Is there a link between self-reported unmet needs and healthcare expenditure?

Liliane Bonnal (), Pascal Favard () and Thomas Laurent ()
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Liliane Bonnal: UFR Sciences Économiques
Pascal Favard: UFR de Droit, d’Économie et des Sciences Sociales
Thomas Laurent: UFR de Droit, d’Économie et des Sciences Sociales

International Journal of Health Economics and Management, 2025, vol. 25, issue 3, No 5, 407-435

Abstract: Abstract This study aims to investigate the factors associated with self-reported unmet healthcare needs among individuals aged 65 and older in France, as well as to determine whether healthcare expenditure and its determinants differ based on self-reported unmet needs. We use data from the 2012 Health and Welfare Survey, matched with health insurance records. Healthcare expenditure for ambulatory care—excluding inpatient care—is modeled using a regime-switching regression approach. Our findings highlight that social and behavioral disparities are the primary factors influencing self-reported unmet needs. The determinants of healthcare expenditure are generally similar, regardless of whether individuals report unmet needs, except for pre-frailty and the number of medical conditions. Surprisingly, we do not find a significant marginal effect of self-reported unmet needs on healthcare expenditure. In our view, this challenges the use of self-reported unmet needs as an indicator of access to care.

Keywords: Healthcare expenditure; Self-reported unmet needs; Core indicator; Older adults; Switching model (search for similar items in EconPapers)
JEL-codes: C31 I12 (search for similar items in EconPapers)
Date: 2025
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DOI: 10.1007/s10754-025-09399-2

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