Health Care Access Survey Results

 

Introduction: Surveying the barriers to accessing Health Care

While access to quality and timely health care is a leading indicator of population health, many studies have revealed that people with disabilities are more likely to go without needed care. The Americans with Disabilities Act (ADA) requires that health care services are accessible to people with disabilities and the ADA Accessibility Guidelines (ADAAG) outline the technical requirements for physical access. Assessing a clinic for all of the technical requirements of the ADAAG requires looking at hundreds of items, and it can be a time consuming process. The RRTC: Health & Wellness is partnering with the Northwest ADA & IT Center in order to create a useful and user-friendly tool called the Outpatient Health Clinic Access Profile (OHCAP). It will be used to evaluate the physical accessibility of outpatient health care clinics and provide information on best practices for access to services. An important element to OHCAP will be the prioritization of areas that are critical for accessibility. For instance, while the ADAAG has requirements about the accessibility of drinking fountains, these requirements may not be as important to people with disabilities as the width of doorways or clearly marked signs.

The first step in developing OHCAP was to get input from people with disabilities on the barriers to accessing health care and what was important to them in accessing health care facilities. To do this the RRTC: Health & Wellness developed a short Internet survey. With the help of our partners at Independent Living Resources Utilization, the survey was distributed nationally though multiple listservs and consumer organizations in the fall of 2005. Initially the survey creators hoped to get at least 100 responses to the survey. After about two weeks, over 950 responses to the survey were received. The overwhelming response to the Health Care Access Survey indicates that the accessibility of health services is clearly an important topic for people in the disability community. It also provides valuable information that will inform the creation of OHCAP.

We have briefly summarized the results in the following document. We would like to thank all the people that took the time to respond to the survey. If you have any questions or concerns please feel free to contact us at:

RRTC: Health & Wellness
OHSU - CDRC
PO Box 574
Portland, OR 97207
503-494-3534
rrtc@ohsu.edu

 

Question 1: How important are each of the following factors to you in accessing primary health care?

Question 1 Response Options:

How important are each of the following factors to you in accessing primary health care? Please rank each of the factors using the following scale: Very important, Somewhat important, Neither Important nor Unimportant, Somewhat unimportant, Not important at all.

Question 1 Response Summary:

This chart shows the results for the question "How important are each of the following factors to you in accessing primary health care?" There were a total of 961 respondents to this survey, though 8 skipped this question. To the first factor, "Health insurance that provides coverage for the care you need" 95% stated "very important", 4% chose "somewhat important", and 1% chose "not important. For "Location of your Primary Health Care Provider's office in relation to public transportation (bus stop or train stop)" 38% chose "very important", 22% chose "somewhat important", 20% chose "neither important nor unimportant", 4% chose "somewhat unimportant", and 17% chose "not important. Regarding "Primary Health Care Provider's knowledge about your disability" 81% chose "very important", 16% chose "somewhat important", 2% chose "neither important nor unimportant", and 1% chose "not important". Concerning "Attitude of your Primary Health Care Provider" 89% chose "very important", 9% chose "somewhat important", and 1% chose "neither important nor unimportant". For "Attitude of the Primary Clinic Staff" 76% chose "very important", 21% chose "somewhat important", and 2% chose "neither important nor unimportant". Finally, for "auxiliary aids and services such as large print forms or sign language interpreters" 31% chose "very important", 23% chose "somewhat important", 24% chose "neither important nor unimportant", 4% chose "somewhat unimportant", and 17% chose "not important".

Question 1 Response Chart:

 

 

 

 

 

 

 

 

 

 

Question 2: What are the five most important areas for accessibility when you visit your primary health care provider?

Question 2 Response Options:

Pick the most important area, and type the number 1 next to it. Pick the second most important area, and type the number 2 next to it. Pick the third most important area, and type the number 3 next to it. Rank the fourth most important area by typing the number next to it. Rank the fifth most important area by typing the number 5 next to it. Use only numerals 1 through 5, and use each number only once.

Question 2 Response Summary:

A total of 943 respondents provided rankings for areas of accessibility.

Question 2 Response Data:

Participants were asked to rank the most important area with a numeral 1, the second most important area with a numeral 2, and so on through their top five. The following tables show the data gathered from this question.

Parking

Rank	Frequency	Percent of Total (943)
1	233	24.7%
2	99	10.5%
3	49	5.2%
4	33	3.5%
5	60	6.4%

Passenger loading zone (drop off or pick up area near entrance)

Rank	Frequency	Percent of Total (943)
1	47	5.0%
2	47	5.0%
3	25	2.7%
4	23	2.4%
5	34	3.6%

Route from my transportation to the entrance of the building (includes curb cuts)

Rank	Frequency	Percent of Total (943)
1	87	9.2%
2	87	9.2%
3	60	6.4%
4	29	3.1%
5	48	5.1%

Signage

Rank	Frequency	Percent of Total (943)
1	36	3.8%
2	38	4.0%
3	33	3.5%
4	23	2.4%
5	27	2.9%

