HEALTHCARE IN THE UNITED STATES
ACCESS ISSUES IN HEALTH CARE
8.7.1 Healthy People 2020
The Healthy People 2020 objectives (ODPHP, 2019b) and corresponding findings are as follows:
• Increase the proportion of persons with health insurance.
◊ 2020 Goal: 100% (83.2% in 2008) (90.6% in 2018 [Cohen et al.,
2019])
• Increase the number of persons with a usual primary care provider.
◊ 2020 Goal: 83.9% (76.3% in 2007) (85.4% in 2018 [Cohen et al.,
2019])
• (Developmental) Increase the number of practicing primary care
providers.
• Increase the proportion of persons who have a specific source of
ongoing care.
◊ 2020 Goal: 95% (86.4% in 2008)
• Reduce the proportion of persons who are unable to obtain or who
delay in obtaining necessary medical care, dental care, or prescription medicines.
◊ 2020 Goal: 4.2% (4.7% in 2007) (4.4% did not receive medical care
due to cost, and 6.3% delayed seeking medical care in 2018 [Cohen et al.); 11.9% did not receive their prescription medicines in 2017 (NCHS, 2019)
• (Developmental) Increase the proportion of persons who receive
appropriate evidence-based clinical preventive services.
• (Developmental) Increase the proportion of persons who have access
to rapidly-responding prehospital emergency medical services.
• Reduce the proportion of hospital emergency department visits in
which the wait time to see an emergency department clinician exceeds the recommended time frame.
8.7.2 Numbers and Availability of Healthcare Providers and Work Models Used
Shortages of healthcare providers, specifically primary care providers, will continue (Institute of Medicine, 2015). New methods of scheduling patients and utilizing resources may need to be addressed. Better utilization of resources might meet the access needs and reduce delays in care. The Institute of Medicine (IOM) describes one issue with access due to a supply-demand mismatch: scheduling and wait times. Any imbalance, or mismatch, with what is needed in terms of healthcare services and what is available in terms of those services results in delays in receiving care and may cause patients to not seek healthcare services or seek
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