Task force 6: Proposed access to care programs in the united states

Payer Status and the Utilization of Hospital Resources in Acute Myocardial Infarction

“…1 Payer status may be an important determinant in the utilization of such resources. [2][3][4][5][6][7][8][9][10][11][12][13][14] However, many of these reports were performed using administrative data that often lacked sufficient characterization of patient clinical characteristics, procedures, and outcomes.…”

Queuing for Coronary Angiography During Severe Supply-Demand Mismatch in a US Public Hospital

“…waged over the problems of escalating costs and increasingly limited access to medical care in the United States. [1][2][3] As Americans consider health care system reform and restricting access to health care, experiences from countries with universal access policies and national health care systems have come under scrutiny. An integral component of most national health care systems is the use of waiting lists for nonurgent medical care and procedures.…”

“…An integral component of most national health care systems is the use of waiting lists for nonurgent medical care and procedures. [1][2][3] In this setting, the care of patients with cardiovascular diseases is of particular concern because adverse cardiac events and excess deaths have been increasingly reported during waits for either percutaneous transluminal coronary angioplasty (PTCA) or coronary artery bypass grafting. [4][5][6][7][8][9][10] Diagnostic procedures are equally as important as therapeutic interventions, raising the question of whether access to coronary angiography (CA) can be safely limited.…”

“…[17][18][19][20][21][22][23][24] This problem has been exacerbated as declining reimbursement rates and market forces have led to an increasing inability of private hospitals to crosssubsidize charity care for the underinsured and uninsured. [1][2][3] More so than ever before in the United States, large numbers of patients who were previously cared for in private hospitals are being diverted to public hospitals. These have become increasingly crowded, [21][22][23][24][25] leading to a de facto need to ration care.…”