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Individuals with more underlying chronic health conditions were more likely to delay or avoid medical care

May 25, 2023, Oakland, Calif.— At the height of the pandemic, individuals were asked to delay preventive care and elective procedures to alleviate incidences of community transmission. Many employers are now understandably concerned about the costs of delayed care, and the impact this has had on those with chronic conditions that may have gone untreated over the past three years. In an effort to understand who is delaying care and why they have delayed care, health and productivity research non-profit Integrated Benefits Institute surveyed 5,003 employed individuals in the US.

IBI’s survey found that less than three-fourths of employees are up to date on preventive screenings and immunizations. Fifty-eight percent of employees delayed necessary medical care due to cost or insurance barriers, 42% reported delays because there wasn’t an appointment available, and 35% delayed or avoided care due to fear of getting or spreading COVID-19.

Among those who are not up to date on preventive screenings, individuals’ top reasons were that it wasn’t necessary because “I’m young and healthy” (17%), and due to costs/can’t afford (14%). The top reasons cited for not being up to date on immunizations were that they don’t like shots/don’t want them/don’t trust them (37%), and that they aren’t necessary because “I have a strong immune system” (15%).

Surprisingly, regardless of sociodemographics, individuals with more chronic conditions were more likely to delay care. Sixty-nine percent of individuals with 3 or more chronic conditions delayed care due cost/insurance barriers, compared to 51% with no chronic conditions. However, those with chronic conditions are also more likely to be up to date on preventive care.

Additional findings include:

  • Individuals with co-morbid anxiety and depression are least likely to be up to date on preventive screenings or adult immunizations.
  • Rural areas have lower rates of preventive care: 55% of individuals in rural areas are up to date on preventive screenings, compared to 61% in urban areas. Sixty percent of individuals in rural areas are up to date on adult immunizations, compared to 69% in urban areas.
  • Individuals with higher income and higher education are more likely to be up to date on preventive screenings and immunizations.
  • Having children in the household was associated with higher rates of preventive screenings and adult immunizations.
  • Older respondents were less likely to delay or avoid medical care for any reason.

IBI spoke with two HR executives from large national and global companies about the effects of delayed care among their employees. Some important themes came up:

Ask why employees are delaying care: Any delays in treatment may exacerbate symptoms and make treatment more difficult, both of which increase the cost of treatment. This makes tracking rates of delayed care important for employers, so they can both encourage employees to get the treatment they need, as well as budget for healthcare costs going forward.

Acknowledge the impact of mental health: Mental health conditions often occur with other chronic conditions such as diabetes, obesity, and asthma, and can impact patients’ ability to adhere to treatment recommendations for other physical health conditions.

Improve access to care where barriers exist: A key barrier to timely healthcare is cost, especially now with inflation impacting the price of everything from groceries to transportation, and high-deductible health plans can cause major challenges for affordability. To address accessibility challenges, employers are utilizing mobile clinics to meet employees wherever they are.

Create a culture that encourages seeking care: Employers can utilize specific employees as champions for benefit programs and encouraging healthful behaviors. Managers can be trained to encourage conversations around healthcare and wellbeing. Having managers that are well-equipped to deal with staff health concerns is key to moving the company culture in the right direction.

For more information the report and infographic are available upon request, please contact Jennifer Santisi at jsantisi@ibiweb.org.

About Integrated Benefits Institute

The Integrated Benefit Institute’s independent research, industry-leading tools and data resources help companies link health-related programs to the outcomes that maximize the contributions of people to productivity and business performance. Founded in 1995, IBI is a national nonprofit research organization and business association serving 1,200 employer and supplier members and their 22 million employees. For additional information, please visit www.ibiweb.org and follow us on Twitter and LinkedIn.

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