Delayed access to health care: risk factors, reasons, and consequences

Article Abstract:

Patients give many different reasons for delays in seeking health care for illnesses. Some people do not realize the severity of their illness, and others perceive or experience financial or other barriers to medical care. Patients who delay medical care are often sicker when they are admitted to the hospital, and may therefore require longer stays at greater cost. Over 12,000 patients at five hospitals were interviewed to determine who might have delayed seeking care and why. Between 20 and 24 percent of patients who were black, lacked insurance, had no regular physician, or belonged to a low socioeconomic group reported delays in seeking health care. Patients admitted urgently or emergently to the hospital had a 50 to 60 percent likelihood of having delayed care. The most common reason cited by patients for delaying care was that they thought that their problems were not serious or would go away by themselves. Choosing to delay care because of cost was about 5 times as common among patients who were poor and who had no regular doctors, 10 times more common among the uninsured, and 12 times more likely if they were both poor and uninsured. Patients who delayed seeking medical care had hospitalizations 9 percent longer than those who did not report delays. No statistically significant association was found in this sample between death and delays in seeking care. Both patient education and insurance issues must be addressed to avoid potentially harmful and costly delays in seeking health care among those groups at greatest risk. (Consumer Summary produced by Reliance Medical Information, Inc.)

Demographic aspects, Surveys, Health insurance, Medical care, Cost of, Health care costs

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Inner-city health care

Article Abstract:

The American College of Physicians proposes several recommendations to improve the health of inner-city residents. Health status in some urban inner cities approaches the levels seen in some Third World countries. Much of the disease seen in inner cities is a product of poverty, homelessness and violence. Medicaid should be enlarged to cover all eligible people. Physicians should receive financial incentives to encourage them to practice in inner cities. Medical schools should recruit more minority students. The improvement in health cannot take place unless underlying social issues are resolved.

Social policy, Inner cities, American College of Physicians

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Access to care is the centerpiece in the elimination of socioeconomic disparities in health

Article Abstract:

Improving access to health care for people in lower socioeconomic classes would substantially contribute to improving the public health. Elimination of financial barriers to care is critical to lessening disparities in health outcomes between socioeconomic classes. The lack of medical insurance and the inability to obtain health care are closely associated with worse health outcomes. The Medicaid program has demonstrated that the availability of care improves birth outcomes, reduces emergency department visits, improves AIDS care, and reduces complications associated with chronic conditions.

Economic aspects, Public health, Social classes, Social class

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