FROM VITAL & HEALTH STATISTICS OF THE NATIONAL CENTER FOR HEALTH STATISTICS 

U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE � Public Health Sewice ] Number,, � February 23, 1978 

Access To Ambulatory Health Care: United States, 19741 

Due to increasing concern over many problems surrounding the accessibility of health care, 

particularly ambulatory care, there is a need for 

information to answer the following kinds of 

questions: How many Americans have a regular 

source of care? What reasons do people give for 

not having a regular source of care? To what 

specific types of health care places do people 

with a regular source of care usually go? 

Whether or not people have a regular source of 

care, to what extent do they contact officebased sources of care as contrasted to hospitalbased sources or clinics that are not associated 

with hospitals? What proportion of the population uses a telephone to get help or advice about 

a health problem? How many Americans have a 

doctor visit them at home? How many Americans have problems getting medical care? Do 

people feel that they are getting all the care they 

�

need? 

This report presents data that bear directly 

on these questions. Information was obtained 

from a one-third subsample of respondents to 

the 1974 Health Interview Survey who reported 

for themselves or for a child under 17 years of 

age. (For further details on the survey design 

and procedures, see the Technical Notes.) 

REGULAR SOURCE OF CARE 

The vast majority of Americans have a regular source of medical care. In 1974 an estimated 

166.8 million people, 80.5 percent of the civilian population not confined in institutions, had 

� 1Prepared by Thomas ??. Drury, M.A., Division of 

HeaIth Interview Statistics. 

, 

a particular doctor .or Place where they could go 

when they were sick’ or needed ad~ice abo~t 

their health (table 1). Having a regular source of 

care was relatively more common among females and white persons than among males and 

all other color groups, respectively. Children 

and youths under the age of 17 were the most 

IikeIy of all the age groups shown in table 1 to 

have a regular source of care; adults between 

the ages of 17 and 44, the least likely. Among 

adults 45 years and over, however, the likelihood 

of having a regular source of care increased in 

each progressively older age group. Higher family income was also positively associated with a 

greater likelihood of having a regular source of 

care. Proportionately more people in the North 

Central Region had a regular source of care than 

in any other geographic region. Among place of 

residence groups, central city residents were the 

least likeIy to have a regular source of health 

care. 

Reasons for Not Having a Regular Source of Care 

While most Americans have a regular source 

of mediczd care, a substantial number do not. In 

1974 approximately 30.9 million people had no 

particular doctor or place to which they could 

go when they were sick or needed advice about 

their health (table 2). More than half (54.2 percent) of these people indicated that the main 

reason for not having a re~lar source of medical 

care was that, as far as they could determine, 

they did not need one. 

Not having a regular source of medical care 

may reflect a person’s orientation toward seeking mediczd care. A substantial number of people 

were classified as being without a regular source 

of care because they saw different doctors 
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2 aduamedata 

@ 

,rable1. Number and percent distribution Of persons by whether or not they have a regular source of medical care, ac­


cording to selected characteristics: United States, 1974
 — .- — 

Persons— Persons—


1 I


For whom For whom
 Chara’cterist
ic Total With a Without a information rotal With a Without a information 

regular regular on source regular regular on source source of source of of care is source source of Of care is care care unavailable of care care unavailable


1 II I I

---1 Number in thousands Percent distribution 

All persons’------------- 30>859 9,657 100.0 80.5 14.9 4.7 

Sex

— 

Male 100,024 75,6341 17,723 6,666 100.0 75.6 17.7 6.7 

Female 107,309 91,183 13,135 2,991 100.0 85.0 12.2 2.8 

Age
 —


Under 17 years 62,953 56,179 5,814 961 100.0 ;;.; 9.2 1.5


W; 5,511 100.0 20.3 6.8
 17-44 years-------------------- 80,778 58,866 l:, 

2,558 100.0 79:7 14.4 6.0
 45-64 years-------------------- 42,862 34,145


65 years and Jver 20,740 17,628 2;485 627 100.0 85.0 12.0 3.0


1


Color


White 180,725 146,804 25,859 8,062 100.0 81.2 14.3 4.5 

A1l other 26,608 20,014 4,999 1,595 100.0 75.2 18.8 6.0 

Family i~co~e 

Less than $5,000 32,316 25,187 6,187 942 100.0 {;.; 19.1 2.9 

$5,000-$9,999 47,398 37,834 7,848 1,716 100.0 16.6 

$10,000-$14,999 51,666 42,193 7,289 2,184 100.0 81:7 14.1 ::: 

