Why do People Avoid Medical Care? A Qualitative Study Using National Data

Taber, Jennifer M.; Leyva, Bryan; Persoskie, Alexander

doi:10.1007/s11606-014-3089-1

Cited by 279 publications

(249 citation statements)

References 55 publications

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“…An additional concerning finding with public health implications was that participants in our study reported delaying medical presentation for their breast symptom due to a "fear of not being able to afford treatment". This is consistent with recent results reported by Taber et al [41] , which found "high cost" and "lack of health insurance" to be reasons why patients reported avoiding medical care. This phenomenon may create an even greater burden in cancer patients, as a delay in presentation may translate to more costly treatment plans that may be even more expensive for the patient.…”

Section: Discussionsupporting

confidence: 93%

Reasons symptomatic breast cancer patients delay seeking medical care

Heath¹,

Paulishak²,

Kasales³

et al. 2019

JUMD

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Aim: To assess for factors contributing to the total delay in care, and specifically the behavioral delay-interval portion of that delay, experienced by a group of symptomatic breast cancer patients. Methods: This retrospective cohort pilot study included 24 females greater than 40 years-old with symptomatic breast cancer at time of diagnosis (including palpable mass, breast pain, other pain, discharge, nipple inversion). Participants were asked demographic information, as well as to identify, from a predefined list of options, the three most relevant causes for their delayed breast cancer diagnosis. Data sources included electronic medical record query and phone surveys. Results: Overall, 21/24 of our study's participants identified at least one of our predetermined barriers to care as relevant to their cause for delay. The most commonly identified reasons for delay were health system utilization factors contributing to behavioral delay, including dependents/pressing matters, employment responsibilities, transportation costs and difficulty, fear of being judged by healthcare workers, and fear of not being able to afford treatment. Conclusion: Women with breast cancer can experience delays to eventual diagnosis and treatment during various timeintervals between first noticing a symptom and finally presenting to medical attention. This study provides evidence that one such possible interval is the behavioral delay interval. Health system utilization factors, psychological factors, demographic factors and help-seeking habits can contribute to an increased behavioral delay interval. Further research is warranted to address these factors and minimize their impact on patient care delivery.

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Section: Discussionsupporting

confidence: 93%

Reasons symptomatic breast cancer patients delay seeking medical care

Heath¹,

Paulishak²,

Kasales³

et al. 2019

JUMD

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“…Patients who are subject to a higher cost of care could suffer from increased economic hardships given that their income is being spent on health care instead of other necessities . Patients are likely to refuse medical care if the cost is too high, which would lead to increased disease severity, complications, and earlier‐than‐anticipated mortality . Given the effect of health‐care cost on patients and society, interventions to promote high‐value, cost‐conscious care have been instituted in the United States, such as the Centers for Medicare and Medicaid nonpayment policy for health care‐acquired conditions .…”

Section: Discussionmentioning

confidence: 99%

Geographical differences exist in high‐value care delivery for inpatient management of cirrhosis: Cost conscious care in cirrhosis

2018

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Background and AimsThe United States spends more money per person on health care than any other country in the world. Patients with cirrhosis are at an increased risk of health‐care utilization. The aim of this study is to evaluate differences in health‐care utilization based on the region of treatment during the inpatient management of patients with cirrhosis.MethodA retrospective database analysis using the Nationwide Inpatient Sample was performed, including adult patients with a primary diagnosis of cirrhosis determined by ICD‐9 codes. Univariate and multivariate analyses were performed to analyze liver decompensation, mortality, length of stay, and total charges in different regions across the United States.ResultsA total of 75 280 patients with cirrhosis who received treatment in nine different regions across the United States were included. Rates of liver decompensation were significantly decreased in the Pacific region compared to the New England region (OR: 0.69, 95% CI: 0.51–0.94). Length of stay was significantly different between regions; however, the means only varied by half a day and were of minimal clinical significance. Inpatient mortality rates were not significantly different between regions. Total charges for inpatient management between regions were significantly different, with the Pacific region having the highest total hospital charges with a mean of $82 731.ConclusionsHealth‐care utilization during the inpatient management of cirrhosis varies based on the region. The charges for treatment were the highest in the West despite no impact on mortality, minimal improvement in length of stay, and fewer features of decompensation on admission.

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“…Notwithstanding national recommendations and health promotion programs, French university students underuse health care services, with 20% not consulting a health professional (general practitioner or specialist) during their university years [3]. A small number of international studies have examined why young people avoid and delay medical care [4], providing a conceptual categorization of three main barriers: low perceived need to seek medical care; traditional barriers to medical care such as high cost, absence of health insurance, and time constraints; and lack of knowledge concerning the organization of the health care system and its services [5]. A study conducted on 41,000 French university students reported that: 23% of the participants did not feel the need to seek medical care, 13% did not have time for medical consultations, and 12% had economic difficulties to access and pay for health care services [3].…”

Section: Introductionmentioning

confidence: 99%

Co-creating and Evaluating a Web-app Mapping Real-World Health Care Services for Students: The servi-Share Protocol

Montagni¹,

Langlois²,

Wittwer³

et al. 2017

JMIR Res Protoc

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BackgroundUniversity students aged 18-30 years are a population group reporting low access to health care services, with high rates of avoidance and delay of medical care. This group also reports not having appropriate information about available health care services. However, university students are at risk for several health problems, and regular medical consultations are recommended in this period of life. New digital devices are popular among the young, and Web-apps can be used to facilitate easy access to information regarding health care services. A small number of electronic health (eHealth) tools have been developed with the purpose of displaying real-world health care services, and little is known about how such eHealth tools can improve access to care.ObjectiveThis paper describes the processes of co-creating and evaluating the beta version of a Web-app aimed at mapping and describing free or low-cost real-world health care services available in the Bordeaux area of France, which is specifically targeted to university students.MethodsThe co-creation process involves: (1) exploring the needs of students to know and access real-world health care services; (2) identifying the real-world health care services of interest for students; and (3) deciding on a user interface, and developing the beta version of the Web-app. Finally, the evaluation process involves: (1) testing the beta version of the Web-app with the target audience (university students aged 18-30 years); (2) collecting their feedback via a satisfaction survey; and (3) planning a long-term evaluation.ResultsThe co-creation process of the beta version of the Web-app was completed in August 2016 and is described in this paper. The evaluation process started on September 7, 2016. The project was completed in December 2016 and implementation of the Web-app is ongoing.ConclusionsWeb-apps are an innovative way to increase the health literacy of young people in terms of delivery of and access to health care. The creation of Web-apps benefits from the involvement of stakeholders (eg, students and health care providers) to correctly identify the real-world health care services to be displayed.

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Why do People Avoid Medical Care? A Qualitative Study Using National Data

Cited by 279 publications

References 55 publications

Reasons symptomatic breast cancer patients delay seeking medical care

Reasons symptomatic breast cancer patients delay seeking medical care

Geographical differences exist in high‐value care delivery for inpatient management of cirrhosis: Cost conscious care in cirrhosis

Co-creating and Evaluating a Web-app Mapping Real-World Health Care Services for Students: The servi-Share Protocol

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