ArticleBMC health services research2026
Financial accessibility of healthcare: characteristics of people who refrain from healthcare due to costs over the period 2016-2024, a repeated cross-sectional study.
Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAffordability is an important dimension of access to healthcare. Out-of-pocket payments could lead to refraining from care. Current increased costs of living and care may lead to certain groups of vulnerable people, like low-income groups, being more likely to refrain from care due to costs. This study aims to assess the characteristics of people who refrain from healthcare due to costs over the period 2016-2024.
methodsQuestionnaires were sent out to samples of 1,500 panel members of the Nivel Dutch Health Care Consumer Panel in the period 2016-2024 (response 41%-56%). The samples were representative of the Dutch adult population regarding age and gender. Multivariate logistic regression analyses were performed to identify characteristics associated with refraining from care due to costs. Refraining from care due to costs was operationalised as refraining from (1) seeing a doctor, (2) a medical examination, treatment or post-treatment and/or (3) medication.
resultsPercentages of refraining from care due to costs ranged from 7% to 16%. A higher income, better financial situation, better self-reported health, being older, and having no migration background were related to lower odds of refraining from care due to costs. When income and financial situation are taken together in the analysis, only financial situation plays a role in refraining from care due to costs. In addition, we found that from 2021 onwards, income is no longer associated with refraining from care due to costs. The association of financial situation with refraining from care due to costs increases over the years 2019-2024.
conclusionsFinancial situation seems to play a more important role in refraining from care due to costs than net monthly income. It is important that, when countering refraining from care due to costs, attention is paid to the whole group of people with a poorer financial situation and not only to those with low incomes.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.