Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #112007

Rumana Rahman¹, Susan Eve, PhD¹, Linda Bryant², and Michael Denis, MS³. (1) University Honors Program, University of North Texas, P.O. Box 305189, Denton, TX 76203-5189, 940-565-4914, eves@unt.edu, (2) Grayson Volunteer Health Clinic, 900 N. Armstrong, Denison, TX 75020, (3) Prairie Health Education Center, University of North Texas, P.O. Box 310590, Denton, TX 76203-0590

Objectives. Objectives of this research are to assess major problems that uninsured residents of suburban and rural counties in north central Texas have accessing health care, to determine the factors that facilitate or hinder their access to care, and to explore solutions to problems of access. Poor and uninsured Texans have relatively poor access to healthcare with 24.4% of the population uninsured. Provision of healthcare for indigents is primarily the responsibility of counties. Only 31.5% of residents with incomes below the federally defined poverty level are covered by Medicaid program. Ways counties can provide indigent healthcare are: (1) by creating a tax-funded hospital district; (2) by operating a public hospital partially funded by taxes; and (3) by creating a county indigent healthcare program (CIHCP) to pay for services from non-tax funded providers. CIHCP plans are weakest and are the focus of this research. Methods. Grayson County is one of 13 suburban and rural counties located in the service area of the Prairie Area Health Education Center. Prairie AHEC and the fledgling not-for-profit Grayson Volunteer Health Clinic are co-sponsors of this project. A telephone survey was conducted in English with a random sample of 50 households that reported difficulty getting healthcare in the past year. Respondents ranged in age from 18-86, and included 16 males and 34 females. Two focus groups were conducted, one with 9 adult county residents, and a second with 10 healthcare and social service providers. Research was approved by the UNT IRB. Major findings. 24% of all residents of the county were uninsured in 1999 including 27.6% of adults aged 19-64. The major problems the respondents reported with healthcare in the past year are as follows: 14.6% had no insurance of any kind; 20% could not get needed surgery or medical care; 36% could not get needed prescription medicine; 28% could not get dental care; 16% had difficulty completing paperwork for healthcare; and 12% had difficulty getting transportation for health care. 26% reported they could not get healthcare or medicine because they needed the money to buy food or clothing, or to pay for housing for themselves or their families. Stories from the focus groups corroborate the findings from the phone survey. Data are being used by the Indigent and Uncompensated Care Project in Grayson County to create more a effective healthcare plan for the uninsured population of the county. Funded by UNT Faculty Research Grant.

Learning Objectives:

• 1. List major problems residents of small urban and rural counties have accessing healthcare providers, including physicians, hospitals, prescription medicines and dental care.
• 2. Discuss policy options for counties for addressing healthcare access problems.

Keywords: Access to Health Care, Insurance-Related Barriers

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.