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Access to Care and Utilization of Services

Fifty-nine percent of the decedents were reported to be covered by some form of private insurance or HMO. Almost 75 percent were covered by Medicare.

 
Number and percent of decedents covered by selected insurance programs: United States, 1993

 

Selected coverage programs Number Percent1 Standard error of percent 95 percent confidence interval
(+/- percent)
Private insurance or HMO 1,301,000 58.7 0.9562 1.9
Medicare 1,649,000 74.4 0.7765 1.5
Medicaid 554,000 25.0 0.8355 1.6
VA 139,000 6.3 0.4500 0.9
Worker's Compensation 37,000 1.7 0.2441 0.5

1 Percents based on 2,215,000 decedents.

NOTES: Excludes deaths to persons under 15 years of age and those deaths occurring in South Dakota. Standard errors are estimated using the statistical software package SUDAAN.

SOURCE: NCHS, National Mortality Followback Survey -- provisional data, 1993.

 

Of the decedents who were reported to need but did not receive health care, one-third were reported to have had problems paying bills. Eighteen percent were reported to have had problems finding or getting treatment.

 

Number and percent of decedents needing but not receiving health care by source of problem: United States, 1993

 

Source of problem Number Percent1 Standard error of percent 95 percent confidence interval
(+/- percent)
Finding or getting into a facility 26,000 13.4 2.2999 4.5
Finding or getting treatment 35,000 18.5 2.6125 5.1
Getting help at home 13,000 6.6 1.4177 2.8
Paying bills 63,000 32.8 3.0377 6.0
Transportation 16,000 8.2 1.7143 3.4

1 Percents based on 191,000 decedents needing but not receiving health care.

NOTES: Excludes deaths to persons under 15 years of age and those deaths occurring in South Dakota.  Standard errors are estimated using the statistical software package SUDAAN.

SOURCE: NCHS, National Mortality Followback Survey -- provisional data, 1993.

 

Almost an equal number of decedents living at home during the last year of life were reported to have used a hospital bed (19-percent) and/or oxygen or a device for breathing therapy (18-percent).

 

Number and percent of decedents living at home during the last year of life who are reported to have used selected medical equipment: United States, 1993

 

Medical equipment Number Percent1 Standard error of percent 95 percent confidence interval
(+/- percent)
Dialysis machine 28,000 1.4 0.2584 0.5
Hospital bed 371,000 19.3 0.8155 1.6
Blood glucose monitor 134,000 7.0 0.5704 1.1
Protective restraints 33,000 1.7 0.2871 0.6
Infusion pump 68,000 3.6 0.3742 0.7
Oxygen or device for breathing therapy 347,000 18.1 0.7908 1.5

1Percents based on 1,918,000 decedents living at home during the last year of life.

NOTES: Excludes deaths to persons under 15 years of age and those deaths occurring in South Dakota.  Standard errors are estimated using the statistical software package SUDAAN.

SOURCE: NCHS, National Mortality Followback Survey -- provisional data, 1993.

 

While 10 percent of the decedents were reported to have never visited a doctor during their last year of life, 9 percent were reported to have seen a doctor 50 or more times.

 

Number and percent distribution of decedents by number of times they were seen by a medical doctor during the last year of life: United States, 1993 

 

Sources of payment Number Percent Standard error of percent 95 percent confidence interval
(+/- percent)
Total 2,215,000 100.0 0.0000 0.0
Never 215,000 9.7 0.5681 1.1
1 time 64,000 2.9 0.3069 0.6
2 to 4 times 351,000 15.8 0.7361 1.4
5 to 9 times 314,000 14.2 0.7102 1.4
10 to 14 times 417,000 18.8 0.7909 1.6
15 to 24 times 265,000 12.0 0.6585 1.3
25 to 49 times 193,000 8.7 0.5529 1.1
50 times or more 194,000 8.7 0.5591 1.1
Item nonresponse 202,000 9.1 0.5485 1.1

NOTES: Excludes deaths to persons under 15 years of age and those deaths occurring in South Dakota.  Figures may not add to totals due to rounding. Standard errors are estimated using the statistical software package SUDAAN.

SOURCES: NCHS, National Mortality Followback Survey -- provisional data, 1993.

 

Ten percent of the decedents where reported to have used their own or family monies to pay for most of their health care during the last year of life. An additional 46 percent reported Medicare as the principal source which paid for most of their health care.

 

Number and percent distribution of decedents by source which paid most of medical expenses during the last year of life: United States, 1993

 

Number of times seen by doctor Number Percent Standard error of percent 95 percent confidence interval
(+/- percent)
All sources 2,215,000 100.0 0.0000 0.0
Decedent’s own money or savings 185,000 8.3 0.5714 1.1
Family living with decedent 24,000 1.1 0.1745 0.3
Family not living with decedent 13,000 0.6 0.1426 0.3
Prepaid HMO 84,000 3.8 0.3569 0.7
Blue Cross/Blue Shield 151,000 6.8 0.5112 1.0
Other private health insurance 233,000 10.5 0.6153 1.2
Medicare 1,027,000 46.3 0.9973 2.0
Medicaid 239,000 10.8 0.5731 1.1
VA 60,000 2.7 0.2965 0.6
Worker’s Compensation 5,000 0.2 0.0926 0.2
Another government program 27,000 1.2 0.2151 0.4
Other source 11,000 0.5 0.1273 0.2
No payments 44,000 2.0 0.1863 0.4
Item nonresponse 114,000 5.2 0.4356 0.9

NOTES: Excludes deaths to persons under 15 years of age and those deaths occurring in South Dakota.  Figures may not add to totals due to rounding. Standard errors are estimated using the statistical software package SUDAAN.

SOURCE: NCHS, National Mortality Followback Survey -- provisional data, 1993.

 

 

 

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