Unmet Medication Needs and the Association with Mortality in Older Adults: Equality-Oriented Monitoring toward Universal Health Coverage.

With population aging becoming a global trend, the unmet medication needs of older individuals are steadily increasing, potentially leading to a decline in quality of life and increased mortality. To identify unmet medication needs and inequality, and the association with health outcomes. A total of 69,443 participants in 31 countries from five international cohorts of aging were included. We measured the unmet medication needs level across sociodemographic strata. We developed an equality-oriented health care service coverage index (ESCI) and explored its relation to all-cause mortality in older adults over 55 years of age. Unmet medication needs in older adults with chronic conditions reached 41.84%. The highest unmet needs were observed in older age groups and participants with multimorbidity. The ESCI was further constructed by covering both the unmet needs level and inequality. An inverse association was observed between the ESCI and all-cause mortality in older adults (β=-16.81, P=0.047) as well as mortality rate owing to noncommunicable diseases (β=-17.58, P=0.041). The ESCI was inversely associated with mortality in older adults. This index could serve as a process evaluation indicator in assessing the progress toward UHC and healthy aging.