Access to health care in America

Access to health care in America

Bibliographic Details
Main Author: Institute of Medicine (U.S.).
Corporate Author: Institute of Medicine (U.S.). Committee on Monitoring Access to Personal Health Care Services (-)
Other Authors: Millman, Michael L. (-)
Format: eBook
Language:Inglés
Published: Washington, D.C. : National Academy Press 1993.
Edition:1st ed
Subjects:
Health services accessibility > United States > Evaluation.
Medical care > United States.
See on Biblioteca Universitat Ramon Llull:https://discovery.url.edu/permalink/34CSUC_URL/1im36ta/alma991009820339406719
Table of Contents:
  • Access to Health Care in America
  • Copyright
  • Contents
  • Summary
  • GENERAL CONCLUSIONS ON THE STATE OF ACCESS
  • DEFINING ACCESS
  • THE COMMITTEE'S INDICATORS AND PROGRESS TOWARD ACCESS OBJECTIVES
  • Objective 1: Promoting Successful Birth Outcomes
  • Objective 2: Reducing the Incidence of Vaccine-Preventable Childhood Diseases
  • Objective 3: Early Detection and Diagnosis of Treatable Diseases
  • Objective 4: Reducing the Effects of Chronic Disease and Prolonging Life
  • Objective 5: Reducing Morbidity and Pain through Timely and Appropriate Treatment
  • RECOMMENDATIONS
  • 1 Introduction
  • BACKGROUND
  • DEVELOPING A SET OF INDICATORS
  • RELATIONSHIP OF ACCESS MONITORING TO OTHER RELEVANT ACTIVITIES
  • MAJOR DATA SOURCES: THEIR USES AND LIMITATIONS
  • Strengths and Weaknesses
  • Vital Statistics
  • Surveys
  • Hospital Discharge Data
  • Tumor Registries
  • Reportable Diseases
  • Claims Data
  • CROSSCUTTING ISSUES
  • Race/Ethnicity
  • Timeliness
  • REFERENCES
  • 2 A Model for Monitoring Access
  • DEFINING ACCESS
  • MEASURING ACCESS
  • Indicators
  • Utilization Indicators
  • Outcome Indicators
  • Utilization and Its Relationship to Health Care
  • Mediating Factors
  • Barriers to Access
  • Structural Barriers
  • Financial Barriers
  • Personal and Cultural Barriers
  • The Relationship of Access Barriers to Indicators
  • REFERENCES
  • 3 Using Indicators to Monitor National Objectives for Health Care
  • OBJECTIVE 1: PROMOTING SUCCESSFUL BIRTH OUTCOMES
  • Utilization Indicator: Adequacy of Prenatal Care
  • Measuring the Indicator
  • Trends in the Data
  • Recommendations
  • Outcome Indicator: Infant Mortality
  • Measuring the Indicator
  • Trends in the Data
  • Recommendations
  • Outcome Indicator: Low Birthweight
  • Measuring the Indicator
  • Trends in the Data
  • Recommendations
  • Outcome Indicator: Congenital Syphilis
  • Measuring the Indicator.
  • Trends in the Data
  • Recommendations
  • OBJECTIVE 2: REDUCING THE INCIDENCE OF VACCINE-PREVENTABLE CHILDHOOD DISEASES
  • Utilization Indicator: Preschool Immunization
  • Measuring the Indicator
  • Trends in the Data
  • Recommendations
  • Outcome Indicator: Incidence of Vaccine-Preventable Childhood Diseases
  • Measuring the Indicator
  • Trends in the Data
  • Recommendations
  • OBJECTIVE 3: EARLY DETECTION AND DIAGNOSIS OF TREATABLE DISEASES
  • Utilization Indicators: Breast and Cervical Cancer Screening Procedures
  • Measuring the Indicator
  • Trends in the Data
  • Recommendations
  • Outcome Indicator: Incidence of Late-Stage Breast and Cervical Cancers
  • Measuring the Indicator
  • Trends in the Data
  • Recommendations
  • OBJECTIVE 4: REDUCING THE EFFECTS OF CHRONIC DISEASES AND PROLONGING LIFE
  • Utilization Indicator: Continuing Care for Chronic Diseases
  • Measuring the Indicator
  • Trends in the Data
  • Recommendations
  • Utilization Indicator: Use of High-Cost Discretionary Care
  • Measuring the Indicator
  • Trends in the Data
  • Recommendations
  • Outcome Indicator: Avoidable Hospitalization for Chronic Diseases
