Access to health care among aged Medicare beneficiaries

The goal of the National Medical Care Utilization and Expenditure Survey (NMCUES) is to improve the understanding of the ways in which Americans use and pay for health care. This report is one in a series of descriptive reports based on NMCUES data. Data concerning several aspects of participants' access to health care services were collected in NMCUES. These included identification of a regular source of care, several characteristics of physical access to the regular source (transportation mode, travel time, waiting room time), insurance coverage, and the existence of medically unattended conditions. The purpose of this report is to provide descriptive information about selected aspects of access to health care among noninstitutionalized elderly people who reported being covered by Medicare. The results presented are based on data collected about noninstitutionalized people in the NMCUES national household sample who: (1) were 65 years of age and over at any time during the survey year, and (2) reported being covered by Medicare Hospital Insurance, Supplementary Medical Insurance, or both during the survey year (1980). The regular source of care for three out of four (74 percent) of the elderly Medicare beneficiaries was a physician's office (including group practice or doctor's clinic), while for 9 percent the regular source was a hospital outpatient clinic, emergency room, health center, or other provider type (referred to hereafter as "clinic"). Of the elderly Medicare beneficiaries, 10 percent reported no regular source of care, and the regular source was unknown for 7 percent. Of those with no regular source of care, 80 percent identified their seldom getting sick as an important reason for having no regular source, 24 percent identified their desire to go to different places for different health care needs, 14 percent said their usual source was no longer available, and 5 percent identified their recently moving into the area as an important reason. Nearly six out of ten (59 percent) of the elderly Medicare beneficiaries who reported that their regular source was a physician's office drove themselves there, and about four out of ten (43 percent) of those who reported that their regular source was a clinic drove themselves to the clinic. On the average, people traveled nearly 10 minutes more to a clinic than to a physician's office (29 versus 20 minutes). There was little variability in reported length of travel time among the various demographic categories--e.g., men tended to travel for the same length of time as did women, black people for the same travel time as white people.(ABSTRACT TRUNCATED AT 400 WORDS)