$15,000or mare 63,265 52,627 7,356 3,282 100.0 83.2 11.6 5.2� 

Geographicregion 

~orthea.st 49,196 39>310 7,446 2,439 100.0 79.9 15.1 

North Central 55,543 46,353 6,469 2,720 100.0 83.5 11.6 

South 65,232 51,868 10,417 2,947 100.0 79.5 ~;.: \ 

West 37,363 29,286 6,526 1,551 100.0 78.4 I 

place of residence


SMSA 142,954 114,168 21,711 7,076 100.0 79.9 15.2 4.9 

Central city 62,520 48,474 10,895 3,151 100.0 77.5 17.4 

Outside central city 80,435 65,694 10,816 3,925 100.0 81.7 13.4 U 

Outside SMSA 64,379 52,650 9,148 2,581 100.0 81.8 14.2 4.0 

Nonfarm---------------------- 56,856 46,379 8,134 2,343 100.0’ 81.6 14.3 4.1 

Farm 17,523
 6,270 1,01: 238 100.0 83.3 13.5 3.2

1Includes persons with unknown income.


according to their various health needs. Interpretation of “seeing different doctors for different 

problems” as a reason for being without a regular source of care is not without some ambiguity, however. At least two different types of 

persons who ought to be distinguished from one 

another may have been grouped together here. 

The question that treated the subject of a regular source of care in the 1974 survey was 

worded, “Is there ONE particular doctor or 

place you usually go to when you are sick or 

when you need advice about your health?” 

People affiliated with two doctors or more 

from whom they usually obtained care might 

properly consider themselves as having a regular, 

although multichannel. , source of care. However, 

a “no; response to the question would classify 

them as being without a regular source of care. 

People receiving care from the same set of doctors are in a somewhat different situation than 

those who go to different doctors for different 

problems but lack a regular set of doctors 

from whom care is received. This latter group 

might well be described as being without either a 

regular or central source of care. The former 

group may or may not lack a central source o 

care, but could aptly be described as having b 

regular source of care. 
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o dmcdata3 

Table 2. Number and percent distribution Of persons without a regular source of medical care by main reason, according co selected characteristics: United States, 1974


I Main reason for not baving a regular source of medical care


Nmber of


persons Prev­
 without See dif- ious
 a regular No ferent Unable doctor Too Health 00 not use


source of All doctor doctors care fac- doctors


care in reasons needed depending ft:d lo~er expen- ility unless Other Unknown


thousands right avail- sive available seriously
 C’n;:n: i= doctor able if needed ill


Characteristic


All persons 1-------


— 

Sex

Male


Female-------------------


Age
 —


Under 17 years-----------
 17-44 years--------------


45-64 years--------------


65 years and over--------


Color


white--------------------


All other----------------


Family income


ESS than $5,000---------


$5,000-$9,999
 —
 $10,000-$14,999


$15,000 or mOre


Geographic region


Northeast


North Central------------


South--------------------
 West


Place of residence


SMSA---------------------
 Central city-----------


Outside central city---
 Outside SMSA


Ncmfann----------------
 Fa~-------------------


Percent distribution


30,859 100.0 54.2


17,723 100.0 59.8
 13,135 100.0 46.6


5,814 100.0 51.6


1;,$;; 100.0 55.8
 100.0 51.1
 2;485 100.0 57.2


2:,;:; 100.0 54.0


> 100.0 55.0


6,187 100.0 52.9 

7,848 100.0 56.8 

7,289 100.0 54.0 

7,356 100.0 51.6 

I 

7,446 100.0 55.2


6,469 100.0 54.1
 1:,;;; 100.0 53.3
 100.0 54.6
 M
 1,015 100.0 55.3

21,711 100.0 54.0 

10,895 100.0 53.5 

1:,;?; 100.0 54.5 100.0 54.7 8;134 100.0 54.6 

17.8 7.6


15.5 6.3
 21.0 9.4


16.9 9.2
 19.1


17.9 i::
 11.3 7.4


17.0 8.0
 22,0 5.7


14.8 8.0
 15.5 8.1
 19.8 8.6
 22.4 6.7


18.4 9.8
 17.3


18.7 H
 16.4 9.1


18.1 8.3
 18.9


17.3 ;:;
 17.3


17.8 R
 13.1 *5.3


7.5 1.4


T

1.2


R 1.6


1.7


;:;
 :::


