OBJECTIVES:

The concave relationship between income and health suggest lowered effectiveness of healthcare measures for an additional dollar of income. Increased unmet health needs during financial crises have been very concerning for the European OECD countries, and thus finding measures to address increasing unmet health needs is pivotal. This study aims to examine the significance of primary care regulations in mitigating the adverse effects of long-term unemployment during financial crises.

METHODS:

The data for 20 high-income European OECD countries (2006 – 2013), extracted from Eurostat, were analyzed using panel data analysis, and the variables for different cross-sections over a time span were observed using random effects and fixed effects model(s). F-test, calculated using R² values adjusted for number of covariates in different models, was used to test the nested models and results were analyzed using Stata-v11.

RESULTS:

While long-term unemployment resulting from financial crises is associated, strongly and positively, with unmet health needs for all levels of income (p < 0.05 to p < 0.01); primary care regulations – a key determinant of primary healthcare – is associated, strongly but negatively, with unmet health needs. The unmet health needs decreased from 0.52, 0.37, 0.29 and 0.24 percent across the first, second, third and fourth income-quintiles to 0.21, 0.16, 0.15 and 0.14 percent, respectively, compared to the countries without the practice of primary care regulations. However, the magnitude of effects of primary care regulations gradually decreased with increasing income.

CONCLUSIONS:

During a financial crisis, primary care regulations can mitigate the adverse effects of long-term unemployment, such as unmet health needs. The presence of primary care regulations as the first point of contact controls patients’ access to tertiary care, significantly, facilitating to meet most of the health issues at the primary level. However, such mitigating effects gradually diminish with increasing income.