Do delayed medical health care visits due to cost vary among adults in the United States?

Introduction: Healthcare utilization has particular relevance in the national efforts presently occurring to improve US health care delivery system. Understanding and ultimately eliminating barriers to health care utilization is a major public health and social concern. The main objective of this study was to examine whether forgoing medical health care due to cost vary by health insurance coverage and uninsurance. Methods: This cross-sectional study examined associations between health insurance status and delayed medical visits, sociodemographic factors, and health factors among adults. Data from the Integrated Health Interview Series 2000 to 2011 were analyzed using logistic regression (n= 649,143; size = 70,107,444). Results: Results show 10.3 % of adults reported forgoing medical care due to costs in the previous year. Significant associations were found between health insurance and delayed medical care visits. Respondents without health insurance coverage were 6.7 times (95% CI 6.29-7.21, P<0.000) more likely to forgo medical visits than those with Medicaid and those with private insurance were 1.2 times (95% CI 1.11-1.27, P<0.000) more likely to forgo medical visits than those with Medicaid. Among covariates assessed, only poverty was not significant. Significant covariates included race and ethnicity, sex, age, education, marital status, self-rated health and whether or not a respondent had a usual place of health care. Conclusion: These results suggest insurance coverage, underlying sociodemographic and health factors are important in the context of healthcare utilization among adults in the U.S. Future public health research might investigate whether results are similar in other insurance coverage subpopulations.