Entrances and exits

Rank	Frequency	Percent of Total (943)
1	97	10.3%
2	79	8.4%
3	57	6.0%
4	53	5.6%
5	66	7.0%

Ramps

Rank	Frequency	Percent of Total (943)
1	85	9.0%
2	63	6.7%
3	61	6.5%
4	40	4.2%
5	28	3.0%

Lobby

Rank	Frequency	Percent of Total (943)
1	16	1.7%
2	19	2.0%
3	28	3.0%
4	30	3.2%
5	38	4.0%

Corridors

Rank	Frequency	Percent of Total (943)
1	13	1.4%
2	15	1.6%
3	14	1.5%
4	26	2.8%
5	22	2.3%

Elevators/Platform lifts

Rank	Frequency	Percent of Total (943)
1	59	6.3%
2	74	7.8%
3	69	7.3%
4	65	6.9%
5	43	4.6%

Stairs

Rank	Frequency	Percent of Total (943)
1	20	2.1%
2	13	1.4%
3	12	1.3%
4	12	1.3%
5	34	3.6%

Restrooms (includes sink, toilet, doors and other physical elements of the room)

 

Rank	Frequency	Percent of Total (943)
1	49	5.2%
2	60	6.4%
3	67	7.1%
4	86	9.1%
5	77	8.2%

 

 

Exam table

Rank	Frequency	Percent of Total (943)
1	69	7.3%
2	49	5.2%
3	53	5.6%
4	58	6.2%
5	46	4.9%

Exam rooms (includes doors and all other physical elements of the room)

Rank	Frequency	Percent of Total (943)
1	83	8.8%
2	72	7.6%
3	82	8.7%
4	86	9.1%
5	66	7.0%

Dressing rooms (includes doors, benches and all other physical elements of the room)

Rank	Frequency	Percent of Total (943)
1	26	2.8%
2	21	2.2%
3	21	2.2%
4	30	3.2%
5	30	3.2%

Diagnostic rooms (includes x-ray room, lab or other diagnostic room)

Rank	Frequency	Percent of Total (943)
1	43	4.6%
2	49	5.2%
3	58	6.2%
4	48	5.1%
5	57	6.0%

Diagnostic equipment (for example, x-ray machines)

Rank	Frequency	Percent of Total (943)
1	47	5.0%
2	37	3.9%
3	39	4.1%
4	52	5.5%
5	48	5.1%

Drinking fountains

Rank	Frequency	Percent of Total (943)
1	15	1.6%
2	10	1.1%
3	12	1.3%
4	11	1.2%
5	26	2.8%

Telephones (for example, amplified phones or TTYs)

Rank	Frequency	Percent of Total (943)
1	30	3.2%
2	22	2.3%
3	18	1.9%
4	14	1.5%
5	30	3.2%

Alarms (for example, fire alarms with flashing lights)

Rank	Frequency	Percent of Total (943)
1	27	2.9%
2	15	1.6%
3	25	2.7%
4	14	1.5%
5	22	2.3%

Detectable warnings (for example, the raised domes on a ramp leading into a crosswalk)

Rank	Frequency	Percent of Total (943)
1	21	2.2%
2	10	1.1%
3	16	1.7%
4	11	1.2%
5	19	2.0%

Medical equipment (for example, a scale accessible to a person in a wheelchair)

Rank	Frequency	Percent of Total (943)
1	53	5.6%
2	33	3.5%
3	43	4.6%
4	47	5.0%
5	96	10.2%

Other

Rank	Frequency	Percent of Total (943)
1	64	6.8%
2	6	0.6%
3	8	0.8%
4	8	0.8%
5	22	2.3%

Most frequently indicated priorities in each rank

Rank	Priority	Frequency	Percent of Total (943)
1	Parking	233	24.7%
2	Parking	99	10.5%
3	Exam rooms	82	8.7%
4	Tie: Restrooms & Exam rooms	86	9.1%
5	Medical equipment	96	10.2%

Question 3: In the past 12 months, was there a time when you needed health care but did not get it?

Question 3 Response Options:

Question 3 Response Summary:

802 of 943 respondents provided an answer to whether they had needed health care, but did not get it. 141 respondents did not answer this question.

Question 3 Response Data:

Answer	Frequency	Percent of Total (943)
Yes	324	34.4%
No	470	49.8%
Don't Know	8	0.8%
No Answer	141	15%

 

Question 4: If you answered "yes" to question 3, what were the most important reasons that you did not get the health care you needed in this situation?

Question 4 Response Options:

Choose up to three reasons and type the number 1 next to the most important reason, type the number 2 next to the second most important reason, and type the number 3 next to the third most important reason.

Question 4 Response Summary:

324 respondents to the survey chose "yes", at which point they were directed to rank the reasons why they were not able to access health care.

Question 4 Response Data:

I could not get an appointment.

Rank	Frequency	Percent of Total (324)
1	51	15.7%
2	24	7.4%
3	19	5.9%

I didn't know a good health care provider or clinic to go to for treatment.

