Under-/Uninsured Health Resources Survey

We are in the preliminary stages of creating an online resource that would provide information about local low-cost health services, targeted to those with little or no health insurance. Your answers will help us focus our efforts where they will be most useful.

1. What level of insurance coverage applies to you?

What level of insurance coverage applies to you? No insurance

Emergency/hospital care only

Self-paid basic insurance with high co-pays/out-of-pocket costs

Medicaid

Medicare

Private Insurance

Other (please specify)

2. In the past year, approximately how many times have you deferred seeking wellness/medical care due to lack of insurance or lack of affordable resources?

In the past year, approximately how many times have you deferred seeking wellness/medical care due to lack of insurance or lack of affordable resources? None

One

Two

Three

More than three

3. If you are under-/uninsured, what obstacles prevent, or might prevent you, from seeking care at a City Health Center or other low/reduced-fee health care provider? (check all that apply)

If you are under-/uninsured, what obstacles prevent, or might prevent you, from seeking care at a City Health Center or other low/reduced-fee health care provider? (check all that apply) Long wait time

Poor quality of care

Confusing system

Hidden costs

Intimidating building/office/setting

Discrimination/poor treatment

Inconvenient location

Inconvenient hours

Didn't know this was available

Other (please specify)

4. On a scale of 1 to 10, with 1 being the MOST valuable to you, please rank the top ten kinds of health resources that you most need information about. (Please add any categories we missed!)

