Access to Care

Trio of factors affects low-income parents' ability to purchase health care for their families

Although U.S. policymakers have been striving for decades to provide health insurance coverage for low-income families, coverage alone may not be the answer to improving U.S. health care, a new study finds. Jennifer E. DeVoe, M.D., Ph.D., of the Oregon Health and Science University, and her colleagues found that care access and cost, along with insurance coverage, affect care use among lower income families.

The Oregon researchers studied 722 responses to a questionnaire mailed in January 2005 and determined the barriers low-income families face when they try to access care for their families. The team identified a trio of interrelated, anxiety-inducing barriers: insurance coverage, access, and cost. Of families that did not have insurance, 87 percent worried about obtaining it. When families did have coverage, 25 percent of those with public insurance and 20 percent with private insurance said they did not always feel welcome at medical offices or had to travel to providers who would accept their plans. Of families with insurance, 30 percent private also worried about paying copayments, deductibles, and for services their insurance did not cover.

Policymakers interested in improving the nation's access to health care need to look beyond merely providing health insurance for more people and increasing the number of primary care physicians, the researchers suggest. Though insurance serves as a foundation for improving care, access and cost also remain important issues to consider. This study was funded in part by the Agency for Healthcare Research and Quality (HS14645 and HS16181).

See "Insurance + access health care: Typology of barriers to health care access for low-income families," by Dr. DeVoe, Alia Baez, B.A., Heather Angier, B.A., and others in the November/December 2007 Annals of Family Medicine 5(6), pp. 511-518.

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