The use of household surveys in community-oriented primary care health needs assessments

This study demonstrates the use of a community household survey and how it can provide information beyond that obtained with secondary epidemiologic data alone.

Adults in 215 randomly selected households in an inner-city neighborhood in Bronx, NY, were assessed by in-person interviews in homes of neighborhood residents. The survey collected data on self-reported health status, source and quality of medical care, possible barriers to obtaining medical care, and perceptions of the community. Demographic information was also obtained. Mortality rates, birth outcomes, and census data were obtained from secondary data sources.

The overall health of the community members surveyed was poor, and rates of self-reported health status, mortality rates, and poor birth outcomes were all generally higher than city-wide rates. More than half the respondents were using hospital-based outpatient clinics or emergency room care as their primary source of medical care. Nearly half the respondents had no personal health provider, and most respondents could not obtain medical advice over the phone or be seen within a week. A number of barriers to obtaining medical care were found to be associated with either gender or ethnic group. These findings are being used as the basis for a number of community-oriented primary care (COPC) outreach efforts.

Although household surveys are expensive to conduct, the information garnered from this survey could not be obtained from secondary data sources and was important in determining the direction of outreach and intervention programs being carried out in the community by the COPC clinic.