  • Measuring the Indicator
  • Trends in the Data
  • Recommendations
  • Outcome Indicator: Access-Related Excess Mortality
  • Measuring the Indicator
  • Trends in the Data
  • Recommendations
  • OBJECTIVE 5: REDUCING MORBIDITY AND PAIN THROUGH TIMELY AND APPROPRIATE TREATMENT
  • Utilization Indicator: Percentage of Healthy Individuals Who Do Not Contact a Physician During an Acute Episode of Illness
  • Measuring the Indicator
  • Trends in the Data
  • Recommendation
  • Utilization Indicator: Dental Services
  • Measuring the Indicator
  • Trends in the Data
  • Recommendations
  • Outcome Indicator: Avoidable Hospitalization for Acute Conditions
  • Measuring the Indicator
  • Trends in the Data
  • Recommendation
  • REFERENCES.
  • 4 Future Indicators
  • ACCESS TO HEALTH CARE FOR PEOPLE WITH DISABILITIES
  • FAMILY VIOLENCE
  • EMERGENCY SERVICES
  • POST-ACUTE-CARE SERVICES FOR THE ELDERLY
  • PRESCRIPTION DRUGS
  • REFERENCES
  • 5 Recommendations
  • RECOMMENDATIONS
  • Crosscutting Recommendations
  • State and Local Monitoring
  • The Federal Role
  • Racial and Ethnic Differences
  • FUTURE STEPS
  • Objective 1: Promoting Successful Births
  • Indicator: Prenatal Care
  • Indicator: Infant Mortality
  • Indicator: Low Birthweight
  • Indicator: Congenital Syphilis
  • Objective 2: Reducing the Incidence of Vaccine-Preventable Childhood Diseases
  • Indicator: Preschool Immunization
  • Indicator: Incidence of Vaccine-Preventable Childhood Diseases
  • Objective 3: Early Detection and Diagnosis of Treatable Diseases
  • Indicator: Breast and Cervical Cancer Screening Procedures
  • Indicator: Incidence of Late-Stage Breast and Cervical Cancers
  • Objective 4: Reducing the Effects of Chronic Diseases and Prolonging Life
  • Indicator: Continuing Care for Chronic Diseases
  • Indicator: High-Cost Discretionary Care
  • Indicator: Avoidable Hospitalization for Chronic Diseases
  • Indicator: Access-Related Excess Mortality
  • Objective 5: Reducing Morbidity and Pain through Timely and Appropriate Treatment
  • Indicator: Acute Medical Care
  • Indicator: Dental Services
  • Indicator: Avoidable Hospitalization for Acute Conditions
  • REFERENCE
  • APPENDIXES
  • A Developing Indicators of Access to Care: The Case for HIV Disease
  • ROBERT WOOD JOHNSON FOUNDATION AIDS HEALTH SERVICES PROGRAM AND EVALUATION
  • ISSUES IN ASSESSING ACCESS TO PERSONAL HEALTH CARE
  • Financial Barriers
  • Insurance Coverage
  • Provider Reimbursement Rates
  • Investment in Resources for Treating HIV Disease
  • Structural Barriers
  • Lack of a Primary Source of Care
  • Lack of Appropriate Service Providers.
  • Distance from care Providers
  • Extended Waiting Times for Providers
  • Personal Barriers
  • Attitudinal Barriers
  • VIABILITY OF DEVELOPING ACCESS INDICATORS FROM EXISTING DATA SETS
  • Decreased Mortality Using Case-Finding
  • Reduced Mortality Using Medical Management
  • Reduced Morbidity and Improved Function
  • CONCLUSION
  • REFERENCES
  • B Developing Indicators of Access to Care: Waiting Lists for Drug Abuse Treatment
  • METHODS
  • THE NUMBER OF PERSONS ON WAITING LISTS
  • ''THERE ARE NO REAL WAITING LISTS FOR TREATMENT
  • WAITING LISTS UNDERESTIMATE UNMET DEMAND
  • SHOULD THERE BE WAITING LISTS?
  • EMPIRICAL STUDIES OF WAITING LIST BEHAVIOR
  • DISCUSSION
  • FINAL COMMENT
  • REFERENCES
  • C Developing Indicators of Access to Care: The Case for Migrants and the Homeless
  • MIGRANT HEALTH STATUS
  • HEALTH STATUS OF THE HOMELESS
  • RECOMMENDATIONS
  • REFERENCES
  • D "Ambulatory-Care-Sensitive" Conditions and "Referral-Sensitive" Surgeries
  • Index.

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