Abstract Aim To investigate the impact of public healthcare expenditure on unmet healthcare needs among older European adults. Subject and methods Using data from wave 8 (2019/2020) of the Survey on Health, Ageing and Retirement in Europe (SHARE), multiple probit regression analyses were conducted to assess the independent effect of public healthcare expenditure on the probability of unmet needs. The study includes 42,780 respondents aged 50+ across 26 European countries. Results The prevalence of unmet healthcare needs increased substantially between 2004 and 2019/2020 across all countries with available data. In 2019/2020, Greece had the highest prevalence (27.8%), followed by Romania (20.9%) and Estonia (19.9%). The greatest increases over time, as well as the highest prevalence, were observed in specialist physician services. Higher public healthcare expenditure significantly reduced the probability of unmet healthcare needs across all outcomes. The marginal effects varied among countries, with the strongest impact observed in those with high unmet need
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