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01-09-2011 | Internal medicine | Article

Nonfinancial factors often limit patient access to care


Free abstract

MedWire News: Nonfinancial factors are more likely to prevent adults from receiving appropriate and timely care than financial factors, findings from a US study indicate.

Accommodation, availability, accessibility, and acceptability of care are the main nonfinancial factors that are often limited among US adults who fail to receive appropriate care in a timely manner, say the authors.

They advise that redistributing healthcare resources and providers may effectively minimize accommodation barriers, and introducing policies to increase the supply of providers may increase availability of care.

The authors, led by Jeffrey Kullgren from the University of Pennsylvania, in Philadelphia, add: "Accessibility and acceptability are less common reasons for unmet need or delayed care among US adults, but they may remain important for certain subgroups… Accessibility barriers could be reduced through expansion of both telemedicine and transportation services for patients who live far from healthcare providers.

"Acceptability barriers could be addressed by requiring ample provider choice in plans participating in state health insurance exchanges and fully funding planned reimbursement increases to ensure diverse provider participation in Medicaid programs."

The study involved the analysis of data from 15,197 individuals who participated in the 2007 Health Tracking Household Survey. Each participant was asked: "During the past 12 months, was there any time when you didn't get the medical care you needed?" and "Was there any time during the past 12 months when you put off or postponed getting medical care you thought you needed?"

Participants who reported unmet medical need or delayed care were also asked the reason for the inadequate receipt of care.

The findings, reported in the journal Health Services Research, show that 18% of participants experienced finance-related barriers to receipt of care, and 21% reported nonfinancial barriers to care receipt. In addition, two-thirds of adults with financial barriers also reported having nonfinancial barriers.

Kullgren and team found that being female, having children, and having a low income or at least one chronic illness were factors associated with an elevated risk for nonfinancial barriers to receipt of care.

The authors conclude: "As financial barriers to care are reduced through implementation of Patient Protection and Affordability Care Act , federal and state policy makers have important opportunities to address nonfinancial barriers experienced by US adults by building directly on existing plans to reform the nation's healthcare system."

By Lauretta Ihonor

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