Codes and Frequencies
For sample adults and sample children, DELAYCOST indicates whether, during the past twelve months, individuals delayed seeking medical care because of worry about the cost. In 1993, DELAYCOST was asked of all persons in quarters 3 and 4 and in 1994-2018 it was asked of all persons. For 1997-2018, respondents were explicitly told not to include dental care when answering this question. Beginning in 2019, respondents were not told to exclude dental care when answering this question, but they were also asked whether, during the past 12 months, they had delayed getting dental care due to the cost (DELAYDT).
The Field Representative's Manual for 1993 forward noted, "Delayed assumes that medical care has been or will eventually be received." This definition of the term was not routinely shared with respondents.
Several other variables available for 1997 forward address reasons other than "worry about the cost" that caused sample adults and sample children to delay getting medical care. The non-financial reasons for delays in getting medical care identified in these variables are: "you couldn't get an appointment soon enough" (DELAYAPPT); "the clinic/doctor's office wasn't open when you could get there" (DELAYHRS); "you couldn't get through on the telephone" (DELAYPHONE); "you didn't have transportation" (DELAYTRANS); and "once you get there, you have to wait too long to see the doctor" (DELAYWAIT).
Available for 1997 forward, YBARCARE, which identifies individuals who needed but did not get medical care because they could not afford it during the past 12 months, covers some of the same ground as DELAYCOST. However, the wording of the question for YBARCARE implies that medical care was foregone for financial reasons, while the wording of the question for DELAYCOST refers to care delayed for financial reasons. The difference in these two variables may, however, be less than is implied by this semantic distinction. In the case of some acute illnesses (such as respiratory infections and "stomach flu"), medical care that was delayed was doubtless ultimately foregone in many cases.
Along with the change in universe, there were differences in the wording of the question between 1993-1996, 1997-2018, and 2019 forward.
For 1993-1996, the question wording was, "During the past 12 months, has anyone in the family delayed seeking medical care because of worry about the cost? (If yes,) who delayed getting needed care?" For 1997-2018, the question wording was, "During the past 12 months, has medical care been delayed for [you/anyone in the family] because of worry about the cost? (If yes,) for which family member was medical care delayed?" Also, as noted above, only for 1997-2018 did interviewers state, "Do not include dental care." For 2019 forward, sample adults are asked "During the past 12 months, have you DELAYED getting medical care because of the cost?" and sample children are asked "During the past 12 months, has medical care BEEN DELAYED for ^SCNAME because of the cost?" Dental care is not explicitly excluded, but there is a separate question asking whether, during the past 12 months, the respondent had delayed getting dental care due to the cost (DELAYDT).
The NHIS questionnaire was substantially redesigned in 2019 to introduce a different data collection structure and new content. For more information on changes in terminology, universes, and data collection methods beginning in 2019, please see the user note.
- 1993: All persons in quarters 3 and 4.
- 1994-2018: All persons.
- 2019-2020: Sample adults age 18+ and sample children ages 0-17.