Unmet Health Care Needs and Adverse Outcomes for Patients with Chronic Disease
Date
2013-03-06
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Abstract
Chronic medical conditions such as diabetes, hypertension, and heart disease are common in Canada and often occur together. Despite the availability of effective treatments, many Canadians do not receive optimal care for these conditions. This may be due to a number of factors, including reduced access to health services. The overall objective of this thesis was to improve knowledge of barriers to care and their association with adverse outcomes among patients with chronic disease.
We conducted three independent studies to address this objective. Our first study provides a national perspective on the potential gaps in care for Canadians with chronic disease. Using population-based survey data we found that 1 in 7 adults with chronic disease report a perceived unmet health care need – a commonly used indicator of limited access to care. Participants with multiple chronic conditions (multi-morbidity) were more likely to report a barrier to care. Furthermore, the most commonly reported reasons for an unmet need were related to service wait times and resource availability. By linking national survey and administrative data, our second study explored whether these perceived barriers to care were associated with adverse health outcomes. Unmet health care need was not associated with an increased risk of hospitalization when studied in aggregate form. However, when stratified by unmet need type, adults reporting barriers related to resource availability had an increased risk of all-cause hospitalization compared to those without. Our final study examined factors related to health system use and their association with adverse outcomes. Using provincial administrative data, specific patterns of health resource use and discharge disposition were associated with increased risk of subsequent hospitalization after discharge among patients with diabetes.
Despite a universal health care system, gaps in care for patients with chronic medical conditions remain. Although our findings highlight a number of potentially modifiable gaps in chronic disease care, further understanding of the concept of unmet health care need and the various factors that influence it are required. This may inform areas for future intervention aimed at enhancing and improving management for those living with chronic medical conditions.
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Epidemiology
Citation
Ronksley, P. E. (2013). Unmet Health Care Needs and Adverse Outcomes for Patients with Chronic Disease (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca. doi:10.11575/PRISM/28587