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Here comes the SUN: Self‐assessed unmet need, worsening health outcomes, and health care inequity
Author(s) -
Gibson Grant,
Grig Michel,
Hurley Jeremiah,
Wang Li
Publication year - 2019
Publication title -
health economics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.55
H-Index - 109
eISSN - 1099-1050
pISSN - 1057-9230
DOI - 10.1002/hec.3877
Subject(s) - socioeconomic status , health equity , equity (law) , health care , environmental health , medicine , self rated health , gerontology , psychology , economic growth , political science , economics , population , law
Summary Utilization‐based approaches have predominated the measurement of socioeconomic‐related inequity in health care. This approach, however, can be misleading when preferences over health and health care are correlated with socioeconomic status, especially when the underlying focus is on equity of access. We examine the potential usefulness of an alternative approach to assessing inequity of access using a direct measure of possible barriers to access—self‐reported unmet need (SUN)—which is documented to vary with socioeconomic status and is commonly asked in health surveys. Specifically, as part of an assessment of its external validity, we use Canadian longitudinal health data to test whether self‐reported unmet need in one period is associated with a subsequent deterioration in health status in a future period, and find that it is. This suggests that SUN does reflect in part reduced access to needed health care, and therefore may have a role in assessing health system equity as a complement to utilization‐based approaches.