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 a standardized interview, a nurse examined health problems, functional abilities and use of health care resources. Unmet health care needs were defined as situations in which a participant needed health care and did not receive it.

RESULTS

The mean age was 83.2 ± 7.4 years. Almost all participants reporting a chronic disease (98.6%) had consulted a physician in the previous 6 months. Unmet health care needs were found in 23.0% of the sample and mainly consisted of lack of dental care (prevalence of 17.7%), followed by lack of management of visual or hearing impairments (prevalence of 4.4% and 3.1%, respectively). Age was the main factor associated with unmet health care needs [compared with people aged 70-79: odds ratio80-89 years = 2.26 (1.70-3.03), odds ratio90 years and over = 3.85 (2.71-5.45)]. Other associated factors were regular smoking, homebound status, poor socioeconomic conditions, depression, limitations in instrumental activities of daily living and low medical density.

CONCLUSION

Unmet health care needs affect almost one-quarter of older people in France. Efforts should be made to improve oral health and develop home care, especially for the oldest-olds.