Access to Health Care in America

Millman, Michael

doi:10.17226/2009

Cited by 112 publications

(8 citation statements)

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“… 10 The focus of this section is to review how these population‐level disparities (SDOH, referral patterns, and access to quality care and insurance) impact an individual with congenital HD throughout the lifespan. The National Academy of Medicine (formerly the Institute of Medicine) and the Healthy People 2030 initiative define access to care as “the timely use of personal health services to achieve the best possible health outcomes.” 11 Children and adults with chronic medical conditions represent a particularly at‐risk group with regard to accessing care because of challenges in obtaining adequate health insurance coverage. Uninsured and underinsured individuals are more likely to forgo necessary testing, doctor visits, and preventive care visits often citing cost barriers.…”

Section: Population‐level Approachmentioning

confidence: 99%

Addressing Social Determinants of Health and Mitigating Health Disparities Across the Lifespan in Congenital Heart Disease: A Scientific Statement From the American Heart Association

Lopez¹,

Baker‐Smith²,

Flores³

et al. 2022

JAHA

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Despite the overall improvement in life expectancy of patients living with congenital heart disease (congenital HD), disparities in morbidity and mortality remain throughout the lifespan. Longstanding systemic inequities, disparities in the social determinants of health, and the inability to obtain quality lifelong care contribute to poorer outcomes. To work toward health equity in populations with congenital HD, we must recognize the existence and strategize the elimination of inequities in overall congenital HD morbidity and mortality, disparate health care access, and overall quality of health services in the context of varying social determinants of health, systemic inequities, and structural racism. This requires critically examining multilevel contributions that continue to facilitate health inequities in the natural history and consequences of congenital HD. In this scientific statement, we focus on population, systemic, institutional, and individual‐level contributions to health inequities from prenatal to adult congenital HD care. We review opportunities and strategies for improvement in lifelong congenital HD care based on current public health and scientific evidence, surgical data, experiences from other patient populations, and recognition of implicit bias and microaggressions. Furthermore, we review directions and goals for both quantitative and qualitative research approaches to understanding and mitigating health inequities in congenital HD care. Finally, we assess ways to improve the diversity of the congenital HD workforce as well as ethical guidance on addressing social determinants of health in the context of clinical care and research.

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Section: Population‐level Approachmentioning

confidence: 99%

Addressing Social Determinants of Health and Mitigating Health Disparities Across the Lifespan in Congenital Heart Disease: A Scientific Statement From the American Heart Association

Lopez¹,

Baker‐Smith²,

Flores³

et al. 2022

JAHA

View full text Add to dashboard Cite

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“…The US Institute of Medicine defines access as the 'timely use of personal health services to achieve the best possible outcome'. 48 Barriers to access that result from the inefficient use of existing capacity and failure to design services around the needs of patients, particularly when these needs are medically advised, is a failure of the NSW public health system objectives to provide appropriate high quality hospital care. This study was unable to investigate the nature, level and cost of morbidity and mortality experienced by the over 27,480 NSW residents that could not be offered public hospital care within the medically recommended time frame, because this information is not currently collected.…”

Section: Resultsmentioning

confidence: 99%

Right care, right place, right time: improving the timeliness of health care in New South Wales through a public–private hospital partnership

Saunders

Carter

2017

Aust. Health Review

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Objective The overall aim of the study was to investigate and assess the feasibility of improving the timeliness of public hospital care through a New South Wales (NSW)-wide public-private hospital partnership. Methods The study reviewed the academic and professional grey literature, and undertook exploratory analyses of secondary data acquired from two national health data repositories informing in-patient access and utilisation across NSW public and private hospitals. Results In 2014-15, the NSW public hospital system was unable to deliver care within the medically recommended time frame for over 27400 people who were awaiting elective surgery. Available information indicates that the annual commissioning of 15% of public in-patient rehabilitation bed days to the private hospital system would potentially free up enough capacity in the NSW public hospital system to enable elective surgery for all public patients within recommended time frames. Conclusions The findings of the study justify a strategic whole-of-health system approach to reducing public patient wait times in NSW and highlight the need for research efforts aimed at securing a better understanding of available hospital capacity across the public and private hospital systems, and identifying and testing workable models that improve the timeliness of public hospital care. What is known about the topic? There are very few studies available to inform public-private hospital service partnerships and the opportunities available to improve timely health care access through such partnerships. What does this paper add? This paper has the potential to open and prompt timely discussion and debate, and generate further fundamental investigation, on public-private hospital service partnerships in Australia where opportunity is available to address elective surgery wait times in a reliable and effective manner. What are the implications for practitioners? The NSW Ministry of Health and its Local Health Districts have the potential to realise a key objective, namely to deliver the 'right care, in the right place, at the right time', through the core value of collaboration, using available infrastructure.

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“…On March 6, 2020, the Coronavirus Preparedness and Response Supplemental Appropriations Act was signed into law and waived Medicare telehealth payment requirements, permitting all Medicare patients to receive telehealth in their place of residence. 5 Though this act expanded telehealth on a temporary and emergent basis, telehealth should continue to be available for all patients in the post-COVID era without barriers. Telehealth can improve access to surgical care through minimizing patient travel, obviating the need for significant time off of work, and promoting flexibility in time of day that visits are scheduled.…”

Section: Strategies Telemedicinementioning

confidence: 99%