Unmet healthcare needs, health outcomes, and health inequalities among older people in China

ObjectiveThis study examines whether the experience of unmet healthcare needs in a large sample of Chinese adults aged 60 and over is associated with adverse health outcomes, and how this association varied across needs related to health conditions. Study designThe 2013 wave of the China Health and Retirement Longitudinal Study is examined. We adopted latent class analysis to identify groups based on health conditions. Then in each identified group, we examined the extent to which unmet needs were associated with self-rated health and depression. To understand the channels through which unmet needs adversely affected health outcomes, we examined the impact of unmet needs attributed to various factors. ResultsCompared to the mean, experiencing unmet outpatient needs is associated with a 3.4% decrease in self-rated health, and people are twice as likely to have depression symptoms (OR = 2.06). Health problems are even more severe when inpatient needs are not met. The frailest people are most affected by affordability-related unmet needs, while healthy people are most affected by unmet needs attributable to availability. ConclusionTo tackle unmet needs, direct measures for particular populations will be required in the future.

Automated summary

This study examines the association between unmet healthcare needs and adverse health outcomes among Chinese adults aged 60 and over, and how this association varies across different health conditions. The findings show that unmet outpatient needs are associated with a 3.4% decrease in self-rated health and a twofold increased risk of depression symptoms. The impact is even more severe when inpatient needs are not met. Affordability-related unmet needs greatly affect the frailest individuals, while availability-related unmet needs have a greater impact on healthy individuals. Direct measures for specific populations will be required to address unmet needs in the future.