Most measures of unmet need for physician services in the United States have not improved since 1998 despite gains in health insurance coverage, according to a study published online Jan. 27 in JAMA Internal Medicine.
Laura Hawks, M.D., from Cambridge Health Alliance in Massachusetts, and colleagues identified changes in unmet need for physician services among insured and uninsured adults aged 18 to 64 years in the United States from 1998 to 2017. Data were included for 117,392 adults aged 18 to 64 years in 1998 and 282,378 from 2017 who responded to the Behavioral Risk Factors Surveillance System.
The researchers observed a 2.1 percent decrease in uninsurance, from 16.9 to 14.8 percent. The adjusted proportion of individuals who were unable to see a physician owing to cost increased by 2.7 percent overall and by 5.9 and 3.6 percent among the uninsured and insured, respectively. For most conditions, there was an increase in the adjusted proportion of persons with chronic medical conditions who were unable to see a physician because of cost. There was no change in the adjusted proportion of chronically ill adults receiving checkups. The adjusted proportion of people receiving guideline-recommended cholesterol tests and flu shots increased, while there was a decrease in the proportion of women receiving mammograms.
"Covering the 29 million who remain uninsured would ameliorate, but not resolve, the access to care problems we identified," the authors write.
Journal information: JAMA Internal Medicine
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