Access to Health Services Workgroup Objectives (12)
About the Workgroup
Approach and Rationale
Access to comprehensive, quality health care services is important for promoting and maintaining health, preventing and managing disease, reducing disability and premature death, decreasing health disparities, and achieving health equity for all Americans. Important components of access include insurance coverage, timeliness of care, and accessibility of primary and preventive health care services.
Medical, dental, and prescription drug insurance coverage, tracked in the first 3 Access to Health Services objectives, help ensure financial access to health care. Individuals with insurance coverage are more likely to have a regular source of care and to receive important preventive health services. The next 3 objectives track whether individuals have difficulty obtaining necessary medical or dental care and prescription drugs. These objectives serve as indicators of the magnitude of financial and service barriers affecting patients’ access to care and of the health care system’s capacity to provide timely access. The last 3 core objectives assess efforts to improve access to primary care providers, appropriate clinical preventive services, and emergency medical services. Seeing a primary care provider and receiving preventive care are important for preventing disease, maintaining health, and lowering health care costs. The emergency department provides essential services when patients are seriously ill or injured, and prolonged wait times are associated with delays in care and dissatisfaction.
The AHS Workgroup also selected 3 high-priority issues as research objectives. These focus on the capacity of the primary care and behavioral health workforce, the use of telehealth to improve access, and the proportion of people younger than 65 years who are underinsured. As more data and evidence become available, these research objectives may become core objectives.
Understanding (Non-API) Access to Health Services
Access to health services means “the timely use of personal health services to achieve the best health outcomes.”1 A lack of access to care can impact overall physical, social, and mental health. It can also affect someone’s quality of life and livelihood. Barriers to access typically include the high cost of care, inadequate or no insurance coverage, and a lack of available services (geographically or remotely), especially culturally competent care. These barriers can lead to unmet health needs, delays in receiving appropriate care, an inability to get preventive services, preventable hospitalizations, and financial burdens.2 Access to care often varies by race/ethnicity, socioeconomic status, age, sex, disability status, sexual orientation, gender identity, and residential location.3
Emerging Issues (Non-API) in Access to Health Services
- Disparities in insurance coverage and a growing problem of underinsurance
- Changes in health care workforce needs as new models for primary care delivery and integration of primary care and behavioral health care become more prevalent
- Use of telehealth as an emerging method of delivering cost-effective health care
Institute of Medicine. (1993). Access to Health Care in America. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/25144064
National Healthcare Quality Report, 2013 [Internet]. Chapter 10: Access to Healthcare. Rockville (MD): Agency for Healthcare Research and Quality; May 2014. Available from: https://archive.ahrq.gov/research/findings/nhqrdr/nhqr13/index.html
Agency for Healthcare Research and Quality. (2016). 2015 National Healthcare Quality and Disparities Report and 5th Anniversary Update on the National Quality Strategy. Retrieved from https://www.ahrq.gov/research/findings/nhqrdr/nhqdr15/access.html