title: Unmet health care needs of older people: prevalence and predictors in a French cross-sectional survey.
abstract: BACKGROUND
  Unmet health care needs are associated with negative health outcomes, yet there is a paucity of data on this problem among older people.
  
  
  OBJECTIVE
  To identify unmet health care needs and associated factors among older people in France.
  
  
  METHODS
  This is a cross-sectional population study of people aged 70 years or older in which 2350 respondents were interviewed in 2008-10. During a standardized interview, a nurse examined health problems, functional abilities and use of health care resources. Unmet health care needs were defined as situations in which a participant needed health care and did not receive it.
  
  
  RESULTS
  The mean age was 83.2 ± 7.4 years. Almost all participants reporting a chronic disease (98.6%) had consulted a physician in the previous 6 months. Unmet health care needs were found in 23.0% of the sample and mainly consisted of lack of dental care (prevalence of 17.7%), followed by lack of management of visual or hearing impairments (prevalence of 4.4% and 3.1%, respectively). Age was the main factor associated with unmet health care needs [compared with people aged 70-79: odds ratio80-89 years = 2.26 (1.70-3.03), odds ratio90 years and over = 3.85 (2.71-5.45)]. Other associated factors were regular smoking, homebound status, poor socioeconomic conditions, depression, limitations in instrumental activities of daily living and low medical density.
  
  
  CONCLUSIONS
  Unmet health care needs affect almost one-quarter of older people in France. Efforts should be made to improve oral health and develop home care, especially for the oldest-olds.
authors.affiliation: 1 Laboratoire Santé-Environnement-Vieillissement (EA2506), Université Versailles Saint Quentin, Paris, France marie.herr@spr.aphp.fr.
authors.forename: Marie
authors.initials: M
authors.lastname: Herr
authors.affiliation: 2 AG2R La Mondiale, Direction des Etudes, Prévoyance Individuelle et IARD, Paris, France.
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Arvieu
authors.affiliation: 1 Laboratoire Santé-Environnement-Vieillissement (EA2506), Université Versailles Saint Quentin, Paris, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Aegerter
authors.affiliation: 3 INSERM U988 and U710, EPHE, Paris and Montpellier, France.
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Robine
authors.affiliation: 1 Laboratoire Santé-Environnement-Vieillissement (EA2506), Université Versailles Saint Quentin, Paris, France.
authors.forename: Joël
authors.initials: J
authors.lastname: Ankri
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D016321:Dental Care for Aged / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D005602:France; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006699:Home Care Services; D006801:Humans; D007407:Interviews as Topic / Q000379:methods; D008297:Male; D012959:Socioeconomic Factors