Unmet health care needs among the working-age population: Evidence from the Great Recession in Spain (2008-2012)

Abstract

Background. This study examines the relationship between unmet healthcare needs and employment status, with a focus on how this relationship was influenced by the Spanish economic recession of 2008-2012. Methods. Data were obtained from the Spanish National Health Survey for 2006 and 2011-2012. The outcome variable was the presence of unmet healthcare needs, describing its reasons. The analysis included the period (pre-crisis/crisis), demo-graphic variables (sex, age, Spanish citizenship), employment status, social factors (level of education, marital status, social-class), and health indicators (self-assessed health, chronic conditions, and limitations). Logistic regression was used to predict unmet health needs based on the period, employment status, and control variables. Results. The frequency of unmet healthcare needs was low and decreased further during the crisis (5% pre-crisis vs. 3% during the crisis). Unmet healthcare needs were more strongly associ-ated with health status than with employment status. However, among the unemployed, unmet healthcare needs increased during the crisis compared to the pre-crisis. Conclusions. The most vulnerable groups, characterized by higher unmet healthcare needs, included women, individuals with lower levels of education, and those in poorer health. These groups may require more targeted attention. These findings should be interpreted in the context of the Spanish National Health System, which is fully decentralized and provides healthcare and protection to all residents

Fundamento. Se analiza la relacion entre las necesidades de atencion medica no cubiertas (UHN) y la situacion laboral, y si esta relacion se vio modificada por la recesion economica de 2008-2012. Metodología. Se obtuvieron datos de la Encuesta Nacional de Salud de Espana de 2006 y de 2011-2012. La variable de resultado fue la existencia de UHN, describiendose sus motivos. Se considero el periodo (pre-crisis/crisis) y variables demográficas (sexo, edad, ciudadania espanola), de empleo, sociales (nivel de estudios, estado civil, clase social) y de salud (autoevaluada, cronicidad y limitaciones). Mediante regresion logistica se predijo la existencia de UHN segun periodo, situacion laboral y variables de control. Resultados. La frecuencia de UHN fue baja y disminuyo aun mas durante la crisis (5 vs. 3%). Las UHN se asociaron mas con el estado de salud que con la situacion laboral. En todo caso, las necesidades de atencion medica no cubiertas de los desempleados aumentarian en el periodo de crisis en comparación con el periodo anterior a la crisis. Conclusiones. Los grupos mas vulnerables (con mas necesidades de atencion medica no cubiertas) fueron las mujeres, las personas con menos nivel educativo, y los individuos menos sanos, por lo que requeririan una atencion mas pormenorizada. Estos hallazgos deben interpretarse considerando que el Sistema Nacional de Salud espanol, completamente descentralizado, brinda atencion medica y proteccion a todos los residentes