Unmet healthcare needs, health outcomes, and health inequalities among older people in China

Objective: This study examines whether the experience of unmet healthcare needs in a large sample of Chinese adults aged 60 and over is associated with adverse health outcomes, and how this association varied across needs related to health conditions. Study design: The 2013 wave of the China Health and Retirement Longitudinal Study is examined. We adopted latent class analysis to identify groups based on health conditions. Then in each identified group, we examined the extent to which unmet needs were associated with self-rated health and depression. To understand the channels through which unmet needs adversely affected health outcomes, we examined the impact of unmet needs attributed to various factors. Results: Compared to the mean, experiencing unmet outpatient needs is associated with a 3.4% decrease in self-rated health, and people are twice as likely to have depression symptoms (OR = 2.06). Health problems are even more severe when inpatient needs are not met. The frailest people are most affected by affordability-related unmet needs, while healthy people are most affected by unmet needs attributable to availability. Conclusion: To tackle unmet needs, direct measures for particular populations will be required in the future.