peterson-kaiser health system tracker how does cost affect access to care?
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Peterson-Kaiser Health System Tracker
How does cost affect access to care?
Peterson-Kaiser Health System Tracker
Source: Kaiser Family Foundation analysis of National Health Interview Survey
About 1 in 10 adults report that they delayed or did not get care because of its cost
Percent of adults who reported delaying or going without care due to costs, 2013
Delayed care because worried about cost
Did not get care due to cost
Yes to either (delayed and/or did not get care due to cost)
0%
2%
4%
6%
8%
10%
12%
9%
7%
11%
Peterson-Kaiser Health System Tracker
Source: Kaiser Family Foundation analysis of National Health Interview Survey
Most adults are in better health and most have health insurance
Percent of adults who reported being in worse health or without insurance, 2013
Excellent Very Good Good Fair Poor Insured Uninsured0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
29%32%
26%
10%
3%
83%
17%
Better health 87%
Peterson-Kaiser Health System Tracker
Source: Kaiser Family Foundation analysis of National Health Interview Survey
Adults who are in worse health have more difficulty accessing care due to cost
Percent of adults who reported delaying or going without care due to cost, 2013
Delayed care because worried about cost
Did not get care due to cost
Yes to either (delayed and/or did not get care due to cost)
0%
5%
10%
15%
20%
25%
8%
6%
9%
20%
17%
22%
Better Health Worse Health
Peterson-Kaiser Health System Tracker
Source: Kaiser Family Foundation analysis of National Health Interview Survey
Uninsured adults are more likely to delay or go without care due to cost
Percent of adults who reported delaying or going without care due to cost, 2013
Delayed care because worried about cost
Did not get care due to cost
Yes to either (delayed or did not get care due to cost)
0%
5%
10%
15%
20%
25%
30%
35%
6%4%
7%
28%
24%
32%
Insured Uninsured
Peterson-Kaiser Health System Tracker
1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 20130%
5%
10%
15%
20%
25%
30%
35%
40%
5%
9%6%
13%
17%14%
All adults 200% FPL and above Below 200% FPL
Source: Kaiser Family Foundation analysis of National Health Interview Survey Note: Shading represents years when a recession took place in the U.S.
Lower income adults report more cost-related access problems than higher income adults
Percent of adults who report delaying and/or going without medical care due to costs, 1998 – 2013
Peterson-Kaiser Health System Tracker
1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 20130%
5%
10%
15%
20%
25%
30%
35%
40%
6%
10%8%
18%
25%
22%
All adults Better health Worse health
Source: Kaiser Family Foundation analysis of National Health Interview Survey Note: Shading represents years when a recession took place in the U.S.
The economic downturn may have affected those in worse health more acutely than those in better healthPercent of adults who report delaying and/or going without medical care due to costs, 1998 – 2013
Peterson-Kaiser Health System Tracker
1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 20130%
5%
10%
15%
20%
25%
30%
35%
40%
5%7%
5%
24%
35%
31%
All adults Insured Uninsured
Source: Kaiser Family Foundation analysis of National Health Interview Survey Note: Shading represents years when a recession took place in the U.S.
Uninsured adults experienced more difficulty accessing care due to cost during the economic downturnPercent of adults who report delaying and/or going without medical care due to costs, 1998 – 2013
Peterson-Kaiser Health System Tracker
Source: Kaiser Family Foundation analysis of National Health Interview Survey
Adults are most likely to go without dental care and prescriptions because of cost reasons
Percent of adults who report delaying and/or going without medical care due to costs, by type of care 2013
Mental health or counseling
Follow-up care Specialist Eye glasses Prescriptions Dental care0%
5%
10%
15%
20%
25%
30%
35%
2%4% 5%
7% 8%
13%
Peterson-Kaiser Health System Tracker
Source: Kaiser Family Foundation analysis of National Health Interview Survey
Adults in worse health report much higher rates of delayed or forgone medical care due to cost
Percent of adults who report delaying and/or going without medical care due to costs, by type of care 2013
Mental health or counseling
Follow-up care Specialist Eye glasses Prescriptions Dental care
-5%
0%
5%
10%
15%
20%
25%
30%
35%
1%3% 4%
6% 6%
11%
6%
11%13%
18%20%
25%
Better health Worse health
Peterson-Kaiser Health System Tracker
Source: Kaiser Family Foundation analysis of National Health Interview Survey
About one in five uninsured adults delayed or went without needed prescriptions because of the costPercent of adults who report delaying and/or going without medical care due to costs, by type of care 2013
Mental health or counseling
Follow-up care Specialist Eye glasses Prescriptions Dental care0%
5%
10%
15%
20%
25%
30%
35%
1%2%
3%5% 5%
9%
6%
14%15%
18%
21%
32%
Insured Uninsured
Peterson-Kaiser Health System Tracker
Source: Kaiser Family Foundation analysis of National Health Interview Survey
Uninsured adults and those in worse health are more worried about paying bills for routine medical carePercent of adults who worry about paying medical bills for routine care, by health and insurance status, 2013
Very worried Moderately worried
Not too worried
Not worried at all
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
13%
18%
27%
41%
31%
20% 19%
30%
Better health Worse health
Very worried Moderately worried
Not too worried
Not worried at all
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
10%
18%
28%
45%45%
24%
17%14%
Insured Uninsured
Peterson-Kaiser Health System Tracker
Source: Kaiser Family Foundation analysis of National Health Interview Survey
Families with uninsured adults and those in worse health report more problems paying medical billsPercent of adults with difficulty paying medical bills, by health and insurance status, 2013
Problems with bills for routine care
Paying off medical bills over time
0%
5%
10%
15%
20%
25%
30%
35%
17%
23%
15%
22%
32% 32%
All adults Better health Worse health
Problems with bills for routine care
Paying off medical bills over time
0%
5%
10%
15%
20%
25%
30%
35%
17%
23%
14%
21%
33% 32%
All adults Insured Uninsured
Peterson-Kaiser Health System Tracker
Source: Kaiser Family Foundation analysis of National Health Interview Survey
Uninsured adults are less likely to have a usual source of healthcare
Percent of adults without a usual source of care, by health and insurance status, 2013
Has Usual Source of Care0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
84% 83%89%
All adults Better health Worse health
Has Usual Source of Care0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
84%
91%
50%
All adults Insured Uninsured
Peterson-Kaiser Health System Tracker
Source: Kaiser Family Foundation analysis of National Health Interview Survey
Uninsured adults who lack a usual source of care are also more likely to forgo preventive carePercent of uninsured adults who did not report a usual source of care, who reported going without preventive care, 2013
Of those with no usual source of care, percent who go without preventive care0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
63%
52%
72%
All adults Insured Uninsured
Peterson-Kaiser Health System Tracker
Source: Kaiser Family Foundation analysis of National Health Interview Survey
Sicker and uninsured adults without usual sources of care tend to report cost barriers
Reported reason for having no usual source of care, by health and insurance status, 2013
Did Not G
et Aro
und to It
Too Ex
pensiv
e/Cost
Reaso
ns
No Med
ical P
roblem
s0%
10%20%30%40%50%60%70%80%90%
100%
5%
36%
53%
5%
33%
56%
6%
62%
17%
All adults Better health Worse health
Did Not Get Around to It Too Expensive/Cost Reasons
0%
10%
20%
30%
40%
50%
60%
70%
5%
36%
9% 8%
2%
59%
All adults Insured Uninsured