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Facilitators and Barriers to Health Care

Health Insurance Coverage
Persons under age 65 with health insurance
Persons under age 65 with public health insurance only
Persons under age 65 with any private health insurance
Persons age 65 and over with any private health insurance
People under age 65 who were uninsured all year
People under age 65 with any period of uninsurance during the year
People under age 65 with any period of public insurance during the year
Usual Source of Care
People who have a specific source of ongoing care
People in fair or poor health who have a specific source of ongoing care
People with a hospital, emergency room, or clinic as source of ongoing care
People without a usual source of care who indicate a financial or insurance reason for not having a source of care
People who have a usual primary care provider
Patient Perceptions of Need
Families that experience difficulties or delays in obtaining health care or do not receive needed care
Families that experience difficulties or delays in obtaining health care due to financial or insurance reasons
Adults who can sometimes or never get appointments for routine care as soon as wanted
Adults who can sometimes or never get care for illness or injury as soon as wanted
People with provider who has office hours nights or weekends
People with difficulty contacting provider over the telephone
Adults without problems getting referral to a specialist in the past year
Children without problems getting referral to a specialist in the past year
Emergency department visits in which the patient left without being seen

Health Insurance Coverage

Measure Title

Persons under age 65 with health insurance.

Measure Source

Healthy People 2010, measure 1-1.

Tables

195. People under age 65 with health insurance, United States, 2004, by

Race
Ethnicity
Family income

Data Source

Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey (NHIS).

Denominator

U.S. civilian population under age 65.

Numerator

Number of persons under age 65 who reported coverage by any type of public or private health insurance.

Comments

Data are age adjusted to the 2000 standard population. Age-adjusted percents are weighted sums of age-specific percents. For a discussion of age adjustment, see Part A, Section 5 of Tracking Healthy People 2010.

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Health Insurance Coverage

Measure Title

Persons under age 65 with public health insurance only.

Measure Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS).

Tables

196. People under age 65 with public health insurance only, United States, 2004, by

Race
Ethnicity
Family income

Data Source

CDC, NCHS, National Health Interview Survey (NHIS).

Denominator

U.S. civilian population under age 65.

Numerator

Number of persons under age 65 who reported coverage by public health insurance only.

Comments

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Health Insurance Coverage

Measure Title

Persons under age 65 with any private health insurance.

Measure Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS).

Tables

197. People under age 65 with any private health insurance, United States, 2004, by

Race
Ethnicity
Family income

Data Source

CDC, NCHS, National Health Interview Survey (NHIS).

Denominator

U.S. civilian population under age 65.

Numerator

Number of persons under age 65 who reported coverage by private health insurance only.

Comments

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Health Insurance Coverage

Measure Title

Persons age 65 and over with any private health insurance.

Measure Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS).

Tables

198. People age 65 and over with any private health insurance, United States, 2004, by

Race
Ethnicity
Family income

Data Source

CDC, NCHS, National Health Interview Survey (NHIS).

Denominator

U.S. civilian population age 65 and over.

Numerator

Number of persons age 65 and over who reported coverage by any private health insurance.

Comments

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Health Insurance Coverage

Measure Title

People under age 65 who were uninsured all year.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).

Tables

199. People under age 65 uninsured all year, United States, 2003, by

Race
Ethnicity
Family income
Education

Data Source

AHRQ, MEPS.

Denominator

U.S. civilian noninstitutionalized population under age 65.

Numerator

U.S. civilian noninstitutionalized population under age 65 who reported no private or public health insurance coverage at any time during the year.

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Health Insurance Coverage

Measure Title

People under age 65 with any period of uninsurance during the year.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).

Tables

200. People under age 65 with any period of uninsurance during the year, United States, 2003, by

Race
Ethnicity
Family income
Education

Data Source

AHRQ, MEPS.

Denominator

U.S. civilian noninstitutionalized population under age 65.

Numerator

U.S. civilian noninstitutionalized population under age 65 years who reported they had no public or private health insurance coverage some time during the year.

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Health Insurance Coverage

Measure Title

People under age 65 with any period of public insurance during the year.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).

Tables

201. People under age 65 with any period of public insurance during the year, United States, 2003, by

Race
Ethnicity
Family income
Education

Data Source

AHRQ, MEPS.

Denominator

U.S. civilian noninstitutionalized population under age 65.

Numerator

U.S. civilian noninstitutionalized population under age 65 who reported they had public health insurance coverage some time during the past year.

Comments

Public insurance includes Medicare, Medicaid, and other public programs that provide hospital/physician coverage.

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Usual Source of Care

Measure Title

People who have a specific source of ongoing care.

Measure Source

Healthy People 2010, measure 1-4.

Tables

202. People who had a specific source of ongoing care, United States, 2004, by

Race
Ethnicity
Family income

Data Source

Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey (NHIS).

Denominator

U.S. civilian population.

Numerator

Number of persons who reported having a specific source of primary care.

Comments

A specific source of primary care includes urgent care/walk-in clinic, doctor's office, clinic, health center facility, hospital outpatient clinic, HMO/PPO, military or other Veterans Administration health care, some other place. A hospital emergency room is not included as a specific source of primary care.

