Primary care access survey in Smith County

Katherine Calaway, The University of Texas School of Public Health


Objectives: The primary purpose of this study was to obtain information about healthcare utilization, perceived barriers to care, and recognition of local health providers among Tyler, Texas residents living at or below 200 percent of the federal poverty line (FPL). Methods: This study used data previously collected by Episcopal Health Foundation between November and December 2016. Demographic variables, including age, gender, race, zip code of residence (recoded as region number), self-identified health rating, and survey language were tabulated. Healthcare utilization variables including the rate of respondents with a primary medical doctor and median number of PCP and general medical visits in the last twelve months were calculated. Among respondents lacking a personal doctor, the reasons for not having a personal doctor were tabulated. Chi Square tests of association were employed to assess for relationships between location of residence and having a PCP, recognition of the local federally qualified health center, and access issues in the last twelve months. Univar ate logistic regression was performed to compute odds ratios, 95% confidence intervals and p values with access issues in the last twelve months and recognition of the local Federally Qualified Health Center (FQHC) as dependent variables. Variables with a p value of less than 0.20 were incorporated into multivariate analysis. Results: Respondents were racially and ethnically diverse. Two thirds of respondents had a personal doctor, and not having a personal doctor was associated with having access issues in the last year. Slightly more than 10 percent identify the emergency room as their usual source of care. When asked about reasons for not having a personal doctor and going to the ER for care, respondents were more concerned with insurance coverage, cost, and accessibility rather than provider-related factors. In addition, those without a personal doctor were less likely to recognize the local FQHC. Conclusions: The data suggest that there are significant gaps in healthcare utilization, identifiable barriers to care, and inadequate recognition of local providers among Tyler residents living at or below 200 percent of the FPL. There is a significant opportunity for targeted interventions to link resource-poor individuals to appropriate care sources, including but not limited to the local FQHC.

Subject Area

Public health|Public policy|Health care management

Recommended Citation

Calaway, Katherine, "Primary care access survey in Smith County" (2016). Texas Medical Center Dissertations (via ProQuest). AAI10131706.