How social policies can improve financial accessibility of healthcare: a multi-level analysis of unmet medical need in European countries

Israel, Sabine

doi:10.1186/s12939-016-0335-7

International Journal for Equity in Health

Table 3 Individual and country-level determinants of income-related unmet medical needs

From: How social policies can improve financial accessibility of healthcare: a multi-level analysis of unmet medical need in European countries

Category	Variable	M1	M2	M3	M4
Sample Population		ALL	ALL	Q1	Q2
Health	Bad health	0.035**	0.037**	0.062**	0.050**
		(8.43)	(9.28)	(9.42)	(8.95)
	Chronic illness	0.010**	0.011**	0.018**	0.013**
		(8.07)	(8.81)	(7.66)	(7.59)
Sex (Ref. male)	Women	0.007**	0.007**	0.010**	0.010**
Sex (Ref. male)		(6.81)	(7.24)	(4.41)	(5.22)
Household composition (Ref. 2 adults, no child)	Single parent	0.008**	0.009**	0.008+/o	0.008*/o
		(4.70)	(4.85)	(1.88)	(2.10)
	Household with children	0.000	0.000	−0.001	−0.002
		(0.26)	(0.26)	(−0.56)	(−1.05)
Migrant status (Ref. national)	Migrant	0.005**	0.005**	0.012**	0.002
Migrant status (Ref. national)		(4.07)	(4.19)	(3.53)	(0.87)
Education (Ref. Higher education)	Low education	0.009**	0.009**	0.015**	0.005+/o
		(6.30)	(6.11)	(3.63)	(1.76)
	Medium education	0.002**	0.003**	0.006	−0.002
		(2.97)	(3.00)	(1.56)	(−0.70)
Location	Access to primary care	−0.008**	−0.008**	−0.012**	−0.009**
		(−7.69)	(−7.40)	(−6.29)	(−5.80)
	Access to public transport	−0.000	−0.000	−0.003*/o	−0.001
		(−0.52)	(−0.07)	(−2.25)	(−1.16)
Employment (Ref. Employed)	Unemployed	0.015**	0.017**	0.019**	0.017**
Employment (Ref. Employed)		(7.19)	(7.09)	(5.22)	(4.47)
Debts	Eviction for financial reasons	0.024**	0.025**	0.042**	0.044**
Debts		(6.44)	(6.80)	(5.34)	(6.06)
Financial situation	Gross income (in log)	−0.008**	−0.008**	−0.007**	−0.007**
Financial situation		(−8.23)	(−9.02)	(−6.57)	(−5.06)
Health policy
Financing	Out-of-pocket expenditure	0.077*/+	0.063+/o	0.001+/o	0.120**
Financing		(2.08)	(1.81)	(1.83)	(2.66)
Infrastructure	Physician density	−0.012*	−0.013**	−0.020*	−0.015*
Infrastructure		(−2.50)	(−2.87)	(−2.55)	(−2.64)
Social policy
Categorical benefits	Unemployment allowance		−0.001	−0.001	−0.002
			(−0.92)	(−0.44)	(−0.94)
	Family allowance		−0.002	−0.003	−0.002
			(−1.55)	(−1.45)	(−1.58)
Pro-poor benefits	Social allowance		−0.01*	−0.005*	−0.008*
			(−2.56)	(−2.27)	(−2.22)
	Housing allowance		−0.000	0.004	0.001
			(−0.85)	(1.56)	(0.23)
N (C = 30)		283,078	283,078	47,640	56,635
Intra-class correlation		0121	0097	0102	0098
R2		0107	0107	0093	0103
Bayes information criterium		72,800	72,806	19,662	17,831
Log-likelihood		−36,262	−36,258	−9707	−8790

Note: Source: EU SILC. Displayed are average marginal effects on having low FAH. Sample: all EU SILC countries (C = 30) except for Croatia and Cyprus. Controlled for but not displayed: population density. Significance levels: ^op/z > 0.1 (insignificant); +p/z < 0.1; *p/z < 0.05; **p/z < 0.001, Bonferroni significance levels (if different) follow after the slash (/). Z-statistics are shown brackets. Social policy variables were added step-wise, the statistics displayed refer to the model with the highest log-likelihood

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