Adults With Two or More Chronic Conditions More Likely to Use Care, More Likely to Delay Care

Troy Brown, RN

March 01, 2017

Adults living with two or more chronic conditions are more likely to use healthcare services compared with adults with one or no chronic conditions, according to a new report from the Centers for Disease Control and Prevention. They are also more likely to delay needed medical care for reasons that may or may not be related to cost.

Brian W. Ward, PhD, National Center for Health Statistics, Division of Health Interview Statistics, Hyattsville, Maryland, compared national estimates of healthcare access and utilization among those diagnosed with two or more of 10 selected chronic conditions and those with one or none of the selected conditions. Those conditions are: hypertension, cancer, stroke, coronary heart disease, diabetes, arthritis (including rheumatoid arthritis, gout, lupus, and fibromyalgia), hepatitis, a current diagnosis of asthma, a diagnosis of weak or failing kidneys in the past 12 months, and a diagnosis of chronic obstructive pulmonary disease.

Regardless of the number of chronic conditions, those aged 18 to 64 years were less likely to obtain healthcare services during the past 12 months compared with those aged 65 years or older; they were also more likely to delay or not get needed medical care as a result of cost and noncost-related reasons.

Healthcare Use Rises as Number of Chronic Conditions Increases

In 2015, the percentage of adults who had seen or spoken with a healthcare professional in the past 12 months increased in line with the number of diagnosed chronic conditions.

For adults aged 18 to 64 years, that percentage was 73.1% for those without a chronic condition compared with 95.4% for those with two or more chronic conditions.

For adults aged 65 years or older, the percentage who had seen or spoken with a healthcare professional during the past 12 months was lowest (80.7%) among those without a chronic condition and highest (98.3%) among those with two or more chronic conditions.

When comparing adults with the same number of chronic conditions, those aged 18 to 64 years were less likely than those aged 65 years or older to have visited or talked with a healthcare professional in the past 12 months.

Delaying Medical Care for Any Reason

During 2012 to 2015, the percentage of adults with two or more chronic conditions who postponed or did not get necessary medical care for any reason decreased from 34.3% to 31.4% for those aged 18 to 64 years, but increased from 13.5% to 15.0% for those aged 65 years or older.

By 2015, a higher percentage of adults put off medical care for a noncost reason (14.6%) compared with those for a cost reason (11.7%).

Among adults aged 65 years or older with two or more chronic conditions, there was no significant change in the percentage of those who delayed or did not get needed medical care during the past 12 months due only to cost or only for a noncost reason.

However, the percentage of adults aged 65 years or older who delayed or did not obtain care for any reason increased.

Delaying Medical Care Due to Cost

From 2012 to 2015, the percentage of adults aged 18 to 64 years with two or more chronic conditions who postponed or did not get needed medical care as a result of cost decreased from 16.5% to 11.7%.

In 2015, the percentage of adults who put off or did not obtain necessary medical care as a result of cost in the past 12 months rose as the number of diagnosed chronic conditions increased.

Among those aged 18 to 64 years, it was highest (16.9%) among those with two or more of the 10 selected chronic conditions and lowest (8.5%) among those with none of the selected conditions.

Among those aged 65 years or older, delaying or not obtaining needed medical care as a result of cost during the past 12 months was more likely by those with two or more chronic conditions (5.2%) compared with those with no (2.7%) and one chronic condition (2.9%).

Among adults living with the same number of chronic conditions, the percentage was higher among those aged 18 to 64 years compared with those aged 65 years or older.

Delaying Medical Care for Reasons Other Than Cost

During 2012 to 2015, the percentage of adults aged 18 to 64 years with two or more chronic conditions who delayed needed medical care for a noncost reason in the past 12 months increased from 12.4% to 14.6%.

Noncost reasons included being unable to get through on the telephone, not being able to get an appointment quickly enough, lengthy wait to see the doctor after arriving, clinic or doctor's office closed when the adult was able to get there, or lack of transportation.

In 2015, the percentage of adults who postponed necessary medical care for a noncost reason in the past 12 months went up as the number of diagnosed chronic conditions increased.

Among adults aged 18 to 64 years, that percentage was 7.9% for those without a chronic condition compared with 19.7% for those with two or more chronic conditions.

Likewise, among adults aged 65 years or older, the percentage was lowest among those without a chronic condition (3.4%) and highest among those with at least two chronic conditions (11.4%).

Among those with the same number of chronic conditions, adults aged 18 to 64 years were more likely than those aged 65 years or older to have postponed needed medical care for a reason other than cost during the past 12 months.

Cost and noncost-related issues such as availability of transportation access to medical care are all barriers to patients being able to obtain medical care, the report shows.

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