Statistical Brief #2: 

ACCESS AND EXPERIENCES REGARDING MEDICAL CARE, Fall 2000 

The quality of the health care received by Americans is an issue of public policy concern for 

several reasons. First, the level of quality of the health care delivery system affects the 

capacity to provide timely, accessible, effective and efficient medical care to the population in 

need of services. Secondly, estimates of quality are vital to evaluate the costs and outcomes 

of health care delivery and to help identify potential areas where improvements are 

necessary. Finally, all components of the population may not be receiving care equally. 

Following these population subgroups over time can provide information about whether 

greater equity has been achieved or whether serious gaps remain. A self-administered 

questionnaire was added to the Medical Expenditure Panel Survey (MEPS) to collect 

information on health care utilization, access, health status and the quality of health care 

received. The quality of care measures were taken from an AHRQ-sponsored instrument, the 

Consumer Assessments of Health Plans (CAHPS®). The questionnaire was administered in 

late 2000 and early 2001. All of the questions refer to events experienced in the last 12 

months. This MEPS Statistical Brief presents preliminary findings based on the data obtained 

from the self-administered questionnaire. 

HIGHLIGHTS 

Access to Care 

Getting urgent care when needed 

Overall, 34.4 percent of the U.S. civilian noninstitutionalized population age 18 or older (69.2 

million) reported that they had an illness or injury that needed care right away from a doctor’s 

office, clinic, or emergency room. Slightly more than half of those needing urgent care 

(53.8%) said they always received care as soon as they wanted. Older people were more 

likely than adults under age 65 to say they needed urgent care (33.6% for age 18-64 and 

38.4% for age 65 and older) and of those needing care, older people were more likely than 

adults under age 65 to say they always received care as soon as they wanted (51.3% for age 

18-64 and 65.7% for age 65 and older) (figure 1a). Among those age 18-64, whites were 

more likely than Hispanics to say they needed urgent care (29.1% of Hispanics, 33.6% of 

blacks, 34.7% of whites, and 26.4% of others) and among those needing care whites were 

more likely than Hispanics to say they always received care as soon as they wanted (41.2% 

of Hispanics, 51.5% of blacks, 52.9% of whites and 42.3% of others) (figure 1b). Also among 

those age 18-64, those with only public insurance were the most likely to have an illness or 

injury needing urgent care (44.1% for public only, 33.0% for any private, and 30.9% for 

uninsured) and among those getting urgent care, the uninsured were more likely than those 

with insurance to report sometimes or never receiving urgent care as soon as they wanted 

(28.6% of uninsured, 19.1% of public only, 16.1% of any private) (figure 1c). 

Receiving care when needed 

Obtaining an appointment as soon as wanted 

Overall, 68.1 percent of the survey population aged 18 and over (137 million) reported making 

1
any appointment with a doctor or other health provider for care in the last 12 months. Older 

people were more likely than adults age 18-64 to make an appointment (51.2% age 18-24, 

59.8% age 25-44, 75.4% age 45-64 and 88.8% age 65 and older). Of those who made an 

appointment, fewer than half (43.0%) reported always obtaining one as soon as they wanted 

and one out of every five said they sometimes or never got one as soon as they wanted 

(20%). Age plays a key role in whether a person who made an appointment always obtained 

one as soon as they wanted. Older adults were much more likely than adults under age 65 to 

say they always obtained an appointment as soon as they wanted (40.0% for age 18-64 vs. 

54.7% for age 65 and older) and adults age 18-64 were nearly twice as likely as older ones to 

say they sometimes or never obtained an appointment as soon as wanted (21.8% vs. 12.3%) 

(figure 2a). Among those age 18-64, the uninsured were less likely than those with insurance 

to make an appointment (43.3% of uninsured, 68.8% of any private and 72.9% of public only) 

and among those with an appointment, the uninsured were also more likely than the insured 

to report sometimes or never obtaining an appointment as soon as they wanted (27.6% of 

uninsured, 21.1% of any private, and 19.2% of public only) (figure 2b). 

