Abstract
Unmet health care needs have been designated as an indicator of equality in access to health care, which provides insight into specific barriers faced by respondents when they need medical services. The purpose of this research was to analyze demographic, socioeconomic, regional characteristics and perception of the health status; and identify predictors of unmet health care needs and consequently determine the size of inequalities in the availability, accessibility and acceptability of health care. The cross-sectional study obtained data from the Survey on Income and Living Conditions in the Republic of Serbia in 2014, based on a sample of 20,069 respondents over 16 years. Data was collected by using a household questionnaire and a questionnaire for individuals. Multivariate logistic regressions were applied. Almost every seventh citizen (14.9%) reported unmet health care needs. Predictors of unmet needs, for overall reasons, which increase the likelihood of their emergence included: self-perceived health status as very bad (OR = 6.37), divorced or widower/widow (OR = 1.31), living in the Sumadija region or Western Serbia (OR = 1.54) and belonging to the age group of 27 to 44 (OR = 1.55) or 45 to 64 years (OR = 1.52). The probability for those least reporting unmet health care needs included female patients (OR = 0.81), those with higher education (OR = 0.77), those who belong to the richest quintile (OR = 0.46) and who are unemployed (OR = 0.64). Reasons for unmet needs that indicate the responsibility of the health system amounted to 58.2% and reasons which represent preferences of the respondents amounted to 41.7%. The most frequent reason for unmet needs was financial (36.6%), and the wish to wait and see if the problem got better on its own (18.3%). Health policy should adopt a multidimensional approach and develop incentives for the appropriate use of health services and should eliminate barriers which restrict the accessibility and availability.
Highlights
Socioeconomic inequalities are present in the population’s health status and in access to and use of health care services [1, 2, 3]
Regional inequality of access to basic health services is significantly present in Serbia, despite systemic laws and the adopted principles of physical, geographical, economic and cultural accessibility of health care and the principle of equity
We recognize regional inequality and defined populations with unmet health care needs as the older male active population with basic education, the unemployed, those in the poorest income quintile group, those who usually live in thinly populated areas or in the regions of Vojvodina, Sumadija and Western Serbia, who assessed their health as poor, with chronic illnesses and functional limitations in daily activities
Summary
Socioeconomic inequalities are present in the population’s health status and in access to and use of health care services [1, 2, 3]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript
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