Multi-criteria decision analysis as a tool for evaluation of unmet needs in health care

The United Nations Sustainable Development Goals appointthat all Member States have agreed to try to achieve Universal HealthCoverage by 2030. This includes financial risk protection, access to qualityessential health-care services and access to safe, effective, quality andaffordable essential medicines for all. The World Health Organisation hasdefined the Universal Health Coverage as a priority, which means that allpeople can use the preventive, curative, rehabilitative and palliative healthcare services they need, of sufficient quality to be effective, while alsoensuring that the use of these services does not expose the user to financialhardship. The classic approach of the unmet medical needs is definedas the total self-reported unmet needs for medical care for the followingthree reasons: financial barriers, waiting times, too far to travel. Accordingto the Eurostat data, overall range of unmet medical needs in Latvia isthe highest of the European Union countries, however, the accessibilityof health services depends on a multitude of factors that relate to thehealth system and also to the patients themselves. Therefore the Multi-criteria decision analysis approach could be acceptable for assessment ofthe unmet medical needs. The data on unmet medical needs for Latviashould be additionally evaluated, taking into account the “therapeutic need”,which refers to the need for a better treatment than the treatment currentlyreimbursed, from the perspective of the patient. Apart from therapeutic need,the concept of societal need should be investigated, which refers to theneed for a better treatment than the currently available treatment for societalreasons.