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.