As for what the author of this response would suggest when it comes to a PICOT question, the author would stick with the prior-mentioned subject of people forgoing care or at least delaying it prior to the implementation of the Affordable Care Act and what has happened since. For example, one could look at how much delays and skipping of medical preventative and acute care was done before the ACA was passed and what has happened since. Each time window could be about five years. Beyond that, there is apparently going to be at least the strong possibility of the ACA being repealed or replaced in the coming months and years. If that comes to pass, another time horizon can be used to measure how well that change performs as compared to the prior two systems that were in place. The population would be those that are poor or that are close to the poverty line. In general, the populations most affected by finances and the ensuing delaying or forgoing of care should be looked at. The intervention is the offering (or lack of offering) of subsidies and other assistance so that the non-covered and under-covered people get care. The comparison would be who much care and in what increment is done without the intervention (or with a different intervention) as compared to the way it was before. The outcome would be a measurement of the efficacy of the change. Finally, the time part of PICOT defines the time periods that were compared and contrasted (Riva & Busse, 2012).
References
GGC. (2017). Library Research Guides: Nursing Students: PICOT Questions. Libguides.ggc.edu. Retrieved 14 January 2017, from http://libguides.ggc.edu/c.php?g=362349&p=2447296
Riva, J. & Busse, J. (2012). What is your research question? An introduction to the PICOT format for clinicians. PubMed Central (PMC). Retrieved 14 January 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3430448/
