There are many other reasons why high-need New Yorkers may find it difficult to make appointments. Be- yond the mere availability of appointments, the ways in which facilities and providers accommodate and accept patients can shape access to healthcare. 13 These dimensions include the extent to which healthcare providers accommodate patients’ irregular schedules, patients’ ability to navigate healthcare interfaces and fill out forms, as well as patients’ sociomedical experiences with providers, whether their health con- cerns are taken seriously or whether they are treated with respect. Regardless of disadvantage, we find that high-need New Yorkers were more able to receive care outside of standard business hours in 2022 than in 2021. 14 Economically disadvantaged New Yorkers saw a 13-percent- age-point increase in receiving care outside of standard business hours (from 20% to 33%) and more-ad- vantaged New Yorkers saw a 12 percentage point increase (from 19% to 31%) (Figure 4). These increases likely reflect the growing capacity of and access to healthcare facilities following the easing of pandemic restrictions, providing more flexibility to accommodate patients’ scheduling needs. However, economically disadvantaged New Yorkers continued to struggle with certain aspects of navigat- ing the medical system. More than half (54%) of economically disadvantaged, high-need New Yorkers re- ported feeling confident filling out medical forms by themselves in 2022—relative to 57% in 2021—whereas more-advantaged New Yorkers felt increasingly confident filling out medical forms by themselves, from 71% in 2021 to 79% in 2022 (Figure 4). 15 Throughout the pandemic, economically disadvantaged New Yorkers were also persistently less likely to be able to change appointments by themselves relative to more-advan- taged New Yorkers (67% versus 77% in 2022, respectively) (Figure 4). 16 Despite some gains in appointment availability after standard hours, patterns around filling forms and changing appointments contribute to the persistent struggles that economically disadvantaged New York- ers face while navigating their healthcare options. Strengthening provider-based supports, such as navi- gation and paperwork assistance and further accommodations for appointments (see Paulette’s story be- low), can be effective in helping high-need, economically disadvantaged New Yorkers meet their healthcare needs.
13 Penchansky and Thomas, “The concept of access: definition and relationship to consumer satisfaction.” 14 On the Poverty Tracker survey, New Yorkers are asked how often they can receive healthcare outside of standard hours (weekends or evenings): “always”, “often”, “sometimes”, “rarely”, or “never”. Those who respond “always” or “often” are defined as often able to receive care outside of standard hours. 15 On the Poverty Tracker survey, New Yorkers are asked how confident they feel filling out medical forms by themselves: “not at all”, “a little bit”, “some- what”, “quite a bit”, or “extremely”. Feeling confident is defined as responding “quite a bit” or “extremely” confident. 16 On the Poverty Tracker survey, New Yorkers are asked how often they are able to make and/or change a healthcare appointment by themselves: “al- ways”, “often”, “sometimes”, “rarely”, or “never”. Those who respond “always” or “often” are defined as often being able to make/change appointments by themselves.
SPECIAL SERIES: HEALTH & HEALTHCARE IN NY 9
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