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Reasons for unmet needs for health care: the role of social capital and social support in some Western EU countries


  • Fiorillo, D.;


This paper focuses on the demand side factors that determine access to health care and analyses the issues of unmet needs for health care and the reasons thereof in western EU countries. A probit model is estimated from a sample of the whole population, accounting for the possibility of individual selection in unmet needs for health care (UN) (selection equation). Expanded probit models (including the inverse Mills ratio) are then used on the reasons for unmet needs (RUN) with social capital and social support as determinants and using the European Union Statistics on Income and Living Conditions (EU-SILC) dataset carried out in 2006. In RUN equations, the findings show that females, large households, people with low income and financial constraints, the unemployed and those in poor health have a higher probability of declaring unmet needs due to economic costs. Additionally, people in tertiary education, those with high income and the employed have a higher probability of not visiting a doctor when needed due to time availability. Furthermore, the frequency of contact with friends and the ability to ask for help are correlated with a lower probability of unmet needs due to economic costs, while the frequency of contact with relatives is related with a lower probability of unmet needs due to time availability and distance. However, the ability to ask for help is also correlated with a higher probability of not having medical care due to time availability and the wait-and-see-approach.

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  • Fiorillo, D.;, 2018. "Reasons for unmet needs for health care: the role of social capital and social support in some Western EU countries," Health, Econometrics and Data Group (HEDG) Working Papers 18/29, HEDG, c/o Department of Economics, University of York.
  • Handle: RePEc:yor:hectdg:18/29

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    References listed on IDEAS

    1. 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.
    2. Fiorillo, Damiano & Sabatini, Fabio, 2015. "Structural social capital and health in Italy," Economics & Human Biology, Elsevier, vol. 17(C), pages 129-142.
    3. repec:eme:jespps:v:43:y:2016:i:5:p:835-862 is not listed on IDEAS
    4. Lee, Sang-Yi & Kim, Chul-Woung & Kang, Jeong-Hee & Seo, Nam-Kyu, 2015. "Unmet healthcare needs depending on employment status," Health Policy, Elsevier, vol. 119(7), pages 899-906.
    5. Ahs, Annika Maria Helen & Westerling, Ragnar, 2006. "Health care utilization among persons who are unemployed or outside the labour force," Health Policy, Elsevier, vol. 78(2-3), pages 178-193, October.
    6. Fiorillo Damiano & Sabatini Fabio, 2011. "Quality and quantity: The role of social interactions in individual health," wp.comunite 0073, Department of Communication, University of Teramo.
    7. Lindstrom, Martin & Axen, Elin & Lindstrom, Christine & Beckman, Anders & Moghaddassi, Mahnaz & Merlo, Juan, 2006. "Social capital and administrative contextual determinants of lack of access to a regular doctor: A multilevel analysis in southern Sweden," Health Policy, Elsevier, vol. 79(2-3), pages 153-164, December.
    8. Bryant, Toba & Leaver, Chad & Dunn, James, 2009. "Unmet healthcare need, gender, and health inequalities in Canada," Health Policy, Elsevier, vol. 91(1), pages 24-32, June.
    9. Kumar, Santosh & Calvo, Rocio & Avendano, Mauricio & Sivaramakrishnan, Kavita & Berkman, Lisa F., 2012. "Social support, volunteering and health around the world: Cross-national evidence from 139 countries," Social Science & Medicine, Elsevier, vol. 74(5), pages 696-706.
    10. repec:aph:ajpbhl:10.2105/ajph.2006.086306_6 is not listed on IDEAS
    11. 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.
    12. Damiano Fiorillo, 2016. "Workers' health and social relations in Italy," Journal of Economic Studies, Emerald Group Publishing, vol. 43(5), pages 835-862, October.
    13. Allin, Sara & Grignon, Michel & Le Grand, Julian, 2010. "Subjective unmet need and utilization of health care services in Canada: What are the equity implications?," Social Science & Medicine, Elsevier, vol. 70(3), pages 465-472, February.
    14. Fiorillo, Damiano & Sabatini, Fabio, 2011. "Quality and quantity: The role of social interactions in self-reported individual health," Social Science & Medicine, Elsevier, vol. 73(11), pages 1644-1652.
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    More about this item


    unmet needs for healthcare; reasons for unmet needs; social capital; social support; EU Western countries; EU-SILC data; Heckman selection model;

    JEL classification:

    • C35 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Discrete Regression and Qualitative Choice Models; Discrete Regressors; Proportions
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • Z1 - Other Special Topics - - Cultural Economics

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