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Health Services Use and Prescription Access Among Uninsured Patients Managing Chronic Diseases

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Abstract

Effective chronic condition management is dependent upon prescription medication access and compliance. Impacted access results in increased pain, worsening of the condition and association of additional health-related problems. Prescription medication costs constitute a significant burden for patients who are uninsured and managing chronic conditions. This burden links to the likelihood of medication non-compliance. The purpose of this research was to test the ability of the Andersen Behavioral Model of Health Services Use to examine health behaviors among adult uninsured patients managing physician-diagnosed chronic conditions. To enhance its chronic disease management model for uninsured patients diagnosed with chronic conditions requiring prescription regimens, a local community health center added a pharmaceutical access component to its health care delivery model. The Andersen Behavioral Model of Health Services Use was employed to gain insight on how the predictors of predisposing, enabling and need factors impact the change in clinical outcomes and the number of non-urgent triage telephone encounters, physician visits, and emergency department visits of each uninsured patient diagnosed with a chronic condition requiring prescription medication treatment and receiving care at this facility. Individual health behavior patterns are based on predisposition to care, factors that impede or enable the use of care and overall need for care. In this study, there was a statistically significant relationship between population characteristics and health behavior; between health behavior and outcomes; and between population characteristics and outcomes.

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Acknowledgments

The authors wish to thank Dean Shelley Mishoe, College of Health Sciences, Interim Chair Dr. Deanne Shuman—School of Community and Environmental Health for their support; and the Office of Graduate Studies for the Old Dominion University Graduate Fellowship Award which supported this work.

Conflict of interest

There were no declared conflicts of interest.

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Authors and Affiliations

  1. School of Community and Environmental Health, College of Health Sciences, Old Dominion University, 3134 Health Sciences Building, Norfolk, VA, 23529, USA

    Jewel Goodman Shepherd & Qi Zhang

  2. School of Physical Therapy and Athletic Training, College of Health Sciences, Old Dominion University, 3118 Health Sciences Building, Norfolk, VA, 23529, USA

    Elizabeth Locke & George Maihafer

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  1. Jewel Goodman Shepherd
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  2. Elizabeth Locke
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  4. George Maihafer
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Correspondence to Jewel Goodman Shepherd.

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Shepherd, J.G., Locke, E., Zhang, Q. et al. Health Services Use and Prescription Access Among Uninsured Patients Managing Chronic Diseases. J Community Health 39, 572–583 (2014). https://doi.org/10.1007/s10900-013-9799-1

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  • DOI: https://doi.org/10.1007/s10900-013-9799-1

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