Foregone care due to cost, distance or sociocultural factors
Data type:
Proportion
Topic:
Ageing
Rationale:
This indicator identifies barriers to healthcare access, revealing disparities and guiding policymakers and healthcare providers in developing targeted interventions for equitable access. It assesses the healthcare system's effectiveness and responsiveness to older persons' needs, informing policy reforms to improve service delivery and reduce financial burdens on older people and their families. Addressing these barriers promotes inclusive and sustainable healthcare systems, ensuring that all older persons receive timely and appropriate healthcare, regardless of their financial situation or location.
Definition:
Forgone care due to cost, distance, or sociocultural factors refers to situations where individuals, in this case older persons aged 60 years and over, decide not to seek or receive necessary healthcare services because of financial limitations, geographic distance from healthcare providers or facilities, or cultural beliefs and practices that influence their healthcare-seeking behaviour. This concept underscores the impact of economic, geographical, and sociocultural barriers on healthcare access and utilization among older people, highlighting disparities in healthcare delivery and potentially affecting health outcomes and well-being.
Disaggregation:
Age (five-year age band), sex, income level, education level, place of residence (administrative region, e.g. cities, towns, semi-dense areas, and rural areas), setting ( residential care facility, at home in the community), disability status, nationally relevant population groups
Method of measurement
This indicator is measured using data from nationally representative population surveys of older persons aged 60 years and over. Respondents are first asked whether they needed health care during the past 12 months. Those who report needing care are then asked whether they received the care they needed. Respondents who report that they did not receive needed care are further asked to identify the reasons for not obtaining care, with response options including cost, distance or transport barriers, and sociocultural factors (such as stigma, discrimination, or cultural beliefs). The numerator comprises older persons aged 60 years and over who report needing care in the past 12 months but not receiving it due to cost, distance, or sociocultural factors. The denominator comprises all older persons aged 60 years and over who report needing health care during the same reference period. The indicator is calculated as the proportion of respondents with unmet need due to these barriers among those reporting a need for care, multiplied by 100.
Other possible data sources:
None recommended
Preferred data sources:
Published nationally-representative population-based surveys
This indicator measures the proportion of older persons who report having forgone needed health care due to cost, distance, or sociocultural factors, but it does not capture the full range or interaction of barriers affecting access to care. It does not distinguish the types of services that were forgone or the severity of unmet need. The indicator relies on self-reported information, which may be affected by recall bias, differences in respondents’ understanding of unmet need, or willingness to report barriers. In addition, variations in survey design, including differences in question wording, response options, and reference periods, may affect prevalence estimates and limit comparability across countries.
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