier, vol. 87(PA).
    9. Carlota Quintal & Luis Moura Ramos & Micaela Antunes & Óscar Lourenço, 2023. "Unmet healthcare needs among the population aged 50+ and their association with health outcomes during the COVID-19 pandemic," European Journal of Ageing, Springer, vol. 20(1), pages 1-14, December.
    10. Palm, Willy & Webb, Erin & Hernández-Quevedo, Cristina & Scarpetti, Giada & Lessof, Suszy & Siciliani, Luigi & van Ginneken, Ewout, 2021. "Gaps in coverage and access in the European Union," Health Policy, Elsevier, vol. 125(3), pages 341-350.
    11. Jens Detollenaere & Lise Hanssens & Veerle Vyncke & Jan De Maeseneer & Sara Willems, 2017. "Do We Reap What We Sow? Exploring the Association between the Strength of European Primary Healthcare Systems and Inequity in Unmet Need," PLOS ONE, Public Library of Science, vol. 12(1), pages 1-13, January.
    12. Veronika Kočiš Krůtilová & Lewe Bahnsen, 2021. "Cost-Induced Unmet Need for Health Care among Europe's Older Adults - The Role of Specific Diseases," European Journal of Business Science and Technology, Mendel University in Brno, Faculty of Business and Economics, vol. 7(2), pages 210-222.
    13. Carla Blázquez-Fernández & David Cantarero-Prieto & Patricio Pérez-González, 2018. "Unmet health care needs among the working-age population. Evidence from the great recession in Spain," Working Papers. Collection B: Regional and sectoral economics 1806, Universidade de Vigo, GEN - Governance and Economics research Network.
    14. Ramos, Luís Moura & Quintal, Carlota & Lourenço, Óscar & Antunes, Micaela, 2019. "Unmet needs across Europe: Disclosing knowledge beyond the ordinary measure," Health Policy, Elsevier, vol. 123(12), pages 1155-1162.
    15. Caterina Francesca Guidi & Laia Palència & Silvia Ferrini and Davide Malmusi, 2016. "Inequalities by immigrant status in unmet needs for healthcare in Europe: the role of origin, nationality and economic resources," RSCAS Working Papers 2016/55, European University Institute.
    16. Quintal, Carlota & Lourenço, Óscar & Ramos, Luís Moura & Antunes, Micaela, 2019. "No unmet needs without needs! Assessing the role of social capital using data from European social survey 2014," Health Policy, Elsevier, vol. 123(8), pages 747-755.
    17. 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.
    18. Šime Smolić & Ivan Čipin & Petra Međimurec, 2022. "Access to healthcare for people aged 50+ in Europe during the COVID-19 outbreak," European Journal of Ageing, Springer, vol. 19(4), pages 793-809, December.

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    More about this item

    Keywords

    Access to health care; Unmet needs; Medical care; Dental care; European comparison; I10; I18;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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