Access to Care

This the third survey in this four part series. Each survey gathers information about a different topic related to health or access to healthcare. We encourage everyone to participate in each survey.

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* 1. Do you currently have any of the following types of healthcare coverage?

Medicaid

Private (employer-based, self-insured)c

Public (Healthy Indiana Plan, Marketplace, Obamacare)

Other (please specify)

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* 2. Do you have a person you consider your personal doctor or personal health care provider? (such as a nurse, doctor, physician’s assistant)

Yes

Do not know/Not sure

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* 3. How long has it been since you last visited a healthcare provider? (such as a nurse, doctor, physician’s assistant)

Within the past 6 months

Within the past year

Within the past 2 years

Within the past 5 years

Do not remember/Unsure

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* 4. Rate the following in terms of whether they have an influence on your ability to be healthy.

	Greatly Influence	Somewhat Influence	No Influence
Access to health insurance coverage	Access to health insurance coverage Greatly Influence	Access to health insurance coverage Somewhat Influence	Access to health insurance coverage No Influence
Availability of transportation	Availability of transportation Greatly Influence	Availability of transportation Somewhat Influence	Availability of transportation No Influence
Ease of scheduling a healthcare appointment	Ease of scheduling a healthcare appointment Greatly Influence	Ease of scheduling a healthcare appointment Somewhat Influence	Ease of scheduling a healthcare appointment No Influence
Access to trails, parks, or outdoor areas	Access to trails, parks, or outdoor areas Greatly Influence	Access to trails, parks, or outdoor areas Somewhat Influence	Access to trails, parks, or outdoor areas No Influence
Access to community recreation centers	Access to community recreation centers Greatly Influence	Access to community recreation centers Somewhat Influence	Access to community recreation centers No Influence
Access to public libraries	Access to public libraries Greatly Influence	Access to public libraries Somewhat Influence	Access to public libraries No Influence
Access to churches or faith-based organizations	Access to churches or faith-based organizations Greatly Influence	Access to churches or faith-based organizations Somewhat Influence	Access to churches or faith-based organizations No Influence
Access to doctors in my community	Access to doctors in my community Greatly Influence	Access to doctors in my community Somewhat Influence	Access to doctors in my community No Influence
Availability of fresh fruits and vegetables at stores, markets, or community gardens	Availability of fresh fruits and vegetables at stores, markets, or community gardens Greatly Influence	Availability of fresh fruits and vegetables at stores, markets, or community gardens Somewhat Influence	Availability of fresh fruits and vegetables at stores, markets, or community gardens No Influence
Access to workplace wellness or employee wellness	Access to workplace wellness or employee wellness Greatly Influence	Access to workplace wellness or employee wellness Somewhat Influence	Access to workplace wellness or employee wellness No Influence
Availability of family support services such as those related to domestic or relationship violence or family social services	Availability of family support services such as those related to domestic or relationship violence or family social services Greatly Influence	Availability of family support services such as those related to domestic or relationship violence or family social services Somewhat Influence	Availability of family support services such as those related to domestic or relationship violence or family social services No Influence

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* 5. During the past 12 months, to what extent have the following experiences applied to you personally?

