Skip to main content
PMC home page
American Journal of Public Health logoLink to American Journal of Public Health
. 1999 Sep;89(9):1410–1413. doi: 10.2105/ajph.89.9.1410

Trends in perceived cost as a barrier to medical care, 1991-1996.

D E Nelson 1, B L Thompson 1, S D Bland 1, R Rubinson 1
PMCID: PMC1508765  PMID: 10474561

Abstract

OBJECTIVES: This study examined trends in perceived cost as a barrier to medical care. METHODS: The Behavioral Risk Factor Surveillance System was used to analyze monthly telephone survey data from 45 states. RESULTS: Overall, the percentage of persons perceiving cost as a barrier to medical care increased from 1991 until early 1993 and then declined to baseline values in late 1996. Perceived cost was a greater barrier in 1996 than in 1991 for persons with low incomes and for those who were unemployed and uninsured. For self-employed persons, percentages increased until mid-1993 and then remained constant. CONCLUSIONS: Further efforts are needed to improve access to medical care for socially disadvantaged populations.

Full text

PDF
1410

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Berk M. L., Schur C. L., Cantor J. C. Ability to obtain health care: recent estimates from the Robert Wood Johnson Foundation National Access to Care Survey. Health Aff (Millwood) 1995 Fall;14(3):139–146. doi: 10.1377/hlthaff.14.3.139. [DOI] [PubMed] [Google Scholar]
  2. Blendon R. J., Brodie M., Benson J. What happened to Americans' support for the Clinton health plan? Health Aff (Millwood) 1995 Summer;14(2):7–23. doi: 10.1377/hlthaff.14.2.7. [DOI] [PubMed] [Google Scholar]
  3. Braveman P., Schaaf V. M., Egerter S., Bennett T., Schecter W. Insurance-related differences in the risk of ruptured appendix. N Engl J Med. 1994 Aug 18;331(7):444–449. doi: 10.1056/NEJM199408183310706. [DOI] [PubMed] [Google Scholar]
  4. Brown E. R. Trends in health insurance coverage in California, 1989-1993. Health Aff (Millwood) 1996 Spring;15(1):118–130. doi: 10.1377/hlthaff.15.1.118. [DOI] [PubMed] [Google Scholar]
  5. Donelan K., Blendon R. J., Hill C. A., Hoffman C., Rowland D., Frankel M., Altman D. Whatever happened to the health insurance crisis in the United States? Voices from a national survey. JAMA. 1996 Oct 23;276(16):1346–1350. [PubMed] [Google Scholar]
  6. Elnicki D. M., Morris D. K., Shockcor W. T. Patient-perceived barriers to preventive health care among indigent, rural Appalachian patients. Arch Intern Med. 1995 Feb 27;155(4):421–424. [PubMed] [Google Scholar]
  7. Freeman H. E., Blendon R. J., Aiken L. H., Sudman S., Mullinix C. F., Corey C. R. Americans report on their access to health care. Health Aff (Millwood) 1987 Spring;6(1):6–8. doi: 10.1377/hlthaff.6.1.6. [DOI] [PubMed] [Google Scholar]
  8. Harvey S. M., Faber K. S. Obstacles to prenatal care following implementation of a community-based program to reduce financial barriers. Fam Plann Perspect. 1993 Jan-Feb;25(1):32–36. [PubMed] [Google Scholar]
  9. Himmelstein D. U., Woolhandler S. Care denied: US residents who are unable to obtain needed medical services. Am J Public Health. 1995 Mar;85(3):341–344. doi: 10.2105/ajph.85.3.341. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Lipson D. J., Naierman N. Effects of health system changes on safety-net providers. Health Aff (Millwood) 1996 Summer;15(2):33–48. doi: 10.1377/hlthaff.15.2.33. [DOI] [PubMed] [Google Scholar]
  11. Marmot M. G., Smith G. D., Stansfeld S., Patel C., North F., Head J., White I., Brunner E., Feeney A. Health inequalities among British civil servants: the Whitehall II study. Lancet. 1991 Jun 8;337(8754):1387–1393. doi: 10.1016/0140-6736(91)93068-k. [DOI] [PubMed] [Google Scholar]
  12. Monheit A. C. Underinsured Americans: a review. Annu Rev Public Health. 1994;15:461–485. doi: 10.1146/annurev.pu.15.050194.002333. [DOI] [PubMed] [Google Scholar]
  13. Pappas G., Queen S., Hadden W., Fisher G. The increasing disparity in mortality between socioeconomic groups in the United States, 1960 and 1986. N Engl J Med. 1993 Jul 8;329(2):103–109. doi: 10.1056/NEJM199307083290207. [DOI] [PubMed] [Google Scholar]
  14. Powell-Griner E., Anderson J. E., Murphy W. State-and sex-specific prevalence of selected characteristics--behavioral risk factor surveillance system, 1994 and 1995. MMWR CDC Surveill Summ. 1997 Aug 1;46(3):1–31. [PubMed] [Google Scholar]
  15. Short P. F., Banthin J. S. New estimates of the underinsured younger than 65 years. JAMA. 1995 Oct 25;274(16):1302–1306. [PubMed] [Google Scholar]
  16. Urban N., Anderson G. L., Peacock S. Mammography screening: how important is cost as a barrier to use? Am J Public Health. 1994 Jan;84(1):50–55. doi: 10.2105/ajph.84.1.50. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Weissman J. S., Stern R., Fielding S. L., Epstein A. M. Delayed access to health care: risk factors, reasons, and consequences. Ann Intern Med. 1991 Feb 15;114(4):325–331. doi: 10.7326/0003-4819-114-4-325. [DOI] [PubMed] [Google Scholar]
  18. Zarabozo C., Taylor C., Hicks J. Medicare managed care: numbers and trends. Health Care Financ Rev. 1996 Spring;17(3):243–261. [PMC free article] [PubMed] [Google Scholar]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

RESOURCES