Health Care Costs Affect Medical Decisions of Women, Survey Finds

Twenty-seven percent of women under age 65 and 67% of uninsured women delayed or went without needed medical care in the last year because they did not think they could afford it, according to a new survey from the Kaiser Family Foundation, the Minneapolis Star Tribune reports (O'Rourke, Scripps Howard/Minneapolis Star Tribune, 7/7). For the survey, researchers queried 2,766 women ages 18 and older by telephone from July though September 2004 (Reuters/New York Post, 7/8).

According to the survey, 17% of women with private insurance delayed or went without care because of cost concerns (CQ HealthBeat, 7/7). One in three Latinas -- who are the least likely among all U.S. women to have a regular physician -- said they delayed or forwent health care because of cost, the survey finds (Scripps Howard/Minneapolis Star Tribune, 7/7).

Eight in 10 mothers or legal guardians said they had the responsibility for health care decisions in a family, and 12% of women said they are caregivers for sick or aging relatives, according to the survey (Powell, Akron Beacon Journal, 7/8).

Among uninsured women, 41% reported that they did not fill a prescription because of costs, compared with 17% of women with private insurance and 19% of women enrolled in Medicaid. Fourteen percent of women also reported that they skipped or took smaller doses of their medicines in the past year to make them last longer, the survey shows (Kaiser Family Foundation release, 7/7).

However, women are more likely than men to use a prescription drug on a regular basis, and they also are more likely to report difficulties affording such medications, the survey finds (Scripps Howard/Minneapolis Star Tribune, 7/7). Moreover, 38% of women have chronic conditions such as diabetes, asthma or hypertension, compared with 30% of men (Akron Beacon Journal, 7/8). Thirty-four percent of women in poor health did not fill a prescription because they could not afford it, the study shows (Kaiser Family Foundation release, 7/7).

According to the survey, about one-third of women reported that they spoke to a physician in the past three years about smoking, 20% spoke to a doctor about alcohol use and 43% discussed calcium intake (CQ HealthBeat, 7/8). Fifty-five percent of women discussed diet, exercise and nutrition with their physicians.

Only 31% of women of reproductive age said they discussed sexual history, sexually transmitted diseases and HIV/AIDS with their physician (Portillo, Knight Ridder/Detroit Free Press, 7/8).

The survey also found that the rate of women receiving a mammogram decreased from 73% in 2001 to 69% in 2004 among women ages 40 to 64 (CQ HealthBeat, 7/8). Three-quarters of women with private insurance coverage in 2004, 73% of Medicare beneficiaries and 40% of uninsured women received a mammogram in the last year (Kaiser Family Foundation release, 7/7).

In addition, the rate of women ages 18 to 64 who received a pap test decreased from 81% in 2001 to 76% in 2004 (Scripps Howard/Minneapolis Star Tribune, 7/7). Thirty-eight percent of women age 50 and older reported having had a colon cancer screening test in the past two years and 37% of women age 45 and older said they received an osteoporosis test in the past two years, the survey shows (CQ HealthBeat. 7/8).

Alina Salgagnicoff, director of women's health policy at the Kaiser Family Foundation and a foundation vice president, said, "We're finding that cost is increasingly becoming a barrier for women. The cost is more of an issue for women than men" (Akron Beacon Journal, 7/8). She added, "A sizeable share of women are falling though the cracks, either because they don't have insurance or even with insurance can't afford to pay for medical care or prescription drugs" (Scripps Howard/Minneapolis Star Tribune, 7/7).

Susan Sered, a researcher who conducted interviews for the survey, said that many women reported discussing payment for care, adding, "Money was actually replacing things like lifestyle in discussions with doctors" (Knight Ridder/Detroit Free Press, 7/8).

Carolyn Clancy, director of the Agency for Healthcare Research and Quality, said during a panel discussion on the survey that women should be more proactive about speaking with their physicians and should prepare a checklist of things to ask before appointments (CQ HealthBeat, 7/7).

The survey is available online.