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Usual Source of Care

Measure Title

People in fair or poor health who have a specific source of ongoing care.

Measure Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS).

Tables

203. People in fair or poor health who had a specific source of ongoing care, United States, 2004, by

Race
Ethnicity
Family income

Data Source

CDC, NCHS, National Health Interview Survey (NHIS).

Denominator

Number of persons who reported fair or poor health.

Numerator

Number of persons who reported fair or poor health and having a specific source of primary care.

Comments

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Usual Source of Care

Measure Title

People with a hospital, emergency room, or clinic as source of ongoing care.

Measure Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS).

Tables

204. People with a hospital, emergency room, or clinic as a source of ongoing care, United States, 2004, by

Race
Ethnicity
Family income

Data Source

CDC, NCHS, National Health Interview Survey (NHIS).

Denominator

U.S. civilian population.

Numerator

Number of persons who reported a hospital, emergency room, or clinic as source of primary care.

Comments

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Usual Source of Care

Measure Title

People without a usual source of care who indicate a financial or insurance reason for not having a source of care.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).

Tables

205. People without a usual source of care who indicated a financial or insurance reason for not having a source of care, United States, 2003, by

Race
Ethnicity
Family income
Education

Data Source

AHRQ, MEPS.

Denominator

U.S. civilian noninstitutionalized population who reported having no usual source of care.

Numerator

U.S. civilian noninstitutionalized population who indicated financial or insurance reasons for not having a usual source of care.

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Usual Source of Care

Measure Title

People who have a usual primary care provider.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).

Tables

206. People who had a usual primary care provider, United States, 2003, by

Race
Ethnicity
Family income
Education

Data Source

AHRQ, MEPS.

Denominator

U.S. population (civilian noninstitutionalized).

Numerator

U.S. civilian noninstitutionalized population who were determined to have a usual primary care provider.

Comments

A person is determined to have had a primary care provider if his or her usual source of care's setting was either a physician's office or a hospital (setting other than an emergency room), and they reported going to this usual source of care for new health problems, preventive health services, and physician referrals.

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Patient Perceptions of Need

Measure Title

Families that experience difficulties or delays in obtaining health care or do not receive needed care.

Measure Source

Healthy People 2010, measure 1-6.

Tables

207A. Families in which a member was unable to receive or delayed in receiving needed medical care, dental care, or prescription medications, United States, 2003,

207B. Families in which a member was unable to receive or delayed in receiving needed medical care, United States, 2003,

207C. Families in which a member was unable to receive or delayed in receiving needed dental care, United States, 2003,

207D. Families in which a member was unable to receive or delayed in receiving needed prescription medications, United States, 2003,

Race
Ethnicity
Family income
Education

Data Source

Agency for Healthcare Research and Quality, Center for Financing, Access and Cost Trends, Medical Expenditure Panel Survey (MEPS).

Denominator

Number of U.S. families.

Numerator

Number of U.S. families who reported having at least one member experience difficulties or delays in obtaining health care or do not receive needed care.

Comments

A change in survey question format in 2002 affected the way responses were collected for this item; these rates should not be compared to data from 2001 and earlier.

Race, ethnicity, family income, and education characteristics are those of the family reference person and are used to characterize the entire family unit.

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Patient Perceptions of Need

Measure Title

Families that experience difficulties or delays in obtaining health care due to financial or insurance reasons.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).

Tables

208A. Families unable to receive or delayed in receiving needed medical care, dental care, or prescription medications due to financial or insurance reasons, United States, 2003,

208B. Families unable to receive or delayed in receiving needed medical care due to financial or insurance reasons, United States, 2003,

208C. Families unable to receive or delayed in receiving needed dental care due to financial or insurance reasons, United States, 2003,

208D. Families unable to receive or delayed in receiving needed prescription medications due to financial or insurance reasons, United States, 2003,

Race
Ethnicity
Family income
Education

Data Source

AHRQ, MEPS.

Denominator

Number of U.S. families who reported having at least 1 member experience difficulties or delays in obtaining health care.

Numerator

Number of U.S. families who reported having at least 1 member experience difficulties or delays in obtaining health care because they 1) could not afford it, 2) their insurance company would not approve/cover/pay for it, 3) their insurance company required a referral they could not get, 4) the doctor refused the family's insurance plan, or 5) it was too expensive to get to the site for care.

Comments

A change in survey question format in 2002 affected the way responses were collected for this item; these rates should not be compared to data from 2001 and earlier.

Race, ethnicity, family income, and education characteristics are those of the family reference person and are used to characterize the entire family unit.

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Patient Perceptions of Need

Measure Title

Adults who can sometimes or never get appointments for routine care as soon as wanted.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).

Tables

175A. Adults who can always get appointments for routine care as soon as wanted, United States, 2003,

175B. Adults who can usually get appointments for routine care as soon as wanted, United States, 2003,

175C. Adults who can sometimes or never get appointments for routine care as soon as wanted, United States, 2003,

Race
Ethnicity
Family income
Education

Data Source

AHRQ, MEPS.

