Prevalence and determinants of unmet healthcare needs in Chinese residents: evidence from the China family panel studies, 2012–2022

Abstract

Introduction To examine temporal trends in unmet healthcare needs among Chinese residents from 2012 to 2022, identify their influencing factors, and high-risk populations, and provide empirical evidence for optimizing health service allocation and relevant policy formulation. Methods Based on six waves of the China Family Panel Studies (CFPS) spanning 2012 to 2022, this study included 11,067 residents aged 16 years and older who reported illness within the preceding 2 weeks, forming an unbalanced panel dataset with 30,925 observations. Guided by Andersen’s Behavioral Model of Health Services Use, generalized estimating equations (GEE) and panel fixed-effects logit regression models were employed to identify factors associated with unmet healthcare needs. Results The prevalence of unmet healthcare needs among Chinese residents fluctuated significantly over the decade. It declined steadily from 37.50% in 2012 to 28.94% in 2016 and subsequently rebounded to 46.07% in 2022. Regression results indicated that employed and urban residents, were more vulnerable to unmet healthcare needs. Stronger health beliefs and higher trust in physicians served as crucial protective factors, whereas perceived disease severity and chronic disease management significantly shaped residents’ healthcare-seeking behavior. Conclusion Unmet healthcare needs remain prevalent among Chinese residents and are affected by multidimensional risk factors. Future health policies should strengthen health system resilience. They must also deliver targeted interventions for high-risk groups, such as employed and urban residents. Furthermore, it is essential to promote public health education and foster physician–patient trust. Finally, scaling up standardized chronic disease management will facilitate early health screening and encourage proactive health management.