title: Delay in seeing a doctor due to cost: disparity between older adults with and without disabilities in the United States.
abstract: OBJECTIVE
  To examine the disparity in delaying seeing a doctor due to cost between older adults with and without disabilities, and whether the disparity could be explained by health and financial variables.
  
  
  METHODS
  Nationally representative sample of community-dwelling adults aged ≥65 who have health insurance and a usual source of care from the 2006 Behavioral Risk Factor Surveillance System (n = 85,015).
  
  
  METHODS
  This cross-sectional study used sequential logistic regression models to examine the associations of delaying seeing a doctor due to cost with disability status, including demographic, health, and financial variables.
  
  
  RESULTS
  Older adults with disabilities had significantly higher odds of delaying seeing a doctor due to cost compared to older adults without disabilities after controlling for demographic, health, and financial factors. Although health and financial variables collectively attenuated the disparity, they did not fully explain the disparity.
  
  
  CONCLUSIONS
  Despite having health insurance and a usual source of care, older adults with disabilities encountered greater economic difficulties in seeing a doctor than their counterparts without disabilities. Policy makers should continue addressing the economic burden to improve timely visits to health care providers.
authors.affiliation: National Institutes of Health, Mark O. Hatfield Clinical Research Center, Rehabilitation Medicine Department, Building 10, CRC, Room 1-1469, 10 Center Drive, MSC 1604, Bethesda, MD 20892-1604, USA. leej31@cc.nih.gov
authors.forename: Jae Chul
authors.initials: JC
authors.lastname: Lee
authors.forename: Romana
authors.initials: R
authors.lastname: Hasnain-Wynia
authors.forename: Denys T
authors.initials: DT
authors.lastname: Lau
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data*; D006304:Health Status; D054625:Healthcare Disparities / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007182:Income; D007348:Insurance, Health / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D012959:Socioeconomic Factors; D013997:Time Factors; D014481:United States
references.citation: J Rural Health. 1996 Winter;12(1):45-53
references.pmid: 10172606
references.citation: Psychiatr Serv. 2004 Dec;55(12):1408-13
references.pmid: 15572569
references.citation: Am J Public Health. 2003 May;93(5):786-91
references.pmid: 12721145
references.citation: Assist Technol. 1999;11(2):105-22
references.pmid: 11010061
references.citation: Milbank Q. 2002;80(2):261-301
references.pmid: 12101873
references.citation: Prev Med. 2003 Nov;37(5):520-8
references.pmid: 14572437
references.citation: Gerontologist. 2004 Dec;44(6):779-87
references.pmid: 15611214
references.citation: Am J Public Health. 2000 Jun;90(6):955-61
references.pmid: 10846515
references.citation: Arch Phys Med Rehabil. 2002 Sep;83(9):1196-201
references.pmid: 12235597
references.citation: Am Fam Physician. 2004 Sep 15;70(6):1035
references.pmid: 15456114
references.citation: J Gerontol B Psychol Sci Soc Sci. 2002 Jul;57(4):S221-33
references.pmid: 12084792
references.citation: Annu Rev Public Health. 2009;30:43-54
references.pmid: 19705555
references.citation: J Gen Intern Med. 2005 Feb;20(2):148-54
references.pmid: 15836548
references.citation: Ann Intern Med. 2006 Nov 7;145(9):637-45
references.pmid: 17088576
references.citation: Am J Public Health. 2005 Mar;95(3):512-7
references.pmid: 15727986
references.citation: Arch Phys Med Rehabil. 2008 Feb;89(2):219-30
references.pmid: 18226644
references.citation: Arch Phys Med Rehabil. 1999 Jun;80(6):642-6
references.pmid: 10378489
references.citation: Soz Praventivmed. 2001;46 Suppl 1:S3-42
references.pmid: 11851091
references.citation: MMWR Morb Mortal Wkly Rep. 2004 Oct 22;53(41):963-6
references.pmid: 15496824
references.citation: Health Aff (Millwood). 2001 Nov-Dec;20(6):242-53
references.pmid: 11816665
references.citation: Med Care Res Rev. 2010 Aug;67(4 Suppl):126S-40S
references.pmid: 20643824
references.citation: Arch Phys Med Rehabil. 2008 Apr;89(4):595-601
references.pmid: 18373987
references.citation: Public Health Rep. 2004 Jul-Aug;119(4):418-26
references.pmid: 15219799
references.citation: Health Qual Life Outcomes. 2006 Mar 03;4:14
references.pmid: 16515690
references.citation: Am J Public Health. 1992 May;82(5):739-41
references.pmid: 1533103
references.citation: J Epidemiol Community Health. 2003 May;57(5):339-43
references.pmid: 12700216
references.citation: N Engl J Med. 2008 Mar 6;358(10):1064-71
references.pmid: 18322289
references.citation: Health Aff (Millwood). 2003 Jul-Dec;Suppl Web Exclusives:W3-552-65
references.pmid: 15506159
references.citation: Am J Public Health. 2011 Feb;101(2):368-75
references.pmid: 21164090
references.citation: Am J Public Health. 2003 Aug;93(8):1335-41
references.pmid: 12893624
references.citation: Diabetes Care. 2009 Jun;32(6):983-9
references.pmid: 19252167
references.citation: Am J Public Health. 2004 Mar;94(3):443-5
references.pmid: 14998811
references.citation: Cancer. 2010 Jul 15;116(14):3493-504
references.pmid: 20549763
references.citation: Annu Rev Public Health. 2004;25:99-117
references.pmid: 15015914
references.citation: Health Serv Res. 2006 Aug;41(4 Pt 1):1258-75
references.pmid: 16899006
references.citation: Ment Retard. 2006 Aug;44(4):249-59
references.pmid: 16834462
references.citation: Am J Prev Med. 2005 Feb;28(2):182-7
references.pmid: 15710274