Unmet Health Care and Health Care Utilization

Abstract

Objective: To examine the causal effect of health care utilization on unmet health care needs. Methods: An instrumental variables approach deals with the endogeneity between the use of health care services and unmet health care. The presence of drug insurance and the number of physicians in each health region are used to identify the causal effect. The reasons for unmet health care needs are grouped into system and personal ones. We use four biennial confidential master files (2001-2010) of the Canadian Community Health Survey. Results: We find a clear and robustly negative relationship between health care use and unmet health care needs; a higher probability of unmet health care needs is attributable to a low use of health care services. One more visit to a medical doctor on average decreases the probability of having unmet health care needs by 0.028 points. If the unmet need is due to accessibility related reasons, this effect is 0.02 compared to only 0.015 point for personal related reasons. Conclusion: Health care use reduces the likelihood of reporting unmet health care. That the link between health care utilization and unmet health care needs is stronger for accessibility related reasons than for personal reasons, suggests that policies like increasing the coverage of public drug insurance, and increasing the number of physicians can reduce the likelihood of unmet health care.