The sluggish economy is prompting more Americans to put off medical tests, prescriptions and so-called elective procedures—like knee or hip replacements—and related health care companies are feeling the pain.

Many patients are deciding to delay testing or treatment either because they lack insurance, face higher out-of-pocket costs or are afraid to take time off work, health care analysts say.??"One of the more the dramatic shifts in this economy has been a slowdown in health-care consumption," says economist Diane Swonk of Mesirow Financial. "It’s become discretionary spending in the U.S. because people are really pulling back."Ask a patient about going without care and the word discretionary takes on new meaning. "I waited a long time to get Neupogen injections because it was so expensive," said Mary Laidman, breast cancer survivor. "It was supposed to increase my white cell count during chemotherapy. Insurance didn't cover it, and it was about $6,000 out-of-pocket."

In her latest economic forecast, Swonk predicts elective spending on medical care to drop relative to other personal consumption in 2013. "We're operating in a do-more-with-less economy when it comes to health care," said Christi Bird, health care analyst for the consulting firm Frost & Sullivan.

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