By Jennifer Fiorillo
Mental Health
Jennifer Fiorillo
It’s likely that most of us will experience an issue navigating and receiving appropriate health care services at some point in our lives. There are a number of reasons why access to health care may be lacking, or we feel our concerns may not be properly addressed. In both instances the end result involves having less than adequate access to care that each one of us should be afforded.
The National Academies of Sciences, Engineering and Medicine defines access to health care as the “timely use of personal health services to achieve the best possible health outcomes.”
One of the most common barriers to receiving accessible care is inadequate or no insurance coverage. The 2021 National Healthcare Quality and Disparities Report published by the Agency for Healthcare Research and Quality offers results from a number of measures that were tracked from 2002 to 2019.
Two measures that were tracked included the percentage of people who were uninsured at any point of the year under the age of 65 all year and the percentage under 65 who were uninsured all year from 2002 to 2018. The percentage of those with any period of being uninsured decreased from 25.5 percent to 17.1 percent. Those who were uninsured all year decreased from 13.4 percent to 7.8 percent.
While this is a good indictor that more people have health care coverage, the report shows disparities that are related to timely access to care which are present among subgroups based on race, ethnicity and geographic location. Some examples of these access measures include wait times for appointments, access to care when it is needed right away for an illness, injury or condition in the last 12 months, and getting appointments for routine care when it was needed in the last 12 months.
In 2019, Hispanic people had worse access to care than White people for 70 percent of access measures. Black people had worse timely access to care than White people for 53 percent of access measures. There was also a disparity in access for those in large central metropolitan areas versus fringe metro areas. Those in large central metro areas had worse access in 71 percent of these measures. People in poor and low-income households experienced worse care than high income households on more than half of quality measures.
The National Healthcare Quality and Disparities Report outlines a number of other dimensions of health care access that are considered when assessing disparities. One key takeaway from this is that health insurance alone doesn’t necessarily eliminate barriers to access and adequate care. It can reduce the risk of poor outcomes, but variables related to delayed care or access based on geography that is also compounded by lack of reliable transportation can be very impactful when it means that a person can’t even see a provider to address health concerns.
Ease of entry into the health care system and the efficient delivery of services are just as critical as the ability to pay if we are going to have a meaningful discussion about how to make health care accessible to everyone.
Jennifer Fiorillo, MBA, MPH is the president and CEO of Bridges Healthcare in Milford, and may be reached at Jfiorillo@bridgesmilford.org.