;:2 *1.4


6.6 3.6


1.1


::: *O.8


7.6 *0.5


*o.9


~:~ ;.;


8:5 1:3


1.1 0.2 8.2 1.9


0.9 0.2
 1.3 *o.2 ;:: ;::


2.0 *o.I 7.6 3.2
 0.9 *o.3 7.0
 *0.8 *0.2 10.6 ;:2
 *.8 *- 12.1 *1.2


0.9 *O.2 8.3 1.8
 1.9 *o.3 8.0 2.1


2.1 *0.2 10.1 1.6
 *0.8 *o.2 2.4
 *0.7 *o.3 ::! 1.1
 *0.8 w. 1 8.5 1.7


*o.7 *o.1 

*o.7 *o.1 ;:: ;:: 1.5 *o.3 10.2 2.1 1.3 *o.2 6.8 1.8 

*0.2 2.0 H *o.2 H 2.2 

1.2 *o.2 

*0.7 *0,2 H H *0.7 *0.1 1.3 

*0.4 *0.6 1?:: *3.8 

lIncludes persons with unknown incmne.


For a sizable number of people, some barrier 

to health care precluded them from having a reguku- health care source. Among those without a 

regular source of care, 7.6 percent were unable 

to find the right doctor. Loss of access to a doctor who was previously being seen was the main 

reason given by an additional 7.5 percent of the 

people who were without a regular health care 

source. For 1.4 percent of those without a regular source of care, the high cost of health care 

was given as the main barrier. 

About 1 percent of the people without a 

regular health care source indicated that their 

reason for not having a particukr doctor or 

place of care was that they would have access to 

-—~ 

a health care facility shouId they need one (e.g., 

civilians working on military bases). Even few-er 

people were without a regular source of care primarily because they did not use doctors unless 

their ‘&Iment was very serious. 

Place of Usual Medical Care 

Among the majority of the population with 

a regular source of medical care, the largest number (62.8 percent) obtained their health care 

from a private doctor’s office or clinic (table 3). 

Older persons, white persons, people in families 

with a $5,000 income or more, and those residing outside of standard metropolitan statistical 

M u K3- 7. 5 1.8 2.8 Farm---------------------------- 53:9 19.8 ;:7 *0.8 2.2, J:j *::; *::; 

‘) 

1Includes persons with unknown income.

4 advancedata 

.—_.— ..0. 

6 aduancedata 

shows the percent of the population that used 

major sources or places of care at least once during a 12-month period, irrespective of whether or 

not they had a regular source of care. Almost 6 

out of 10 people (58.2 percent) contacted a private doctor’s office or clinic. The next two most 

contacted sources were group practices (17 percent) and hospital emergency rooms (14 percent ). About 9 percent of the population contacted a hospital outpatient clinic. Company or 

industry clinics and public health clinics were 

each utilized at least once by about 3 percent of 

the population; neighborhood health centers, by 

1 percent. Sixteen percent used the telephone to 

obtain help or advice about their health, and 1.5 

percent were visited by a doctor at home. 

There were numerous differences among 

Figure 1. PERCENT OF PERSONS IN EACH FAMILY INCOME 

MEDICAL CARE DURING YEAR PRIOR TO 

70 

60 

50 

F 40 z 

Ill 

CJ 

a 

Lu 

n 30 

20 

10 

— 

population subgroups in respect to the percentage of people contacting each source or place of 

care shown in table 4. The most consistent differences occurred among the family income 

groups (figure 1). People in families with higher 

incomes were more likely than those with lower 

incomes to have received care at private doctor’s 

offices and group practices as well as over the 

telephone. However, the reverse was true for 

most other sources of care. Contact with hospital outpatient departments, emergency rooms, 

public health clinics, and neighborhood health 

centers was relatively more common among persons in families with lower incomes. Contact 

with a company or industry clinic during the 

year was slightly more likely among higher income groups. 

