Cost-Related Access Barriers, Medical Debt, and Dissatisfaction with Care Among Privately Insured Americans.
J Gen Intern Med
; 38(4): 938-945, 2023 03.
Article
em En
| MEDLINE
| ID: mdl-36167955
ABSTRACT
BACKGROUND:
Understanding experiences with private important to improving the quality of health care coverage.OBJECTIVE:
To examine the association of health with cost-related access barriers, medical debt, and dissatisfaction with care among privately insured Americans.DESIGN:
We classified Americans with private insurance by self-reported health status into five groups (excellent, very good, good, fair, and poor health). We examined self-reported difficulty seeing a doctor due to costs, not taking medications due to costs, medical debt, and dissatisfaction with care among individuals with differing health status. We used logistic regression to examine the association of health status with individuals' experiences after accounting for baseline characteristics. The analysis was repeated among individuals with different forms of private insurance. Odds ratios were converted to risk ratios to improve ease of interpretation of the results.SETTING:
Behavioral Risk Factor Surveillance System of Americans in 17 statesRESULTS:
The sample included 82,494 US adults with private insurance. Following adjustment, compared to individuals with excellent health those in very good health, good health, fair health, and poor health reported increasingly higher risks of difficulty seeing a doctor due to costs with risk ratios of 1.02 (95% CI 1.01, 1.03), 1.07 (95% CI 1.06, 1.08), 1.18 (95% CI 1.17, 1.20), and 1.29 (95% CI 1.27, 1.31), respectively. Compared to individuals with excellent health, those in very good health, good health, fair health, and poor health reported increasingly higher risks of not taking medication due to costs, outstanding medical debt, and dissatisfaction with care. Similar relationships were seen across individually purchased and employer-sponsored insurance.CONCLUSION:
Cost-related access barriers, medical debt, and dissatisfaction with care were common among individuals with private insurance and most pronounced among those with fair and poor health who likely need and use their health insurance the most.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Acessibilidade aos Serviços de Saúde
/
Seguro Saúde
Tipo de estudo:
Health_economic_evaluation
/
Risk_factors_studies
Limite:
Adult
/
Humans
País/Região como assunto:
America do norte
Idioma:
En
Revista:
J Gen Intern Med
Assunto da revista:
MEDICINA INTERNA
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Estados Unidos