Going to a doctor’s office/clinic for care and problems receiving needed care 

Overall, 72.3 percent of the survey population aged 18 and over (145.4 million) reported going 

to a doctor’s office or clinic to get care in the last 12 months and of those receiving care, 82.6 

percent reported that they had no problems receiving the care they or their doctor believed 

necessary. As with obtaining an appointment, older people were more likely than adults under 

age 65 to report going to a doctor’s office or clinic for care. Overall, those describing their 

health status as fair/poor were more likely than those who said their health was excellent or 

good/very good to receive care and among those receiving care, persons describing their 

health as fair/poor were less likely than those in better health to indicate it was not a problem 

receiving needed care (86.2% for excellent, 79.1% for good/very good, and 74.3% for 

fair/poor) (figure 3a). Among those age 18-64, the uninsured were less likely than those with 

public-only insurance or with any private insurance to go for care (48.9% of uninsured, 77.8% 

of public only and 74.1% of any private insurance) and of those receiving care, the uninsured 

and those with public only coverage were less likely than those with any private insurance to 

say it was no problem receiving needed care (72.9% of uninsured, 71.5% of public only, and 

84.5% of any private insurance) (figure 3b). 

Experiences During Care 

Patients were asked to report on their experiences over the last 12 months during visits to a 

doctor’s office or clinic to get care. They were asked how often during visits their health 

providers listened carefully to them, explained things in a way they could understand, and 

showed respect for what they had to say. They were also asked if, during their visits, their 

health providers spent enough time with them. 

Health providers listening carefully to patients: Overall, 56.4% of those who made one or 

more visits to a doctor’s office or clinic for care in the last 12 months said their health 

providers always listened carefully to them (56.4% always, 33.4% usually, and 10.2% 

sometimes or never). Among those with one or more visits to a doctor’s office or clinic, 

people age 65 and older were more likely than adults under age 65 to say their providers 

always listened carefully to them (54.2% for 18-24, 52.1% for 25-44, 57.1% for 45-64, and 

2
64.8% for 65 and older). Among those age 18-64 who made one or more visits, persons 

describing their health as fair/poor were more likely than those saying their health was 

excellent or good/very good to say their providers sometimes or never listened carefully to 

them (9.0% for excellent, 12.8% for good/very good, and 17.6% for fair/poor health status) 

(figure 4). 

Explaining care to patients: A majority of those with one or more visits to a doctor’s office or 

clinic for care indicated that their health providers always explained things in a way they could 

understand (58.6%) while nearly 10 percent said their providers sometimes or never 

explained things so they understood (9.1%). Older people (65 and older) were more likely 

than adults age 18-24 to say their providers always explained things so they understood 

(54.5% for age 18-24, 58.1% for age 25-44, 59.2% for age 45-64, and 60.7% for age 65 and 

older). Blacks were more likely than other race/ethnicity groups to say their health providers 

always explained things so they understood (53.1% of Hispanics, 64.4% of blacks, 58.6% of 

whites, and 53.1% of others). Among those age 18-64, the uninsured and those with only 

public insurance were more likely than persons with any private insurance to say providers 

sometimes or never explained things so they understand (15.3% of uninsured, 16.1% of 

public only, and 7.4% of any private). (figure 5). 

Showing respect to patients: A majority of those with one or more visits to a doctor’s office or 

clinic for care reported that their health providers always showed respect for what they had to 

say (58.4% always, 31.8% usually, and 9.8% sometimes or never). Older people were more 

likely than adults under age 65 to say their providers always showed respect (55.1% of age 

18-24, 54.8% of age 25-44, 59.5% of age 45-64 and 65.3% of age 65 and older). Among 

those age 18-64, persons describing their health as fair/poor were more likely to say their 

providers sometimes or never showed respect than those reporting their health as good/very 

good or excellent (17.7% of fair/poor, 12.4% of good/very good, and 8.3% of those with 

excellent health) (figure 6). 

