Monitoring the Health Care Safety Net Doing Your Own Survey

1. Monitoring the Health Care Safety NetDoing Your Own Survey Institute for Health, Health Care Policy and Aging Research Joel Cantor Professor and Director Rutgers Center for State Health Policy September 24, 2003 Institute for Health, Health Care Policy, and Aging Research

2. Should you conduct a local survey? • Existing sources do not meet local needs • Check federal, state, and local sources • Surveys can be extrapolated to local areas • Useful for engaging stakeholders • Locale-specific questions • Population can provide needed information • Sufficient resources (time & $) are available

3. Set Clear ObjectivesSome Examples • Measure access to primary care. • Assess satisfaction. • Assess cultural and linguistic competency. • Determine timeliness of referrals for specialty care. • Assess adequacy of the supply of basic health services for theuninsured.

4. The Questionnaire • Refer to your survey objectives early & often • Use previously tested questions • Writing good questions is hard • Can provide benchmarks • Some good sources… • Medical Expenditure Panel Survey (MEPS) • Behavioral Risk Factor Surveillance Survey • Coordinated State Coverage Survey (SHADAC)

5. Coverage Health status Access barriers Utilization Usual source of care Attitudes Jobs & employer characteristics Socio-economic status and education Demographics & language Safety Net Survey TopicsSome Examples

6. Other Important Considerations • Sampling strategy and size • Confidentiality • Follow-up strategies • Interview mode (phone, in-person, mail) • Interviewer selection and training • Data management, editing, analysis • Reporting findings

7. Potential Pitfalls • Not working closely with the community • Running out of money, time, or steam • Not enough development time • Data quality & sampling problems • Lack of focus on how the data will be used • Not enough emphasis on analysis and reporting