Lin, Jin-Mann S, Brimmer, Dana J, Boneva, Roumiana S et al. · BMC health services research · 2009 · DOI
This study looked at why people with ME/CFS and other fatiguing illnesses skip or delay needed medical care. Researchers surveyed 780 people, including 112 with CFS, and found that 55% of those with CFS faced barriers to getting healthcare. The main barriers fell into three categories: trouble accessing care (like travel or scheduling), healthcare providers' attitudes and knowledge gaps, and problems with how the healthcare system itself works.
Many patients with ME/CFS struggle to access care, yet barriers have not been well-characterized in population-based studies. Understanding these barriers—whether practical (accessibility), provider-related (attitudes/knowledge), or system-based—can guide targeted interventions to improve healthcare delivery and outcomes for this vulnerable population.
This study does not prove that healthcare barriers *cause* worse outcomes in ME/CFS, nor does it establish which barriers are most important to address first. The cross-sectional design cannot determine whether fatiguing illness itself causes barriers (through reduced ability to attend appointments) or whether barriers predate and contribute to fatiguing illness. Additionally, the study relies on self-reported barriers, which may not capture all relevant obstacles.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Lin, Jin-Mann S, Brimmer, Dana J, Boneva, Roumiana S, Jones, James F, & Reeves, William C (2009). Barriers to healthcare utilization in fatiguing illness: a population-based study in Georgia.. BMC health services research. https://doi.org/10.1186/1472-6963-9-13
BibTeX
@article{mecfsatlas-lin-2009-barriers-healthcare,
author = {Lin, Jin-Mann S and Brimmer, Dana J and Boneva, Roumiana S and Jones, James F and Reeves, William C},
title = {Barriers to healthcare utilization in fatiguing illness: a population-based study in Georgia.},
journal = {BMC health services research},
year = {2009},
doi = {10.1186/1472-6963-9-13},
note = {PubMed: 19154587},
url = {https://www.mecfsatlas.com/evidence/lin-2009-barriers-healthcare},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/lin-2009-barriers-healthcare
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