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Do We Reap What We Sow? Exploring the Association between the Strength of European Primary Healthcare Systems and Inequity in Unmet Need

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  • Jens Detollenaere
  • Lise Hanssens
  • Veerle Vyncke
  • Jan De Maeseneer
  • Sara Willems

Abstract

Access to healthcare is inequitably distributed across different socioeconomic groups. Several vulnerable groups experience barriers in accessing healthcare, compared to their more wealthier counterparts. In response to this, many countries use resources to strengthen their primary care (PC) system, because in many European countries PC is the first entry-point to the healthcare system and plays a central role in the coordination of patients through the healthcare system. However it is unclear whether this strengthening of PC leads to less inequity in access to the whole healthcare system. This study investigates the association between strength indicators of PC and inequity in unmet need by merging data from the European Union Statistics on Income and Living Conditions database (2013) and the Primary Healthcare Activity Monitor for Europe (2010). The analyses reveal a significant association between the Gini coefficient for income inequality and inequity in unmet need. When the Gini coefficient of a country is one SD higher, the social inequity in unmet need in that particular country will be 4.960 higher. Furthermore, the accessibility and the workforce development of a country’s PC system is inverse associated with the social inequity of unmet need. More specifically, when the access- and workforce development indicator of a country PC system are one standard deviation higher, the inequity in unmet healthcare needs are respectively 2.200 and 4.951 lower. Therefore, policymakers should focus on reducing income inequality to tackle inequity in access, and strengthen PC (by increasing accessibility and better-developing its workforce) as this can influence inequity in unmet need.

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  • 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.
    • Handle: RePEc:plo:pone00:0169274
    DOI: 10.1371/journal.pone.0169274
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    3. Ann, Kirby & Murphy, Aileen, 2022. "Would universal general practitioner care impact Irish adolescents’ utilisation?," Health Policy, Elsevier, vol. 126(7), pages 652-660.
    4. Kang, Lili & Zhao, Guangchuan, 2022. "Financial support for unmet need for personal assistance with daily activities: Implications from China's long-term care insurance pilots," Finance Research Letters, Elsevier, vol. 45(C).
    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. Dorien Vanden Bossche & Sara Willems & Peter Decat, 2022. "Understanding Trustful Relationships between Community Health Workers and Vulnerable Citizens during the COVID-19 Pandemic: A Realist Evaluation," IJERPH, MDPI, vol. 19(5), pages 1-15, February.
    7. Kuhlmann, Ellen & Groenewegen, Peter P. & Bond, Christine & Burau, Viola & Hunter, David J., 2018. "Primary care workforce development in Europe: An overview of health system responses and stakeholder views," Health Policy, Elsevier, vol. 122(10), pages 1055-1062.
    8. Andrea Riganti, 2021. "Containing costs in the Italian local healthcare market," Health Economics, John Wiley & Sons, Ltd., vol. 30(5), pages 1001-1014, May.
    9. 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.
    10. 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.

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