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Health Care systems And Policies > Access to Healthcare-Determinants of Access (exam 2) > Flashcards

Access to Healthcare-Determinants of Access (exam 2) Flashcards

1
Q

access to health services (definition)

A

timely use of personal health services to achieve the best health outcomes

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2
Q

access to health care (definition)

A

ability to obtain needed, affordable, convenient, acceptable, and effective personal health services in a timely fashion

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3
Q

criteria/determinants for/of access (6)

A

-availability
-affordability
-convenience
-acceptability
-effectiveness
-timeliness

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4
Q

access importance

A

-key determinant of health
-key measure of effectiveness of health care delivery
-access inequalities are important contributors to health disparities
-linked to quality of care
-access, navigation & effective utilization of health services have huge implication for population health and healthcare costs

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5
Q

how much do access to and use of health services contribute to health of individuals and society?

A

10%

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6
Q

comparing to 10 other industrialized countries does the US have a big problem with access to healthcare?

A

yes

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7
Q

Was the US found to be significantly different with respect to access, healthcare costs and affordability?

A

yes

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8
Q

factors for determining access to healthcare (4)

A

health system characteristics
individual characteristics
actual utilization of health services
outcomes of health services utilization

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9
Q

actual utilization of health services

A

objective measures of use

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10
Q

outcomes of health services utilization

A

measures patient satisfaction with the convenience, affordability, and acceptability of services

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11
Q

determinants of access: health system characteristics (3)

A

determined by Health Policies

-physical availability
-geographic distribution in relation to location of the individual
-organization of health care delivery

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12
Q

organization of health care delivery includes

A

how the patient enters the system,
navigates the system (eg referral system),
pays for the services provided

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13
Q

Determinants of Access: Individual Characteristics (3)

A

predisposing factors
enabling factors
perceived need

*according to the Andersen Behavioral Model of Healthcare Use

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14
Q

predisposing factors (definition)

A

demographic factors that may make the individual more or less likely to access or use available health services

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15
Q

predisposing factors include (5)

A

age
gender
marital status
educational level
health beliefs which may be culturally-related

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16
Q

enabling factors (definiton)

A

may facilitate the individuals’s access to and use of available health services

17
Q

enabling factors include (4)

A

health insurance coverage
employment status
income
family & other support systems

18
Q

perceived need (definition)

A

access and use of an individual depends on whether the individual believes that the services are actually needed and if they will be beneficial

19
Q

Determinants of Access: Actual Utilization Measures (3)

A
  • types of services used over a given period
  • volume of services used by type
  • frequency of services used by type, locality
20
Q

volume of services used by type analyzed by (4)

A

population sub-groups

age group,
gender,
race/ethnicity,
insurance status

21
Q

frequency of services used by type, locality analyzed by (4)

A

population sub-groups

age group,
gender,
race/ethnicity,
insurance status

22
Q

Determinants of Access: Outcomes of Access Measured by Patient Satisfaction

A

patient-provider relationships
information/education provided and received
privacy/confidentiality of the care environment
overall quality of care received

23
Q

patient satisfaction surveys

A

have become increasingly important
form an integral part of Patient-reported Health Outcomes (PRO)
required for health system and health plans accreditation
frequently used for marketing purposes

24
Q

Patient-provider relationships (3)

A

cordial
respectful
inclusive in decision making

25
Q

barriers to access to health services (6)

A
  • cost of care (deductibles, copay for those insured)
  • lack of coverage of selected services and/or providers by insures
  • lack of insurance & hence usual source of care
  • difficulty in navigating the system
  • lack of coordination between services and/or providers
  • patient’s perceived poor quality of care
26
Q

difficulty in navigating the system due to

A

low health literacy and/or language barriers

27
Q

patient’s perceived poor quality of care arising from

A

prejudice/stereotyping/discrimination on account of race/ethnicity, gender, sexual orientation

28
Q

Access Disparities/Inequalities arise when

A

different sections of the population have differences in a access to needed services

29
Q

Access Disparities/Inequalities (8)

A
  • race/ethnicity
  • socioeconomic status
  • health insurance coverage
  • gender
  • culture or religious affiliation
  • sexual orientation
  • nature of illness
  • geographic location
30
Q

Implications of Access Disparities

A
  • disparities in access are important since they contribute to health disparities
  • Minorities and several under-served populations in the U.S. have higher burden of disease but poorer access to healthcare which together fuel health disparities
31
Q

strategies for promoting access to healthcare: cost of care

A

Discounts enjoyed by using in-network providers & facilities

32
Q

strategies for promoting access to healthcare: lack of insurance

A

Health insurance marketplace; provisions of the Affordable Care Act (ACA) including subsidies, expansion of Medicaid & CHIP etc

33
Q

strategies for promoting access to healthcare: access navigation difficulties

A

Promoting health literacy & patient education; using interpreters to promote patient understanding and input into their own care

34
Q

Strategies for Promoting Access to Care: Lack of coordination between services and/or providers

A

Use of case managers, patient navigators and coaches

35
Q

Strategies for Promoting Access to Care: Perceived poor quality of care arising from prejudice/stereotyping/discrimination

A
  • Promoting diversity among health workers to reflect the increasing population diversity
  • Cultural competency training for healthcare providers

Health Care systems And Policies (8 decks)

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