HEALTH CARE ACCESS IN
SOUTHWEST VIRGINIA
Executive Summary: January 2002
The
Southwest Virginia Graduate Medical Education Consortium (GMEC) conducted a
study of access to health care in Southwest Virginia during the summer and fall
of 2001. The study suggests that about 200,000 Virginians in the Southwest have
incomplete access to health services due to a lack of insurance coverage, the
high cost of care, and a shortage of healthcare professionals. Limited access to care helps explain the
poor health status of people living in the area*.
The
GMEC study gathered data from interviews with individuals and focus groups and
from a broad-based survey of the area population. The survey sampled 1,569 households, representing 4,103
individuals; more than 1% of the total population in our service area. Among households surveyed:
§
21%
included at least one person with heart disease (Virginia rate – 4.2%)
§
48%
included at least one person with high blood pressure (Virginia rate –
23.5%)
§
21%
included at least one person with diabetes (Virginia – 6.1%)
§
43%
included at least one person with arthritis (Virginia – 22.7%)
§
36%
included at least one person who with the loss of many teeth (Virginia –
18%), and
§
29%
included at least one person with depression.
Among
survey respondents:
§
48% rated their health as poor or fair (Virginia – 11%)
§
46% reported doing without or putting off medical care in the past year
due to cost
§
26% reported seeing a doctor as a last resort or never seeing a doctor
when they are sick
§
24% had no medical insurance (32% - adults; 14% - children)
§
53% had no dental insurance
§
66% had no vision insurance
§
63% reported trouble getting medical appointments, and
§
87% reported long waits at the doctor’s office.
Survey Comments
People
feel strongly about access to health care.
An unusually high number (73%) of the people who responded to our survey
included written comments. Several
themes run through their comments.
People complained of an
inability to get needed services and about the high cost of care.
§
“Right now I am out of seven of my medicines and
cannot afford to buy them…I can’t afford eye care and I am a diabetic.””
§
“My husband and I received Medicaid for 3 months
last year…Found out we had serious health problems, but now with my husband’s
job, we don’t quality for Medicaid, and can’t afford insurance. I guess we got stuck in the crack.”
§
“My brother-in-law is 63 and on dialysis three times
a week. He has $569 income and his
prescriptions total $596 monthly.”
People have a strong sense
of community and are concerned about the health and welfare of others.
§
“Lack of affordable insurance for the working class
is a huge problem here…though my family is blessed to be financially
comfortable, even our co-payments put a big dent in our budget… how difficult
it must be for some other families!”
§
“We need health care for everyone. My mother had no insurance and I had to
provide as much help as I could at the time.
She died …at age 58…better health care would have extended her life.”
People want doctors to be
integrated in the local community.
§
“We have had the same doctors for 15-20 years and
have an excellent relationship with them.
They feel like friends.”
§
“I know my family doctor personally and he is a
friend. I feel I can trust his
judgment.”
§
“[My doctor] is local born and cares about the
people in the area and is very good.”
People are dissatisfied with
revolving-door doctors.
§
“The physician I see changes often. High rate of turnover. I have had three doctors in one year due to
this.”
§
“As soon as you get comfortable with a doctor they
either leave the area completely or move to an inconvenient location.”
§
“My current doctor is the only one…that I am
comfortable going to. I hope he does
not leave.”
§
“In our area the doctors change too often.”
Poor people are forced to
“make do” with less health care.
§
“We were taught to be responsible…if you can’t
afford it, you don’t get it!”
§
“My wife and I both have bad teeth, but we have to
leave it that way.”
§
“I know what its like to suffer because you can’t
afford care. I would have died, if I
had not been able to obtain my insulin through a free drug prescription
program.”
People are tired of
overworked health care providers.
§
“Because of the shortage of doctors, the one I use is
always swamped…”
§
“I do not like having 4 minutes to explain my
problem. No one gets more than 10
minutes ever.”
§
“I feel my doctor is overloaded with patients and
I’m just a number.”
People have trouble
communicating with doctors.
§
“Please remind doctors that we do not necessarily
understand medical ‘lingo’ and speak to us in laymen’s terms.”
§
“We need English speaking doctors who listen to our
issues.”
§
“We have had foreign doctors in the past and just
were not pleased.”
§
“I have a problem getting physicians to listen to
me…therefore a lot of times [my] problems go untreated.”
People want better access to
health care.
§
“Have more competent, qualified health care
providers in this area.”
§
“Doctors are overworked, overstressed, and having to
fight insurance companies to provide care.”
§
“Hire more doctors and limit law suit awards so
costs will go down.”
§
“My medical insurance has no local providers.”
§
“I don’t believe in socialism, but I do believe that
all people should have access … to health care in general.”
§
“America should have affordable national health
care.”
The
GMEC study revealed that local residents know something is wrong with their
health and something is wrong with the healthcare system. The Southwest Virginia population is sicker
than the population of Virginia as a whole and needs more medical care rather
than less. However, fully half of this
“sicker” population has limited access to health services because of financial
distress and provider shortages.
*See
GMEC’s December 2001 Report to the Virginia General Assembly.
SOUTHWEST VIRGINIA GMEC
University of Virginia’s
College at Wise
One College Avenue
Wise, Virginia 24293
www.uvawise.edu/gmec (276) 328-0249 lal8s@uvawise.edu