Unmet healthcare needs in Southeastern Europe: a systematic review.

ABSTRACT

Objectives: This study sought to systematically review the existing literature on self-reported unmet healthcare needs in Southeastern Europe. Methods: A systematic literature review of quantitative evidence in English and Bulgarian was performed in July 2023 using the following databases Medline, Embase and EconLit. Publications were only included if they used self-reported unmet healthcare needs as an indicator of access to healthcare, concerned people living in Albania, Bosnia and Herzegovina, Bulgaria, Greece, Kosovo, Montenegro, Serbia, North Macedonia or Romania and if they were published after 2003. Quality assessment of the included publications was performed using the Appraisal tool for Cross-Sectional Studies (AXIS) tool. Results: Twenty-three publications of varying quality were included in the review. Significantly more evidence was available for Greece, Bulgaria and Romania than for the rest of the region. Data collected through Pan-European surveys were commonly used, but almost half of the studies were only descriptive. Generally, the prevalence of unmet healthcare needs has decreased over the years. Unmet healthcare needs were higher among people of lower socioeconomic and educational status, ethnic minorities and migrants and high cost was consistently identified as the primary barrier to accessing healthcare. Conclusion: Unmet healthcare needs are more prevalent among already disadvantaged societal groups. A trend of a declining prevalence of unmet needs has been observed, but it is more notable in the more socioeconomically developed countries. Improving financial protection should be a priority for the healthcare systems.

Unmet healthcare needs in Southeastern Europe A person is very good at identifying when their health needs are met. So, using self-reported unmet need is very useful when studying access to healthcare. This study looked at all of the existing literature on self-reported unmet healthcare needs of people living in Southeastern Europe ­ Albania, Bosnia and Herzegovina, Bulgaria, Greece, Kosovo, Montenegro, Serbia, North Macedonia and Romania. A study had to be in English or Bulgarian and containing numerical data in order to be included. Studies were picked from three academic databases (Medline, Embase and EconLit) in July 2023. Not a lot of evidence on unmet healthcare needs in Southeastern Europe was available. Only 23 studies were included in the review, and among those, the quality was variable. A lot more evidence was present for Greece, Bulgaria and Romania than for the other countries. Most of the studies used data from Pan-European surveys, but more than half of them did not analyse them. A general trend that emerged was that unmet healthcare needs have decreased over the years. However, they were found to still be higher among people who are poorer or less educated, migrants or from ethnic minorities. Also, people most often said that high costs are the biggest issue when accessing healthcare. This means that the healthcare systems in those countries should become more protective of these groups of society.