Medicare is not a fix: Delayed care among older adults

Introduction: When the cost of medical care becomes too great, families may delay or postpone needed medical care or reduce other household expenses. The delay of medical care may result in greater health complications, resulting in more advanced treatment.

Methods: The 2011–2013 National Health Interview Survey (NHIS) asked adults, 18 and older, “Has medical care been delayed for costs in the last 12 months?” The analysis focuses on adults 65 years and older (n = 22,016). We explored the relationship between delay of medical care and select respondents’ characteristics and experiences. All analyses reflect the complex NHIS sampling frame. Study limitations include absence of detailed information regarding costs and health outcomes subsequent to delay.

Results : Among older adults, 4% delayed medical care due to costs. Among those, 75% were worried about the costs of care. The majority of older adults had either government (63%) or private supplemental (32%) health insurance. Adults with government insurance (aOR=1.4, P=0.0008) and the uninsured (aOR=5.9, P<0.0001) were more likely to delay care. Fair/poor health, income, and worry about medical costs were strongly associated with delaying care.

Conclusions: While only a small proportion of older adults delayed medical care due to costs, those who delayed care were more vulnerable, due to the combination of poor health and reduced resources. Clinicians need to discuss costs of medications and other therapies with patients; community planners need to address the need for financial assistance even among a well-insured population.