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Younger Age, Female Sex, Low Income, and Poor Mental Health Are Patient-Perceived Risk Factors for Poor Access to
Alejandro M Holle1,2, Sayi P Boddu3, Vikram S Gill3
1Mayo Clinic Alix School of Medicine, Scottsdale, Arizona, U.S.A.
Purpose:
To evaluate which patient factors are associated with specific metrics of poor access to care in patients with a rotator cuff tear (RCT).
Methods:
The All of Us Database was utilized to form a cohort of patients with RCT between May 2018 and May 2023. Patients with a diagnosis of RCT using Systematized Nomenclature of Medicine clinical terms were included. The association of RCT diagnosis and patient-specific factors on self-reported outcomes of "delayed care," "could not afford care," "skipped medication," and "have not seen provider in more than 1 year" were analyzed. Statistical tests performed were univariate regression and multivariable logistic regression.
Results:
In total, 4,265 patients with RCT who completed the access to care survey were included. In the RCT cohort, 26.7% reported delayed care, 24.9% reported an inability to afford care, 12.1% reported skipped medications, and 1.7% reported not seeing a provider in more than 1 year. Multivariable analysis of patient treatment and demographic features revealed younger age, female sex, lower income, poor physical health, and poor mental health to be strongly associated with higher reported rates of delayed care, inability to afford care, and skipped medications. History of rotator cuff repair, marital status, and sexual orientation were not associated with reported poor access to care.
Conclusions:
A quarter of patients with rotator cuff tears report delays in overall medical care and inability to afford care. Among patients diagnosed with RCT, patients of younger age, female sex, low income, and poor physical and mental health have higher odds of decreased access to health care.
Clinical Relevance:
Health care disparities and access to care are topics that should be investigated to reduce them.
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