Medically underserved area; health care quality; access; and evaluation; emergency service; hospital; qualitative research; low-income population


Community Health and Preventive Medicine | Health Services Research | Public Health


The purpose of this study was to explore patients’ experiences and perceptions regarding the accessibility of healthcare services within a low-income, culturally diverse community in the post-Affordable Care Act era. We conducted a cross-sectional qualitative analysis of 32 interviews with patients that presented to a community emergency department in South L.A with one or more adult ambulatory care sensitive conditions. Both insured and uninsured patients shared many of the same experiences and perceptions when accessing healthcare services. The most prominent commonalities were related to healthcare cost, difficulty qualifying for insurance, lack of awareness of existing services, and healthcare service availability. Increased insurance coverage had a positive impact on patients’ perceived ability to access outpatient primary and specialty healthcare services. However, patients still cited significant barriers to healthcare access, including lack of awareness of covered services and limited service availability.