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Poor outcomes await patients, providers alike when medical treatment is delayed

by Dianne Barnard | Contributor
October 19, 2020

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Health promotion and maintenance are important components of disease and disability management. Timely access to comprehensive and quality health care reduces disability and premature deaths across the board. The combination of access to quality care, insurance coverage and timing of care is important to overall quality and longevity of life and the delay of treatment has long-ranging consequences for both the individual and the health care system.

A delay in medical treatment occurs when there is a delay from the time the individual first notices a problem and obtaining the right diagnosis and treatment. It also means when the patient does not receive a treatment ordered for them in the time frame that is should have been delivered.

  • Medications
  • Lab tests
  • Physical therapy
  • Referral to specialist
  • Appointment with specialist
  • Any kind of treatment

What could make an individual delay diagnosis and treatment of condition?

There are multiple reasons that an individual may delay seeking treatment and two very prominent variables are the patient’s ability to access care and to pay for it.

People in waiting room at doctor's office

According to Healthy People 2020, the ability to access health services equals the timely use of personal health services for the best possible outcome.

  • Being able to access the right health care at the right time depends on multiple variables.
  • First, the patient must be able to access the right health care in the community. They may not have the resources or mobility to travel far to the appropriate provider. The increased use of telehealth will be a boon to those individuals who live far from services, as long as they have access to private and secure internet. The geographic availability of services is a key variable in the decision to delay health care.
  • Second, the patient must have insurance coverage or a way to pay for the services. There have been strides with increasing coverage nationwide, but there still are many individuals who remain uninsured or underinsured. A report by the Gallup Poll states that over 25% of Americans delayed treatment in the past year due to cost.
  • Third, there are cultural and societal barriers to accessing health care that remain factors. To access health care, the person first must gain entry to the health care system. Cultural barriers that impact access vary based on socioeconomic status, race, age, disability, sex, sexual orientation, race, gender identity and even geographic location. Some cultures may be resistant to western medicine or the decision-maker may not be the patient.
  • Fourth, COVID-19 has seriously impacted routine follow-up and management of known conditions and delayed diagnosis of new conditions. The pandemic has impacted all industries including health care. The most recent Kaiser Family Foundation Poll reports that 48% of Americans skipped or delayed medical care because of the pandemic, and 11% of the poll participants reported a worsening of the condition due to delayed treatment. Many medical care providers canceled non-emergency appointments due to COVID-19 concerns.

Some of the barriers to accessing health care are the following:

  • The high cost of care
  • Inadequate or no insurance coverage
  • Lack of availability of services
  • Lack of culturally competent care

What are the consequences of delaying medical care?

Access to timely and appropriate care is essential to a person’s overall physical, social and mental health status. Lack of access impacts the overall quality of life by increasing mental stress, financial stress and worsening illness.

When a person does not receive timely care, a cascade of untoward consequences can follow.

  • Worsening illness
  • Increased complications
  • Increased emotional stress
  • Increased financial stress as more intensive treatment is necessary as the disease progresses
  • Higher treatment costs
  • Increased possibility of hospitalizations that might have been preventable if care was obtained when first needed
  • Prolonged ER wait times
  • Increased exposure to infection because of increased ER visits
  • Decreased customer satisfaction
  • Overloads the health care system when all the patients who have delayed care seek treatment at the same time

Preventing delays in medical care is important has proven benefits. Cancers detected early have a better prognosis. People who are uninsured or underinsured typically present for treatment with more advanced malignancies. Acute conditions such as asthma, congestive heart failure or cellulitis require less management when addressed early. For example, a CHF patient who reports a 2-pound weight gain to the physician may quite easily be managed with a medication dose change or a home health referral, but if left untreated would require hospitalization.

The importance of timeliness in seeking health care cannot be underestimated, particularly in this COVID-19 era. People are reluctant to present at medical facilities and may be restricted in obtaining their prescriptions for fear of going to the pharmacy. With unemployment at high levels, the cost of routine health care may seem prohibitive. These are serious and valid concerns but timely health care at a maintenance appointment can reduce a person’s risk. When an individual delays treatment for a suspected or known problem, the risk of that medical concern worsening increases, and urgent or emergency care becomes more likely.

The decision to seek medical care sooner rather than later improves health outcomes by managing the illness before it becomes worse. By doing so, this lessens the possible need for urgent or emergent care which increases cost, and may even eliminate the need for hospitalization.

The collateral consequences of delayed treatment can be catastrophic in physical, emotional and financial ways.

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