GROUP UTILIZING SPECIFIC SOURCES OR PLACES OF 

INTERVIEW: UNITED STATES, 1974 

Family Income 

~Lassthan $5,000 

] $5,000-$9,999 ImEl 

~$lo,ooo-$lwsl 

] $15,0000, n-lore 

0 

Private Group Telephone Company Hospital Hospital Public Neighborhood 

doctor’s practice or outpatient emergency health health 

office or industry clinic room clinic center — 

clinic clinic 
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“> 

A smaller but substantial number (4.8 percent) of the group that had a regular source of 

care identified hospital-based outpatient clinics 

as their usual place of care. Although adults 17 

to 44 years old were similar to those 45 to 64 

years old in their selection of outpatient clinics, 

younger people were generally more likely to be 

affiliated with hospital outpatient clinics as a 

regular source than were older people. People in 

families with less income were also more likely 

to note outpatient clinics as their regular health 

care source, as were color groups other than 

white. Persons living in the South and West were 

similar in the extent to which they affiliated 

themselves with outpatient clinics as a regular 

source of care. Both of these groups were more 

likely than the other regional groups to have 

damedab5 

outpatient clinics as a regular source of care. 

Central city residents were the most likely 

among place of residence groups to identify hospital outpatient clinics as regular sources of care. 

Other sources of regular care were much less 

common. Less than 1 percent of those with a 

regular source identified emergency rooms as the 

usual place of care. Under 0.5 percent received 

regular medical care at a company or industry 

clinic or at home. 

CONTACTS WITH SOURCES


AND PLACES OF MEDICAL CARE


Personal health care is obtainable, whether 

or not a person has a regular source of care, 

from a wide variety of sources or places. Table 4 

Table 4. Number and percent of persons utilizing specific sourcesor places of Outpatient medical care during Year PriOr to inter-
 view, by selected characteristics: United States, 1974


Source or place of care


Number
 of
 - Characteristic persons Private Hos- Hos­


in


thou- ioctor’s GrouP Tele- pital pital Company or Mb 1‘c To:%’;d Home other


office sands clinic
 m clinic practice phone yi:;:- ~n:; industry :l;;;; health 

center clinic room 

I I I I I I I I 1 

Percent of persons utilizing any services


All personal---------------- 207,334 58.2 16.6 16.1 8.9 14.1 3.1 2.6 1.0 1.5 2.5


~ 

Male 100,024 51.9 14.6 12.2 8.4 15.1 4.7 2.2 0.8 1.2 2.8 

Female 107,309 64.1 18.4 19.7 9.4 13.2 1.6 2.9 1.1 1,8 2.2 

Age 

Under 17 years-------------------- 62,953 55.6 19.8 23.0 16.2 0.2 3.7 1.4 1.3 2.1


17-44 years 80,778 58.9 15.1 14.5 ::2 15.4 2.8 1.0 3.4


45-64 years----------------------- 42,862 58.0 15.3 11.0 9.1 Lo.7 ::? 1.3 ;:: 1.9


65 years and over----------------- 20,740 63.9 15.3 11.6 7.5 9.5 0.4 1.0 0.5 ::: 1.1


c&


White----------------------------- 180,725 60.1 17.3 17.4 13.8 3.1 2.2 0.7 1.6 2.4


All other------------------------- 26,608 45.3 12.2 6.7 12:2 16.4 3.2 5.4 2.8 1.2 2.7


Family income


Less than $5,000------------------ 32,316 54.6 13.0 10.4 13.1 15.9 1.7 5.0 2.2 2.0 2.7


$5,000-$9,999 47,398 56.2 14.8 14.4 LO.O 15.6 3.0 3.3 1.1 1.4 2.2


$10,000-$14,999 51,666 59.1 17.7 17.9 7.7 14.3 ;.: 2.1 0.8 1.1 2.2


$15,000 or more------------------- 63,265 62.5 19.7 19.6 7.2 12.5 1.4 0.4 1.7 2.9


Geographic regkm


Northeast 49,196 61.4 10.8 16.1 9.4 15.9 3.6 1.7 0.9 2.7 3.2


Nc,rthCentral--------------------- 55,54? 57.7 18.7 17.8 8.5 13.8 3.6 2.1 0.9 1,2 2.4


