Western New York Care Coordination Project
Physical Health Services Survey 2008 – Initial Report
Survey Response Rate
Overall there was a 5% increase to 45% in the overall (across counties) survey response rate in
comparison to the 2004 survey results. Chautauqua County substantially increased its response
rate whereas Wyoming County members were less responsive. Genesee County’s surveys were
received later than others, and will be included in a second report. In addition, there was a
substantial increase in the average number of those enrolled.
2008
County
Chautauqua
Erie
Genesee
Monroe
Onondaga
Wyoming
Total:
%
Surveys
Returned
82%
45%
0%
30%
66%
40%
45%
2004
#
Surveys
Returned
94
367
0
271
367
16
1115
Average
Enrolled
115
810
44
889
558
40.5
2456.5
%
Surveys
Returned
50%
43%
0%
27%
57%
75%
40%
#
Surveys
Returned
47
321
0
183
195
33
779
Average
Enrolled
94
744
40
690
340
44
1952
%
Change
32%
2%
0%
4%
8%
-35%
5%
Respondent Characteristics
Respondent characteristics in 2008 were very similar to those in 2004. The average age across
counties was 43 years in comparison to 46 years in 2004. In general, there was an even split
between males and females (Wyoming County continues to be predominantly female). Racial
categories essentially mirrored those in 2004.
2008 - Ge nde r by County
100%
80%
4%
43%
3%
3%
3%
52%
47%
41%
3%
6%
46%
60%
94%
40%
20%
53%
44%
49%
56%
Erie
Monroe
Onondaga
51%
0%
Chautauqua
Female
Male
Wyoming
Total
Missing
2008 - Race by County
100%
90%
2%
3%
4%
3%
3%
1%
5%
3%
3%
3%
7%
2%
6%
2%
2%
2%
4%
1%
5%
6%
80%
70%
48%
60%
50%
46%
57%
64%
85%
40%
94%
2%
1%
1%
30%
20%
39%
1%
37%
0%
30%
23%
10%
5%
Chautauqua
African American
Erie
Asian
Monroe
Caucasian
Onondaga
Hispanic/Latino
Wyoming
Multi-Racial
Total
Other
Missing
1
Medical Care Provider
 83% (in comparison to 86% in 2004) indicated that they “have a medical practitioner that
you can go to for all their non-mental health needs.”
 84% (in comparison to 85% in 2004) have been seen by “a medical practitioner in an
office or clinic setting” during the past year. County-specific responses are as follows:
2008 - % Respondents Seen by Practitioner in Office/Clinic in
Past Year
2008 - % Respondents with Medical Practitioner
100%
90%
85%
83%
81%
83%
100%
83%
81%
87%
90%
80%
78%
80%
70%
87%
81%
81%
84%
70%
60%
60%
50%
50%
40%
40%
30%
30%
20%
20%
10%
10%
0%
0%
Chautauqua
Erie
Monroe
Onondaga
Wyoming
Total
Chautauqua
Erie
Monroe
Onondaga
Wyoming
Total
Health Status
 Overall, there has been little change in respondents’ BMI across counties. 26% report a
BMI between 25 and 29.9 (overweight) as compared to 25% in 2004. 38% have a BMI
greater than 30 (obese) in comparison to 40% in 2004. County specific responses are as
follows:
2008 - BMI by County
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
5%
37%
10%
35%
10%
41%
40%
10%
25%
38%
38%
% Overweight
% Obese
W
yo
m
ga
nd
a
O
no
M
% < 25
25%
26%
l
24%
To
ta
25%
26%
13%
in
g
26%
e
28%
21%
on
ro
qu
a
28%
28%
Er
ie
30%
ut
au
C
ha
12%
% Missing
2

As in 2004, 41% of all respondents describe their current health as fair to poor.
2008 - Rating of Physical Health
100%
90%
1%
15%
2%
7%
2%
11%
31%
80%
70%
25%
25%
40%
44%
37%
36%
32%
33%
30%
20%
30%
36%
34%
60%
50%
40%
17%
13%
13%
4%
9%
11%
12%
5%
Chautauqua
Erie
Monroe
Onondaga
10%
0%
Excellent

