Delays and unmet need for health care among adult primary care patients in a restructured urban public health system.
OBJECTIVE
We estimated the prevalence and determinants of delayed and unmet needs for medical care among patients in a restructured public health system.


METHODS
We conducted a stratified cross-sectional probability sample of primary care patients in the Los Angeles County Department of Health Services. Face-to-face interviews were conducted with 1819 adult patients in 6 languages. The response rate was 80%. The study sample was racially/ethnically diverse.


RESULTS
Thirty-three percent reported delaying needed medical care during the preceding 12 months; 25% reported an unmet need for care because of competing priorities; and 46% had either delayed or gone without care.


CONCLUSIONS
Barriers to needed health care continue to exist among patients receiving care through a large safety net system. Competing priorities for basic necessities and lack of insurance contribute importantly to unmet health care needs.
Diamant
Allison L
AL
Division of General Internal Medicine and Health Services Research, University of California-Los Angeles, 911 Broxton Avenue, Los Angeles, CA 90095-1736, USA. adiamant@mednet.ucla.edu
Hays
Ron D
RD
Morales
Leo S
LS
Ford
Wesley
W
Calmes
Daphne
D
Asch
Steven
S
Duan
Naihua
N
Fielder
Eve
E
Kim
Sehyun
S
Fielding
Jonathan
J
Sumner
Gerald
G
Shapiro
Martin F
MF
Hayes-Bautista
David
D
Gelberg
Lillian
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D003153:Community Health Services / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D007407:Interviews as Topic; D015141:Los Angeles; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012494:Sampling Studies