Health-Care Utilization as a Proxy in Disability Determination (2018) / Chapter Skim
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2 Factors That Affect Health-Care Utilization
2 Factors That Affect Health-Care Utilization
Pages 21-38
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From page 21... ...
Finally, it concludes with a discussion of what is known about the relationship between disability status and use of health-care services. People use health-care services to diagnose, cure, or ameliorate disease or injury; to improve or maintain function; or to obtain information about their health status and prognosis.
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Finally, health-care utilization by people who have disabilities is discussed. NEED FOR HEALTH-CARE SERVICES Health status and the need for health-care services to improve or maintain health are major determinants of health-care utilization.
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. Clinicians note that timely access to health care is important inasmuch as it might enable patients and physicians to prevent illness, control acute episodes, or manage chronic conditions, any of which could avoid exacerbation or complication of health conditions (NCHS, 2017b)
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Others are related to differences in access, such as health insurance coverage or income needed to obtain services, ease of obtaining services, and discriminatory practices of providers.
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Nonwhite people 1 face substantial disparities in access to and utilization of health care. Black, American Indian, and Alaska Native adults fare worse than whites on most of the measures of health status and outcomes that were examined.
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(2016) examined racial and ethnic disparities in health-care access and utilization after the ACA health insurance mandate was fully implemented in 2014.
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. Spoken Language Many Americans in racial and ethnic minorities experience language barriers and have low or no proficiency in speaking, reading, or comprehending English.
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. Income and Poverty Income correlates highly with risk factors for chronic disease: for example, people who have lower family income have higher rates of heart disease, stroke, diabetes, or hypertension, and have four or more common chronic conditions (NCHS, 2017b)
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The greatest racial and ethnic diversity was found in central counties of large metropolitan areas. In 2010, the population of central counties nationwide was 27 percent Hispanic origin, 17 percent non-Hispanic black, 9 percent non-Hispanic Asian or Pacific Islander, 2 percent people identifying with multiple races, and less than 1 percent nonHispanic or American Indian or Alaska Native (AI/AN)
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Residents of central counties of large metropolitan areas and nonmetropolitan counties have similarly high percentages of residents who lack health insurance. In general, central counties of large metropolitan areas often have the most adverse health measures in the Northeast and Midwest, and nonmetropolitan counties tend to fare the worst in the South and West (Meit et al., 2014)
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Only 64 percent of rural employers offer their workers health insurance compared with 71 percent in urban areas (Coburn et al., 2009)
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The disabled population is clinically diverse. Some members have multiple chronic conditions that are stable with treatment and will persist for years; others have extreme functional limitations.
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Many factors facilitate and hinder access to needed health care. Disability correlates with increased health-care utilization, and people who have disabilities often have worse overall health status, are poorer, and have a higher prevalence of poor health behaviors such as smoking and obesity.
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Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/data/sites/default/files/NSDUH FFR1-2016/NSDUH-FFR1-2016.htm (accessed December 26, 2017)
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Bethesda, MD: Rural Health Reform Policy Research Center. https://ruralhealth.und.edu/projects/health-reform-policy-research center/pdf/2014-rural-urban-chartbook-update.pdf (accessed December 27, 2017)
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In Health, United States, 2015: With special feature on racial and ethnic health disparities. Hyattsville, MD: National Center for Health Statistics (US)
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2016. Health insurance coverage in the United States: 2015.
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