South----------------------------- 65,232 60.8 16.9 14.6 8.5 13.8 2.6 3.4 1.1 1.9


west 37,36: 55.2 22.1 16.C 9.6 12.7 2.5 2.9 ;:; 1.2 2.4


Place of residence


SMSA------------------------------ 142,95L 58.6 16.6 17.4 9.8 14.8 2.! 1.1 1.7 2.7


Central city 62,52( 54.9 15.4 15.3 12.5 15.3 ::; 3.4 1.7 1.9 2.7


Outside central city------------ 80,43! 61.4 17.5 19.1 7.7 14.4 3.5 l.t 0.6 1.5 2.6


outside SMSA--.--------.---------. 64,37! 57.5 16.7 13.( 6.9 12.6 1.7 2.8 0.7 1.2 2.0


Nonfat------------------------- 56,85( 58.0 16.3 13.5 13.0 1.8 0.7 l.? 2.2
 -
 Fa~---------------------------- 7,52: 53.9 19.8 9.7 ;:: 9.6 *0.8 ::; *0.6 *0.5 *0.9


1 Includes persons with unknown inccme. 

—. —— 
6


shows the percent of the population that used 

major sources or places of care at least once during a 12-month period, irrespective of whether or 

not they had a regular source of care. Almost 6 

out of 10 people (58.2 percent) contacted a private doctor’s office or clinic. The next two most 

contacted sources were group practices (17 percent) and hospital emergency rooms (14 percent). About 9 percent of the population contacted a hospital outpatient clinic. Company or 

industry clinics and public health clinics were 

each utilized at least once by about 3 percent of 

the population; neighborhood health centers, by 

1 percent. Sixteen percent used the telephone to 

obtain help or advice about their health, and 1.5 

percent were visited by a doctor at home. 

There were numerous differences among 

Figure 1. PERCENT OF PERSONS IN EACH FAMILY INCOME 

MEDICAL CARE DURING YEAR PRIOR TO 

70 -

60 -

50 -

!- 40 - z 

8 

5 

n 30 -

20 -

10 -

0 — 

Private 

doctor’s 

office or 

clinic 

Group Telephone Company 

practice or 

industry 

clinic 

population subgroups in respect to the percentage of people contacting each source or place of 

care shown in table 4. The most consistent differences occurred among the family income 

groups (figure 1). People in families with higher 

incomes were more likely than those with lower 

incomes to have received care at private doctor’s 

offices and group practices as well as over the 

telephone. However, the reverse was true for 

most other sources of care. Contact with hospital outpatient departments, emergency rooms, 

public health clinics, and neighborhood health 

centers was relatively more common among persons in families with lower incomes. Contact 

with a company or industry clinic during the 

year was slightly more likely among higher income groups; 

GROUP UTILIZING SPECIFIC SOURCES OR PLACES OF 

INTERVIEW: UNITED STATES, 1974 

Family Income 

� LaSSthan $5,000 

$5,000-$9,999 

610,000-$14,999 

$15,000 or more 

Hospital Hospital Public Neighborhood 

outpatient emergency health health 

clinic room clinic center 

—. —— 
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o 

PROBLEMS IN GETTING 

MEDiCAL CARE 

An estimated 10 percent of the population 

experienced some problem in getting medical 

care during the 12 months prior to the interview 

(table 5). A delay in getting an appointment was 

the most common problem, with 5 percent of 

the population reporting that difficulty. The unavailability of a doctor when one was needed 

and the cost of care were problems for nearly 3 

percent of the population in each case. Just 

under 2 percent had a problem getting care because office hours were inconvenient for them. 

dmcdata7 

About 1 percent had a problem because they 

lacked transportation or did not know where to 

go. 

Overall, the likelihood of having had some 

problem in getting medical care varied among 

sex, age, and income groups. In 1974 females 

and Iower family income groups experienced 

some difficulty in getting care proportionately 

more often than other comparable groups. 

