How Health Insurance Status Affects Accessing Care

Lisa Nelson Health Pro
  • Let's say you are having chest pains. You know you should contact your physician and/or head to the emergency room, but does the thought of medical bills cross your mind first? Do you delay seeking medical help due to financial worries?


    Not much is known about how health insurance (or a lack of health insurance) impacts your decision to seek your doctor's care during an emergency medical situation. A study was recently published in the Journal of the American Medical Association and I'd like to share the resuts with you.


    Researchers in the Netherlands connected a study to determine the association between health insurance status and financial concerns about accessing care. The time from symptom onset to hospital arrival during acute myocardial infarctions (i.e. heart attacks) was also examined.

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    The study included 3,721 heart attack patients enrolled between April 2005 and December 2008 located at 24 different hospitals throughout the United States. Participants were separated into 3 groups: 1. Insured without financial concerns, 2. Insured with financial concerns about accessing care, 3. Uninsured. Insurance status was obtained from medical records, while concerns about accessing care were compiled through structured interviews with participants.


    The time delay for seeking medical care was also broken down into three categories: 1. 2 hours or less, 2. between 2-6 hours, 3. greater than 6 hours. (Times were adjusted for various demographic, clinical, social, and psychological factors.)


    Out of the 3721 patients. . .

    • 2294 were insured without financial concerns (61.7%)
    • 689 were insured but had financial concerns about accessing care (18.5%)
    • 738 were uninsured (19.8%)

    Study results showed that uninsured and insured patients with financial concerns tended to delay seeking medical during an acute myocardial infarction (AMI).


    The percent of individuals with a time delay of greater than 6 hours before seeking medical care:

    • 48.6% of uninsured patients
    • 44.6% of patients with insurance and financial concerns
    • 39.3% of insured patients without medical concerns

    Individuals that were fastest to seek medical care (time delay of 2 hours or less) during an AMI were patients with insurance and no financial concerns (36.6%) versus 33.5% of insurance patients with financial concerns and 27.5% of uninsured patients.


    Researchers concluded that a lack of health insurance and concerns about cost when accessing medical care for those with health insurance were linked to time delays accessing emergency medical during an acute myocardial infarction.


    Some additional interesting results:


    For individual with health insurance and financial concerns 82.8% reported they avoid medical care, 55.6% reported they avoid taking medications, and 12.8% reported difficulty obtaining health care due to cost.


    The findings of this study just reaffirm the impact limited health care coverage has on the lives of many American's and the need to provide improved options. Those who require emergency medical care need to have access to medical care AND not be worried about the consequences of seeking care.


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    From answering your questions on I know many of you are in this situation. You know you need medical care, but you seem to take a more "wait and see" approach. If you start to feel better you can avoid going to the doctor or emergency room and avoid unwanted medical bills. Please share your thoughts below.


    Be sure to grab the special report "How to Make Heart Healthy Changes into Lifelong Habits" and a subscription to The Heart of Health at


Published On: April 15, 2010