Unmet Needs because of Cost in the Paris Metropolitan Area: Evolution between 2005 and 2010

Emilie Renahy, St Michael's Hospital
Isabelle Parizot, Centre Maurice Halbwachs (CNRS-EHESS-ENS), Paris
Amélie Quesnel-Vallée, McGill University
Pierre Chauvin, Institut National de la Santé et de la Recherche Médicale (INSERM) and UPMC Sorbonne

In this paper, we assess the social determinants of unmet health care needs, both at the individual and societal level. Using data from the SIRS Cohort study (Paris) in 2005 and 2010, we showed that, at comparable socioeconomic status, the gap between expectations and access to health care can sometimes be perceived as a frustration that occur more frequently among people with negative perceptions of their socioeconomic and health status, have been through difficult life trajectories, are socially isolated and have high care expectations or needs. Our work stressed that unmet needs because of cost cannot be understood without paying special attention to how people perceive their health needs and their financial situation. We also showed how the impact of health coverage status has changed over time and how the health system – and any change in public policy – might have a strong impact on health inequalities.