Abstract
BackgroundUnmet healthcare needs - the difference between healthcare services deemed necessary to deal with a particular health problem and the actual services received - is commonly measured by the question, "During the past 12 months, was there ever a time when you felt that you needed healthcare, but you didn't receive it?" In 2003, unmet needs were reported by 10% of immigrants in Canada, yet, little is known specifically about Chinese- or Punjabi-speaking immigrants' perceptions and reporting of unmet needs. Our study examined: 1) How are unmet healthcare needs conceptualized among Chinese- and Punjabi-speaking immigrants? 2) Are their primary healthcare experiences related to their unmet healthcare needs?MethodsTwelve focus groups (6 Chinese, 6 Punjabi; n = 78) were conducted in Chinese or Punjabi and socio-demographic and health data were collected. Thematic analysis of focus group data examined the perceptions of unmet needs and any relationship to primary healthcare experiences.ResultsOur analysis revealed two overarching themes: 1) defining an unmet healthcare need and 2) identifying an unmet need. Participants had unmet healthcare needs in relation to barriers to accessing care, their lack of health system literacy, and when the health system was less responsive than their expectations.ConclusionsAsking whether someone ever had a time when they needed healthcare but did not receive it can either underestimate or overestimate unmet need. Measuring unmet need using single items is likely insufficient since more detail in a revised set of questions could begin to clarify whether the reporting of an unmet need was based on an expectation or a clinical need. Who defines what an unmet healthcare need is depends on the context (insured versus uninsured health services, experience in two or more healthcare systems versus experience in one healthcare system) and who is defining it (provider, patient, insurer).
Highlights
Unmet healthcare needs - the difference between healthcare services deemed necessary to deal with a particular health problem and the actual services received - is commonly measured by the question, “During the past 12 months, was there ever a time when you felt that you needed healthcare, but you didn’t receive it?” In 2003, unmet needs were reported by 10% of immigrants in Canada, yet, little is known about Chinese- or Punjabi-speaking immigrants’ perceptions and reporting of unmet needs
Unmet healthcare need has been defined as the “difference between healthcare services deemed necessary to deal with a particular health problem and the actual services received” [1]
Examples of questions include: “What is the first thing you do after deciding that you need healthcare or advice?"; “What are the most important things to take into consideration in choosing this specific provider/place to go for healthcare or advice?"; “During the past 12 months, was there ever a time when you felt that you needed healthcare, but you didn’t receive it?” This paper reports on a secondary analysis conducted to examine participants’ discussions of unmet healthcare needs within the context of primary healthcare
Summary
Unmet healthcare needs - the difference between healthcare services deemed necessary to deal with a particular health problem and the actual services received - is commonly measured by the question, “During the past 12 months, was there ever a time when you felt that you needed healthcare, but you didn’t receive it?” In 2003, unmet needs were reported by 10% of immigrants in Canada, yet, little is known about Chinese- or Punjabi-speaking immigrants’ perceptions and reporting of unmet needs. Our study examined: 1) How are unmet healthcare needs conceptualized among Chinese- and Punjabi-speaking immigrants? Differences in unmet needs among different population groups could represent either true differences in access to healthcare or differences in interpretation by respondents who speak a different language or have different cultural backgrounds. Without examining the concept of unmet healthcare needs in ESL groups, self-report measures of unmet needs may be inadequate
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