Question

The United States is a very large country with a very diverse population. While a lot of effort goes into keeping a high quality of health care for all citizens, there are limitations and barriers that prevent people from receiving optimal health care. Please discuss what could prevent a patient from receiving a high quality of care quickly if they become ill.

Answer 1

Factors Influencing Access to Health Care -

• Among non elderly Americans, disparities in access to health care have been well documented, with the primary reason being lack of health insurance (i.e., either employer-sponsored or public). Some socio-demographic factors such as race and income are highly correlated with a lack of insurance in younger populations.
• Socio-demographic factors, socioeconomic status, and type of insurance coverage have a substantial impact on the elderly population’s access to health care.Among seniors, psychological and physical barriers affect access to care and may be influenced by poverty more than by race.
• In one study supporting this concern, Fitzpatrick et al. evaluated self-perceived access to health care from self-administered questionnaires in a cohort of Medicare beneficiaries with a mean age of 76 years. He found the most common barriers to seeing a physician were the doctor’s lack of responsiveness to patient concerns, medical bills, transportation, and street safety. Independently related to perceptions of barriers to access to health care were low income, no supplemental insurance, older age, and female gender; race was not significant after adjustment for other factors.
• Interestingly, there is a perception of greater equality regarding access to health care in U.S. seniors due to their eligibility for Medicare; however, conclusions from recent studies show otherwise. Even for Medicare recipients, cost appears to be one of the significant factors associated with lack of access to care. Since the greatest financial burden for Medicare recipients involves out-of-pocket expenses, issues of cost in the elderly are primarily related to insurance coverage that is supplemental to Medicare coverage. This type of insurance has been reported to be independently related to both the use of health services and medical outcomes.
• Lack of complementary health insurance may affect the health care services received by individuals aged 65 years and older, in addition to race, education, age, and gender.