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Access to Health Care


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The Healthy People 2020 Objective and how it affects access to health care.

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Access to Health Care

  1. 1. A Presentation by: Cynthia Brown, MBA, RHIT, CCS
  2. 2. Healthy People 2020 Objective:Emphasize the role of community partnerssuch as businesses, local governments, andcivic, professional, and religious organizationsas effective agents for improving health in theirlocal communities (Shi & Singh, 2010).
  3. 3. Healthy People 2020 “Health for All” Increase quality Promote healthy and years of behaviors healthy lifeEliminate health Promote healthy disparities communities Prevent/Reduce Diseases and Disorders
  4. 4. Access to Care DefinedThe ability to obtainneeded, affordable,convenient, acceptable ,and effective personalhealth services in a timelymanner (Shi & Singh,2008).
  5. 5. Key Implications of Access Key determinants of health, along with environment, lifestyle, and hereditary factors. Significant benchmark in assessing the effectiveness of the medical care delivery system (Healthy People 2020, performance/accountability of health care plans and providers. Determines whether or not delivery of health care is equitable. Linked to quality of care and efficient use of needed services (Shi & Singh, 2008).
  6. 6. Access to Health Services Topic Areas AHS-1 Increase the proportion of persons with health insurance (Medical, Dental, & Prescription Drug). Target: 100% Baseline: 83.2% AHS- 2 Increase the proportion of insured persons with coverage for clinical preventive services. AHS-3 Increase the proportion of persons with a usual primary care provider. Target: 83.9% Baseline: 76.3%
  7. 7. Access to Health Services Topic Areas AHS-4 Increase the number of practicing primary care providers (medical doctor, doctor of osteopathy, physician assistant, & nurse practitioner) AHS-5 Increase the proportion of persons who have a specific source of ongoing care. 5.1 All ages. Target: 95% Baseline: 86.4% 5.2 17 years and under Target: 100% Baseline: 94.3% 5.3 Adults 18 to 64 Target: 89.4% Baseline: 81.3% 5.4 Adults 65 and older Target: 100% Baseline: 96.3%
  8. 8. Access to Health Services Topic Areas AHS-6 Reduce the proportion of individuals who are unable to obtain or delay in obtaining necessary medical care, dental care, or prescription medicines. AHS-7 Increase the proportion of persons who receive appropriate evidence-based clinical preventive services. AHS-8 Increase the proportion of persons who have access to rapidly responding pre-hospital emergency medical services (basic life support, advanced life support).
  9. 9. Access to Health Services Topic Areas AHS-9 Reduce the proportion of hospital emergency department visits in which the wait time to see an emergency department clinician exceeds the recommended timeframe (all visits, immediate, emergent, urgent, & semi-urgent).
  10. 10. Dimensions of AccessAvailability-fit between service capacity and individual’srequirements (Shi & Singh, 2008).Examples:• Primary or preventive services available• Transportation, language, & social services available• Sufficient specialists• 24/7 availability of primary care servicesAccessibility-fit between locations and providersExamples:• Private/Public Transportation• Disabled/Elderly accessibility• Payment Options (Medicare, Medicaid, cash)
  11. 11. Dimensions of AccessAffordability-individual’s ability to pay.Examples:• High insurance premiums• Co-payments/deductibles reasonable• Prescription prices affordabilityAccommodation-the fit between how resources areorganized to provide services and the individual’s abilityto use the arrangement.Examples:• Appointment availability; Office hours compatibility• Routine appointments within 1 week; walk-ins services• Urgent cases seen within 1 hour; non-emergency within 1 day
  12. 12. Dimensions of AccessAcceptability-compatibility between patients’ attitudesabout providers’ personal and practice characteristics,and providers’ attitudes toward their clients’ personalcharacteristics and values.Examples:• Waiting time for scheduled appointments• Patients encouraged to ask questions and review records.• Acceptance of patients/providers regardless of race, religion, or ethnic origin.
  13. 13. Barriers to Access Geography Financing Culture Race Language (Shi & Singh, 2010)
  14. 14. Persons Likely to Face Access Problems People without health insurance Minorities Low-income individuals People with little formal education People with special needs/Disability People with chronic illnesses
  15. 15. Solution to Access DisparityPatient Protection and Affordable Care Act (Democrats, 2011):• Quality, affordable health care for all Americans• The role of public programs• Improving quality/efficiency of health care• Prevention of chronic disease and improving public health• Health care workforce• Transparency/program integrity• Improving access to innovative medical therapies• Community living assistance services and supports• Revenue provisions
  16. 16. (2011). Responsible reform for the middle class: The patient protection and affordable care act, detailed summary. Retrieved from, L. & Singh, D.A. (2010). Essentials of the U.S. health care system (2nd ed.). Sudbury, MA: Jones and Bartlett Publishers.Shi, L. & Singh, D.A. (2008). Delivering health care in America: A systems approach (4th ed.). Sudbury, MA: Jones and Bartlett Publishers.