Rank	Frequency	Percent of Total (324)
1	22	6.8%
2	11	3.4%
3	18	5.6%

I couldn't find a health care provider who speaks my language.

Rank	Frequency	Percent of Total (324)
1	7	2.2%
2	2	0.6%
3	7	2.2%

The primary health care provider's hours were not convenient.

Rank	Frequency	Percent of Total (324)
1	18	5.6%
2	16	4.9%
3	11	3.4%

I did not have childcare

Rank	Frequency	Percent of Total (324)
1	5	1.5%
2	2	0.6%
3	6	1.9%

I had no transportation, or the health care provider's office was too far.

Rank	Frequency	Percent of Total (324)
1	31	9.6%
2	20	6.2%
3	13	4.0%

It cost too much.

Rank	Frequency	Percent of Total (324)
1	56	17.3%
2	32	9.9%
3	14	4.3%

I was too afraid or nervous.

Rank	Frequency	Percent of Total (324)
1	8	2.5%
2	10	3.1%
3	13	4.0%

I didn't want to go.

Rank	Frequency	Percent of Total (324)
1	5	1.5%
2	11	3.4%
3	14	4.3%

My health problem went away.

Rank	Frequency	Percent of Total (324)
1	6	1.9%
2	6	1.9%
3	10	3.1%

My health care was not covered by insurance.

Rank	Frequency	Percent of Total (324)
1	38	11.7%
2	38	11.7%
3	23	7.1%

It was too difficult to get to the health care provider's office.

Rank	Frequency	Percent of Total (324)
1	15	4.6%
2	26	8.0%
3	17	5.2%

I had difficulty or a disagreement with my health care provider.

Rank	Frequency	Percent of Total (324)
1	11	3.4%
2	14	4.3%
3	19	5.9%

I couldn't find a health care provider who understands or was willing to treat my disability.

Rank	Frequency	Percent of Total (324)
1	32	9.9%
2	30	9.3%
3	34	10.5%

I couldn't find a health care provider who was willing to provide a sign language interpreter.

Rank	Frequency	Percent of Total (324)
1	11	3.4%
2	5	1.5%
3	7	2.2%

The wait in the health care provider's office was too long.

Rank	Frequency	Percent of Total (324)
1	8	2.5%
2	10	3.1%
3	20	6.2%

The paperwork was too great.

Rank	Frequency	Percent of Total (324)
1	5	1.5%
2	5	1.5%
3	8	2.5%

I don't know.

Rank	Frequency	Percent of Total (324)
1	2	0.6%
2	1	0.3%
3	6	1.9%

Other.

Rank	Frequency	Percent of Total (324)
1	57	17.6%
2	14	4.3%
3	27	8.3%

Most Frequently indicated reasons in each rank

Rank	Reasons	Frequency	Percent of Total (324)
1	Other	57	17.6%
2	Not covered by insurance	38	4.0%
3	Couldn't find provider to treat disability	34	3.6%

 

Question 5: Which of the following categories are affected by your disability?

Question 5 Response Options:

Check all of the following that apply.

Question 5 Response Summary:

Of 961 respondants, 33.6% stated that their mobility was affected by disability; 33.4% claimed more than one area affected; 16.2% gave no response; 6.8% responded that their hearing was affected; 4.4% stated "other"; 3.1% claimed that their vision was affected; 2.5% stated that their cognitive functioning was affected.

Questions 5 Response Chart:

 

Question 6: What is your gender?

Question 6 Response Options:

Male, Female, No Response.

Question 6 Response Summary:

Of a total of 961 respondants, 57.5% were female, 27.4% were male, and 15.1% gave no response to the question regarding gender. The mean age of respondants was 45 years old.

Questions 6 Response Chart:

 

Question 7: What is your ethnicity? (check only one)

Question 7 Response Options:

Hispanic or Latino/a, Not Hispanic or Latino/a, Don't Know, No Response.

Question 7 Response Summary:

Of 961 respondants, 78.7% were not Hispanic or Latino/a, 16.6% gave no response, 3.1% were Hispanic or Latino/a, and 1.6 responded that they don't know their ethnicity.

Question 7 Response Chart:

 

Question 8: What is your race? (check all that apply)

Question 8 Response Options:

Asian, Black or African American, Didn't Know, Native American or Alaskan Native, Native Hawaiian or other Pacific Islander, No Response, White.

Question 8 Response Summary:

Of 961 respondants, 76.1% were White, 15.3% gave no response, 3.1% were "other", 2.8% were Black or African American, 1.2% were Native American or Alaskan Native, 0.7% were Asian, 0.6% responded that they didn't know, 0.1% were Native Hawaiian or other Pacific Islander.

Question 8 Response Chart:

 

Question 9: How would you describe the community where you live?

Question 9 Response Options:

Didn't know, No response, Rural Community and Urban Community.

Question 9 Response Summary:

Of 961 respondants, 54.9% lived in an urban community, 26.7% lived in a rural community, 15.1% gave no response, and 3.2% stated that they didn't know what type of community they lived in.

Question 9 Response Chart: