Transition to Adulthood: Delays and Unmet Needs among Adolescents and Young Adults with Asthma

Objective

To examine the effect of the transition to adulthood on financial and non-financial barriers to care in youth with asthma.

Study design

With National Health Interview Survey data from 2000 to 2005, we examined delays and unmet needs because of financial and non-financial barriers, evaluating the effect of adolescent (age, 12-17 years; n = 1539) versus young adult age (age, 18-24 years; N = 833), controlling for insurance, usual source of care, and sociodemographic characteristics. We also simulated the effects of providing public insurance to uninsured patients and a usual source of care to patients without one.

Results

More young adults than adolescents encountered financial barriers resulting in delays (18.6% versus 8%, P < .05) and unmet needs (26.6% versus 11.4%, P < .05), although delays caused by non-financial barriers were similar (17.3% versus 14.9%, P = not significant). In logistic models young adults were more likely than adolescents to report delays (odds ratio [OR], 1.45; 95% CI, 1.02-2.08) and unmet needs (OR, 1.8; 95% CI, 1.29-2.52) caused by financial barriers.

Conclusions

Delays and unmet needs for care caused by financial reasons are significantly higher for young adults than they are for adolescents with asthma.

Abbreviations: NHIS, National Health Interview Survey, NCHS, National Center for Health Statistics, OR, Odds ratio