The hidden crisis: classifying unmet healthcare needs in European older adults during COVID-19

This study investigates the unmet healthcare needs of older adults during the COVID-19 pandemic, leveraging data from the Survey of Health, Ageing and Retirement in Europe (SHARE) and the two waves of the SHARE Corona Survey (SCS) conducted in 2020 and 2021. Using latent class analysis (LCA) with covariates, we identified distinct groups based on experiences of forgoing medical treatments due to fear of infection, postponed medical appointments, and denied care, while examining socio-demographic, economic, and health-related differences in class membership. The two-wave data provide insights into patterns of unmet healthcare needs across time, highlighting groups whose situations appeared to either improve or deteriorate. Our findings reveal six distinct classes of healthcare needs: no unmet needs, high early postponement with rapid improvement, rising barriers, high early fear-based barriers, high denial with persistent postponement, and persistently high fear-based barriers. We observe significant disparities in class membership based on age, gender, living arrangements, rural/urban residence, education, employment status, financial hardship, self-rated health, changes in health, and the number of chronic conditions. High-risk groups, particularly women, those with lower education, those experiencing financial hardship, and individuals with multiple chronic conditions, were identified as especially vulnerable to unmet healthcare needs during the pandemic. Our findings offer targeted insights for intervention and policy, aiming to address healthcare access disparities among older adults during such crises.