Table 2.
Health Care Utilization and Health Care Access Barriers Among Adults With Past-Year CKD Diagnosis by Psychological Distress Level
| No Distress (K6<8) | Mild to Moderate Distress (K6=8-12) | Serious Distress (K6 ≥ 13) | P | |
|---|---|---|---|---|
| Total | 2,877 (74.3%) | 592 (15.2%) | 454 (10.6%) | |
| Health Care Utilization in Preceding y | ||||
| Saw general practitioner | 2,512 (88.3%) | 524 (87.4%) | 409 (90.5%) | 0.5 |
| Saw medical specialist | 1,773 (62.7%) | 383 (65.1%) | 272 (61.4%) | 0.6 |
| Saw mental health professional | 256 (8.9%) | 121 (18.4%) | 163 (36.6%) | <0.001 |
| No. of ED visits in past y | <0.001 | |||
| 0 | 1,566 (56.2%) | 247 (40.2%) | 146 (34.8%) | |
| 1 | 641 (23.3%) | 109 (19.9%) | 97 (21.8%) | |
| 2-3 | 401 (13.1%) | 137 (26.1%) | 100 (22.4%) | |
| ≥4 | 216 (7.5%) | 97 (14.9%) | 108 (21.0%) | |
| Hospitalization in past y | 967 (32.0%) | 247 (40.4%) | 197 (41.5%) | <0.001 |
| Health insurance types | ||||
| Medicare | 1,942 (63.6%) | 359 (58.2%) | 228 (47.5%) | <0.001 |
| Medicaid | 576 (18.2%) | 213 (32.6%) | 197 (38.8%) | <0.001 |
| Private health insurance | 1,297 (47.5%) | 160 (29.7%) | 101 (25.1%) | <0.001 |
| VA/military insurance | 244 (8.6%) | 50 (8.1%) | 23 (6.0%) | 0.4 |
| Health Care Access Barriers in Preceding y | ||||
| No health insurance coverage | 162 (5.7%) | 46 (9.0%) | 59 (12.9%) | <0.001 |
| No usual place of sick or preventive care | 265 (8.4%) | 66 (13.5%) | 59 (13.0%) | 0.003 |
| No usual place of sick care | 245 (7.6%) | 60 (12.5%) | 57 (12.3%) | 0.002 |
| No usual place of preventive care | 203 (6.6%) | 49 (11.0%) | 41 (9.2%) | 0.01 |
| Could not afford medical specialist | 161 (5.4%) | 93 (17.9%) | 125 (27.6%) | <0.001 |
| Could not afford prescription drugs or had to use cost-saving strategy | 818 (29.4%) | 280 (49.0%) | 260 (54.7%) | <0.001 |
| Could not afford prescription drugs | 286 (10.0%) | 142 (25.7%) | 173 (37.1%) | <0.001 |
| Had to use a prescription drug cost-saving strategy | 754 (27.1%) | 240 (41.8%) | 229 (47.6%) | <0.001 |
| Could not afford mental health counseling | 44 (1.5%) | 36 (5.4%) | 86 (18.5%) | <0.001 |
| Could not afford dental care | 431 (14.4%) | 186 (30.7%) | 176 (38.6%) | <0.001 |
Note: Values expressed as number (percent). Probability values were calculated using Pearson χ2 tests. The n/N may be unequal to the percentages shown for the categorical variables as the proportions were calculated accounting for the survey sampling design.
Abbreviations: CKD, chronic kidney disease; ED, emergency department; K6, Kessler Psychological Distress Scale; VA, Veterans Administration.