A study from Yale University indicates that while more money has been invested in the health care system over the last two decades, barriers to care and racial and ethnic disparities have only worsened.
Barriers to timely medical care have worsened in the last 20 years, particularly among racial and ethnic minority groups, according to a study published in JAMA Network. For the study, a team of researchers from the Yale Center for Outcomes Research and Evaluation (CORE) used data from 1999 to 2018 to analyze trends related to five barriers to timely medical care, including an inability to get an appointment soon enough, conflicts with office hours, an inability to get through by telephone, long wait times, and a lack of transportation.
Researchers found the percentage of adults who reported these barriers to care nearly doubled from 1999 (7.1 percent) to 2018 (13.5 percent), leaving one in seven Americans struggling with these barriers. Racial and ethnic disparities have also intensified over the last 20 years. By 2018, Black and Latino adults were more likely to experience both delayed care due to lack of transportation and long wait times compared to white adults.
“Despite health reforms and innovations by the private sector, our nation is losing ground on access to health care. People are facing greater barriers now than 20 years ago despite the trillions more dollars that have flowed into the health care system,” said senior author Harlan M. Krumholz, M.D., Harold H. Hines Jr. Professor of Medicine and director of CORE, in a statement. “How is it possible that, compared with the turn of the century, people are having a harder time getting health care in recent years – and disparities have not only not improved, but have worsened. Our current approaches are failing to improve access.”
The findings underscore several health policy implications and action areas to address existing barriers and racial/ethnic disparities, according to the study team, including:
- The need for improved national investments to measure and track primary care availability and accessibility for all social determinants of health
- The need for multisectoral collaboration to improve accessibility to quality care for racial/ethnic minority groups, such as urgent care clinics, insurance coverage for nonemergency transportation to medical care, and digital health technologies for telehealth options
- The need to address women’s access to health care throughout the different stages of the life cycle