	Never	Rarely	Sometimes	Often
I have been able to talk with my healthcare provider in the language with which I am most comfortable	I have been able to talk with my healthcare provider in the language with which I am most comfortable Never	I have been able to talk with my healthcare provider in the language with which I am most comfortable Rarely	I have been able to talk with my healthcare provider in the language with which I am most comfortable Sometimes	I have been able to talk with my healthcare provider in the language with which I am most comfortable Often
I have felt discriminated against by a healthcare provider because of my race ethnicity, or culture.	I have felt discriminated against by a healthcare provider because of my race ethnicity, or culture. Never	I have felt discriminated against by a healthcare provider because of my race ethnicity, or culture. Rarely	I have felt discriminated against by a healthcare provider because of my race ethnicity, or culture. Sometimes	I have felt discriminated against by a healthcare provider because of my race ethnicity, or culture. Often
I have had negative experiences in healthcare that caused me to lose trust in medical care providers.	I have had negative experiences in healthcare that caused me to lose trust in medical care providers. Never	I have had negative experiences in healthcare that caused me to lose trust in medical care providers. Rarely	I have had negative experiences in healthcare that caused me to lose trust in medical care providers. Sometimes	I have had negative experiences in healthcare that caused me to lose trust in medical care providers. Often
Health care providers have communicated with me in a respectful and clear manner.	Health care providers have communicated with me in a respectful and clear manner. Never	Health care providers have communicated with me in a respectful and clear manner. Rarely	Health care providers have communicated with me in a respectful and clear manner. Sometimes	Health care providers have communicated with me in a respectful and clear manner. Often
I have felt discriminated against by a healthcare provider because of my medical condition or lifestyle.	I have felt discriminated against by a healthcare provider because of my medical condition or lifestyle. Never	I have felt discriminated against by a healthcare provider because of my medical condition or lifestyle. Rarely	I have felt discriminated against by a healthcare provider because of my medical condition or lifestyle. Sometimes	I have felt discriminated against by a healthcare provider because of my medical condition or lifestyle. Often

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* 6. Within the past 12 months, have you been worried that your food would run out before you got money to buy more?

Yes

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* 7. Within the past 12 months, how often have the following things applied to you?

	Often	Sometimes	Never
You have been worried that your food would run out before you got money to buy more.	You have been worried that your food would run out before you got money to buy more. Often	You have been worried that your food would run out before you got money to buy more. Sometimes	You have been worried that your food would run out before you got money to buy more. Never
The food you bought didn’t last and you didn’t have money to get more.	The food you bought didn’t last and you didn’t have money to get more. Often	The food you bought didn’t last and you didn’t have money to get more. Sometimes	The food you bought didn’t last and you didn’t have money to get more. Never
It is hard for you to pay for the very basics like food, housing, medical care, and heating.	It is hard for you to pay for the very basics like food, housing, medical care, and heating. Often	It is hard for you to pay for the very basics like food, housing, medical care, and heating. Sometimes	It is hard for you to pay for the very basics like food, housing, medical care, and heating. Never

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* 8. In the past 12 months, has the electric, gas, oil, or water company threatened to shut off service in your home?

Yes

Already shut off

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* 9. During the last year have you had any medical bill problems or medical debt?

Yes

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* 10. How do you learn about the health services available in your community?

Yellow pages

Word of mouth

Presentations

Newspaper

Radio

Website/Internet

Social media

Television

Referral

Other (please specify)

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* 11. What words come to mind when you think of telemedicine?

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* 12. If offered in Martin County, how likely are you to meet a primary care provider by telephone for a medical appointment?

Very likely

Somewhat likely

Somewhat unlikely

Very unlikely

Access to Care

Question Title

* 1. Do you currently have any of the following types of healthcare coverage?

Question Title

* 2. Do you have a person you consider your personal doctor or personal health care provider? (such as a nurse, doctor, physician’s assistant)

Question Title

* 3. How long has it been since you last visited a healthcare provider? (such as a nurse, doctor, physician’s assistant)

Question Title

* 4. Rate the following in terms of whether they have an influence on your ability to be healthy.

Question Title

* 5. During the past 12 months, to what extent have the following experiences applied to you personally?

Question Title

* 6. Within the past 12 months, have you been worried that your food would run out before you got money to buy more?

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* 7. Within the past 12 months, how often have the following things applied to you?

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* 8. In the past 12 months, has the electric, gas, oil, or water company threatened to shut off service in your home?

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* 9. During the last year have you had any medical bill problems or medical debt?

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* 10. How do you learn about the health services available in your community?

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* 11. What words come to mind when you think of telemedicine?

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* 12. If offered in Martin County, how likely are you to meet a primary care provider by telephone for a medical appointment?

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* 13. What resources would you need to participate in telemedicine services?