Économie et Statistique n° 469-470 - Statistics on Income and Living Conditions (EU-Silc/SRCV) Income and poverty - longitudinal approach and international comparisons; quality of life
Refusal of medical and dental care: an analysis using SILC data
According to the figures from the fourth wave of the Statistics on Income and Living Conditions (SILC) survey carried out by INSEE in 2007, in the course of the last 12 months around 4% of people aged 16 or over decided not to seek medical care despite feeling the need for it, and almost 7% refrained from consulting a dentist. The financial obstacle is the reason most commonly given by respondents. However, many of them put forward non-financial reasons. Regarding medical care, a lack of time and the decision to wait for an improvement are often reported. For dental care, fear of the treatment is the second most common reason for refusal. The financial argument is more often mentioned in relation to dental care than to medical care (in one case out of two against one out of three). Over the period 2004-2007, the refusal rates for medical and dental care varied little. Similarly, the proportion of refusals for financial reasons remained fairly stable. Exploitation of the longitudinal part of the SILC survey reveals that among those who refused care in a given year, a fairly large number (in the order of 40% regarding dental care) made the same decision the following year. This recurring factor is even more marked when the refusal is for financial reasons. As can be expected, the results of panel data regressions (2004-2007) show that the financial situation of the household is one of the main factors in the decision not to seek care, whether medical or dental. Age, state of health, family status (especially among women) and the availability or not of a vehicle also have a significant impact on the likelihood of refusal. It is observed that poor health increases both the risk of refusal for financial reasons and the likelihood of refusal for other reasons. This link between state of health and refusal remains significant when the potentially endogenous nature of this factor is taken into account, at least in the case of dental care.