Access to Health Care in America (1993) / Chapter Skim
Currently Skimming:
1. Introduction
1. Introduction
Pages 19-30
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 19... ...
Many besides the poor may have difficulty getting access to health care. Those with preexisting disease conditions fear that they will lose insurance coverage if they change jobs.
|
From page 20... ...
For these and other reasons, the desirable objective of improving access to health care remains elusive. The IOM Access Monitoring Project was designed to develop a way to monitor access to health care that will be useful to health care policymakers.
|
From page 21... ...
The nation needs, but currently lacks, an entity to continuously monitor the numerous types of utilization and health status problems arising from insurance inadequacies, cultural impediments, geographic barriers, or other factors and place these problems in the broader context of national health policies. The 14-member IOM access monitoring committee was constituted in February 1990 as a first step toward this goal.
|
From page 22... ...
Many of the recommendations were directed at public and private organizations that collect information intended to enhance the nation's ability to monitor access to personal health care services. Taken together, the recommendations constitute a research agenda.
|
From page 23... ...
Other factors that can affect health and that are addressed in Healthy People, such as traffic accidents, misuse of firearms, environmental controls, and safe work environments, are not dealt with by the IOM project. In contrast to the great breadth of Healthy People, other monitoring projects have focused on particular subpopulations, particularly children and pregnant women.
|
From page 24... ...
: ~ ~ ~~ :: ~ ~:~ :, i; :~:~:~ ::: ~~ :~ ~ i::: i:: ::: :~::: ::::: : i::: ::: i::: : ::: ~ :: : : ::: ~ :::::::: ::~: i: i: :;.: ~~:~ :: ~:::~ :~ :::::: i:: . a: ,: a: ;: :::; ~ ::::::: Hi::: :: of.:: : Hospital: discharge State hospital'' :~ : :: : :data ~~ ~ ~ ~ discharge data ~bases:: : : Nr)
|
From page 25... ...
Death records provide mortality statistics and when linked to the birth record offer insight into the important correlates of infant mortality related to prenatal care. The cause-of-death information recorded on a death certificate can be used to compare the mortality experience of different subpopulations and to assess its relationship to access barriers.
|
From page 26... ...
The report also notes findings from other national surveys specifically, the National Medical Care Expenditure Survey, the Medicare Beneficiary Survey, the National Maternal and Infant Health Survey, the Robert Wood Johnson Foundation access surveys, and the behavioral risk factor surveys of the Centers for Disease Control. These and other instruments are extremely helpful in delineating the underlying relationships that are the root causes of access barriers.
|
From page 27... ...
The lack of income data on a discharge abstract poses a methodological obstacle that is addressed by using patient zip code information. To avoid what methodologists call the "ecological fallacy," it is necessary to limit the unit of analysis to neighborhoods (characterized according to income levels)
|
From page 28... ...
There are numerous ongoing efforts to make claims data more usable, efforts that will be considerably furthered by the movement toward widespread use of computerized medical records. In the meantime, the Health Care Financing Administration could investigate the potential contribution of the Medicaid and Medicare data bases to access monitoring.
|
From page 29... ...
Some examples of the need for more research and analysis to further the evolution of measuring access can be cited from the committee's work. Future capacity to monitor access would be improved by creating better surrogate measures of such concepts as socioeconomic and insurance status.
|
From page 30... ...
1991. Healthy People 2000: National Health Promotion and Disease Prevention Objectives.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.