Among age groups, children and youths under 

17 years old were the least likely, and adults between the ages of 17 and 44 were the most likely, to have experienced some problem in getting 

medical care. However, there were no differences 

Table 5. Number of persons, percent of persons reporting 1 problem or more in getting medical care during year prior


to interview, and percent of persons reporting specific types of problems, by selected characteristics: United


States, 1974- -


Type of problem


Persons
 Number of
 with 1 Could not Characteristic No doctor Office Did not
 :~u;~nd~ problem get ap- available Lack of know
 or more pointment when cost ~- transpOr- where Other


as soon needed venient tation to go
 as needed


Percent of population


All personsl 207,334 10.4 5.C 2.7 2.5 1.7 1.2 1.0 0.5 

Male 

-1-

100,024 2.3 2.1 0.8 0.7

Female 107,309 1::: 3.1 3.0 H 1.6 1.2 M 

Age
 —


Under 17 years------------------ 62,953 2.1 1.8 1.4 1.1 0.6 0.3 

17-44 years 80,778 J:: 2.4 0.4 

45-64 years--------------------- 42,862 10.0 ::? ;:3 1.2 ::; ::? 0.6 

65 years and over 20,740 9.0 2.2 2.0 0.8 2.8 1.0 0.6 

Color


White--------------------------- 5.1 2.8 2.4 1.7 1.0 0.5 

All other 3.9 2.1 3.3 1.7 2: 1.1 0.3 

Family inccme


Less than $5,000---------------- 32,316 14.2 5.1 3.2 5.1 1.7 3.6 1.3 0.7 

$5,000-$9,999------------------- ;;,;:; 11.6 2.9 1.9 1.4 

$10,000-$14,999----------------- 9.1 2:; 2.6 ?:: 1.7 ;;; ::$ 

$15,000 or more 63;265 8.7 5.2 2.6 0.8 1.6 ::: 0.6 0.4 

GeozraDhic reEion


Northeast----------------------- 49,196 4.c 2.9 2.3 1.7 0.9 1.1


North Central 55,543 1%; 5.6 2.6 1.7 1.9 1.1 0.9 ::2


South--------------------------- 65,232 10.1 4.4 2.6 2.7 1.5 1.3 0.4


West 37,363 12.9 6.2 2.8 3.9 1.7 1.5 H 0.5


Place of residence


SMSA 142,954 10.5 2.6 1.8 1.1 0.5 

Central city 62,520 10.7 ?:: H 1.3 0.5 

Outside central city 

Outside SMSA-------------------- 80,435 

64,379 10.3 10.1 H 

H 

3.0 

2.1 

2.5 

H 

1.5 1.0 

0.6 0.5 

0.4 

Nonfarm----------------------- 56,856 10.6 5.1 3.2 2.6 1.6 0.4 

Farm 7,523 6.6 L3.5 1.9 1.3 *o. 7 L 0.2 

@ 1Includes persons with unknown income.

8 achancedata 

between people 45 to 64 years old and those 65 

years of age and older. 

These overall differences were not invariant, 

however. For example, while there was almost 

complete uniformity among the family groups 

regarding such problems as doctor unavailability, 

the scheduling of appointments, and office 

hours, people in lower family income groups 

confronted cost, transportation, and knowledge 

barriers to care proportionately more often than 

people in higher family income groups. 

SELF-PERCEIVED UNMET 

HEALTH CARE NEEDS 

Self-perceptions may be imperfect indicators 

of unmet health care needs. People may be unaware that they have a condition requiring medical attention. They may perceive themselves as 

needing certain kinds of health care which, from 

a medical point of view, they do not need. They 

may perceive themselves as not needing care for 

a known medical condition when a physician 

would deem care necessary. In the absence of 

more refined and specific measurements, however, global assessments of unmet health care 

needs provide a useful, if tentative, indication of 

the number and kinds of people who feel that 

our health care delivery systems are not fully 

responsive to their needs. 

In 1974, 6 percent of the population felt 

that they were not getting as much medical care 

as they needed. Among the various demographic 

and social groups shown in table 6, this feeling 

was more prevalent in some groups than in 

others. Perceptions of unmet health needs were 

relatively more common among females, adults 

between the ages of 17 and 64, color groups 

other than white, lower family income groups, 

residents of the West and South Regions, and 

central city dwellers. 

There were numerous reasons why people 

felt that they were not getting all the medical 

care they needed. The most frequently identified reason was the high cost of care. Almost 

half (48.6 percent) of the people who reported 

some unmet health care need indicated that 

costs were a factor. A smaller but still substantial number of people identified the brevity of 

time spent with the doctor (14 percent) and the 

inability to get an appointment (13.8 percent) as 

sources of their perceived unmet needs. Difficulty getting to the doctor (6 percent) and inconvenient hours (8 percent) figured prominently in the perceptions of some people who 

felt their needs were unmet. The large “other” 

category reflected the vast array of additional 

reasons that led’ to perceptions of unmet health 

care needs. 

