Access to Healthcare-Determinants of Access (exam 2)

Question 1

access to health services (definition)

Answer 1

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

Question 2

access to health care (definition)

Answer 2

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

Question 3

criteria/determinants for/of access (6)

Answer 3

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

Question 4

access importance

Answer 4

-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

Question 5

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

Answer 5

10%

Question 6

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

Answer 6

yes

Question 7

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

Answer 7

yes

Question 8

factors for determining access to healthcare (4)

Answer 8

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

Question 9

actual utilization of health services

Answer 9

objective measures of use

Question 10

outcomes of health services utilization

Answer 10

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

Question 11

determinants of access: health system characteristics (3)

Answer 11

determined by Health Policies

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

Question 12

organization of health care delivery includes

Answer 12

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

Question 13

Determinants of Access: Individual Characteristics (3)

Answer 13

predisposing factors
enabling factors
perceived need

*according to the Andersen Behavioral Model of Healthcare Use

Question 14

predisposing factors (definition)

Answer 14

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

Question 15

predisposing factors include (5)

Answer 15

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

Question 16

enabling factors (definiton)

Answer 16

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

Question 17

enabling factors include (4)

Answer 17

health insurance coverage
employment status
income
family & other support systems

Question 18

perceived need (definition)

Answer 18

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

Question 19

Determinants of Access: Actual Utilization Measures (3)

Answer 19

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

Question 20

volume of services used by type analyzed by (4)

Answer 20

population sub-groups

age group,
gender,
race/ethnicity,
insurance status

Question 21

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

Answer 21

population sub-groups

age group,
gender,
race/ethnicity,
insurance status

Question 22

Determinants of Access: Outcomes of Access Measured by Patient Satisfaction

Answer 22

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

Question 23

patient satisfaction surveys

Answer 23

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

Question 24

Patient-provider relationships (3)

Answer 24

cordial
respectful
inclusive in decision making

Question 25

barriers to access to health services (6)

Answer 25

- 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

Question 26

difficulty in navigating the system due to

Answer 26

low health literacy and/or language barriers

Question 27

patient's perceived poor quality of care arising from

Answer 27

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

Question 28

Access Disparities/Inequalities arise when

Answer 28

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

Question 29

Access Disparities/Inequalities (8)

Answer 29

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

Question 30

Implications of Access Disparities

Answer 30

- 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

Question 31

strategies for promoting access to healthcare: cost of care

Answer 31

Discounts enjoyed by using in-network providers & facilities

Question 32

strategies for promoting access to healthcare: lack of insurance

Answer 32

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

Question 33

strategies for promoting access to healthcare: access navigation difficulties

Answer 33

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

Question 34

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

Answer 34

Use of case managers, patient navigators and coaches

Question 35

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

Answer 35

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