title: Nonfinancial barriers and access to care for U.S. adults.
abstract: OBJECTIVE
  To identify prevalences and predictors of nonfinancial barriers that lead to unmet need or delayed care among U.S. adults.
  
  
  METHODS
  2007 Health Tracking Household Survey.
  
  
  METHODS
  Reasons for unmet need or delayed care in the previous 12 months were assigned to one of five dimensions in the Penchansky and Thomas model of access to care. Prevalences of barriers in each nonfinancial dimension were estimated for all adults and for adults with affordability barriers. Multivariable logistic regression models were used to estimate associations between individual, household, and insurance characteristics and barriers in each access dimension.
  
  
  RESULTS
  Eighteen percent of U.S. adults experienced affordability barriers and 21 percent experienced nonfinancial barriers that led to unmet need or delayed care. Two-thirds of adults with affordability barriers also reported nonfinancial barriers. Young adults, women, individuals with lower incomes, parents, and persons with at least one chronic illness had higher adjusted prevalences of nonfinancial barriers.
  
  
  CONCLUSIONS
  Nonfinancial barriers are common reasons for unmet need or delayed care among U.S. adults and frequently coincide with affordability barriers. Failure to address nonfinancial barriers may limit the impact of policies that seek to expand access by improving the affordability of health care.
authors.affiliation: Robert Wood Johnson Foundation Clinical Scholars, Philadelphia Veterans Affairs Medical Center, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Jeffrey T
authors.initials: JT
authors.lastname: Kullgren
authors.forename: Catherine G
authors.initials: CG
authors.lastname: McLaughlin
authors.forename: Nandita
authors.initials: N
authors.lastname: Mitra
authors.forename: Katrina
authors.initials: K
authors.lastname: Armstrong
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001071:Appointments and Schedules; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000458:organization & administration*; D006302:Health Services Research; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data*; D007348:Insurance, Health / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012111:Residence Characteristics; D012737:Sex Factors; D012959:Socioeconomic Factors; D013997:Time Factors; D014481:United States; D055815:Young Adult
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