	#1 Most Valuable	2	3	4	5	6	7	8	9	10	N/A
General medical care (non-emergency)	*On a scale of 1 to 10, with 1 being the MOST valuable to you, please rank the top ten kinds of health resources that you most need information about. (Please add any categories we missed!) General medical care (non-emergency) #1 Most Valuable	General medical care (non-emergency) 2	General medical care (non-emergency) 3	General medical care (non-emergency) 4	General medical care (non-emergency) 5	General medical care (non-emergency) 6	General medical care (non-emergency) 7	General medical care (non-emergency) 8	General medical care (non-emergency) 9	General medical care (non-emergency) 10	General medical care (non-emergency) N/A
Emergency care	Emergency care #1 Most Valuable	Emergency care 2	Emergency care 3	Emergency care 4	Emergency care 5	Emergency care 6	Emergency care 7	Emergency care 8	Emergency care 9	Emergency care 10	Emergency care N/A
Walk-in clinics	Walk-in clinics #1 Most Valuable	Walk-in clinics 2	Walk-in clinics 3	Walk-in clinics 4	Walk-in clinics 5	Walk-in clinics 6	Walk-in clinics 7	Walk-in clinics 8	Walk-in clinics 9	Walk-in clinics 10	Walk-in clinics N/A
Dental Care	Dental Care #1 Most Valuable	Dental Care 2	Dental Care 3	Dental Care 4	Dental Care 5	Dental Care 6	Dental Care 7	Dental Care 8	Dental Care 9	Dental Care 10	Dental Care N/A
Resources for Adults	Resources for Adults #1 Most Valuable	Resources for Adults 2	Resources for Adults 3	Resources for Adults 4	Resources for Adults 5	Resources for Adults 6	Resources for Adults 7	Resources for Adults 8	Resources for Adults 9	Resources for Adults 10	Resources for Adults N/A
Resources for Children	Resources for Children #1 Most Valuable	Resources for Children 2	Resources for Children 3	Resources for Children 4	Resources for Children 5	Resources for Children 6	Resources for Children 7	Resources for Children 8	Resources for Children 9	Resources for Children 10	Resources for Children N/A
Resources for Women	Resources for Women #1 Most Valuable	Resources for Women 2	Resources for Women 3	Resources for Women 4	Resources for Women 5	Resources for Women 6	Resources for Women 7	Resources for Women 8	Resources for Women 9	Resources for Women 10	Resources for Women N/A
Resources for Seniors	Resources for Seniors #1 Most Valuable	Resources for Seniors 2	Resources for Seniors 3	Resources for Seniors 4	Resources for Seniors 5	Resources for Seniors 6	Resources for Seniors 7	Resources for Seniors 8	Resources for Seniors 9	Resources for Seniors 10	Resources for Seniors N/A
Reproductive Health	Reproductive Health #1 Most Valuable	Reproductive Health 2	Reproductive Health 3	Reproductive Health 4	Reproductive Health 5	Reproductive Health 6	Reproductive Health 7	Reproductive Health 8	Reproductive Health 9	Reproductive Health 10	Reproductive Health N/A
LGBTQ	LGBTQ #1 Most Valuable	LGBTQ 2	LGBTQ 3	LGBTQ 4	LGBTQ 5	LGBTQ 6	LGBTQ 7	LGBTQ 8	LGBTQ 9	LGBTQ 10	LGBTQ N/A
Nutrition and Food	Nutrition and Food #1 Most Valuable	Nutrition and Food 2	Nutrition and Food 3	Nutrition and Food 4	Nutrition and Food 5	Nutrition and Food 6	Nutrition and Food 7	Nutrition and Food 8	Nutrition and Food 9	Nutrition and Food 10	Nutrition and Food N/A
Exercise	Exercise #1 Most Valuable	Exercise 2	Exercise 3	Exercise 4	Exercise 5	Exercise 6	Exercise 7	Exercise 8	Exercise 9	Exercise 10	Exercise N/A
Physical therapy	Physical therapy #1 Most Valuable	Physical therapy 2	Physical therapy 3	Physical therapy 4	Physical therapy 5	Physical therapy 6	Physical therapy 7	Physical therapy 8	Physical therapy 9	Physical therapy 10	Physical therapy N/A
Mental health	Mental health #1 Most Valuable	Mental health 2	Mental health 3	Mental health 4	Mental health 5	Mental health 6	Mental health 7	Mental health 8	Mental health 9	Mental health 10	Mental health N/A
Vision	Vision #1 Most Valuable	Vision 2	Vision 3	Vision 4	Vision 5	Vision 6	Vision 7	Vision 8	Vision 9	Vision 10	Vision N/A
Complementary/alternative services (acupuncture, chiropractic, massage, etc.)	Complementary/alternative services (acupuncture, chiropractic, massage, etc.) #1 Most Valuable	Complementary/alternative services (acupuncture, chiropractic, massage, etc.) 2	Complementary/alternative services (acupuncture, chiropractic, massage, etc.) 3	Complementary/alternative services (acupuncture, chiropractic, massage, etc.) 4	Complementary/alternative services (acupuncture, chiropractic, massage, etc.) 5	Complementary/alternative services (acupuncture, chiropractic, massage, etc.) 6	Complementary/alternative services (acupuncture, chiropractic, massage, etc.) 7	Complementary/alternative services (acupuncture, chiropractic, massage, etc.) 8	Complementary/alternative services (acupuncture, chiropractic, massage, etc.) 9	Complementary/alternative services (acupuncture, chiropractic, massage, etc.) 10	Complementary/alternative services (acupuncture, chiropractic, massage, etc.) N/A
Insurance options (e.g. eligibility criteria for Medicaid, costs of services)	Insurance options (e.g. eligibility criteria for Medicaid, costs of services) #1 Most Valuable	Insurance options (e.g. eligibility criteria for Medicaid, costs of services) 2	Insurance options (e.g. eligibility criteria for Medicaid, costs of services) 3	Insurance options (e.g. eligibility criteria for Medicaid, costs of services) 4	Insurance options (e.g. eligibility criteria for Medicaid, costs of services) 5	Insurance options (e.g. eligibility criteria for Medicaid, costs of services) 6	Insurance options (e.g. eligibility criteria for Medicaid, costs of services) 7	Insurance options (e.g. eligibility criteria for Medicaid, costs of services) 8	Insurance options (e.g. eligibility criteria for Medicaid, costs of services) 9	Insurance options (e.g. eligibility criteria for Medicaid, costs of services) 10	Insurance options (e.g. eligibility criteria for Medicaid, costs of services) N/A
Medicine/pharmacies	Medicine/pharmacies #1 Most Valuable	Medicine/pharmacies 2	Medicine/pharmacies 3	Medicine/pharmacies 4	Medicine/pharmacies 5	Medicine/pharmacies 6	Medicine/pharmacies 7	Medicine/pharmacies 8	Medicine/pharmacies 9	Medicine/pharmacies 10	Medicine/pharmacies N/A
Specialists	Specialists #1 Most Valuable	Specialists 2	Specialists 3	Specialists 4	Specialists 5	Specialists 6	Specialists 7	Specialists 8	Specialists 9	Specialists 10	Specialists N/A
HIV care	HIV care #1 Most Valuable	HIV care 2	HIV care 3	HIV care 4	HIV care 5	HIV care 6	HIV care 7	HIV care 8	HIV care 9	HIV care 10	HIV care N/A
Free screenings	Free screenings #1 Most Valuable	Free screenings 2	Free screenings 3	Free screenings 4	Free screenings 5	Free screenings 6	Free screenings 7	Free screenings 8	Free screenings 9	Free screenings 10	Free screenings N/A
Research study opportunities	Research study opportunities #1 Most Valuable	Research study opportunities 2	Research study opportunities 3	Research study opportunities 4	Research study opportunities 5	Research study opportunities 6	Research study opportunities 7	Research study opportunities 8	Research study opportunities 9	Research study opportunities 10	Research study opportunities N/A
Activism	Activism #1 Most Valuable	Activism 2	Activism 3	Activism 4	Activism 5	Activism 6	Activism 7	Activism 8	Activism 9	Activism 10	Activism N/A

Other (please specify)

5. What wellness resources (online or otherwise) have you found useful?

What wellness resources (online or otherwise) have you found useful?

6. What kind of information about local health resources is currently difficult to find?

What kind of information about local health resources is currently difficult to find?

7. Where do you live/work? For which locations would information be most relevant to you?

Where do you live/work? For which locations would information be most relevant to you? Center City/Old City

West Philly

South Philly

Kensington/Fishtown/Northern Liberties

North Philly

Olney/Oak Lane

Germantown/Chestnut Hill

Roxborough/Manayunk

"The Northeast"

Southwest Philly

Delaware County

Montgomery County

Bucks County

Chester County

South Jersey

Delaware

Other (please specify)

8. Do you know of any groups, organizations, or people who would find this information useful? If so, where can we find them?

Do you know of any groups, organizations, or people who would find this information useful? If so, where can we find them?

9. Do you know of any groups, organizations, or people who might make good partners in this effort? (If you are interested as an individual in helping with this effort, please include your email address.)

Do you know of any groups, organizations, or people who might make good partners in this effort? (If you are interested as an individual in helping with this effort, please include your email address.)

10. Do you have any other ideas/suggestions/advice/insight?

Do you have any other ideas/suggestions/advice/insight?

Under-/Uninsured Health Resources SurveyExit this survey