Table 1 Data items

Authors and date of publication

Extraction of authors and the date of publication.

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Study design

Categorisation by primary studies of quantitative and qualitative nature.

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Time period and location researched

Description of research period and research location (e.g., regions).

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Study description

A free text description of the study

Description according to study aims

A free-text description of study outcomes categorised through thematic analysis into major themes

The categorisation process of the study outcomes related to specific barriers was based on the framework of Levesque et al. (2013) [23].

UMN emerged as one central theme during the categorisation process. UMN was not clustered under the categories of Levesque et al. (2013), as the concept of UMN concerns the aggregated barriers for measuring access to healthcare [23].

The concept of UMN was based on the EU-SILC survey allowing full comparability.

The four major themes emerged as follows:

1) Unmet Healthcare Need;

2) Availability and Accommodation;

3) Affordability of Access to Healthcare;

4) Appropriateness

Organisation:

Free text descriptions of the four emerged main themes were broken down into two subthemes.

The following two recurring sub-themes emerged per major theme: “Austerity on the general population” and “Austerity on vulnerable population groups”.

Vulnerable populations are defined as individuals that are disadvantaged in one or more socioeconomic factors (e.g., income, employment, housing and education) and may have difficulty accessing healthcare and receiving a certain quality of care which can affect individuals’ health. This state, in turn, causes them to be at higher risk for disparate healthcare access and outcomes [32].