Abstract
BACKGROUND: Access, satisfaction, and affordability with healthcare services are critical to optimal health-related outcomes. These issues have not been traditionally considered in the study of people with aphasia (PWA). OBJECTIVE: To assess healthcare access, satisfaction, and affordability among a nationally representative sample of PWA and compare wot stroke survivors without aphasia. METHODS: Data from 404 PWA obtained from the 2019, 2020, 2021, and 2022 Medical Expenditure Panel Survey (MEPS) were used to examine ease of accessibility, satisfaction with healthcare, and affordability of healthcare and compared to stroke survivors without aphasia (N=4,120). RESULTS: Estimates indicated that, compared to their counterparts (stroke survivors without aphasia), PWA who were female (OR=1.1, CI=1.5, 2.4) and those earning low incomes (OR=1.9, CI=1.8, 4.4) were more likely to spend more than 15 minutes traveling to their usual source of care (USC). Hispanic PWA (OR=1.1, CI=1.2, 1.1), Black PWA (OR=1.5, CI=1.2, 1.6), and PWA living in the South (OR=3.4, CI=1.5, 2.4) were more likely to have difficulty contacting their USC by phone than the reference group. Hispanic (OR=1.5, CI=1.4, 1.6) and low income (OR=1.3, CI=1.1, 1.8) PWA had comparatively greater difficulty contacting their USC after hours. Additionally, Black (not explain OR=1.4, CI=1.1, 1.6; decide OR=1.4, CI=1.1, 1.9) and Hispanic (not explain OR=1.8, CI=1.6, 2.5; decide OR=1.3, CI=1.2, 1.3) PWA were more likely than Whites to feel that their provider did not explain all treatment options or ask them to help decide on their treatment. Finally, Black PWA (OR= 4.0, CI=1.3, 12.7) were more likely to have difficulty paying their medical bills than White PWA. No racial or ethnic differences in accessibility, satisfaction, or affordability appeared among those without aphasia. CONCLUSIONS: The study results indicate that PWA, particularly those from marginalized and low-income populations, may face additional barriers accessing healthcare, receive comparatively less satisfying care, and experience greater difficulty financing their healthcare.