Spending enough time with patients: Among those with one or more visits to a doctor’s office 

or clinic for care, fewer than half said that their health providers always spent enough time 

with them (45.3% always, 38.7% usually, and 15.9% sometimes or never). Those age 65 and 

older were more likely than adults age 18-24 to say their health providers always spent 

enough time with them (41.1% of age18-24, 41.2% of age 25-44, 47.9% of age 45-64 and 

51.4% of those age 65 and older). Among those age 18-64, the uninsured were more likely 

than those with insurance to say their providers sometimes or never spent enough time with 

them (23.5% of uninsured, 15.9% of any private, and 17.3% of public only) (figure 7). 

About MEPS and CAHPS® 

This Statistical Brief summarizes access and quality of care measures pertaining to the health 

care received by the civilian noninstitutionalized population of the United States. The Medical 

Expenditure Panel Survey (MEPS) collects nationally representative data on health care use, 

expenditures, sources of payment, insurance coverage and the quality of care for the U.S. 

civilian noninstitutionalized population. MEPS is sponsored by the Agency for Healthcare 

Research and Quality (AHRQ). The health care quality measures used for this study were 

taken from the Consumer Assessments of Health Plans (CAHPS®), an AHRQ sponsored 

3
instrument to measure quality of care by consumers. A conditional response rate of 

87% was achieved for the MEPS self-administered questionnaire, yielding an overall 

response rate 61% for the survey (15,662 respondents to the SAQ). Specific item 

nonresponse rates generally varied from 1 to 4 percent for the study questions. The 

results presented in this Statistical Brief are statistically significant at the .05 level. 

More information about MEPS can be obtained through the MEPS website at 

www.meps.ahrq.gov. More information about CAHPS® can be obtained through the 

CAHPS® website (www.cahps-sun.org) or on the AHRQ website (www.ahrq.gov). 
 Figure 1A Figure 1A

 Among those age 18 and older with an illness/injury needing urgent care Among those age 18 and older with an illness/injury needing urgent care

from a doctor’s office, clinic, or emergency room in the last 12 months, from a doctor’s office, clinic, or emergency room in the last 12 months,

percent distribution of getting care as soon as wanted percent distribution of getting care as soon as wanted

� Among those age 18 and older, older people were more likely than adults age 18-64 Among those age 18 and older, older people were more likely than adults age 18-64

to say they needed urgent care and among those needing this care, persons age 65 to say they needed urgent care and among those needing this care, persons age 65

and older were more likely than those age 18-64 to say they always received care as and older were more likely than those age 18-64 to say they always received care as

soon as wanted. soon as wanted.

51.3 

65.7 

53.8 

26.5 

29.5 30.1

16.7 

18.6 

7.8 

0 

10 

20 

30 

40 

50 

60 

70 

Total 18-64 65+ 

Always Usually Sometimes/Never 

Source: Center for Cost and Financing Studies, AHRQ, Medical Expenditure Panel Survey, 2000 

38.4 

33.6 34.4 

0 

10 

20 

30 

40 

50 

60 

70 

Total 18-64 65+ 

Needed Urgent Care Got Care as Soon as wanted 
 Figure 1B Figure 1B

 Among those age 18-64 with an illness/injury needing urgent care Among those age 18-64 with an illness/injury needing urgent care

from a doctor’s office,clinic, or emergency room in the last 12 months, from a doctor’s office,clinic, or emergency room in the last 12 months,

percent distribution of getting care as soon as wanted percent distribution of getting care as soon as wanted

� Among those age 18-64, whites were more likely than Hispanics to report needing Among those age 18-64, whites were more likely than Hispanics to report needing

urgent care and among those needing care, whites were more likely than Hispanics urgent care and among those needing care, whites were more likely than Hispanics

to report they always received care when needed. to report they always received care when needed.

