The role of healthcare system hassles in delaying or forgoing care
- PMID: 32127306
- DOI: 10.1016/j.hjdsi.2020.100411
The role of healthcare system hassles in delaying or forgoing care
Abstract
Background: Several factors besides appointment availability can influence access to care. Among these factors are the diverse challenges that patients may experience in navigating the healthcare system. However, the relationship between these challenges or "hassles" and delaying or forgoing care has not been assessed.
Methods: We examined the relationship between healthcare system hassles and delaying or forgoing needed care. We used data from a 2016 Veterans Affairs (VA) survey of women veterans (N = 821) who were active users of primary care (3+ primary care visits in the past year) at any of 12 VA medical centers. The main independent variable was a measure of 16 healthcare system hassles, encompassing a wide range of clinically-relevant aspects of patient experience, such as uncertainty about when/how to take a medication or difficulty getting questions answered between appointments. The outcome was a self-reported measure of delaying or forgoing needed care. We used logistic regression to estimate this outcome as a function of hassles, adjusting for age, comorbidities, and health care utilization. Survey weights accounted for within-site clustering, nonproportional sampling, and nonresponse.
Results: Overall, 26% of participants reported 0 hassles, and 39% reported 4 or more. Reporting 4 or more hassles (vs. 0) was associated with a roughly 5-fold increase in the predicted probability of delaying or forgoing care.
Conclusion: Addressing healthcare system hassles could yield unexpected benefits to realized access.
Keywords: Access to care; Patient centered care; Patient satisfaction; Patient surveys; Veterans.
Published by Elsevier Inc.
Conflict of interest statement
Declaration of competing interest The authors have no conflicts of interest to disclose. The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs or the United States Government.
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