Before Affordable Care Act: Health Insurance Coverage and Delayed Health Services Visits Due to Cost

• In Event: 598 - Section on Sociology of Mental Health Roundtable Session
  In Refereed Roundtable: Table 10. Policy and Societal Context

Abstract

Objective: To examine how insurance status among adults affect foregoing medical and mental health care visits due to cost and to identify patient-related predictors of foregoing health care visits.

Methods: A pooled sample of participants who reported health insurance status in the 2000-2011, Integrated Health Interview Series, was extracted for a cross-sectional analysis. Delayed medical and mental health care visits related to cost represented outcome and insurance coverage (Medicaid, private, and no insurance) represented the independent measure.
Results: Results show 10.3 % of adults forwent medical care and 3.1% reported no mental health care visits in the prior year. Stark insurance differences in delayed care were found. Adjusted odds ratios revealed that delayed medical care in the prior 12 months was 6.7 times higher among uninsured responders than among Medicaid enrollees and respondents with private insurance were 1.2 times more likely to delay medical visits than those with Medicaid. After adjustments for significant covariates, uninsured respondents were 3.2 times more likely to delay mental care visits than those with Medicaid and respondents with private health insurance coverage were 0.8 times more likely to delay mental health care visits than those with Medicaid.
Conclusion: The findings suggest underlying sociodemographics and health factors contribute to differences in delayed care visits are important in the context of healthcare utilization among adults in the U.S with different insurance statuses. Because persons who delay obtaining care are at higher risk for worse health outcomes, having PPACA address the delay in obtaining care is especially important.

Authors

• Allison Houston, State University of New York-Albany

• Ann-Marie Gomes, State University of New York-Albany