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2001 CHAP
Telephone Survey
Where Do Sedgwick County Residents Seek Medical Care?
When asked “where do you receive
most of your care?” overwhelmingly, respondents indicate a
particular physician’s office (78.5%), followed by a hospital
emergency department (5.2%), a hospital outpatient department
(4.3%), other site (4.2%), an HMO group office (2.3%), a community
health center (2.1%), or medical school clinic or hospital
residency clinic (1.5%). Findings are similar for dependents and
other adults (see Table 14).
Respondents were asked, “If you
use hospital outpatient care, what location do you use?” Nearly
60% of the respondents listed no response or don’t know,
suggesting that outpatient medical services are not frequently
used. When a choice was listed, the most frequently listed
response was Wesley Medical Center (11.5%) followed by Via Christi
St. Francis campus (9.6%), Via Christi St. Joseph campus (4.8%),
Riverside Hospital (1.9%) and the Veteran’s Administration
Hospital (1.0%). Other location was listed by 11.5% of
respondents (Table 15).
Nearly three-fourths of survey
respondents do not used residency clinics. When a choice was
indicated, the most frequently listed response was the University
of Kansas Medical School-Wichita residency clinic (9.7%) followed
by Wesley Medical Center (8.3%), Via Christi St. Francis campus
(5.6%), and Via Christi St. Joseph campus (2.8%) (See
Table 15).
When asked where emergency care
is sought, again Wesley Medical Center is the most frequently
listed response (18.3%), followed by Via Christi St. Joseph
(11.7%), Via Christi St. Francis (10.0%), Riverside Hospital
(4.2%) and Veteran’s Administration Hospital (0.4%). Over 50% of
the respondents listed no response or don’t know, suggesting that
emergency medical services are not frequently used (see
Table 15).
Survey respondents were asked
about their use of community health center clinics in Sedgwick
County. The majority of respondents reported they do not use
these clinics. In fact, only 27 respondents stated they use one
of the low-income community health centers. The low numbers may
reflect the sampling bias described earlier. In addition, the
survey was conducted with English-speaking residents of Sedgwick
County only, and these clinics serve a large number of
Spanish-speaking clients. This may account for the clinics under
representation in this survey.
Why and How Often Do Sedgwick County Residents Seek Medical
Care?
Respondents were asked, “When you
or someone in your household goes to the doctor, what are the
reasons you go?” The most frequent reason for seeking care was
for illness (35.5%), followed by annual physical exam (20.7%), for
injury (10.2%), and for advice (7.4%) (See
Table 16). Medical
visits related to dependents’ care comprised 15.2% of reasons for
seeking medical care. Chronic illness was reported by more than
5.0% of respondents as a reason they seek medical services,
whereas refilling a prescription was listed most infrequently
(4.3%) as a reason to seek medical care.
The majority of respondents
report a physician visit between one and three times per year
(58.2%) (See Table 17). Nearly one quarter of respondents see
their physician between four and eight times per year, and
approximately 10% report a physician visit nine or more times per
year. More than 7.0% of respondents indicate they did not seek an
office visit during the last year. Physician visits are similar
for other adults living in household. For their dependents, 27.3%
of respondents indicate they take their children to see a doctor
one to three times annually, while a physician’s care is sought
four to eight visits, or nine visits or more by 15.8% and 7.7% of
respondents, respectively. Three percent of respondents report
they do not take their dependents for a physician visit at all
over the course of the year, and over 46.1% had no response or
indicated they didn’t know if their dependents had seen a
physician in the previous year.
The 1999 BRFSS data
shows slightly lower reports of physician office visits. When
asked “About how long has it been since you last visited a doctor
for a routine checkup? Over 70% of Sedgwick County, Kansas and US
respondents report having a routine doctor visit in the previous
year, while approximately 12% of Sedgwick County, Kansas, and the
US respondents had a routine doctor visit during the past two
years (Graph 12). Approximately one percent never visited a
doctor.
What Are the Costs Associated with Medical Care Use in Sedgwick
County?
Self-reported out-of-pocket
expenses for respondents, their dependents and other adults living
in the household were assessed, including physician /clinic
visits, prescription medication, and emergency department bills.
For the majority of respondents, out-of-pocket expenses are less
than $500 per year for physician /clinic visits (82.1%),
prescription medication (82.9%) and emergency department bills
(80.6%). For physician office or clinic visits, nearly 12% of
respondents reported spending between $500 and $1,500, whereas
nearly 11% reported spending between $500 and $1,500 out-of-pock
for prescription medications. For emergency department visits,
approximately 81.0% of respondents reported spending less than
$500; while nearly four percent spend between $500 and $1,500, and
2.1% spend more than $1,500 for out-of-pocket expenses (see
table
18).
When asked about
out-of-pocket medical care expenses for their dependents,
respondents indicated that most of their expenses associated with
medical care are under $500. A small percentage (4.3%) reported
physician office/ clinic visits out-of-pocket expenses,
prescription medications (2.5%), and emergency department visits
(2.1%) range between $500 and $1,500 for their dependents (see
Table 19).
The majority of out of pocket
health care costs for other adults living in the household were
estimated to run less than $500 per year. For physician office or
clinic visits, the majority of additional adults living in the
household were reported to spend less than $500 out-of-pocket for
physician office/clinic visits (66.9%), prescription medicines
(64.8%) or emergency department bills (64.1%). A small percentage
were estimated to have out-of-pocket expenses between $500 and
$1,500 for the same categories of health care expenses.
Furthermore, less than two percent of adults of this group are
estimated to have more than $1,500 out of pocket expenses for
physician office/ clinic visits, prescription medicines, or
emergency department bills (see
Table 20).
Respondents were asked, “When you
go to the doctor, how much do you have to pay (on average) at the
time of the visit?” Nearly 30% stated they paid nothing out of
pocket for a medical visit, whereas over 50.0% pay between $1-$15,
and 9.0% pay between $16 and $40 for a doctor’s visit. Just over
five percent pay more than $40 out of pocket to see the physician
(see Table 21). Less than 15% of respondents reported delaying or
not visiting their physician due to cost of care (see
Table 22).
The 1999
BRFSS data indicates that cost prevented a visit to the doctor
office among Sedgwick County, Kansas and US respondents 9.2%, 7.2%
and 9.6%, respectively. However, the 2001 CHAP shows the cost
prevents a doctor office visit at a slightly higher percentage of
14.3% (Graph 13).
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