Americans' confidence in their ability to access and pay for healthcare has hit its lowest level since December, according to a consumer sentiment index from Thomson Reuters.

Overall confidence dropped to 95 points on the Thomson Reuters Consumer Healthcare Sentiment Index in July — the lowest level since the index was launched in December 2009.

The index is based on telephone interviews with 3,000 people each month. Respondents are asked to characterize their household's recent and anticipated use of healthcare services and their ability to access and pay for those services.

Compared with the June survey, people in July were significantly more likely to say they expect to delay or cancel physician visits, laboratory tests, or medical procedures in the next three months. "That's a cause for concern to healthcare providers and policymakers," said Gary Pickens, chief research officer at Thomson Reuters.

On every survey question responses were more pessimistic in July — to a statistically significant degree — than they were in December. "The index has been trending downward all year, but this is the first time we've seen this type of across-the-board decline," Pickens said.

The index, which is based on the Thomson Reuters PULSE™ Healthcare Survey, has two parts. A retrospective component gauges respondents' experiences during the past three months and a prospective component assesses their expectations for the coming three months.

The Thomson Reuters PULSE Healthcare Survey collects information about healthcare behaviors, attitudes and utilization from more than 100,000 U.S. households annually. It is representative of all U.S. adults and households. The Consumer Healthcare Sentiment Index is based on responses from a survey subset of 3,000 respondents each month. Its baseline measurement of 100 was set in December 2009.