NU Online News Service, March 21, 2:18 p.m. – Inability to get timely appointments may be the fast growing barrier to access to medical care.

The Center for Studying Health System Change, Washington, put out a report today emphasizing the barriers caused by the high cost of care and the lack of health insurance.

“Cost was overwhelmingly the main barrier to care for the uninsured,” Bradley Strunk and Peter Cunningham write in a center report. “More than half of people with insurance also cited cost as a barrier.”

The center surveyed 60,000 adult U.S. residents under age 65 in 1997, 1999 and 2001.

Researchers found that 15% of the uninsured participants and 4.4% of the insured participants reported delaying or going without needed care in 2001.

Among the participants with access problems, 62.6% cited worries about cost as a major obstacle. But that figure was little changed from levels of 62.4% in 1997 and 61.2% in 1999.

Although most uninsured participants with access problems cited cost as a major obstacle, the level of concern was about the same in all three surveys.

But researchers found a huge increase in the percentage of participants who put off getting care, or went without care, because of an inability to get an appointment soon enough.

The percentage increased to 32.6% in 2001, from 22.9% in 1997.

For insured participants with access problems, the percentage citing appointment delays and related “system-related” barriers as major obstacles increased to 62.4%, from 54% four years earlier.

“Longer waiting times for appointments suggest growing physician capacity constraints,” the report authors write. “Some experts are predicting physician shortages.”

Survey results also show an increase in access problems caused by another capacity-related problem: an inability to get through to the doctor’s office by telephone.

The percentage of participants with access problems who were unable to reach doctors’ offices on the telephone increased to 12.3% in 2001, from 6.9% four years earlier.