Abstract:
Current measures for monitoring progress towards universal health coverage (UHC) do not adequately account for populations that do not have the same level of access to quality care services and/or financial protection to cover health expenses for when care is accessed. This gap in accounting for unmet health care needs may contribute to underutilization of needed services or widening inequalities. Asking people whether or not their needs for health care have been met, as part of a household survey, is a pragmatic way of capturing this information. This analysis examined responses to self-reported questions about unmet need asked as part of 17 health, social and economic surveys conducted between 2001 and 2019, representing 83 low-, middle- and high-income countries. Noting the large variation in questions and response categories, the results point to low levels (less than 2%) of unmet need reported in adults aged 60+ years in countries like Andorra, Qatar, Republic of Korea, Slovenia, Thailand and Viet Nam to rates of over 50% in Georgia, Haiti, Morocco, Rwanda, and Zimbabwe. While unique, these estimates are likely underestimates, and do not begin to address issues of poor quality of care as a barrier or contributing to unmet need in those who were able to access care. Monitoring progress towards UHC will need to incorporate estimates of unmet need if we are to reach universality and reduce health inequalities in older populations.
摘要:
目前监测全民健康覆盖(UHC)进展的措施没有充分考虑到那些无法获得高质量护理服务和/或财政保护以支付获得护理时的医疗费用的人群。在解决未满足的医疗保健需求方面的这种差距可能导致所需服务的利用不足或不平等现象扩大。询问人们对医疗保健的需求是否得到满足,作为家庭调查的一部分,是捕捉这些信息的一种务实的方式。这项分析检查了对自我报告的问题的回应,这些问题是作为17个健康问题的一部分提出的,2001年至2019年之间进行的社会和经济调查,代表83个低,中高收入国家。注意到问题和答复类别的差异很大,结果表明,在安道尔等国家,60岁以上的成年人报告的未满足需求水平较低(不到2%),卡塔尔,大韩民国,斯洛文尼亚,泰国和越南在格鲁吉亚的比率超过50%,海地,摩洛哥,卢旺达,津巴布韦。虽然独一无二,这些估计很可能被低估了,并且不开始解决护理质量差的问题,将其作为障碍或导致能够获得护理的人的需求未得到满足。如果我们要实现普遍性并减少老年人口的健康不平等,监测全民健康覆盖的进展将需要纳入未满足需求的估计。