The health effects of cost-related treatment delays.

The number of Americans who report delaying or forgoing necessary medical care because of cost concerns has increased markedly in recent years. Delaying or forgoing treatment may result in negative health effects, but empirical evidence is scarce. Using the merged data set of the Medical Expenditure Panel Survey and the National Health Interview Survey 2002-2006, the effect of delaying or forgoing medical care on ex post health status was estimated. Results indicate that people who delayed or forwent medical treatment were significantly less likely to report having excellent or very good ex post health status and had significantly lower quality-of-life scores compared with people who never delayed or forwent necessary medical care, controlling for socioeconomic and demographic factors, chronic medical conditions, and baseline health status. The Blinder-Oaxaca decomposition results suggest that expanding health insurance coverage can prevent 9% to 12% of the health decrements associated with delaying or forgoing medical treatment.