42.3 

32.3 

25.3 

51.5 52.9 

41.2 

30.3 29.5

34.2 

24.7 

18.3 17.6 

0 

10 

20 

30 

40 

50 

60 

Hispanic Black White Other 

Always Usually Sometimes/Never 

Source: Center for Cost and Financing Studies, AHRQ, Medical Expenditure Panel Survey, 2000 

Received care as soon as wanted 

29.1 

33.6 34.7 

26.4 

0 

10 

20 

30 

40 

50 

60 

Hispanic Black White Other 

Needed Urgent Care 
 Figure 1C Figure 1C

Among those age 18-64 with an illness/injury needing urgent care Among those age 18-64 with an illness/injury needing urgent care

from a doctor’s office,clinic, or emergency room in the last 12 months, from a doctor’s office,clinic, or emergency room in the last 12 months,

percent distribution of getting care as soon as wanted percent distribution of getting care as soon as wanted

� Among those age 18-64, those with only public insurance were more likely to report Among those age 18-64, those with only public insurance were more likely to report

needing urgent care than others and among those needing care, the uninsured were needing urgent care than others and among those needing care, the uninsured were

more likely than the insured to report they sometimes or never received care when more likely than the insured to report they sometimes or never received care when

needed. needed.

55.6 

42.1 

52.8 

29.3 

25.3 

31.1 

16.1 

19.1 

28.6 

0 

10 

20 

30 

40 

50 

60 

Any private Public only Uninsured 

Always Usually Sometimes/Never 

Source: Center for Cost and Financing Studies, AHRQ, Medical Expenditure Panel Survey, 2000 

Receiving care as soon as wanted 

30.9 

33.6 33 

44.1 

0 

10 

20 

30 

40 

50 

60 

Total 18-64 Any private Public only Uninsured 

Needed Urgent Care 
54.7 

40 43 

33 

38.3 37.1 

12.3 

21.8 19.9 

Always Usually Sometimes/Never 

ones to indicate they always obtained an appointment as soon as they wanted ones to indicate they always obtained an appointment as soon as they wanted. 

68.1 

51.2 

59.8 

75.4 

88.8 

Total 18-24 25-44 45-64 65+ 

Made an appointment for routine care Got appointment when wanted 

0 

10 

20 

30 

40 

50 

60 

70 

80 

90 

100 

Total 18-64 65 and older 

Figure 2A

 Among those age 18 and older who made an appointment with a health provider

 for routine care in the last 12 months, percent distribution of 

getting an appointment as soon as wanted 

� Overall, 68% of those age 18 and older made an appointment for routine care and the Overall, 68% of those age 18 and older made an appointment for routine care and the

incidence of getting care rose with age. Fewer than half (43%) said they always received incidence of getting care rose with age. Fewer than half (43%) said they always received

an appointment as soon as they wanted. Older people were more likely than younger an appointment as soon as they wanted. Older people were more likely than younger

Source: Center for Cost and Financing Studies, AHRQ, Medical Expenditure Panel Survey, 2000 

0 

10 

20 

30 

40 

50 

60 

70 

80 

90 

100 
35.4 

47.9 

40 39.7 

37 

32.9 

38.3 39.2 

19.2 

27.6 

21.8 21.1 

Always Usually Sometimes/Never 

64.1 

68.8 

72.9 

43.3 

Total Any private Public only Uninsured 

Got appointment when wanted 

0 

20 

40 

60 

80 

100 

Total Any private Public Only Uninsured 

Figure 2B

 Among those age 18-64 who made an appointment with a health provider

 for routine care in the last 12 months, percent distribution of 

getting an appointment as soon as wanted 

� Among those age 18-64, the uninsured were less likely than those with public or private Among those age 18-64, the uninsured were less likely than those with public or private

insurance to have made an appointment with a health provider and they were also more insurance to have made an appointment with a health provider and they were also more

likely than the insured to say they sometimes or never obtained an appointment as soon likely than the insured to say they sometimes or never obtained an appointment as soon

as they wanted as they wanted.

Source: Center for Cost and Financing Studies, AHRQ, Medical Expenditure Panel Survey, 2000 

0 

10 

20 

30 

40 

50 

60 

70 

80 Made an appointment for routine care 
 Figure 3A Figure 3A

 Among those age 18 and older who went to a doctor’s office/clinic to get care Among those age 18 and older who went to a doctor’s office/clinic to get care

in the last 12 months, percent distribution of how big a problem it was to get needed care in the last 12 months, percent distribution of how big a problem it was to get needed care

� Persons describing their health status as fair or poor were more likely than Persons describing their health status as fair or poor were more likely than

others to have gone to a doctor’s office for care and among those getting care, others to have gone to a doctor’s office for care and among those getting care,

persons describing their health as excellent were more likely than others to persons describing their health as excellent were more likely than others to

report that getting care was no problem. report that getting care was no problem.

