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Subjective unmet need and utilization of health care services in Canada: what are the equity implications?

Allin, Sara, Grignon, Michel and Le Grand, Julian ORCID: 0000-0002-7864-0118 (2010) Subjective unmet need and utilization of health care services in Canada: what are the equity implications? Social Science & Medicine, 70 (3). pp. 465-472. ISSN 0277-9536

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Identification Number: 10.1016/j.socscimed.2009.10.027


This study aimed to evaluate whether subjective assessments of unmet need may complement conventional methods of measuring socioeconomic inequity in health care utilization. This study draws on the 2003 Canadian Community Health Survey to develop a conceptual framework for understanding how unmet need arises, to empirically assess the association between utilization and the different types of unmet need (due to waiting times, barriers and personal reasons), and to investigate the effect of adjusting for unmet need on estimates of income-related inequity. The study's findings suggest that a disaggregated approach to analyzing unmet need is required, since the three different subgroups of unmet need that we identify in Canada have different associations with utilization, along with different equity implications. People who report unmet need due to waiting times use more health services than would be expected based on their observable characteristics. However, there is no consistent pattern of utilization among people who report unmet need due to access barriers, or for reasons related to personal choice. Estimates of inequity remain unchanged when we incorporate information on unmet need in the analysis. Subjective assessments of unmet need, namely those that relate to barriers to access, provide additional policy-relevant information that can be used to complement conventional methods of measuring inequity, to better understand inequity, and to guide policy action.

Item Type: Article
Official URL:
Additional Information: © 2009 Elsevier Ltd
Divisions: Social Policy
LSE Health
Subjects: F History United States, Canada, Latin America > F1001 Canada (General)
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
JEL classification: I - Health, Education, and Welfare > I1 - Health > I11 - Analysis of Health Care Markets
N - Economic History > N9 - Regional and Urban History > N92 - U.S.; Canada: 1913-
Date Deposited: 16 Feb 2011 16:27
Last Modified: 11 Jun 2024 01:09

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