In the EU, 4 per cent of people aged 16 and over have reported having an unmet need for a medical examination or treatment.
Among individuals who actually have required medical care, the proportion reporting unmet health care is even higher.
These unmet medical needs may be due to personal reasons or systemic issues with healthcare provision in individual countries, including long waiting times, costs, and so on.
The proportion of people reporting unmet healthcare needs varies significantly across Europe.
So, which countries have the highest rates of unmet healthcare needs? What are the main reasons for this? And how do experts and scholars explain the country-level differences?
The proportion of people reporting unmet healthcare needs ranged from 0.2 per cent in Cyprus to 15.5 per cent in Estonia, with an EU average of 3.8 per cent.
Albania and Greece were among the top three countries, each reporting rates above 13 per cent.
Surprisingly, Denmark (12.2 per cent), Finland, and Norway (both over 7.5 per cent) report relatively high levels of unmet healthcare needs, despite being among the wealthy Nordic countries. Sweden also ranked above the EU average.
Central and Western European countries like Germany (0.5 per cent), Austria (1.3 per cent), and the Netherlands (1.4 per cent) show very low unmet needs, suggesting highly accessible and efficient healthcare systems.
Among the EU’s four largest economies, France reported the highest level of unmet healthcare needs at 6.3 per cent, while the others remained below the EU average.
Health system factors vs personal reasons
Unmet medical needs in the EU consist of two main reasons: reasons related to the healthcare system (2.4 per cent) and reasons that are not related to the health system but are personal factors (1.4 per cent), resulting in a total of 3.8 per cent.
These proportions vary widely across EU member states, candidate countries, and EFTA countries included in the survey.
Healthcare system issues include three main factors: waiting list (1.2 per cent), treatment being too expensive (1 per cent), and too far to travel for treatment (0.1 per cent), with these figures representing the EU average.
Healthcare system-related reasons dominate in five countries, three of which report unmet medical needs exceeding 10 per cent: Estonia (12.9), Greece (11.6), and Albania (10.7). This proportion was also above 7.5 per cent in Finland and Latvia.
Cost vs waiting times
The sources of systemic problems vary across countries. For example, in Greece and Albania, over 9 per cent of people reported being unable to meet their medical needs due to healthcare being too expensive.
In contrast, long waiting lists were the main barrier in Estonia (12 per cent) and Finland (7.5 per cent).
Reasons not related to the healthcare system include personal factors, such as: "No time," "Didn't know any good doctor or specialist," "Fear of doctor, hospital, examination or treatment," and "Wanted to wait and see if problem got better on its own".
The OECD and European Commission’s Health at a Glance: Europe 2024 report notes that focusing only on the subgroup of the population with medical care needs increases the rate of unmet needs in all countries. This excludes those who reported no care needs.
In some cases, the increase is quite substantial, Greece being a notable example. Here, over one in five people (21 per cent) who had medical care needs reported that their needs were not met in 2023 due to reasons related to the healthcare system.
This was 12 per cent in Finland and 10 per cent in Latvia.
Unmet care needs rise with lower income
In every EU country, people with the lowest incomes face more unmet medical needs than those with the highest incomes, due to reasons related to the healthcare system. In the EU, the overall average was 2.4 per cent.
This share rose to 3.8 per cent among low-income groups, while it was just 1.2 per cent among those with higher incomes.
This gap is wider in some countries, in particular. For example, in Greece, nearly one in four people (23 per cent) in the lowest income quintile reported unmet medical care, compared to just 3.4 per cent in the highest income group.
In Finland, the figures were 10 per cent versus 4.9 per cent, and in France, 5.3 per cent versus 1.9 per cent.
"Unmet health needs are an important public health challenge that arises from different reasons," Dr Tit Albreht, President of the European Public Health Association (EUPHA), told Euronews Health.
"We can assume that an important part of the causes lies in the governance of health systems, but also in the ways other complementary systems are integrated in a more holistic management of health needs of the population".
Why are there gaps between countries?
Tina Taube, Director, Market Access & OMP Policy Lead at European Federation of Pharmaceutical Industries and Associations (EFPIA), explained that unmet medical needs vary widely across European countries due to differences in disease areas, access to diagnosis and treatment, healthcare system readiness, and national reimbursement policies.
She noted that the concept of unmet need is context-specific, depending on the patient, disease type, and available technology.
"Needs for cardiovascular patients might differ from the needs of patients with rare diseases… It’s not just about product availability but also access to diagnosis and healthcare at national level," she told Euronews Health.
'Waiting times vary widely'
Andy Powrie-Smith, Communications Executive Director at EFPIA, emphasised the significant disparities across European countries in terms of access to new treatments.
He notes that patients in one country can wait up to seven times longer than those in a neighbouring country due to a variety of barriers.
These include regulatory processes, pricing and reimbursement delays, and the readiness of healthcare systems.
As treatments become more advanced - for instance, with gene and cell therapies - the need for skilled professionals and robust healthcare infrastructure becomes even more critical.
Powrie-Smith stated that differences in healthcare spending, infrastructure, and economic capacity across countries all influence how well a country can deliver new treatments to its population.
Albreht of EUPHA pointed out that the level of healthcare financing does not appear to be the decisive factor in the survey results, as some countries with high total health expenditure - such as Denmark, Finland, and Norway - still report high unmet needs, while others with much lower expenditure - like Albania and Greece - show similar patterns.
"These results definitely require a closer insight into the figures," he said.
Eurostat highlighted that the results are derived from self-reported data, so it is, to a certain extent, affected by respondents’ subjective perception as well as by their social and cultural background.