Source: Center for Cost and Financing Studies, AHRQ, Medical Expenditure Panel Survey, 2000 

72.3 

68.7 74.5 

85.9 

0 

10 

20 

30 

40 

50 

60 

70 

80 

90 

100 

Total Excellent Good/Very good Fair/Poor 

17.5 

8.2 

74.3 

79.1 

86.2 

82.6 

16.1 

13.5 11.3

4.8 2.4 3.9 

0 

10 

20 

30 

40 

50 

60 

70 

80 

90 

100 

Total Excellent Good/Very 

good 

Fair/poor 

No Problem Small Problem Big Problem 

Went to doctor for care Problems getting care
72.9 71.5 

84.5 

81.7 

19.2 19.2

12.6 14.1 

7.9 

2.9 

9.2 

4.2 

0 

10 

20 

30 

40 

50 

60 

70 

80 

90 

Total Any private Public only Uninsured 

Not a Problem Small Problem Big Problem 

Figure 3B

 Among those age 18-64 who went to a doctor’s office or clinic to get care, 

how much of a problem was it to get the care you or your doctor believed necessary 

� Among those age 18-64, the uninsured were less likely than those with insurance to go Among those age 18-64, the uninsured were less likely than those with insurance to go

to a doctor’s office/clinic for care and of those going for care, the uninsured and those to a doctor’s office/clinic for care and of those going for care, the uninsured and those

with public coverage were less likely than those with private insurance to say it was no with public coverage were less likely than those with private insurance to say it was no

problem getting needed care. problem getting needed care.

Source: Center for Cost and Financing Studies, AHRQ, Medical Expenditure Panel Survey, 2000 

69.5 74.1 

77.8 

48.9 

0 

10 

20 

30 

40 

50 

60 

70 

80 

90 

Total Any private Public only Uninsured 

Problems getting care 

25.2 

Went to a doctor for routine care 
Figure 4 Figure 4

 Among those going to a doctor’s office or clinic for care in the last 12 months, Among those going to a doctor’s office or clinic for care in the last 12 months,

percent distribution with providers who listened carefully to what they had to say percent distribution with providers who listened carefully to what they had to say

�For those going for care, people age 65 and older were more likely than adults age 18- For those going for care, people age 65 and older were more likely than adults age 18­

44 to say their provider always listened to them. Among adults age 18-64, those 44 to say their provider always listened to them. Among adults age 18-64, those

reporting their health as fair or poor were more likely to say their providers only reporting their health as fair or poor were more likely to say their providers only

sometimes or never listened to what they had to say. sometimes or never listened to what they had to say.

56.6 

49.4 

33 

17.6 

51.5 

54.4 

34.6 34.4 35.7

9 

12.8 11 

0 

10 

20 

30 

40 

50 

60 

70 

80 

Total 18-64 Excellent Good/Very 

good 

Fair/Poor 

Always Usually Sometimes/Never 

Source: Center for Cost and Financing Studies, AHRQ, Medical Expenditure Panel Survey, 2000 

54.2 52.1 

57.1 

64.8 

33.1 

36.4 

33 

28.4 

12.7 11.5 9.9 

6.7 

56.4 

33.4 

10.2 

0 

10 

20 

30 

40 

50 

60 

70 

80 

Total 18+ 18-24 25-44 45-64 65+ 

Always Usually Sometimes/Never 

Age 18+ Provider listened carefully to them Age 18-64 Provider listened carefully to them 
Figure 5 Figure 5

 Among those going to a doctor’s office or clinic for care in the last 12 months, Among those going to a doctor’s office or clinic for care in the last 12 months,

percent distribution with providers who explained things so they understood percent distribution with providers who explained things so they understood

� Among those receiving care, blacks were more likely than others to say their providers Among those receiving care, blacks were more likely than others to say their providers

always explained things so they understood. always explained things so they understood. Among those age 18-64, the uninsured and Among those age 18-64, the uninsured and

those with only public insurance were more likely than persons with any private those with only public insurance were more likely than persons with any private

insurance to say providers sometimes or never explained things so they understood. insurance to say providers sometimes or never explained things so they understood.

