Many Americans who have experienced a serious illness or injury within the past year are concerned about the costs of medical care, and struggle to ensure that their care is appropriate, according to a recent poll by the Robert Wood Johnson Foundation, NPR, and Harvard School of Public Health. RWJF commissioned the poll to better understand Americans’ experiences and attitudes related to cost and quality of U.S. medical care.

A large majority of the general public (87 percent) thinks the cost of care is a serious problem for the country. In addition, about two-thirds of the general public (65 percent) believes the cost of care has gotten worse over the last five years.

In addition to surveying the general public, this poll also examined sick Americans’ experiences with and perceptions of the costs and quality of medical care over the last year. “Sick Americans” (27 percent of adults surveyed) are defined as those who said they had a serious illness, medical condition, injury, or disability requiring a lot of medical care or who had been hospitalized overnight in the past 12 months.

Many sick Americans reported having problems due to the cost of their own medical care. More than 40 percent say that the cost of their medical care over the last 12 months has caused a “very serious” (20 percent) or “somewhat serious” (23 percent) problem for their own or their family’s finances. They also reported that high health care costs affected their ability to access care. One in six sick Americans say that there was a time in the past 12 months when they could not get the medical care they needed (17 percent).

Among the sick Americans who could not receive care, 52 percent report that it was because they could not afford the needed care, and 24 percent say it was because their insurers would not pay for it. Lastly, about one in 10 sick Americans (11 percent) report being turned away by a doctor or hospital for financial or insurance reasons at some time during the past 12 months when they tried to receive care.

The financial barriers to accessing care were more pronounced for sick people who were uninsured at some point in the last year. Forty percent of sick people who were uninsured at some time in the past 12 months say there was a time when they needed medical care but could not get it. In comparison, only 10 percent of those who were sick and who had health insurance for the entire 12 months said they could not access needed care.

“The rising cost of medical care affects everyone, but people who have been unwell know firsthand that an illness or injury can mean financial hardship or ruin,” said Risa Lavizzo-Mourey, president and CEO of the Robert Wood Johnson Foundation. “These findings confirm how thinly individuals and families have been stretched.”

The poll also finds nearly three out of five people in the general public believe the quality of health care is a serious problem for the country (57 percent). About four in five people said not being able to afford to get the tests or drugs they need is a major reason for quality problems (78 percent). Similarly, 64 percent of the general public says the influence of insurance plans on treatment decisions is a major reason for quality problems.

Many of the sick respondents complained of quality of care problems during their treatment. Findings show:

About one in eight sick Americans believe they were given the wrong diagnosis, treatment, or test (13 percent). About a quarter of sick Americans say that their condition was not well-managed (26 percent).

A quarter of sick Americans report that a doctor, nurse, or other health professional did not provide all the needed information about their treatment or prescriptions (25 percent) — or they had to see multiple medical professionals, and no single doctor understood or kept track of all the different aspects of their medical issues and treatments (23 percent).

Three in 10 hospitalized Americans say there was poor communication among the doctors, nurses, and other health care professionals involved in their care (30 percent).

About one in six sick Americans believe they did not get the tests they thought they needed (18 percent), while 15 percent of sick Americans surveyed were tested or treated for something they believed to be unnecessary.

The poll was designed and analyzed by a team of researchers at the Harvard School of Public Health. Interviews were conducted in March, 2012, via telephone by SSRS, a research company, with a representative national sample of 1,508 adults age 18 and over.

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