Delays and Unmet Need for Health Care Among Adult Primary Care Patients in a Restructured Urban Public Health System

Published in: American Journal of Public Health, v. 94, no. 5, May 2004, p. 783-789

Posted on RAND.org on December 31, 2003

by Allison Diamant, Ron D. Hays, Leo S. Morales, Wesley Ford, Daphne Calmes, Steven M. Asch, Naihua Duan, Eve Fielder, Sehyun Kim, Jonathan E. Fielding, Gerald C. Sumner, Martin F. Shapiro, David E. Hayes-Bautista, Lillian Gelberg

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OBJECTIVES: The authors estimated the prevalence and determinants of delayed and unmet needs for medical care among patients in a restructured public health system. METHODS: The authors conducted a stratified cross-sectional probability sample of primary care patients in the Los Angeles County Department of Health Services. Face-to-face interviews were conducted with 1819 adult patients in 6 languages. The response rate was 80%. The study sample was racially/ethnically diverse. RESULTS: Thirty-three percent reported delaying needed medical care during the preceding 12 months; 25% reported an unmet need for care because of competing priorities; and 46% had either delayed or gone without care. CONCLUSIONS: Barriers to needed health care continue to exist among patients receiving care through a large safety net system. Competing priorities for basic necessities and lack of insurance contribute importantly to unmet health care needs.

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