title: Statewide Assessment of Cost-Related Healthcare Access Barriers in Rhode Island.
abstract: Although co-payments and deductibles are means of keeping health expenditures low, they have also been cited as barriers that inhibit patients from accessing necessary healthcare. We aimed to evaluate Rhode Island residents' experiences with cost-related access challenges within the state's healthcare system. We conducted a cross-sectional survey of resident experiences with healthcare in Rhode Island. Our survey instrument was composed of the RAND Corporation "Short-Form Patient Satisfaction Questionnaire (PSQ-18)", questions developed by the Rhode Island Office of the Health Insurance Commissioner, and ranking of health priorities based on prior community assessments conducted by the Rhode Island Department of Health. Data were collected at venues across the state as part of the Rhode Island Department of Health 2015 Statewide Health Inventory. From July to August 2015, 404 surveys were completed. We found that 40% of respondents had a co-pay of $20-$50, while 35.7% of respondents had a deductible of greater than $500. Further, one-third of respondents delayed receiving care due to financial barriers. This decision resulted in a worsening condition or hospital visit for nearly half of those respondents. Co-pays and deductibles pose challenges to Rhode Islanders accessing health care. Cost-related barriers to healthcare access should continue to be addressed, especially in the context of preventive care services, which are now being built into health insurance premiums through the Patient Protection and Affordable Care Act. [Full article available at http://rimed.org/rimedicaljournal-2016-11.asp].
authors: Division of Policy, Information, and Communications, Rhode Island Department of Health, Providence, RI.
authors: Brooke
authors: B
authors: Moore
authors: Division of Policy, Information, and Communications, Rhode Island Department of Health, Providence, RI; Department of Internal Medicine, Yale School of Medicine, New Haven, CT.
authors: Theodore
authors: T
authors: Long
authors: Division of Policy, Information, and Communications, Rhode Island Department of Health, Providence, RI.
authors: Michael
authors: M
authors: Dexter
authors: Division of Policy, Information, and Communications, Rhode Island Department of Health, Providence, RI.
authors: Sandra
authors: S
authors: Powell
authors: Division of Policy, Information, and Communications, Rhode Island Department of Health, Providence, RI.
authors: Cheryl
authors: C
authors: LeClair
authors: Director of Health, State of Rhode Island.
authors: Nicole
authors: N
authors: Alexander-Scott
mesh_terms: D003430:Cross-Sectional Studies; D003669:Deductibles and Coinsurance / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000191:economics*; D006801:Humans; D058991:Patient Protection and Affordable Care Act / Q000191:economics*; D011315:Preventive Medicine / Q000191:economics*; D012237:Rhode Island
keywords: Rhode Island healthcare; co-payments; deductibles; financial barriers; preventative care