The impact of insurance status on psoriasis patients’ healthcare-seeking behavior: a population-based study in the United States

Abstract Background Psoriasis is a chronic, inflammatory skin condition requiring long-term care. However, many psoriasis patients may not regularly receive care. Several factors affect access to care in the United States, including health insurance status. Additionally, it is unknown how health ins...

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Main Authors: Kaviyon Sadrolashrafi, Audrey Hao, Rebecca K. Yamamoto, Lily Guo, Robin Kikuchi, Hannah C. Tolson, Sara N. Bilimoria, Danielle K. Yee, April W. Armstrong
Format: Article
Language:English
Published: BMC 2024-11-01
Series:BMC Health Services Research
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Online Access:https://doi.org/10.1186/s12913-024-11992-z
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author Kaviyon Sadrolashrafi
Audrey Hao
Rebecca K. Yamamoto
Lily Guo
Robin Kikuchi
Hannah C. Tolson
Sara N. Bilimoria
Danielle K. Yee
April W. Armstrong
author_facet Kaviyon Sadrolashrafi
Audrey Hao
Rebecca K. Yamamoto
Lily Guo
Robin Kikuchi
Hannah C. Tolson
Sara N. Bilimoria
Danielle K. Yee
April W. Armstrong
author_sort Kaviyon Sadrolashrafi
collection DOAJ
description Abstract Background Psoriasis is a chronic, inflammatory skin condition requiring long-term care. However, many psoriasis patients may not regularly receive care. Several factors affect access to care in the United States, including health insurance status. Additionally, it is unknown how health insurance status impacts the healthcare-seeking behavior of psoriasis patients. Healthcare-seeking behavior is broadly defined as an individual’s actions to prevent or treat a perceived health problem, such as visiting a physician’s office. Because early diagnosis and timely treatment improve patient outcomes, determining how insurance status impacts psoriasis patients’ healthcare-seeking behavior and their ability to get care is important. This allows us to identify patients at risk for being untreated or undertreated. In this study, we aimed to assess the relationship between insurance status and (1) the degree to which psoriasis patients delay seeking or receiving care and (2) the degree to which psoriasis patients are unable to obtain care. Methods This population-based study used 20 years of data from the Medical Expenditure Panel Survey from 2002 to 2021. We calculated descriptive statistics and performed adjusted multivariable logistic regression analyses. Results We identified a weighted total of 4,506,850 psoriasis patients. Compared to those with private insurance, psoriasis patients with public-only insurance were 2.7 times more likely to delay seeking or receiving care (95% CI, 1.26–5.87). Compared to private insurance patients, uninsured psoriasis patients were 3.4 times more likely to be unable to obtain care (95% CI, 1.31–8.92). Compared to those with public-only insurance, uninsured psoriasis patients were 3.7 times more likely to be unable to obtain care (95% CI, 1.32–10.38). Conclusions This study found that psoriasis patients with public-only insurance were significantly more likely to delay seeking or receiving care compared to those with private insurance. This study also found that uninsured psoriasis patients were significantly more likely to be unable to obtain care than psoriasis patients with private insurance and those with public-only insurance. Developing strategies to increase healthcare access is necessary to ensure equitable, timely, and appropriate care for all psoriasis patients, regardless of their insurance status.
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spelling doaj-art-aed31ef13b8d4de19ca6832ea70bb2fd2025-08-20T02:51:43ZengBMCBMC Health Services Research1472-69632024-11-012411810.1186/s12913-024-11992-zThe impact of insurance status on psoriasis patients’ healthcare-seeking behavior: a population-based study in the United StatesKaviyon Sadrolashrafi0Audrey Hao1Rebecca K. Yamamoto2Lily Guo3Robin Kikuchi4Hannah C. Tolson5Sara N. Bilimoria6Danielle K. Yee7April W. Armstrong8Kirk Kerkorian School of Medicine at UNLVKeck School of Medicine of University of Southern CaliforniaGeorgetown University School of MedicineDuke University School of MedicineKeck School of Medicine of University of Southern CaliforniaThe University of Arizona College of Medicine – PhoenixDivision of Dermatology, Department of Medicine, David Geffen School of Medicine at UCLADivision of Dermatology, Department of Medicine, David Geffen School of Medicine at UCLADivision of Dermatology, Department of Medicine, David Geffen School of Medicine at UCLAAbstract Background Psoriasis is a chronic, inflammatory skin condition requiring long-term care. However, many psoriasis patients may not regularly receive care. Several factors affect access to care in the United States, including health insurance status. Additionally, it is unknown how health insurance status impacts the healthcare-seeking behavior of psoriasis patients. Healthcare-seeking behavior is broadly defined as an individual’s actions to prevent or treat a perceived health problem, such as visiting a physician’s office. Because early diagnosis and timely treatment improve patient outcomes, determining how insurance status impacts psoriasis patients’ healthcare-seeking behavior and their ability to get care is important. This allows us to identify patients at risk for being untreated or undertreated. In this study, we aimed to assess the relationship between insurance status and (1) the degree to which psoriasis patients delay seeking or receiving care and (2) the degree to which psoriasis patients are unable to obtain care. Methods This population-based study used 20 years of data from the Medical Expenditure Panel Survey from 2002 to 2021. We calculated descriptive statistics and performed adjusted multivariable logistic regression analyses. Results We identified a weighted total of 4,506,850 psoriasis patients. Compared to those with private insurance, psoriasis patients with public-only insurance were 2.7 times more likely to delay seeking or receiving care (95% CI, 1.26–5.87). Compared to private insurance patients, uninsured psoriasis patients were 3.4 times more likely to be unable to obtain care (95% CI, 1.31–8.92). Compared to those with public-only insurance, uninsured psoriasis patients were 3.7 times more likely to be unable to obtain care (95% CI, 1.32–10.38). Conclusions This study found that psoriasis patients with public-only insurance were significantly more likely to delay seeking or receiving care compared to those with private insurance. This study also found that uninsured psoriasis patients were significantly more likely to be unable to obtain care than psoriasis patients with private insurance and those with public-only insurance. Developing strategies to increase healthcare access is necessary to ensure equitable, timely, and appropriate care for all psoriasis patients, regardless of their insurance status.https://doi.org/10.1186/s12913-024-11992-zPsoriasisAccess to careDelayed careHealth insuranceHealth equityHealthcare-seeking behavior
spellingShingle Kaviyon Sadrolashrafi
Audrey Hao
Rebecca K. Yamamoto
Lily Guo
Robin Kikuchi
Hannah C. Tolson
Sara N. Bilimoria
Danielle K. Yee
April W. Armstrong
The impact of insurance status on psoriasis patients’ healthcare-seeking behavior: a population-based study in the United States
BMC Health Services Research
Psoriasis
Access to care
Delayed care
Health insurance
Health equity
Healthcare-seeking behavior
title The impact of insurance status on psoriasis patients’ healthcare-seeking behavior: a population-based study in the United States
title_full The impact of insurance status on psoriasis patients’ healthcare-seeking behavior: a population-based study in the United States
title_fullStr The impact of insurance status on psoriasis patients’ healthcare-seeking behavior: a population-based study in the United States
title_full_unstemmed The impact of insurance status on psoriasis patients’ healthcare-seeking behavior: a population-based study in the United States
title_short The impact of insurance status on psoriasis patients’ healthcare-seeking behavior: a population-based study in the United States
title_sort impact of insurance status on psoriasis patients healthcare seeking behavior a population based study in the united states
topic Psoriasis
Access to care
Delayed care
Health insurance
Health equity
Healthcare-seeking behavior
url https://doi.org/10.1186/s12913-024-11992-z
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