Building predictive models to better understand older people’s unmet health needs around the world
As populations age, their health needs become increasingly complex. But in many countries, not all health needs of older people are being met, with services either not being provided, accessed, or affordable. Measuring older people’s unmet needs in health is a complex and multifaceted problem, with no standard definition or agreed method of measurement. Needs may be partially met, met with difficulty or delay, or met sometimes and not other times. Health and social care services might be available, accessed and provided, but not necessarily in a way that is appropriate to the problem, or acceptable to the patient. Current survey instruments don’t always catch those with unmet needs or capture all the nuance required to understand why needs went unmet.
A recent study supported by the WHO Centre for Health Development (WHO Kobe Centre – WKC) explored how to capture and predict this information using novel mathematical models.
Existing studies of unmet health need often use self-reporting in surveys to measure unmet need; however, on their own, self-reporting depends on a number of factors that introduce bias, such as perception of need and propensity to seek care, and do not provide further information on why care could not be obtained, what demand or supply side barriers exist, or how coverage could be improved. Previous studies supported by WKC found a very wide range of levels of unmet need from self-reported surveys.
The authors aimed to better estimate true prevalence by identifying other measures that could serve as proxy indicators of unmet need, such as the individual’s personal factors (age, sex, and education level), enabling factors (social and financial support), and contextual factors (healthcare system and setting).
The study found that a universally applicable model was not possible - personal, social, and contextual factors play a more definitive role than was anticipated. Certain factors were more important in determining levels of unmet need in some countries and settings than in others, preventing the development of a universal method of measurement. While unmet need for health among older people remains a primary emerging issue for most countries around the world, more research is needed to understand country- and region-specific context that contribute to unmet need.
Find more about our work on unmet needs here.
WKC Working Paper: Measuring unmet need for older adults in low-, middle- and high-income countries: theoretical and analytical model building.
This paper was written by Barbara Corso, Kanya Anindya, Nawi Ng, Nadia Minicuci, Megumi Rosenberg, Paul Kowal, and Julie Byles.