Unmet health care needs and inequality: A cross-country comparison of the situation of people with spinal cord injury

Health Services Research, 2021 · DOI: 10.1111/1475-6773.13738 · Published: January 1, 2021

Simple Explanation

This study examines the problem of unmet healthcare needs among people with spinal cord injuries (SCI) in 20 different countries. It looks at how income affects whether people with SCI can get the medical care they need and what barriers they face. The findings help to highlight the areas where improvements are needed in different countries to ensure that people with SCI receive appropriate healthcare.

Study Duration

Not specified

Participants

12,095 adults aged 18 years and older with SCI

Evidence Level

Cross-sectional study

Key Findings

1
Unmet health care needs are significant for people with long-term conditions like SCI, and those in low-income groups are more affected.
2
The most significant barrier to accessing health care is the cost of health care services, followed by transportation and service availability.
3
The probability of unmet health care needs is highest in Morocco, followed by South Africa and Brazil, and lowest in Spain, followed by Norway, Thailand, France, and Switzerland.

Research Summary

This article analyzes the unmet health care needs of persons with spinal cord injury (SCI). We compared the results between low- and high-income groups across 20 countries to identify areas for intervention. Unmet health care needs for persons with SCI are a latent issue explained by the costs of health care services, transportation, and services availability.

Practical Implications

Prioritize Areas for Action

Results can be used to prioritize areas for action in each country, which can also improve effectiveness and efficiency in the provision of health services.

Design Pro-Poor Insurance Schemes

The health care system can design pro-poor insurance schemes that eliminate copayments or cap the OOP expenditure for low-income groups.

Implement Support Measures

The social system can support the health system by designing support measures aiming at financial protection for high-needs groups, like persons with SCI. These measures can target barriers that are not directly linked to the health system, such as transportation or the lack of information.

Study Limitations

1
Limited information about the incidence and prevalence of SCI makes designing representative samples challenging.
2
Some countries were unable to randomize their sample, and convenience sampling had to be implemented.
3
Lack of information from the highest income groups.

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