Denominator

U.S. civilian, noninstitutionalized adults age 18 and older who report that, during the previous 12 months, they had made an appointment with a doctor or other health provider for regular or routine health care.

Numerator

Percent distribution of the denominator population who can always (table 175A), usually (table 175B), or sometimes or never (table 175C), get the appointment for regular or routine health care as soon as they wanted.

Comments

This measure is also presented in the Timeliness section.

Tables report data from the MEPS 2003 Self-Administered Questionnaire (SAQ). See the MEPS entry in Appendix A: Data Sources for more information on the SAQ.

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Patient Perceptions of Need

Measure Title

Children who can sometimes or never get appointments for routine care as soon as wanted.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).

Tables

176A. Children who can always get appointments for routine care as soon as wanted, United States, 2003,

176B. Children who can usually get appointments for routine care as soon as wanted, United States, 2003,

176C. Children who can sometimes or never get appointments for routine care as soon as wanted, United States, 2003,

Race
Ethnicity
Family income

Data Source

AHRQ, MEPS.

Denominator

U.S. civilian noninstitutionalized children under age 18 whose parents reported that they, during the previous 12 months, had made an appointment with a doctor or other health provider for regular or routine health care.

Numerator

Percent distribution of the denominator population who can always (table 176A), usually (table 176B), or sometimes or never (table 176C), get the appointment for regular or routine health care as soon as they wanted.

Comments

This measure is also presented in the Timeliness section.

Tables report data from the MEPS 2003 Self-Administered Questionnaire (SAQ). See the MEPS entry in Appendix A: Data Sources for more information on the SAQ.

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Patient Perceptions of Need

Measure Title

People with provider who has office hours nights or weekends.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).

Tables

209. People with provider who has office hours nights or weekends, United States, 2003, by

Race
Ethnicity
Family income
Education

Data Source

AHRQ, MEPS.

Denominator

U.S. civilian noninstitutionalized population who reported having a usual source of care.

Numerator

U.S. civilian noninstitutionalized population who reported having a usual source of care who subsequently reported that they have a provider who has office hours nights or weekends.

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Patient Perceptions of Need

Measure Title

People with difficulty contacting provider over the telephone.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).

Tables

210. People with difficulty contacting provider over the telephone, United States, 2003, by

Race
Ethnicity
Family income
Education

Data Source

AHRQ, MEPS.

Denominator

U.S. civilian noninstitutionalized population who report having a usual source of care.

Numerator

U.S. civilian noninstitutionalized population who report having a usual source of care who subsequently reported that they have difficulty contacting provider over the telephone.

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Patient Perceptions of Need

Measure Title

Adults without problems getting referral to a specialist in the past year.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).

Tables

211. Adults without problems getting referral to a specialist in the past year, United States, 2003, by

Race
Ethnicity
Family income
Education

Data Source

AHRQ, MEPS.

Denominator

U.S. civilian noninstitutionalized adults age 18 and older who reported that, during the previous 12 months, they or a doctor thought they needed to see a specialist.

Numerator

U.S. civilian noninstitutionalized adults age 18 and older who reported that, during the previous 12 months, they or a doctor thought they needed to see a specialist who subsequently reported no problems getting referral to a specialist in the past year.

Comments

Tables report data from the MEPS 2003 Self-Administered Questionnaire (SAQ). See the MEPS entry in Appendix A: Data Sources for more information on the SAQ.

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Patient Perceptions of Need

Measure Title

Children without problems getting referral to a specialist in the past year.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).

Tables

212. Children without problems getting referral to a specialist in the past year, United States, 2003, by

Race
Ethnicity
Family income

Data Source

AHRQ, MEPS.

Denominator

U.S. civilian noninstitutionalized children under age 18 whose parents reported that, during the previous 12 months, they or a doctor thought they needed to see a specialist.

Numerator

U.S. civilian noninstitutionalized children under age 18 whose parents reported that, during the previous 12 months, they or a doctor thought they needed to see a specialist and who subsequently reported no problems getting referral to a specialist in the past year.

Comments

Tables report data from the MEPS 2003 Child Health and Preventive Care section. See the MEPS entry in Appendix A: Data Sources for more information on this component of MEPS.

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Patient Perceptions of Need

Measure Title

Emergency department visits in which the patient left without being seen.

Measure Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS).

Table

179. Emergency department visits in which the patient left without being seen, United States, 2003–2004, by

Race

Data Source

CDC, NCHS, National Hospital Ambulatory Medical Care Survey (NHAMCS)—Emergency Department.

Denominator

Patients who visited hospital emergency departments (ED) located in the 50 States and the District of Columbia.

Numerator

Patients with a Visit Disposition of "Left before being seen" on the NHAMCS Emergency Department Patient Record Form.

Comments

This measure is also presented in the Timeliness section.

U.S. civilian noninstitutionalized population who reported having a usual source of care who subsequently reported that they were not very satisfied with the professional staff at the provider's office.