As shown in table 6, each of these reasons 

played a more prominent role in the perceptions 

of some groups than they did in others. These 

subgroup differences highlight the diverse reasons for perceptions of unmet health care needs 

among different social groups. Costs, transportation, and a host of “other” specific reasons were 

more frequently cited sources of perceived unmet needs among lower income groups. However, inconvenient office hours, difficulties in 

getting appointments, and the feeIing that the 

doctor gave them an inadequate amount of time, 

were relatively more common reasons given by 

higher income groups for self-preceived unmet 

needs. 

A CONCLUDING NOTE 

There are many other descriptive questions 

that can be asked about sources of medical care. 

How many people have a particular doctor or 

other medical person that they usually see at 

their regular source of care? What kinds of doctors do they usually see? How disposed are 

people to using their regular source of care? 

How many people contact their regular source 

of care during the course of a year and how 

often? How many people receive services both 

from their regular source of care and from other 

sources? How many people bypass their regular 

source to obtain medical attention from another 

source of care? Are people who receive setices 

from sources of care other than their regular 

source referred by their regular source or do 

they refer themselves? What sources of payment 

do people use to cover the expenses of the outpatient care they receive? A more detailed report that will deal with these questions is in 

preparation. 
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----------------------------------------

------------------------------

o achKeMa9 

Table 6. Number and percent of uersons reuortinz self-uerceived unmet health care needs. and percent of these persons giving spe­
 cifik ressans,”by miected characteristics: United States, 1974 -


Self-perceived unmet health care need


Persons reporting Reason for


Characteristic


Percent Doctor


Number in of total spends in- Cannot get Difficulty


thousands p0pu3.a cost adequate appoint- getting to
 -
 ment doctor


All personsl-------------------------­


~ 

Male 

Female


Age


—


Under 1? years------------------------------
 17-44 years---------------------------------


45-64 years---------------------------------
 65 years and over--------------------------­


~r


Ubite---------------------------------------


All other-----------------------------------


Family income


Less than $5,000


$5,000-$9,999


$10,000-$14,999


$15,000 or more
 � Geographic region


Northeast----------------------------------


North Central


south ---------------------------------------
 West


Place of residence


SMSA----------------------------------------
 Central city


Outside central city----------------------


Outside SM8A--------------------------------


Nonfarm-----------------------------------


Farm-------------------------------------­


lIncludespersons with unlmown income.


tion ttie


Percent of persons


12,384 6.0 48.6 14.0 13.8 8.3


5,695 47.6 12.i 13.2 

6,689 ::; 49.5 15.1 14.3 

2,591 4.1 47.7 10.0
 5,572 6.9 49.0 J:: 16.3


2,994 50.3 15.9 13.0


1,228 H 44.7 25.9 12.0


;,;;: 47.3 15.3 14.9


, 1?:; 52.6 9.9 10.1


3,308 10.2 ;;.; 12.1 32.4


3,472 7.3 13.3 32.2
 2,649 5.1 43:1 16.2 15.3
 2,273 3.6 29.3 17.6 17.7


2,816 43.0 12.1 14.9
 2,362 z:; 38.2 18.8 18.4


4,566 7.0 51.8 12.1 11.5
 2,641 7.1 58.3 15.0 12.2


8,883 6.2 47.9 14.3 13.1


4,629 7.4 50.0 14.6 12.6
 4,254 45.6 14.0 13.7


3,501 ::2 50.5 13.3 15.4


3,125 5.5 50.3 12.7 16.0


376 5.0 51.9 *18.1 *LO.4


Office hours


inconvenient other


6.5 26.5


27.9


25.4


zi.o


29.6


25.1


27.9


27.3


24.1


21.2


25.1


28.3


36.8


27.7


25.9


26.4


26.2


27.0


25.2


28.9


25.4


25.9


21.8

-------------

-------------

------------

------------

-----

----

----

----

� 

10 acimncedata 

@ 

TECHNICAL NOTES 

SOURCE OF DATA. The data presented in this 

report were obtained from household interviews 

in the Health Interview Survey. These interviews 

were conducted throughout 1974 in a probability sample of the civilian noninstitutiona.lized population of the United States. During 

that year approximately 116,000 persons living 

in about 40,000 households were included in the 

sample. The questions about sources of medical 

care and problems in getting care were asked of 

each household member who was identified as a 

‘‘s ample person. ” This subsample included 

37,062 persons. 

