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Evolution of the determinants of unmet health care needs in a universal health care system: Canada, 2001–2014

Published online by Cambridge University Press:  18 August 2020

Ian Allan  and
Mehdi Ammi Open the ORCID record for Mehdi Ammi [Opens in a new window]
Ian Allan
Affiliation:
School of Public Policy and Administration, Carleton University, Ottawa, Ontario, Canada
Mehdi Ammi*
Affiliation:
School of Public Policy and Administration, Carleton University, Ottawa, Ontario, Canada Centre for the Business and Economics of Health, University of Queensland, Queensland, Australia
*
*Corresponding author. Email: mehdi.ammi@carleton.ca
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Abstract

While ensuring adequate access to care is a central concern in countries with universal health care coverage, unmet health care needs remain prevalent. However, subjective unmet health care needs (SUN) can arise from features of a health care system (system reasons) or from health care users' choices or constraints (personal reasons). Furthermore, investigating the evolution of SUN within a health care system has rarely been carried out. We investigate whether health needs, predisposing factors and enabling factors differentially affect SUN for system reasons and SUN for personal reasons, and whether these influences are stable over time, using representative data from the Canadian Community Health Surveys from 2001 to 2014. While SUN slightly decreased overall during our period of observation, the share of SUN for system reasons increased. Some key determinants appear to consistently increase SUN reporting over all our observation periods, in particular being a woman, younger, in poorer health or not having a regular doctor. The distinction between personal and system reasons is important to better understand individual experiences. Notably, women report more SUN for system reasons and less for personal reasons, and reporting system reasons increases with age. Given this stability over time, our results may inform health policymakers on which subpopulations to target to ensure access to health care is universal.

Keywords

Accessibility of careCanadalongitudinal analysissystem and personal barriersuniversal health care systemsunmet health care needs
Type
Article
Information
Health Economics, Policy and Law , Volume 16 , Issue 4 , October 2021 , pp. 400 - 423
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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