0%
2%
13%
2%
12%
Very Good
Good
Fair
19%
14%
0%
6%
8%
Wyoming
Total
Poor
No Answer
As in 2004, high blood pressure was the most frequently reported health problem with
33% of all 2008 respondents identifying it as such (as compared to 31% in 2004). Also
as in 2004, diabetes remained in second place with 19% of 2008 respondents reporting it
as a health problem (in comparison to 20% in 2004). Heart problems ranked 3rd (13% vs.
10% in 2004, a statistically significant increase, p = .047) and emphysema 4th (12% vs.
13% in 2004).
2008 - Self-Reported Health Conditions - % Yes
50%
44%44%
45%
40%
37%
33%
35%
30%
33%
30%
29%
25%25%
25%
20%
15%
23%
18%
18%
16%
13%
11%
10%
19%
18%
14%
12%
12%13%
Monroe
Onondaga
13%
12%
7%
5%
0%
Chautauqua
Diabetes
Erie
Emphysema
Heart Problems
Wyoming
Total
High Blood Pressure
Smoking, Alcohol, and Recreational Drug Use
Although declining (62% in 2008 vs. 67% in 2004, statistically significant decrease, p = .025),
the majority of clients report smoking cigarettes. Use of alcohol and other legal drugs is less
frequently reported but has increased slightly from 2004 (18% for each in 2008 vs. 15% for each
in 2004).
3
2008 - % Respondents Who Smoke, Drink Alcohol, and/or Used Drugs in
Past Year
80%
70%
68%
67%
64%
63%
60%
62%
54%
50%
40%
30%
22%
19%
25%
19%
25%
15%14%
20%
18%18%
17%
14%
13%
10%
0%
Chautauqua
Erie
Smoke
Monroe
Drink Alcohol
Onondaga
Wyoming
Total
Used Recreational Drugs In Past Year
Use of Acute Services
 Total reported emergency department visits have increased from 44% in 2004 to 49% in
2008 (a statistically significant increase, p =.034).
 The total number of respondents who reported 1 or more hospital admissions in the past
year also increased from 25% in 2004 to 28% in 2008.
2008 - % Respondents with 1 or More Hospital Admissions in
Past Year
2008 - % Respondents with 1 or more ED Visits in Past Year
70%
63%
50%
49%
46%
51%
33%
35%
56%
60%
49%
30%
26%
28%
27%
26%
25%
40%
19%
20%
30%
15%
20%
10%
10%
5%
0%
0%
Chautauqua
Erie
Monroe
Onondaga
Wyoming
Total
Chautauqua
Erie
Monroe
Onondaga
Wyoming
Total
Use of Prescription Medication
Frequency of prescription medication use remains high with 14% of all surveyed reporting
taking 7-9 prescribed medications (in comparison to 17% in 2004) and 11% taking 10 or more
prescribed medications (as compared to 9% in 2004).
2008 - % Respondents Taking More Than 6
Prescriptions
50%
40%
30%
25%
10%
9%
16%
23%
7%
9%
17%
14%
19%
14%
Chautauqua
Erie
Monroe
Onondaga
Wyoming
Total
20%
10%
0%
7-9
11%
10 or more
4
Health Issues Interested in Addressing
 As in 2004, respondents were interested in addressing a number of health issues with weight
(52%) and exercise (46%) getting the most responses with smoking and nutrition 3rd and 4th.
The reduction in the percent of respondents concerned about weight, exercise, smoking and
sugar management are all statistically significant.
Chaut
Erie
Monroe
Onondaga
Wyoming
Total
Weight
46%
46%
50%
60%
63%
52%
2004
57%

