March 14, 2007
JAMA and Health Disparities
The current issue of JAMA has several articles that address the issue of health disparities.
One study concluded that financial barriers to health care are associated with worse outcomes after an acute myocardial infarction. To determine if a financial barrier existed researchers asked questions to patients such as, "In the past year, have you avoided obtaining health care services because of cost?" Among their findings:
Individuals who reported financial barriers had significantly higher unadjusted rehospitalization rates. Reported financial barriers to health care services were associated with an 11.2% higher all-cause rehospitalization rate (P <.001) and an 8.0% higher cardiac rehospitalization rate at 1-year follow-up (P<.001).
In another article, researchers state that those who experienced a unexpected health injury or chronic condition and did not have insurance received less medical care and "poorer short-term changes in health." One of their findings said:
Uninsured individuals were significantly less likely to see a clinician following an unintentional injury or a new chronic condition. However, if an individual did see a clinician, he/she was equally likely to have further care recommended regardless of insurance status. Despite the equal recommendations for further care, uninsured individuals in the unintentional injury sample were significantly more likely to have received none of the recommended follow-up care and significantly less likely to have received all of the recommended follow-up care. In the new chronic condition sample, uninsured individuals also were significantly more likely to have received none of the recommended follow-up care and were significantly less likely to still be receiving treatment for their chronic condition.
Also, in a commentary titled, "Health Disparities and Access to Care" the authors explain that "availability of health insurance does not guarantee access to care—and certainly does not guarantee access to high quality of care."