THE DETERMINANTS OF FORGOING HEALTHCARE FOR FINANCIAL REASONS IN FRANCE: A SYSTEMATIC REVIEW

Abstract

In order to study inequalities in access to healthcare, the international literature often uses the notion of unmet healthcare needs, whereas French studies are based on the notion of forgoing healthcare, and particularly on its financial reasons. It seems interesting to review the determinants of healthcare forgo for financial reasons (HFFR) in order to identify the most vulnerable populations. To achieve this objective, the article carries out a systematic review according to the criteria defined by the PRISMA 2020 method. Four research engines were consulted: Pubmed, Scopus, Cairn and Google Scholar. The different research engines identified 544 publications. After the selection process, 20 articles constituted the final corpus of the systematic review. It appears that the HFFR is impacted by both financial (income, precariousness, exposure to out-of-pocket expenses, etc.) and non-financial (social, demographic and health characteristics) factors. The literature on the determinants of HFFR in France is relatively rich and reaches a scientific consensus on some characteristics that lead to overexposure to HFFR. It could nevertheless be improved by studies taking into account more dimensions of access to healthcare and by adding a temporal dimension to improve the estimates.