Oh brother how art thou? The propensity to report self-assessed unmet need

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Résumé (français)

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Résumé (anglais)

Research investigating self-assessed unmet need (SUN) has taken the reports from surveys as given and subsequently attempted to discover patterns in inequality of access to healthcare. This requires the yet untested assumption that, given a certain level of care and demand, the likelihood of reporting unmet need does not vary across socio-economic status, be satisfied. Using an administrative dataset and a set of conditions that suggest unmet need, we evaluate the proposition that propensity to report unmet need does not vary along socio-economic status. The results are further validated using the Canadian Community Health Survey. Subsequent discussions frame the results within a set of priors about inequality. We find that the assumption of independence between reporting and socio-economic status is not satisfied. Many of the groups found to have less access in previous studies seem to have a higher propensity to report unmet need. The results of this research suggest that, in its present incarnation, survey data on self-assessed unmet need does not adequately measure what much of the academic literature has assumed it does.