School of Medicine and Population Health, University of Sheffield, Sheffield, United Kingdom.
PLoS One. 2024 Oct 29;19(10):e0312475. doi: 10.1371/journal.pone.0312475. eCollection 2024.
Self-reported unmet healthcare needs are a useful indicator of access to healthcare, but there is little research from low- and middle-income countries. This study sought to investigate the prevalence and determinants of unmet needs arising from wait times, distance/transportation and financial affordability in Bulgaria using European Health Interview Survey data. We explored associations between individual characteristics and the probability of reporting unmet need by fitting logistic regression models to the data. Unaffordability-related unmet needs were the most cited barrier to access. The largest proportion of people reported unmet dental care needs (14%) or unmet needs due to unaffordability of medicines (8%); distance/transportation problems were the least cited reason (3%). People with poor physical and mental health had a substantially higher probability of experiencing unmet needs. Those with a disability, less disposable income, less social support and lower educational attainment were also more likely to report unmet healthcare needs. People who lived in rural areas experienced specific barriers to access, most notably from distance or transportation issues. Unmet healthcare needs lead to inefficiencies for the healthcare system and are more prevalent among already disadvantaged societal groups. Ensuring better access to healthcare is therefore important from both the efficiency and equity perspectives.
自我报告的未满足的医疗保健需求是衡量获得医疗保健的有用指标，但来自低收入和中等收入国家的研究甚少。本研究旨在利用欧洲健康访谈调查数据，调查保加利亚因等待时间、距离/交通和经济负担能力而产生的未满足需求的流行程度和决定因素。我们通过拟合逻辑回归模型来探索个人特征与报告未满足需求的概率之间的关联。与经济负担能力相关的未满足需求是获得医疗保健的最大障碍。报告未满足牙科护理需求（14%）或因药品负担能力而导致的未满足需求（8%）的人所占比例最大；距离/交通问题是最少被提及的原因（3%）。身心健康状况较差的人更有可能经历未满足的需求。有残疾、可支配收入较少、社会支持较少和受教育程度较低的人也更有可能报告未满足的医疗保健需求。居住在农村地区的人面临着特定的获得医疗保健的障碍，最明显的是距离或交通问题。未满足的医疗保健需求导致医疗保健系统效率低下，而且在已经处于不利社会地位的群体中更为普遍。因此，从效率和公平的角度来看，确保更好地获得医疗保健是很重要的。
