National Healthcare Disparities Report - LDI Health Economist

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Access to Health Care Chapter 9 n Overall, 86% percent of people had a specific source of ongoing care in 2009 (data not shown). n In 2009, the percentage of people with a specific source of ongoing care was lower for Blacks and AI/ANs than for Whites (85% compared with 86%; and 79% compared with 86%; data not shown). n In 2009, the percentage of people with a specific source of ongoing care was significantly lower for Hispanics than for non-Hispanic Whites (77% compared with 88%; Figure 9.7). n In 2009, the percentage of people with a specific source of ongoing care was significantly lower for poor and low-income people than for high-income people (78% and 80%, respectively, compared with 92%). n In 2009, the percentage of people with a specific source of ongoing care was lower for people with less than a high school education and people with a high school education than for people with any college education (75% and 83% respectively, compared with 88%; data not shown). Also, in the NHQR: n In 2009, people age 65 and over were most likely to have a specific source of ongoing care, while people ages 18-44 were least likely to have a specific source of ongoing care. n Females were more likely to have a specific source of ongoing care than males from 1999 to 2009. Usual Primary Care Provider Having a usual primary care provider (a doctor or nurse from whom one regularly receives care) is associated with patients’ greater trust in their provider and with good provider-patient communication. These factors increase the likelihood that patients will receive appropriate care. By learning about patients’ diverse health care needs over time, a usual primary care provider can coordinate care (e.g., visits to specialists) to better meet patients’ needs. Having a usual primary care provider correlates with receipt of higher quality care (Parchman & Burge, 2002; Inkelas, et al., 2004). A person is determined to have had a primary care provider if his or her usual source of care setting was either a physician’s office or a hospital (setting other than an emergency room), and he or she reported going to this usual source of care for new health problems, preventive health services, and physician referrals. 228 National Healthcare Disparities Report, 2011
Access to Health Care Figure 9.8. People with a usual primary care provider, by race and family income, 2002-2008 100 90 Total White Black Asian AI/AN >1Race 100 90 Poor Low Income Middle Income High Income 80 Percent 70 60 50 40 Percent 80 70 Chapter 9 30 60 20 10 0 2002 2003 2004 2005 2006 2007 2008 50 Z 0 2002 2003 2004 2005 2006 2007 2008 Key: AI/AN = American Indian or Alaska Native. Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2008. Denominator: Civilian noninstitutionalized population of all ages. Note: A usual primary care provider is defined as the source of care that a person usually goes to for new health problems, preventive health care, and referrals to other health professionals. n In 2008, Blacks and Asians were less likely than Whites to have a usual primary care provider (72% and 72%, respectively, compared with 76%; Figure 9.8). n In 2008, the percentage of people with a usual primary care provider was significantly lower for Hispanics than for non-Hispanic Whites (65% compared with 79%; data not shown). n In 2008, the percentage of people with a usual primary care provider was significantly lower for poor people, low-income people, and middle-income people than for high-income people (68%, 71%, and 76% respectively, compared with 80%). Also, in the NHQR: n From 2002 to 2008, people ages 18-44 were least likely to have a usual primary care provider. n Uninsured people ages 0-64 were much less likely to have a usual primary care provider than people with private or public insurance. Patient Perceptions of Need Patient perceptions of need include perceived difficulties or delays in obtaining care and problems getting care as soon as wanted. Although patients may not always be able to assess their need for care, problems getting care when patients perceive that they are ill or injured likely reflect significant barriers to care. National Healthcare Disparities Report, 2011 229
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NATIONAL HEALTHCARE DISPARITIES REP
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