Nonfinancial Barriers and Access to Care for US Adults

As health care reform seeks to expand access to health care by improving affordability, significant nonfinancial barriers prevent many adults from seeking or delaying the care they need.

These researchers used data from the 2007 Health Tracking Household Survey to estimate the prevalence of nonfinancial barriers and the groups that experience them.

The researchers categorized five dimensions of access to health care. The four nonfinancial barriers were more frequent reasons for unmet need or delayed care in the previous 12 months (21%) compared to affordability, the only cost-related dimension (18.5%).

The prevalence of nonfinancial barriers and top examples include:

  • Accommodation (17.5%) —busy with work or other commitments
  • Availability (8.4%)—couldn’t get appointment soon enough
  • Accessibility (4.4%)—took too long to get to the doctor’s office or clinic
  • Acceptability (4.0%) —doctor or hospital wouldn’t accept health insurance

Some 66.8 percent of adults who reported an affordability barrier, also experienced a nonfinancial barrier. Women, more than men, had accommodation and availability barriers. Non-Black, non-Hispanic minorities, more than Whites, had availability and acceptability barriers. Blacks, more than Whites, reported accessibility barriers. Adults in poor health had a higher prevalence of nonfinancial barriers than healthy adults.

The researchers suggest specific ways for policy-makers to address nonfinancial barriers.