title: Delays and unmet need for health care among adult primary care patients in a restructured urban public health system.
abstract: 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.
authors.affiliation: 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
authors.forename: Allison L
authors.initials: AL
authors.lastname: Diamant
authors.forename: Ron D
authors.initials: RD
authors.lastname: Hays
authors.forename: Leo S
authors.initials: LS
authors.lastname: Morales
authors.forename: Wesley
authors.initials: W
authors.lastname: Ford
authors.forename: Daphne
authors.initials: D
authors.lastname: Calmes
authors.forename: Steven
authors.initials: S
authors.lastname: Asch
authors.forename: Naihua
authors.initials: N
authors.lastname: Duan
authors.forename: Eve
authors.initials: E
authors.lastname: Fielder
authors.forename: Sehyun
authors.initials: S
authors.lastname: Kim
authors.forename: Jonathan
authors.initials: J
authors.lastname: Fielding
authors.forename: Gerald
authors.initials: G
authors.lastname: Sumner
authors.forename: Martin F
authors.initials: MF
authors.lastname: Shapiro
authors.forename: David
authors.initials: D
authors.lastname: Hayes-Bautista
authors.forename: Lillian
authors.initials: L
authors.lastname: Gelberg
mesh_terms: 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