Presentation (CTI)

OBJECTIVES: Analyzing and addressing the unmet medical needs (UMNs) of older adults is one of the key agendas for health systems to achieve the goals of universal health coverage. This study aims to investigate the distribution, determinants, and inequalities of UMNs among Chinese older adults.
METHODS: The data used from the 2023 National Health Service Survey in Hainan, with a sample of 4112 adults aged 60 and above. The UMNs were operationalized into four types: financial difficulty, access difficulty, perceived dissatisfaction, and other reasons. Chi-square tests and binary logistic regression were used to examine the factors associated with UMNs. Additionally, concentration indices and concentration curves were to reflect the health inequalities in UMNs, and a decomposition approach was further employed to examine the contribution of each factor to these inequalities.
RESULTS: 21.60% of the sample reported UMNs. Compared to the reference group, older adults who are of the Li ethnic group, had no personal income, did not participate in social activities, had no access to aging services, had a higher number of chronic diseases, and not physically independent had a higher likelihood of UMNs (P < 0.05). Additionally, socioeconomic-related health inequalities existed in the UMNs of the older adults, with a higher concentration among those with poorer economic conditions, lower educational levels, and those living in the western region (P < 0.01). The top three contributing factors to these inequalities were ethnicity (-47.03%), number of chronic diseases (-36.93%), and household per capita income (-25.36%).
CONCLUSIONS: The UMNs of older adults and the potential threat to inequalities require the attention of policymakers. Policy interventions should focus on expanding the coverage of medical services and address financial and non-financial barriers to accessing medical services, especially for poor and vulnerable individuals living in areas with fewer medical resources.