OBJECTIVES : Avoiding healthcare can increase the occurrence of cardiovascular diseases and place significant economic burdens on older adults with hypertension. This study examines the factors associated with avoiding healthcare among Medicare beneficiaries with hypertension.

METHODS : This cross-sectional study used data from the 2015 Medicare Current Beneficiary Survey. The study population was older adults with hypertension (unweighted N=8,293; weighted N=34,415,713). The dependent variable was avoiding healthcare defined by the question, “Will you do just anything to avoid going to doctors?”. Healthcare utilization-related factors (e.g., issue in access to care due to costs, doctors that failed to recognize health issues, and satisfaction with the health information provided by their doctors) were included as the primary independent variables. Survey-weighted multivariate logistic regression was used by controlling for demographics, economic status, and health status.

RESULTS : Approximately 65.9% (95% Confidence Interval (CI)=64.6-67.2) of Medicare beneficiaries reported having hypertension. Among them, 27.7% (95% CI=26.2-29.3) reported that they would do anything to avoid going to the doctor. Older adults with hypertension who were seen by doctors who failed to recognize health issues were more likely to avoid healthcare than those that did not encounter such doctors (Odd Ratio (OR)=2.66; 95% CI=2.06-3.43; p<0.001), and those who were not satisfied with the information provided by their doctors concerning their health were more likely to avoid healthcare than those who were satisfied with the information provided by their doctors (OR=1.64; 95% CI=1.11-2.42; p=0.013). Among older adults with hypertension, having issues with access to care due to costs increased the likelihood of avoiding healthcare (OR=1.61; 95% CI=1.19-2.17; p=0.001).

CONCLUSIONS : Among older adults with hypertension, cost barriers increase the risk of avoiding healthcare; however, the quality of the patient-doctor relationship can be an even more important factor.