TY - JOUR
T1 - Prevalence and Determinants of Difficulty in Accessing Medical Care in U.S. Adults
AU - Al Rifai, Mahmoud
AU - Mahtta, Dhruv
AU - Kherallah, Riyad
AU - Kianoush, Sina
AU - Liu, Jing
AU - Rodriguez, Fatima
AU - Nasir, Khurram
AU - Valero, Javier
AU - Khan, Safi U.
AU - Ballantyne, Christie
AU - Petersen, Laura A.
AU - Virani, Salim S.
N1 - Funding Information:
The authors thank the other investigators, the staff, and the participants of the Behavioral Risk Factor Surveillance System survey for their valuable contributions. FR was funded by a career development award from the National Heart, Lung, and Blood Institute (K01 HL 144607) and the American Heart Association/Robert Wood Johnson Harold Amos Medical Faculty Development Program. SSV reports receiving research support from the Department of Veterans Affairs, World Heart Federation, and Tahir and Jooma Family and an honorarium from the American College of Cardiology (Associate Editor for Innovations, acc.org). FR is on the advisory board for Janssen and consults for Novo Nordisk and Novartis. No other financial disclosures were reported.
Funding Information:
FR was funded by a career development award from the National Heart, Lung, and Blood Institute ( K01 HL 144607 ) and the American Heart Association / Robert Wood Johnson Harold Amos Medical Faculty Development Program.
Funding Information:
SSV reports receiving research support from the Department of Veterans Affairs, World Heart Federation, and Tahir and Jooma Family and an honorarium from the American College of Cardiology (Associate Editor for Innovations, acc.org). FR is on the advisory board for Janssen and consults for Novo Nordisk and Novartis. No other financial disclosures were reported.
Publisher Copyright:
© 2021
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/10
Y1 - 2021/10
N2 - Introduction: Ensuring adequate access to health care is essential for timely delivery of preventive services. It is important to evaluate the prevalence and determinants of difficulty in accessing medical care in the overall U.S. population and among those with high-risk chronic conditions. Methods: The study utilized cross-sectional data from the 2016–2019 Behavioral Risk Factor Surveillance System, a nationally representative telephone-based survey of adults aged ≥18 years. The prevalence and sociodemographic characteristics associated with difficulty in receiving medical care were assessed, including regional variations across U.S. states. Results: The prevalence of difficulty in accessing medical care was 14% overall, 15% among those with hypertension, 15% among those with diabetes mellitus, and 17% among those with atherosclerotic cardiovascular disease. Age 18−34 years, having less than high school education, having annual household income <$75,000, unemployment, and living in a state without Medicaid expansion were all associated with a higher risk of not accessing medical care. The prevalence of difficulty in accessing medical care was 27% among individuals with ≥3 of these sociodemographic characteristics. There was regional variation across the U.S. states in the distribution of difficulty in accessing medical care with a median of 13.6% (IQR=11.3%−15.9%) for the overall population: 16.3% (IQR=14.1%−19.0%) among those living in states without Medicaid expansion versus 12.7% (IQR=10.9%−15.6%) among those living in states with Medicaid expansion (p=0.01). Conclusions: In total, 1 in 7 adults report difficulty in accessing medical care. This prevalence is nearly 1 in 4 adults with ≥3 sociodemographic characteristics related to difficulty in accessing medical care. There are regional variations in the distribution of the difficulty in accessing medical care, especially among individuals living in states that have not undergone Medicaid expansion.
AB - Introduction: Ensuring adequate access to health care is essential for timely delivery of preventive services. It is important to evaluate the prevalence and determinants of difficulty in accessing medical care in the overall U.S. population and among those with high-risk chronic conditions. Methods: The study utilized cross-sectional data from the 2016–2019 Behavioral Risk Factor Surveillance System, a nationally representative telephone-based survey of adults aged ≥18 years. The prevalence and sociodemographic characteristics associated with difficulty in receiving medical care were assessed, including regional variations across U.S. states. Results: The prevalence of difficulty in accessing medical care was 14% overall, 15% among those with hypertension, 15% among those with diabetes mellitus, and 17% among those with atherosclerotic cardiovascular disease. Age 18−34 years, having less than high school education, having annual household income <$75,000, unemployment, and living in a state without Medicaid expansion were all associated with a higher risk of not accessing medical care. The prevalence of difficulty in accessing medical care was 27% among individuals with ≥3 of these sociodemographic characteristics. There was regional variation across the U.S. states in the distribution of difficulty in accessing medical care with a median of 13.6% (IQR=11.3%−15.9%) for the overall population: 16.3% (IQR=14.1%−19.0%) among those living in states without Medicaid expansion versus 12.7% (IQR=10.9%−15.6%) among those living in states with Medicaid expansion (p=0.01). Conclusions: In total, 1 in 7 adults report difficulty in accessing medical care. This prevalence is nearly 1 in 4 adults with ≥3 sociodemographic characteristics related to difficulty in accessing medical care. There are regional variations in the distribution of the difficulty in accessing medical care, especially among individuals living in states that have not undergone Medicaid expansion.
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U2 - 10.1016/j.amepre.2021.03.026
DO - 10.1016/j.amepre.2021.03.026
M3 - Article
C2 - 34229931
AN - SCOPUS:85109112692
SN - 0749-3797
VL - 61
SP - 492
EP - 500
JO - American Journal of Preventive Medicine
JF - American Journal of Preventive Medicine
IS - 4
ER -