Nov. 01--Nearly 1 million Ohioans say they don't have a family doctor or nurse practitioner who they can see about health problems.
Of those, 43 percent say they don't need one because they're healthy, not because they don't have insurance, according to a recently released Ohio Family Health Survey. Researchers said this finding suggests that a mandate under federal health reform that everyone have health insurance is not enough to ensure that people will get regular care.
"They don't have a need for it; they may feel invincible," said William Hayes, an author of the survey and a teacher of health policy at Ohio State University. "I think they're being risky ... but in a given year, people with insurance don't use it a lot."
In the second-highest response, 29 percent of those surveyed said the high cost of health care kept them from having a regular doctor or nurse practitioner.
The Ohio Family Health Survey is a regular assessment of health care by government, human-service-agency and university officials across the state. For the 2010 survey, 8,276 adults responded. There were 2,002 proxy responses for children.
Advocates say the answers suggest some big problems in the way society views health care.
"If we want to shift our health-care system from a sick-based system to a health system," then everyone needs to have a family doctor, said Jeff Biehl, executive director of Access HealthColumbus, a group that works to increase access to health care.
When these 1 million Ohioans get sick or injured, many often seek care at the most-expensive place --hospital emergency departments. Survey researchers said that about 634,000 Ohioans consider the emergency department their usual place for care, no matter their insurance status. Many say they consider it the most convenient and best place to get care.
"If you need a scan, they can get it right away and take your blood," Hayes said. "If you go to the doctor, they have to send you out for a scan. Hospitals have it all."
And hospital emergency departments are open around the clock.
"We have the ability to access all sorts of technology for patient care at all times of the day," said Dr. Frank Orth, an emergency physician at Mount Carmel St. Ann's hospital. "I think many patients are interested in that approach as opposed to what they'll get in the primary-care doctor's office."
He said patients without a family doctor are given the contact information of a primary-care physician to follow up with after leaving the emergency department. Still, many return with minor illnesses or injuries.
"I think every emergency department in this city has patients that they do see regularly for primary-care issues," Orth said.
shoholik@dispatch.com
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