Exercise
52%
43%
43%
50%
44%
46%
Smoking
40%
39%
44%
35%
38%
39%
Nutrition
37%
41%
43%
49%
25%
43%
Cholesterol
21%
17%
22%
25%
25%
22%
Blood
Pressure
15%
20%
23%
18%
19%
19%
Sugar
Mgt
14%
14%
15%
15%
19%
14%
Alcohol
Use
12%
13%
6%
5%
0%
8%
Drug
Use
0%
0%
0%
0%
0%
0%
54%
47%
47%
24%
22%
19%
9%
0%
When asked “how much their physical problems interfered with their normal social activities
with family, friends, neighbors or groups, 41% responded at least some of the time during
the past 4 weeks. This total percentage is unchanged from 2004.
2008 - % Respondents With Physical Health Problems Inteferring
with Activities - at least "Some of the Time" (during past 4 weeks)
80%
70%
60%
50%
40%
30%
20%
10%
0%
75%
56%
47%
41%
37%
31%
Chautauqua
Erie
Monroe
Onondaga
Wyoming
Total
Feelings about Medical Care Providers
 Although on the decline, failure to coordinate care between physical health and mental health
providers remains a substantive challenge with 36% of total respondents (as compared to
43% in 2004, a statistically significant decline, p = .002) reporting lack of communication
between their providers when a health concern is present.
2008 - % Respondents Who Answered "None of the Time" to
"My medical practitioner talks with my mental health provider
when there is a concern about my health"
50%
41%
40%
45%
39%
30%
36%
21%
20%
6%
10%
0%
Chautauqua
Erie
Monroe
Onondaga
Wyoming
Total
5

As in the last survey, many respondents (27% vs. 30% in 2004) report they would not go
to their medical doctor with a personal or emotional problem.
35%
30%
2008 - % Respondents Who Answered "Strongly Disagee" to "I
would go to my medical doctor with a personal or emotional
problem"
31%
29%
26%
25%
25%
27%
20%
20%
15%
10%
5%
0%
Chautauqua

Erie
Monroe
Onondaga
Wyoming
Total
Fewer respondents (36% vs. 41% in 2004, a statistically significant decline, p = .028)
reported preferring to receive their medical care in the place they receive their mental
health care.
2008 - % Respondents Who Answered "Strongly Agree" or
"Somewhat Agree" to "I would like to receive my medical care
at the same clinic I receive my MH services"
50%
40%
43%
35%
35%
Chautauqua
Erie
32%
31%
Onondaga
Wyoming
36%
30%
20%
10%
0%
Monroe
Total
6
Barriers to Obtaining Health Care

23% of respondents reported transportation as a barrier to obtaining health care; this was
an increase from 17% in 2004. Weather and remembering appointments times remained
the other most frequently reported barriers, which was consistent with the 2004 data.
2008 - "Big Barriers" to Obtaining Medical Care
Chautauq
ua
31e - Transportation to appointments
31b - Remembering appointment times
31f – Weather
31h - Amount of time you have to spend in the waiting room before
seeing the medical practitioner
31a - Amount of time you have to wait to get an appointment
31c - You don't want to go
31g - Location where you see a medical practitioner
31o - Need to go out of county for specialist care
31n - Cost of medications
31k - Issues around trauma, survivor concerns
31m - Cost of appointments
31j - Unable to understand what the practitioner is saying because he/she
does not speak my language or the jargon is too technical to understand
31l - The medical practitioner tells you your physical problem is in your
head
31i - The way you are treated by people at the practitioner's office
31d - Child Care
Monroe
Onondaga
Wyoming
Total
32%
27%
29%
23%
18%
17%
Erie
18%
23%
20%
23%
24%
20%
44%
25%
19%
23%
22%
20%
16%
10%
15%
16%
22%
12%
10%
2%
16%
14%
15%
12%
10%
5%
6%
7%
13%
12%
12%
8%
7%
7%
8%
6%
20%
21%
18%
12%
7%
14%
11%
11%
6%
13%
25%
13%
44%
31%
13%
13%
17%
16%
15%
11%
10%
10%
8%
7%
0%
6%
4%
11%
0%
7%
4%
5%
4%
5%
6%
3%
7%
6%
3%
8%
7%
3%
6%
6%
0%
6%
6%
3%
Summary
 In summary, the survey response rate improved in 2008 but the results are largely similar to
those obtained in 2004. All statistically significant differences are noted in the text. Given
the number of comparisons made, the substantial increase in the number of enrolled clients
(and therefore respondents) as well as the relatively small real changes reported, most
differences are likely explained by natural sampling variation as opposed to meaningful
changes in the respondent population.
7