What does this research mean for the field?

Individuals in Serbia had 1.6 times higher odds of reporting unmet healthcare needs during the COVID-19 pandemic compared to the pre-pandemic period. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.CHALLENGES_CONSENSUS.

What question did this study set out to answer?

This research analyzes the factors associated with unmet healthcare needs in Serbia during the COVID-19 pandemic compared to the pre-pandemic period.

February 28, 2026Open Access

Factors Associated with Unmet Healthcare Needs in Serbia Before and During the COVID-19 Pandemic: Analysis Based on EU-SILC Data

Key Points

This research analyzes the factors associated with unmet healthcare needs in Serbia during the COVID-19 pandemic compared to the pre-pandemic period.
Data sourced from the Survey on Income and Living Conditions in Serbia for 2019 and 2021.
Pooled sample comprised of 21,422 adults aged 16 and older from both survey years.
Multivariable logistic regression analysis used to examine associations.
Respondents had 1.6 times higher odds of unmet healthcare needs during the pandemic.
Older adults and those with poor self-rated health were significantly more likely to report unmet needs.
Higher education levels and retirement were linked to lower odds of unmet needs.
Individuals in higher income quintiles reported fewer unmet needs compared to the lowest income quintile.
Residents in thinly populated areas had higher odds of reporting unmet needs.

Abstract

Background/Objectives: The COVID-19 pandemic substantially affected both the provision and demand for health services. There are few studies that analyzed factors associated with unmet healthcare needs during the COVID-19 pandemic relative to regular pre-pandemic period, mainly in high-income countries. This study examines the change in the likelihood of reporting unmet healthcare needs as well as individual demographic, socioeconomic, health-related, and geographical characteristics associated with unmet healthcare needs during the COVID-19 pandemic and during the pre-pandemic period in Serbia. Methods: We utilized data from the Survey on Income and Living Conditions in the Republic of Serbia for 2019 and 2021. Multivariable logistic regression analysis was conducted on the pooled sample comprising 21,422 respondents aged 16 years and older from both survey years. Results: Overall, respondents had 1.6 times higher odds of reporting unmet healthcare needs during the COVID-19 pandemic compared with the pre-pandemic period. In the pooled multivariable analysis, older adults (OR = 2.32), individuals reporting poor or very poor self-rated health (OR = 2.16), and those with chronic diseases (OR = 1.46) were more likely to report unmet healthcare needs. In contrast, individuals with higher levels of education (ORs = 0.72 for high school, 0.65 for college, and 0.51 for master’s degree), retired individuals (OR = 0.70), inactive persons (OR = 0.76), and students/pupils (OR = 0.22) had significantly lower odds of unmet needs, compared to their counterparts. Relative to the poorest income quintile, individuals in all higher income quintiles were less likely to report unmet healthcare needs, with the lowest odds observed in the 5th quintile (OR = 0.49). Residents of thinly populated areas had higher odds compared to those in densely populated areas (OR = 1.19). Conclusions: Identified associations with unmet healthcare needs should be used to develop targeted strategies for strengthening healthcare access, particularly in the context of future crises.

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