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Purpose of Study
The purpose of the Barriers to Health Care Services study was to survey low-income consumers and primary care practitioners for information that would contribute to designing a more successful access program. In particular, we were interested in perceptions about the barriers that limited-income consumers faced in accessing primary care and how the system responds to patients who may be more complicated to treat and less likely to be able to pay for their care. Because the solutions may be different, access barriers were categorized as follows:
- Health system problems.
- Perceptions on the value of insurance.
- Financial barriers.
- Primary care and treatment barriers.
- Health status improvement.
- Consumer knowledge of the system.
- Customer service.
Summary of Survey Findings
- Payment and Capacity Issues: Access
- All of the primary care practices that responded stated that they had a lot or some experience working with limited-income consumers.
- Most consumers are uninsured for relatively long periods of time.
- A significant percentage (38%) of consumers without insurance said they have not been able to find a physician who will treat them.
- Consumers with insurance who feel they need to see doctor are more likely to see one (100%) than those without insurance (77%).
- Consumers state that they are uninsured because they are not aware of affordable options (40%), they had difficulty getting or understanding information about options (14%), or they did not want the stigma of medical coupons (15%).
- Consumers are motivated to become enrolled with a health insurance plan through
Basic Health primarily out of fear of financial ruin, for peace of mind and because they are unable to afford other insurance options or routine care.
- Service and Treatment Issues: Utilization
- The majority of limited-income adult consumers do not obtain preventive services.
- Consumers are less concerned about "wellness and prevention" than practitioners.
- Over 40% of consumers said they would call the emergency room or go to the hospital for care after hours; 36% would call their practitioner.
- Nearly three quarters of the practitioners said that working with limited-income consumers is different than other consumers. Reason cited most often include:
- They cancel or miss appointment.
- They are less compliant to instructions.
- They take more time.
- They are more demanding.
- They are less healthy.
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