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Researchers have long known about disparities in access to care for individuals with asthma and COPD. These disparities are often compounded by additional factors that exacerbate symptoms and make the entire care process more difficult. In the past, researchers have focused on the racial, ethnic, and economic breakdown of these disparities. This study, published in Chest, focuses on long-term trends in access to care.

Data for this study were based on the National Health Interview Survey from 1997 to 2018. Trends relating to healthcare affordability and the price of prescription drugs for asthma and COPD were examined. Multivariable linear probability regressions were used to compare coverage and access from 1997 to 2018.

The study looked at data from 76,843 adults with asthma and 30,548 adults with COPD. Although uninsurance rates initially rose at the start of the decade leading up to the Great Recession, they sharply fell after the adoption of the Affordable Care Act (ACA). From 1997 to 2018, the percentage of uninsured people with asthma fell from 19.4% to 9.6%. 

Despite this improvement in insurance coverage, the percentage of patients delaying or forgoing medical treatment due to cost did not improve. Racial and ethnic disparities that were present in 1997 remained intact in 2018. Overall, results were similar for patients with COPD, although the proportion of patients who were not taking a needed medication rose by 7.8 percentage points. 

The researchers concluded that although coverage rates improved as a result of the ACA, further reform is needed to ensure equitable and affordable care for adults with asthma and COPD [1].


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[1] Gaffney, A. W., Hawks, L., Bor, D., White, A. C., Woolhandler, S., McCormick, D., & Himmelstein, D. U. (2021). National trends and disparities in healthcare access and coverage among adults with asthma and COPD: 1997 – 2018. Chest. https://doi.org/10.1016/j.chest.2021.01.035


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