UNMET MEDICAL CARE NEEDS AMONG PATIENTS WITH DEMENTIA AND THEIR FAMILY MEMBERS: A HOUSEHOLD-LEVEL ANALYSIS OF MEPS
Author(s)
yuzhi han, BS1, luyi chen, BS1, Shanshan Li, MS2, Shaoxi Pan, MS3, Hongyan Wu, PhD1, Beini Lyu, PhD2;
1Guizhou Medical University, Guiyang, China, 2Peking University, Beijing, China, 3Department of Health Economics and Medical Insurance, The Second Affiliated Hospital of Army Medical University, Chongqing, China
1Guizhou Medical University, Guiyang, China, 2Peking University, Beijing, China, 3Department of Health Economics and Medical Insurance, The Second Affiliated Hospital of Army Medical University, Chongqing, China
OBJECTIVES: Family members of patients with dementia may experience higher unmet medical needs than patients themselves because caregiving responsibilities, time constraints, psychological burden, and health-system barriers often shift attention away from their own care. However, empirical evidence remains limited. We aimed to estimate differences in unmet medical needs between patients with dementia and their family members.
METHODS: We used data from the Medical Expenditure Panel Survey (MEPS) from 2012-2017. We identified families that included a patient with dementia and at least one family member without dementia. Unmet medical needs were defined as self-reported inability to obtain or delays in receiving medical care, dental care, or prescription medications. Covariates included demographic characteristics, socioeconomic status, and comorbidities. Conditional logistic regression models were used to compare unmet medical needs between patients and their family members within households.
RESULTS: The study included 628 families comprising 634 patients with dementia and 917 family members. Patients were significantly older (mean age 76.88 vs 56.24 years), had lower educational attainment, and had greater comorbidity burden and functional limitations than family members. Overall, 10.57% of patients and 14.72% of family members reported at least one unmet medical need. After adjustment, family members had significantly higher odds of any unmet medical need (adjusted odds ratio [OR] 2.59, 95% CI 1.46-4.59), unmet medical care (4.77, 1.70-13.42), and unmet prescription medication needs (4.46, 1.62-12.30), but not unmet dental care needs.
CONCLUSIONS: Family members of patients with dementia face substantially higher unmet medical needs than patients themselves. These findings highlight caregivers as a vulnerable yet under-recognized population. Health systems that focus exclusively on patient-centered care may inadvertently overlook caregivers’ access to needed medical services. Integrating caregiver health assessment and support into dementia care pathways may help reduce hidden disparities and improve the sustainability of dementia care.
METHODS: We used data from the Medical Expenditure Panel Survey (MEPS) from 2012-2017. We identified families that included a patient with dementia and at least one family member without dementia. Unmet medical needs were defined as self-reported inability to obtain or delays in receiving medical care, dental care, or prescription medications. Covariates included demographic characteristics, socioeconomic status, and comorbidities. Conditional logistic regression models were used to compare unmet medical needs between patients and their family members within households.
RESULTS: The study included 628 families comprising 634 patients with dementia and 917 family members. Patients were significantly older (mean age 76.88 vs 56.24 years), had lower educational attainment, and had greater comorbidity burden and functional limitations than family members. Overall, 10.57% of patients and 14.72% of family members reported at least one unmet medical need. After adjustment, family members had significantly higher odds of any unmet medical need (adjusted odds ratio [OR] 2.59, 95% CI 1.46-4.59), unmet medical care (4.77, 1.70-13.42), and unmet prescription medication needs (4.46, 1.62-12.30), but not unmet dental care needs.
CONCLUSIONS: Family members of patients with dementia face substantially higher unmet medical needs than patients themselves. These findings highlight caregivers as a vulnerable yet under-recognized population. Health systems that focus exclusively on patient-centered care may inadvertently overlook caregivers’ access to needed medical services. Integrating caregiver health assessment and support into dementia care pathways may help reduce hidden disparities and improve the sustainability of dementia care.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
HSD5
Topic
Health Service Delivery & Process of Care