CARE DENIED - US RESIDENTS WHO ARE UNABLE TO OBTAIN NEEDED MEDICAL-SERVICES

Objectives. This study analyzed data on US residents reporting that they were unable to obtain needed care. Inadequately immunized children-and women inadequately screened for breast or cervical cancer were also examined. Methods. Data from the 1987 National Medical Expenditure Survey was analyzed. Results.: A total of 6 375 000 (90% confidence interval [CI] = 6 039 000, 6 711 000) people could not get hospitalization, prescription medications, medical equipment/supplies, or emergency, pediatric, mental health, or home care. Although the uninsured were more likely to forego care unavailable, three quarters of those unable to obtain services were insured, and 46% (90% CI = 42.4%, 49.6%) had private coverage. Of those reporting the reason why they failed to obtain care, 65.1% (90% CI = 61.7%, 68.6%) listed high costs or lack of insurance, including 60.7%: (90% CI = 57.1%, 64.3%) of the privately insured. More than a third of women had not had a breast examination in the previous 2 years, a fifth had not had a Pap smear within the previous 4 years, and half had never had a mammogram (ages 50-69 only). Of children 2 to 5 years old, 35.1% (90% CI = 31.5%, 35.7%) were inadequately immunized. Medicaid recipients had measures of access to care similar to those of the uninsured. Conclusions. Many US residents-most of whom have insurance-are unable to obtain needed care, usually because of high costs.