MPC Member Publications

This database contains a listing of population studies publications written by MPC Members. Anyone can add a publication by an MPC student, faculty, or staff member to this database; new citations will be reviewed and approved by MPC administrators.

Full Citation

Title: Barriers to Care and Health Care Utilization Among the Publicly Insured.

Citation Type: Journal Article

Publication Year: 2017

ISSN: 1537-1948

DOI: 10.1097/MLR.0000000000000644

PMID: 27579910

Abstract: BACKGROUND Although the Affordable Care Act has been successful in expanding Medicaid to >17 million people, insurance alone may not translate into access to health care. Even among the insured, substantial barriers to accessing services inhibit health care utilization. OBJECTIVES We examined the effect of selected barriers to health care access and the magnitude of those barriers on health care utilization. RESEARCH DESIGN Data come from a 2008 survey of adult enrollees in Minnesota's public health care programs. We used multivariate logistic regression to estimate the effects of perceived patient, provider, and system-level barriers on past year delayed, foregone, and lack of preventive care. SUBJECTS A total of 2194 adults enrolled in Minnesota Health Care Programs who were mostly female (66%), high school graduates (76%), unemployed (62%), and living in metro areas (67%) were included in the analysis. RESULTS Reporting problems across all barriers increased the odds of delayed care from 2 times for provider-related barriers (OR=2.0; 95% CI, 1.2-3.3) to >6 times for access barriers (OR=6.2; 95% CI, 3.8-10.2) and foregone care from 2.6 times for family/work barriers (OR=2.6; 95% CI, 1.3-5.1) to >7 times for access barriers (OR=7.1; 95% CI, 3.9-13.1). Perceived discrimination was the only barrier consistently associated with all 3 utilization outcomes. CONCLUSIONS Multiple types of barriers are associated with delayed and foregone care. System-level barriers and discrimination have the greatest effect on health care seeking behavior.

Url: http://insights.ovid.com/crossref?an=00005650-201703000-00002

Url: http://www.ncbi.nlm.nih.gov/pubmed/27579910

Url: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC5309146

User Submitted?: No

Authors: Allen, Elizabeth M; Call, Kathleen Thiede; Beebe, Timothy J; McAlpine, Donna D; Johnson, Pamela Jo

Periodical (Full): Medical care

Issue: 3

Volume: 55

Pages: 207-214

Countries:

IPUMS NHGIS NAPP IHIS ATUS Terrapop