Health Insurance Coverage and Adverse Experiences With Physician Availability in the US

December 17, 2013

Rates of private insurance and public coverage have been increasing. As coverage and utilization increase, a growing concern is the availability of health care providers to meet patient needs. Almost 90% of general physicians accept new patients with private insurance, but less than 75% accept new patients with public coverage (e.g., Medicare, Medicaid), and the proportion of specialists accepting new patients with Medicare or Medicaid is declining. While most studies approach access from a provider perspective, a new report examines the percentage of people who had each of three adverse experiences with physician availability in the past 12 months. Estimates were produced by age group and health insurance status using data from the 2012 National Health Interview Survey.

Key Findings From the Report:

  • In the 12 months prior to interview, 2.4% of people in the U.S. had problems finding a general doctor, 2.1% had been told that a doctor would not accept them as new patients, and 2.9% had been told that a doctor did not accept their health care coverage.
  • People under age 65 who had public coverage only were more likely than those with private insurance to have these three types of adverse experiences with physician availability.
  • Adults aged 18–64 who were uninsured were more likely than privately insured adults to have trouble finding a general doctor or be told that a doctor would not accept them as new patients.
  • Adults aged 65 and over with Medicare only were as likely as those with both Medicare and private insurance to have these experiences with physician availability.

National Study of Long-Term Care Providers Report

December 13, 2013

NCHS has released the first in a series of NSLTCP reports today. Long-Term Care Services in the United States: 2013 Overview includes general, descriptive information on the supply, organizational characteristics, staffing, and services offered by providers of long-term care services; and the demographic, health, and functional characteristics of users of these services.

long_term_care_services_2013

The report shows that in 2012, about 58,000 paid, regulated long-term care services providers served about 8 million people in the U.S.

  • Each day in 2012 there were 273,200 participants enrolled in adult day services centers, 1,383,700 residents in nursing homes, and 713,300 residents in residential care communities.
  • In 2011, about 4,742,500 patients received services from home health agencies, and 1,244,500 patients received services from hospices.

Selected summary highlights from the report include:

  • Provider sectors differed in ownership, and average size and supply varied by region.  In all sectors except adult day services centers, the majority of long-term care services providers were for profit.  The largest share of adult day services centers, home health agencies, hospices, and nursing homes was in the South, while the largest share of residential care communities was in the West.
  • Provider sectors differed in their nursing staffing levels, use of social workers, and the types of services offered.  The majority of nursing employee full-time equivalents (FTE) in residential care communities, adult day services centers, and nursing homes were aides, while the majority of nursing FTEs in hospices and home health agencies were registered nurses.
  • Rates of use of long-term care services varied by sector and state.  Users of long-term care services varied by sector in their demographic characteristics and functional status.  Hospices, nursing homes, and residential care communities served more persons aged 85 and over, and adult day services centers served more persons under age 65.  Adult day services centers were the most racially and ethnically diverse among the five sectors.

Measures of Muscular Strength in U.S. Children and Adolescents

December 13, 2013

In 2008, the federal government released the Physical Activity Guidelines for Americans, which provide guidance on the types and amounts of physical activities that provide substantial health benefits for Americans of all ages. Regular physical activity reduces the risk of many adverse health outcomes and helps control the percentage of body fat in children and adolescents. This report provides the first nationally representative data on core, upper body, and lower body measures of muscle strength among U.S. children and adolescents aged 6–15 years by sex and age group.

Key Findings from the Report:

  • There were no significant differences by sex in core, lower, or upper body measures of strength for younger boys and girls. In contrast, adolescent boys had higher values than adolescent girls on all measures of strength.
  • Adolescent boys and girls had higher scores than younger boys and girls on the core and lower body strength measures and upper body strength as measured by the grip strength test.
  • Adolescent boys completed more modified pull-ups, a measure of upper body strength, than younger boys. There was no significant difference in the number of modified pull-ups completed between adolescent and younger girls.

Winter Injuries

December 13, 2013

With winter now upon us, several storms have already hit much of the country with dangerous snow and ice. The wintery conditions can result in injuries that often lead to hospitalizations that are sometimes fatal.  The impact on society is direct in terms of medical costs and indirect in terms of lost productivity.