SAMPLING. The sampling pattern for sample 

person selection was based on the total number 

of related and unrelated household members. 

Sample persons (a one-third subsample of the 

Health Interview Survey sample) were selected 

by the interviewer at the time of interview. To 

determine which household member(s) to designate as a sample person, the interviewer referred to a preselected flashcard after listing all related and unrelated persons in the household on 

the questionnaire. The flashcard contained, for 

each household size, one person number or more 

that were to be identified as the sample person(s). 

Since the estimates shown are based on a 

sample of the population rather than on the entire population, they are subject to sampling 

error. Standard errors appropriate for the estimates of the number of persons are shown in 

table I; standard errors appropriate for percentages are shown in table II. 

LIMITATIONS AND QUALIFICATIONS OF 

DATA. While the procedures used in the Health 

Interview Survey are designed to minimize nonsampling errors , including various forms of response errors, the data presented in this report 

are, to some extent, still subject to this type of 

error. Estimates derived from the 1974 Health 

Interview Survey on sources of medical care and 

problems encountered in getting care may also 

differ somewhat from those derived from other 

surveys dealing with the same subject matter due 

to differences in definitions, sample design, 

question wording, and other procedural aspects 

of the data collection process. 

Table I. Standard errors of estimates of


aggregates


Size of estimate Standard error
 in thousands in thousands


70---------------- 21


1oo---------------


3oo--------------- ::


5oo--------------- 55


7oo--------------- 65


l,ooo


5,000 1;!?


lo,boo------------ 243


20,000------------ 337


30,000 405


50,000 501


loo,boo----------- 626


Table II. Standard errors, expressed in


percentage points, of estitiated per­


centages


Estimated percentage


Base of


percentage in .02 .05 10 20 

thousands or or or or 50 

98 95 90 80 

70-------- 4.1 6.4 14.8 

1oo------- 5.4 12.4 

3oo-------

5oo-------

;:; 

1.5 M 

7oo------- 1.3 2.0 

l,ooo 

5,000----- U M 

lo,ooo---- 0.3 0.5 

20,000 0.2 0.4 ;:; 

30,000 0.2 0.3 0.6 

50,000 0.2 0.4 

loo,ooo--- ::: 0.2 0.3 0.4 

For a more detailed discussion of the limitations and qualifications of data collected in the 

Health Interview Survey, see an earlier report 

entitled “Current Estimates from the Health Interview Survey, United States, 1974, Vital and 

Health Statistics, Series 10, No. 100, DHE W@ 

Publication No. (HRA) 76-1527. 
---

o 

In this report, terms such as “similar” and 

“the same” mean that no statistical significance 

exists between the statistics being compared. 

Terms relating to differences (i.e., “greater,” 

“less,” etc.) indicate that differences are statistically si@ficant. The t test with a critical value 

of 1.96 (0.05 level 

test all comparisons 

comment regardhg 

two statistics does 

tested and found to 

admcdda 11 

of significance) was used to 

which are discussed. Lack of 

the difference between any 

not mean the difference was 

be not significant. 

Statistics 

SYMBOLS 

Data not available 

Category not applicable—--—————— 

Quantity zero 

Quantity more than Obut less than 0.05— 

)@re does not meet standards of 

reliabilityy or precision 

. . . 

0.0 

* 

Recent Issues of fldvance Data From Vital and Health 

No. 16.	Office Visits to Internists: Natioml Ambu- No. 14. Weight by Height and Age of Adults 18-74 

Iatory Medical Care Survey, United States, Years: United States, 1971-74 (Issued: No1975 (Issued: February 7, 1978) vernber 30, 1977) 

No. 13. Ambulatory MedicaJ Care Rendered in Pediatricians’ Offices During 1975 (Issued: October 

13, 1977) 

No. 15. National Ambulatory Medical Care Survey of 

Vkits to General and Family Practitioners, No. 12. Ambulatory Medical Care Rendered in PhysiJanuary-December 1975 (Issued: December cians’ Offices: United States, 1975 (Issued: 

14, 1977) October 12, 1977) 

A complete list of Advance Data From the Vital and Health Statistics is available from the Scientific and 

Technical Information Branch.