Trends in Access to Health Care, 1996-2006 (Text Version)

On September 16, 2009, Jim Kirby made this presentation at the 2009 Annual Conference. Select to access the PowerPoint® presentation (999 KB).

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Slide 1

Trends in Access to Health Care, 1996-2006

Jim Kirby
AHRQ

Slide 2

Objective

• Describe trends in health care access over the decade 1996-2006
• Focus on Disparities by:
  • Insurance
  • Age
  • Income
  • Race/ethnicity

Slide 3

Data and Measures

• Data
  • Household component of the Medical Expenditure Panel Surveys (MEPS), 1996-2006
  • Representative of the US civilian non-institutionalized population
  • Sample sizes range from 22,601 to 39,165, depending on year
• Two measures of Access to ambulatory health care
  • Usual Source of Care (USC)
  • One or more physician visits in an office setting during a year

Slide 4

Methods

• Calculate weighted percentages, testing differences across groups and years
• Percentages and standard errors are adjusted for the complex sample design of MEPS

Slide 5

Percent with a Usual Source of Care and At Least One Office Visit

Year	USC	Any Office Visit
1996	0.82	0.68
1997	0.82	0.67
1998	0.82	0.66
1999	0.82	0.67
2000	0.82	0.67
2001	0.82	0.69
2002	0.81	0.69
2003	0.81	0.69
2004	0.81	0.67
2005	0.82	0.69
2006	0.8	0.68

Slide 6

Percent with a Usual Source of Care by Insurance Status

Year	Private Insurance	Public Insurance	No insurance
1996	0.85	0.85	0.58
1997	0.85	0.85	0.56
1998	0.85	0.85	0.54
1999	0.85	0.85	0.53
2000	0.84	0.87	0.53
2001	0.85	0.86	0.51
2002	0.85	0.86	0.49
2003	0.85	0.85	0.46
2004	0.84	0.87	0.47
2005	0.84	0.86	0.47
2006	0.85	0.87	0.47

Slide 7

Percent with At Least One Office Visit by Insurance Status

Year	Private Insurance	Public Insurance	No insurance
1996	0.72	0.72	0.41
1997	0.71	0.71	0.41
1998	0.7	0.73	0.36
1999	0.7	0.74	0.37
2000	0.7	0.74	0.38
2001	0.72	0.75	0.4
2002	0.72	0.75	0.38
2003	0.73	0.74	0.36
2004	0.71	0.74	0.35
2005	0.72	0.73	0.37
2006	0.72	0.73	0.36

Slide 8

Percent with a Usual Source of Care by Age

Year	0-17	18-49	50-64	65+
1996	0.908156	0.735706	0.863085	0.902632
1997	0.903	0.732	0.86	0.91
1998	0.895941	0.730061	0.856347	0.9243
1999	0.89796	0.724663	0.852518	0.921125
2000	0.903875	0.715246	0.856916	0.932132
2001	0.889694	0.716104	0.864375	0.933995
2002	0.895097	0.706233	0.860559	0.9358
2003	0.904462	0.69849	0.857383	0.931711
2004	0.90582	0.690739	0.850244	0.934447
2005	0.898833	0.685374	0.854814	0.929422
2006	0.917728	0.68375	0.861261	0.931943

Slide 9

Percent with At Least One Office Visit by Age

Year	0-17	18-49	50-64	65+
1996	0.6752571	0.6166761	0.7593781	0.8703838
1997	0.6608312	0.5947031	0.7654094	0.8815109
1998	0.6471542	0.5889631	0.7598065	0.8821827
1999	0.6560605	0.5950758	0.7563764	0.8785968
2000	0.6496163	0.5926952	0.7490752	0.8804955
2001	0.6743249	0.610707	0.7734517	0.8914983
2002	0.6818531	0.5991564	0.7740195	0.905449
2003	0.6899453	0.5975288	0.7717633	0.8994029
2004	0.6794233	0.57104	0.7651794	0.908861
2005	0.6741781	0.5833448	0.7586979	0.9029373
2006	0.669516	0.5801706	0.7650301	0.9094282

Slide 10

Percent with a Usual Source of Care by Poverty Status, 1996-2006

Year	<200%	200-400%	400%+
1996	0.77	0.83	0.86
1997	0.77	0.82	0.86
1998	0.77	0.82	0.85
1999	0.75	0.82	0.85
2000	0.77	0.81	0.84
2001	0.75	0.82	0.85
2002	0.75	0.81	0.85
2003	0.74	0.81	0.85
2004	0.76	0.79	0.84
2005	0.75	0.78	0.85
2006	0.75	0.8	0.85

Slide 11

Percent with At Least One Office Visit by Poverty Status, 1996-2006

Year	<200%	200-400%	400%+
1996	0.63	0.68	0.73
1997	0.62	0.67	0.72
1998	0.61	0.66	0.71
1999	0.62	0.66	0.71
2000	0.62	0.66	0.71
2001	0.63	0.68	0.74
2002	0.64	0.67	0.74
2003	0.63	0.68	0.74
2004	0.62	0.65	0.73
2005	0.62	0.66	0.74
2006	0.62	0.66	0.74

Slide 12

Percent with a Usual Source of Care by Race/ethnicity, 1996-2006

Year	NH White	NH Black	Hispanic
1996	0.846218	0.78504	0.689472
1997	0.846	0.785	0.689
1998	0.846728	0.784755	0.689215
1999	0.844636	0.784135	0.682431
2000	0.843228	0.768868	0.690844
2001	0.840045	0.787119	0.686153
2002	0.844604	0.783325	0.667898
2003	0.846763	0.763981	0.66107
2004	0.835921	0.763727	0.678286
2005	0.838582	0.757974	0.671802
2006	0.844049	0.782726	0.676437

Slide 13

Percent with At Least One Office Visit by Race/Ethnicity, 1996-2006

Year	NH White	NH Black	Hispanic
1996	0.723564	0.5844027	0.5564895
1997	0.7172594	0.5613347	0.5412635
1998	0.7151332	0.5414819	0.5325134
1999	0.7126203	0.5588458	0.5526766
2000	0.7122375	0.5549996	0.5430056
2001	0.7351078	0.6067464	0.5460268
2002	0.732699	0.6088377	0.5534737
2003	0.7355726	0.6133491	0.5572794
2004	0.7236461	0.5985684	0.5276642
2005	0.7298021	0.600022	0.5382532
2006	0.7260377	0.6080745	0.5462259

Slide 14

Summary

• Overall, the ambulatory access measures have changed little between 1996 and 2006
• Between 1996 and 2006, access to health care has worsened for:
  • The uninsured
  • Those aged 18-49
• Disparities by Race/ethnicity remain relatively large and stable