There is a wealth of NCHS data that help illustrate the impact of injuries on Americans. Mortality data from 2010 show that injuries are among the leading causes of death in the United States, and unintentional injuries (accidents) are the 5th leading cause of death for all ages.

More striking than the number of injury deaths is the number of injuries seen in hospitals and emergency departments. In 2010, for each death by injury, there about 11 times as many hospitalizations and 182 times as many emergency department visits. In 2010, nearly 1 in 4 emergency department visits-almost 30 million visits-had injury as the primary diagnosis.

Diagnosed injuries are classified by mechanism—the cause of the injury. The five most common mechanisms of diagnosed injury for people who sought treatment in emergency departments were: falls, being struck by a person or object, motor vehicle traffic accidents, cut, and exposure and other natural or environmental injuries. Also, the average length of hospital stay for treatment of an injury was almost 5 days.

For non-fatal injuries, CDC estimates that falls were the leading mechanism of initial injury emergency department in 2010.  Also, nearly half of the respondent-reported non-fatal medically attended injuries occurred in or around the home.

So watch out for those patches of ice.


Trends in Insurance Coverage and Source of Private Coverage Among Young Adults

December 11, 2013

NCHS has put a report that provides estimates describing the previous insurance status and sources of coverage among privately insured young adults aged 19–25, using data from the 2008–2012 National Health Interview Survey.  Comparisons are made with adults aged 26–34, the most similar age group that was not affected by the Affordable Care Act (ACA) provision.  Young adults often experience instability with regard to work, school, residential status, and financial independence. This could contribute to a lack of or gaps in insurance coverage. In September 2010, the ACA extended dependent health coverage to young adults up to age 26. This provision was expected to lead to increases in private coverage for young adults aged 19–25 when they became eligible for coverage through their parents’ employment.

Key Findings From the Report:

  • The percentage of young adults with private health insurance coverage increased from the last 6 months of 2010 through the last 6 months of 2012 (52.0% to 57.9%).
  • Except for an increase in the first 6 months of 2011, the percentage of privately insured young adults who had a gap in coverage during the past 12 months decreased from the first 6 months of 2008 through the last 6 months of 2012 (10.5% to 7.8%).
  • The percentage of privately insured young adults with coverage in their own name decreased from 40.8% in the last 6 months of 2010 to 27.2% in the last 6 months of 2012.
  • The percentage of privately insured young adults with employer-sponsored health insurance increased from the last 6 months of 2010 to the last 6 months of 2012 (85.6% to 92.5%).

Motor Vehicle Deaths

December 6, 2013

The recent news that Paul Walker, the star of the “Fast & Furious” movie series, was killed in a car crash has generated  interest from the public into data on motor vehicle fatalities.

Though the National Highway Traffic Safety Administration is the main source of information about traffic accidents and fatalities in the U.S., the National Center for Health Statistics also tracks this leading cause of death as a standard part of its mortality data collection activities.

Motor vehicle-related deaths remain a significant cause of preventable death, accounting for about 34,000 deaths in the U.S. in 2011 for all age groups.  It also accounted for nearly one out of five of injury deaths.   The age-adjusted death rate for these injuries has recently begun to decrease — 3.6% from 11.1 per 100,000 population in 2009 to 10.7 in 2010.

Motor vehicle-related death rates are higher for males and females aged 15-24 than for most other age groups.  For males and females aged 15-19, motor vehicle-related deaths declined 47% from 2000 to 2010.  Motor vehicle-related deaths rates declined 31% for males aged 20-24 and 26% for females in the same age group during this 10-year period.

According to our National Hospital Ambulatory Medical Care Survey, motor vehicle-related accidents resulted in over 3 percent of emergency department visits.

In terms of years of life lost, motor vehicle crashes rank third, behind only cancer and heart disease and account for approximately $99 billion in medical and lost work costs annually.


Recent Trends in Births and Fertility Rates Through June 2013

December 6, 2013

NCHS has released a Health E- Stat that gives a provisional count of birth in the United States. The provisional count of births in the U.S. for the 12-month period ending June 2013 was 3,941,000, which was not significantly different from the 3,944,000 births (provisional count) for the 12-month period ending June 2012 . The number of births has declined from the historic high of 4,316,233 in 2007. However, the decline has slowed from 2010 through 2011, and the number was essentially unchanged from 2011 through 2012.