This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (43)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Caring for the Uninsured and Underinsured  • Alert me on articles by topic  Social Bookmarking   What's this?

David W. Baker, MD, MPH; Martin F. Shapiro, MD, PhD; Claudia L. Schur, PhD

Arch Intern Med. 2000;160:1269-1274.

Background  The uninsured receive less medical care than the insured. However, it is not known whether the uninsured are less likely to seek medical care for highly "serious" or "morbid" symptoms.

Methods  Participants in the National Access to Care Survey were asked whether they had experienced any of 15 highly serious or morbid symptoms. Those who did were asked whether they received medical care and, if care was not received, whether care was thought to have been necessary.

Results  A total of 574 respondents (16.4%) reported 794 new serious or morbid symptoms. Of these, 499 people (86.9%) had health insurance, and they reported 691 new symptoms; 75 (13.1%) lacked health insurance, and they reported 103 symptoms. The uninsured were less likely to have received medical care and more likely to say they did not receive care even though they thought it was needed (P=.001). Medical care was received for 45.4% of symptoms for the insured and 24.3% for the uninsured; care was not thought to have been needed for 41.0% of symptoms for the insured and 45.6% for the uninsured; and care was thought necessary but was not received for 13.6% of symptoms for the insured and 30.1% for the uninsured. In multivariate analysis, the uninsured were much less likely to have received care than the insured (adjusted odds ratio, 0.43; 95% confidence interval, 0.23-0.81).

Conclusion  Lack of health insurance is a major barrier to receiving medical care, even for highly serious and morbid symptoms.

From the Departments of Medicine and Epidemiology & Biostatistics, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio (Dr Baker); the Department of Medicine, University of California at Los Angeles School of Medicine (Dr Shapiro); and Project HOPE Center for Health Affairs, Bethesda, Md (Dr Schur).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Uninsured Adults Presenting to US Emergency Departments: Assumptions vs Data
Newton et al.
JAMA 2008;300:1914-1924.
ABSTRACT | FULL TEXT  

Health Care Access, Use of Services, and Experiences Among Undocumented Mexicans and Other Latinos
Ortega et al.
Arch Intern Med 2007;167:2354-2360.
ABSTRACT | FULL TEXT  

Certificate of Need Regulation and Cardiac Catheterization Appropriateness After Acute Myocardial Infarction
Ross et al.
Circulation 2007;115:1012-1019.
ABSTRACT | FULL TEXT  

Person and Place: The Compounding Effects of Race/Ethnicity and Rurality on Health
Probst et al.
Am. J. Public Health 2004;94:1695-1703.
ABSTRACT | FULL TEXT  

Can Universal Access to Health Care Eliminate Health Inequities Between Children of Poor and Nonpoor Families?: A Case Study of Childhood Asthma in Alberta
Sin et al.
Chest 2003;124:51-56.
ABSTRACT | FULL TEXT  

The Content of a Low-income, Uninsured Primary Care Population: Including the Patient Agenda
Mauksch et al.
J Am Board Fam Med 2003;16:278-289.
ABSTRACT | FULL TEXT  

Commentary
Ayanian
Med Care Res Rev 2003;60:76S-81S.
 

World Heart Day 2002: The International Burden of Cardiovascular Disease: Responding to the Emerging Global Epidemic
Bonow et al.
Circulation 2002;106:1602-1605.
FULL TEXT  

A Policy Analysis of Access to Health Care Inclusive of Cost, Quality, and Scope of Services
Taub
Policy Politics Nursing Practice 2002;3:167-176.
ABSTRACT  

Response to Symptoms among a U.S. National Probability Sample of Adults Infected with Human Immunodeficiency Virus
Kilbourne et al.
Med Care Res Rev 2002;59:36-58.
ABSTRACT  

Socioeconomic Disparities In Health: Pathways And Policies
Adler and Newman
Health Aff (Millwood) 2002;21:60-76.
ABSTRACT | FULL TEXT  

Cigarette Smoking: How Much Worse Can It Get?
David
Circulation 2001;103 :e128-e128.
FULL TEXT  

Health and Health Insurance
Addy et al.
Arch Intern Med 2001;161:128-128.
FULL TEXT  

Unmet Health Needs of Uninsured Adults in the United States
Ayanian et al.
JAMA 2000;284:2061-2069.
ABSTRACT | FULL TEXT