Millions of U.S. residents who have chronic conditions are not receiving appropriate care because they are uninsured, according to a study published on Tuesday in the journal Annals of Internal Medicine, the New York Times reports.

For the study, lead author Andrew Wilper of the University of Washington-Seattle and colleagues analyzed health surveys of adults ages 18 to 64 conducted by the federal government. The researchers found that about 11 million people out of the 36 million people who reported having no health insurance in 2004 -- the latest data examined by the study -- had been diagnosed with a chronic condition. However, researchers noted the estimate likely is low because it does not factor in uninsured U.S. residents who have a chronic condition with which they have not yet been diagnosed.

The study also found that less than 25% of the uninsured with a chronic condition reported seeing a physician within the previous year and that about 7% said they would visit the emergency department if they needed care.

The study's authors said, "For some of the 11.4 million uninsured Americans with serious chronic conditions, access to care seems to be unobtainable; many may face early disability and death as a result."

According to the Times, if the proportion of uninsured residents with chronic conditions has held steady over the last four years, there currently would be about 16 million uninsured U.S. residents with a chronic condition.

Dispelling Myths
The researchers noted that the study raises doubts regarding the common assumption that many uninsured U.S. residents are young and healthy. According to Steffie Woolhandler, one of the study's authors and associate professor of medicine at Harvard Medical School, that assumption often leads to underestimating the cost of covering the uninsured. Woolhandler -- who supports a national health care system -- cited as an example Massachusetts' new health insurance law, which is costing the state more than projected and has not led to universal coverage because state lawmakers assumed more residents would be healthy (Abelson, New York Times, 8/5).

The study is available online.