Public pensions and unmet medical need among older people: cross-national analysis of 16 European countries, 2004–2010

نویسندگان

  • Aaron Reeves
  • Martin McKee
  • Johan Mackenbach
  • Margaret Whitehead
  • David Stuckler
چکیده

BACKGROUND Since the onset of the Great Recession in Europe, unmet need for medical care has been increasing, especially in persons aged 65 or older. It is possible that public pensions buffer access to healthcare in older persons during times of economic crisis, but to our knowledge, this has not been tested empirically in Europe. METHODS We integrated panel data on 16 European countries for years 2004-2010 with indicators of public pension, unemployment insurance and sickness insurance entitlement from the Comparative Welfare Entitlements Dataset and unmet need (due to cost) prevalence rates from EuroStat 2014 edition. Using country-level fixed-effects regression models, we evaluate whether greater public pension entitlement, which helps reduce old-age poverty, reduces the prevalence of unmet medical need in older persons and whether it reduces inequalities in unmet medical need across the income distribution. RESULTS We found that each 1-unit increase in public pension entitlement is associated with a 1.11 percentage-point decline in unmet medical need due to cost among over 65s (95% CI -0.55 to -1.66). This association is strongest for the lowest income quintile (1.65 percentage points, 95% CI -1.19 to -2.10). Importantly, we found consistent evidence that out-of-pocket payments were linked with greater unmet needs, but that this association was mitigated by greater public pension entitlement (β=-1.21 percentage points, 95% CI -0.37 to -2.06). CONCLUSIONS Greater public pension entitlement plays a crucial role in reducing inequalities in unmet medical need among older persons, especially in healthcare systems which rely heavily on out-of-pocket payments.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

The attack on universal health coverage in Europe: recession, austerity and unmet needs

More than 1.5 million extra people have unmet need for healthcare since the beginning of the economic crisis in Europe. The advent of the Great Recession has placed Europe's health systems under severe pressure, with real terms cuts to funding in many countries. 1 Accounts in the peer-reviewed literature and popular media have catalogued examples of vulnerable groups and individuals unable to a...

متن کامل

Health-Related Needs of Older Adults in Rafsanjan City, Kerman Province, Iran

Introduction: Meeting the needs of the elderly in order to promote active aging among them is becoming more and more important every day. Moreover, careful planning is needed for principled planning. In this regard, this study tries to use Camberwell Assessment of Need for the Elderly (CANE) as a multi-dimensional tool, to get a comprehensive understanding of the health-related needs of the eld...

متن کامل

Unmet health care needs of older people: prevalence and predictors in a French cross-sectional survey

BACKGROUND Unmet health care needs are associated with negative health outcomes, yet there is a paucity of data on this problem among older people. OBJECTIVE To identify unmet health care needs and associated factors among older people in France. METHODS This is a cross-sectional population study of people aged 70 years or older in which 2350 respondents were interviewed in 2008-10. During ...

متن کامل

Assessing Vision-Related Quality of Life of Older People in Tehran and Associated Factors

Background: Visual disorders in old age is one of the most important factors in decreasing quality of life of older people. This study aimed to access the vision-related quality of life of older people in Tehran and to examine some of the underlying factors. Materials and Methods: This was a population-based cross-sectional study among 566 older people aged 60 years and over, living in Tehran....

متن کامل

The Main Determinants of Under 5 Mortality Rate (U5MR) in OECD Countries: A Cross-Sectional Study

Introduction: Child mortality indices are key element that reflects health Status of societies and inform policy makers to take suitable policies to reduce them. This study was performed to examine the main determinants of under-5 mortality rate (U5MR) in OECD countries in two cross-sections, 2010 and 2013, and the results of them was compared. Material and Methods: This was a cross- sectional ...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:

دوره 71  شماره 

صفحات  -

تاریخ انتشار 2017