59.2 

52.2 

32.5 

15.3 

57.4 58.1 

26.5 

32.7 33.5

7.4 

16.1 

9.3 

0 

10 

20 

30 

40 

50 

60 

70 

80 

Total 18-64 Any private Public only Uninsured 

Always Usually Sometimes/Never 

Source: Center for Cost and Financing Studies, AHRQ, Medical Expenditure Panel Survey, 2000 

53.1 

64.4 

58.6 

53.1 

34.8 

24.8 

33 32.1 

12.1 10.9 

8.4 

14.8 

58.6 

32.3 

9.1 

0 

10 

20 

30 

40 

50 

60 

70 

Total 18+ Hispanic Black White Other 

Always Usually Sometimes/Never 

Age 18+ Provider Explained things so they understood Age 18-64 Provider explained things so they understood 
Figure 6 Figure 6

Among those going to a doctor’s office or clinic for care in the last 12 months, Among those going to a doctor’s office or clinic for care in the last 12 months,

percent distribution with providers who showed respect for what they had to say percent distribution with providers who showed respect for what they had to say

�Among those receiving care, people age 65 and older were more likely than adults age Among those receiving care, people age 65 and older were more likely than adults age

18-44 to say their providers always showed respect. Among those age 18-64, persons 18-44 to say their providers always showed respect. Among those age 18-64, persons

describing their health as excellent were more likely than others to say their providers describing their health as excellent were more likely than others to say their providers

always showed respect for what they had to say. always showed respect for what they had to say.

59.4 

50.6 

31.7 

17.7 

53.2 

56.8 

34.4 32.7 32.3

8.3 

12.4 10.5 

0 

10 

20 

30 

40 

50 

60 

70 

Total 18-64 Excellent Good/Very 

good 

Fair/Poor 

Always Usually Sometimes/Never 

Source: Center for Cost and Financing Studies, AHRQ, Medical Expenditures Panel Survey, 2000 

55.1 54.8 

59.5 

65.3 

33 34.4 

30.8 

28.1 

11.9 10.8 9.7 

6.6 

58.4 

31.8 

9.8 

0 

10 

20 

30 

40 

50 

60 

70 

Total 18+ 18-24 25-44 45-64 65+ 

Always Usually Sometimes/Never 

Age 18+ Provider showed respect Age 18-64 Provider showed respect 
 Figure 7 Figure 7

 Among those going to a doctor’s office/clinic in the last 12 months, Among those going to a doctor’s office/clinic in the last 12 months,

percent distribution with providers who spent enough time with them

� Older people (age 65+) were more likely than younger ones (age 18-44) to say their Older people (age 65+) were more likely than younger ones (age 18-44) to say their

providers always spent enough time with them. Among those age 18-64, the providers always spent enough time with them. Among those age 18-64, the

uninsured were more likely than those with insurance to say their providers uninsured were more likely than those with insurance to say their providers

sometimes or never spent enough time with them. sometimes or never spent enough time with them.

40.8 

48 

43.9 44

35.8 

34.7 

40.1 39 

23.5 17.3 17.1 

15.9 

0 

10 

20 

30 

40 

50 

60 

70 

80 

90 

100 

Total 18-64 Any private Public only Uninsured 

Always Usually Sometimes/Never 

Source: Center for Cost and Financing Studies, AHRQ, Medical Expenditure Panel Survey, 2000 

41.2 

51.4 

47.9 

41.1 

45.3 

40.2 37.8 37.6 38.3 38.7 

11 

14.3 

18.6 20.6 

15.9 

0 

10 

20 

30 

40 

50 

60 

Total 

18+ 

18-24 25-44 45-64 65+ 

Always Usually Sometimes/Never 

18+ Provider spent enough time 18-64 Provider spent enough time