Evidence map›Paper›PMID 36167955›Full record

ArticleJournal of general internal medicine2023

Cost-Related Access Barriers, Medical Debt, and Dissatisfaction with Care Among Privately Insured Americans.

Charlie M Wray, Lenny Lopez, Meena Khare, Salomeh Keyhani

Open access · bronzeAbstract read
In one paragraph

Article in Journal of general internal medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.6field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Charlie M WrayDepartment of Medicine, University of California, San Francisco, San Francisco, USA. charlie.wray@ucsf.edu.ORCID 0000-0001-9203-2031
Lenny LopezDepartment of Medicine, University of California, San Francisco, San Francisco, USA.
Meena KhareNorthern California Institute for Research and Education, San Francisco Veterans Affairs Medical Center, San Francisco, USA.
Salomeh KeyhaniDepartment of Medicine, University of California, San Francisco, San Francisco, USA.
San Francisco VA Medical Center · US

Funding

Improving Access Through Targeted Delivery of TelemedicineIK2HX003139 · VA · VETERANS AFFAIRS MED CTR SAN FRANCISCO · PI WRAY, CHARLIE M · 2021 to 2025
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HSRD VA IK2 HX003139VA CDA 19-349-3
6 · The paper itself

Abstract

backgroundUnderstanding experiences with private important to improving the quality of health care coverage.

objectiveTo examine the association of health with cost-related access barriers, medical debt, and dissatisfaction with care among privately insured Americans.

designWe classified Americans with private insurance by self-reported health status into five groups (excellent, very good, good, fair, and poor health). We examined self-reported difficulty seeing a doctor due to costs, not taking medications due to costs, medical debt, and dissatisfaction with care among individuals with differing health status. We used logistic regression to examine the association of health status with individuals' experiences after accounting for baseline characteristics. The analysis was repeated among individuals with different forms of private insurance. Odds ratios were converted to risk ratios to improve ease of interpretation of the results.

settingBehavioral Risk Factor Surveillance System of Americans in 17 states

resultsThe sample included 82,494 US adults with private insurance. Following adjustment, compared to individuals with excellent health those in very good health, good health, fair health, and poor health reported increasingly higher risks of difficulty seeing a doctor due to costs with risk ratios of 1.02 (95% CI 1.01, 1.03), 1.07 (95% CI 1.06, 1.08), 1.18 (95% CI 1.17, 1.20), and 1.29 (95% CI 1.27, 1.31), respectively. Compared to individuals with excellent health, those in very good health, good health, fair health, and poor health reported increasingly higher risks of not taking medication due to costs, outstanding medical debt, and dissatisfaction with care. Similar relationships were seen across individually purchased and employer-sponsored insurance.

conclusionCost-related access barriers, medical debt, and dissatisfaction with care were common among individuals with private insurance and most pronounced among those with fair and poor health who likely need and use their health insurance the most.

Indexed as

Health Services AccessibilityInsurance, HealthAdultBehavioral Risk Factor Surveillance SystemHealth StatusHumansInsurance CoverageLogistic ModelsMedically UninsuredUnited States

Identifiers

PMID36167955
PMCPMC10039217
OpenAlexW4297327206

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.