Access disparity and health inequality of the elderly: unmet needs and delayed healthcare

Abstract

The purpose of this study is to investigate healthcare access disparity that will cause delayed and unmet healthcare needs for the elderly, and to examine health inequality and healthcare cost burden for the elderly. To produce clear policy applications, this study adapts a modified PRECEDE-PROCEED model for framing theoretical and experimental approaches. Data were collected from a large collection of the Community Tracking Study Household Survey 2003-2004 of the USA. Reliability and construct validity are examined for internal consistency and estimation of disparity and inequality are analyzed by using probit/ols regressions. The results show that predisposing factors (e.g., attitude, beliefs, and perception by socio-demographic differences) are negatively associated with delayed healthcare. A 10% increase in enabling factors (e.g., availability of health insurance coverage, and usual sources of healthcare providers) are significantly associated with a 1% increase in healthcare financing factors. In addition, information through a socio-economic network and support system has a 5% impact on an access disparity. Income, health status, and health inequality are exogenously determined. Designing and implementing easy healthcare accessibility (healthcare system) and healthcare financing methods, and developing a socio-economic support network (including public health information) are essential in reducing delayed healthcare and health inequality.

Figure 1

Self-reported generally perceived delay in healthcare and generally perceived unmet needed healthcare: Individuals aged 65 or older in the Community Tracking Survey.

Figure 2

Application of PRECEDE-PROCEED Model to examine generally perceived delay in health care and generally perceived unmet needed health care.

Figure 3

Concentration curves—Access Disparity (Income): Generally perceived delay in healthcare (Delayed care), Generally perceived unmet needed health care (Unmet needs), and Unmet needed prescription drug (Unmet prescription).

Figure 4

Concentration curves—Access Disparity (Out of Pocket): Generally perceived delay in healthcare (Delayed care), Generally perceived unmet needed health care (Unmet needs), and Unmet needed prescription drug (Unmet prescription) by Out-of-pocket costs.