Abstract
BACKGROUND: Equitable access to healthcare services remains a major public health concern, particularly for vulnerable populations. Despite significant improvements following comprehensive healthcare reforms in Türkiye, perceived unmet healthcare needs persist, disproportionately affecting individuals with chronic illnesses, depressive symptoms, and limited social support. This study, therefore, examines gender-stratified associations between these factors and different types of perceived unmet healthcare needs. METHODS: We analyzed data from the 2019 Türkiye Health Survey (n = 17,084), a nationally representative dataset. The primary outcome, perceived unmet healthcare needs, was a categorical variable capturing eight distinct types: long wait times, transportation difficulties, cost-related barriers to medical care, dental care, prescribed medications, mental healthcare, and the presence of multiple unmet needs. Key independent variables included social support, measured using the Oslo Social Support Scale (OSSS-3); depression, assessed via the Patient Health Questionnaire (PHQ-8 ≥ 10); and the presence of a long-standing illness. Survey-weighted multivariable logistic regression models, stratified by gender and adjusted for relevant sociodemographic covariates, were employed to estimate adjusted odds ratios (aOR). We also examined regional disparities in perceived unmet healthcare needs to better understand geographic variation in healthcare access across Türkiye. RESULTS: Overall, 46.7% of participants reported multiple unmet healthcare needs, with long wait times, dental costs, and transportation as leading barriers. Depression was strongly associated with unmet mental healthcare (men: aOR = 7.35; 95% CI: 2.10–15.75; women: aOR = 3.91; 95% CI: 1.34–5.46). Chronic illness increased the odds of unmet needs, especially for medical costs and mental healthcare (women: aOR = 3.43; 95% CI: 1.23–9.58; 9.41; 95% CI: 2.01–14.10). Social support was found to be a protective factor against perceived unmet healthcare needs among both men and women. Regional differences were evident across various perceived unmet healthcare needs, with individuals from all regions more likely to report experiencing multiple unmet needs. CONCLUSION: Addressing healthcare inequalities requires tackling both structural and psychosocial barriers. Our results show that unmet needs are highest among those with chronic illness, depression, and low social support. Expanding the healthcare workforce and prioritizing disadvantaged groups can help reduce these gaps and improve access.