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: LéP [Poitiers] - Laboratoire d'économie de Poitiers [UR 13822] - UP - Université de Poitiers = University of Poitiers, TSE-R - Toulouse School of Economics - UT Capitole - Université Toulouse Capitole - Comue de Toulouse - Communauté d'universités et établissements de Toulouse - EHESS - École des hautes études en sciences sociales - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement
Pascal Favard: IRJI - Institut de Recherche Juridique Interdisciplinaire - UT - Université de Tours
Thomas Laurent: IRJI - Institut de Recherche Juridique Interdisciplinaire - UT - Université de Tours

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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)
Date: 2025-07-08
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Published in International Journal of Health Economics and Management, 2025, 25 (3), pp.407-435. ⟨10.1007/s10754-025-09399-2⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-05552333

DOI: 10.1007/s10754-025-09399-2

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