Important Facts for Cost as a Barrier to Health Care

Definition

Percentage of adults aged 18 years and older who reported they were unable to receive needed health care in the past year due to cost.

Numerator

Number of survey respondents who reported they were unable to receive needed health care in the past year due to cost.

Denominator

Total number of survey respondents excluding those with missing, "Don't know/Not sure", and "Refused" answers.

Data Interpretation Issues

Question Text: "Was there a time in the past 12 months when you needed to see a doctor but could not because of cost?" Starting in 2009, the BRFSS included both landline and cell phone respondent interviews along with a new weighting methodology called iterative proportional fitting, or raking. This methodology utilizes additional demographic information (such as education, race, and marital status) in the weighting procedure. Both of these methodology changes were implemented to account for an increased number of U.S. households without landline phones and an under-representation of certain demographic groups that were not well-represented in the sample. More details about these changes can be found at: [https://ibis.health.utah.gov/pdf/opha/resource/brfss/RakingImpact2011.pdf]. As with all surveys, some error results from nonresponse (e.g., refusal to participate in the survey or to answer specific questions), and measurement (e.g., social desirability or recall bias). Error was minimized by use of strict calling protocols, good questionnaire design, standardization of interviewer behavior, interviewer training, and frequent, on-site interviewer monitoring and supervision.

Why Is This Important?

Access to health care is still a problem for many Utahns. Individuals who cannot obtain needed health care tend to have higher rates of death and disability from chronic disease. Cost is the most commonly reported barrier to getting needed health care.

Healthy People Objective AHS-6.2:

Reduce the proportion of persons who are unable to obtain or delay in obtaining necessary medical care
U.S. Target: 4.2 percent

Other Objectives

Related to HP2030 Objective AHS-4: Reduce the proportion of people who can't get medical care when they need it [[br]]'''U.S. Target:''' 3.3%

How Are We Doing?

The age-adjusted percentage of Utah adults who reported being unable to see a doctor in the past 12 months due to cost was 10.3% in 2020. The percentage (crude rate) was the highest for adults aged 25-34 (13.9%) and lowest for Utah adults aged 65 and older (4.0%). In 2020, Utah adults with low incomes had a higher age-adjusted rate (23.6%) of reporting cost as a barrier to health care than those with higher incomes (4.3%), as did those without health insurance (28.3%) versus the insured (7.8%).

How Do We Compare With the U.S.?

When comparing Utah to the U.S. as a whole, the age-adjusted percentage of adults who reported they were unable to get needed health care in the past year due to cost has been similar over the years. In 2020, this percentage was 11.2% in the U.S. compared to 10.3% in Utah.

What Is Being Done?

The Utah Department of Health administers programs to improve access to care, such as Medicaid, the Children's Health Insurance Program (CHIP), UPP (Utah's Premium Partnership for Health Insurance), primary care grants, and clinics for children with disabilities. Local health departments provide preventive services such as immunizations and screenings at low or no cost to eligible persons who cannot afford them. Members of the Association for Utah Community Health (AUCH), including Federally Qualified Health Centers and other providers, strive to meet the needs of the medically underserved in Utah.