Policy Area Two—Access to Care
new series of HSC publications—Tracking Reports—identifies
trends in access, coverage, managed care and local markets. The first reported
that despite the strong U.S. economy, overall rates of access failed to improve
between 1997 and 2001. More Americans reported problems getting timely physician
appointments, insurers refusing to pay for services and providers refusing to
accept their insurance.
Closing Ethnic and Racial Disparities
hile there has been small reductions in disparities between
racial and ethnic minority Americans and whites, disparities in access to care
persist. HSC has joined this national debate by focusing research on the link
between gaps in insurance coverage and problems accessing needed services. A
second study revealed that minority physicians have more trouble than their
white counterparts obtaining medically necessary care for their patients, including
hospital admissions and specialist referrals.
Living with Chronic Conditions
eople living with chronic medical conditions face particularly
difficult barriers to care. Often perceived primarily as a problem of the elderly,
HSC research showed that chronic conditions are widespread among working-age
adults. People living with chronic conditions are less likely than healthy adults
to be able to afford individual insurance. While Medicare and Medicaid play
a key role in providing coverage for the most vulnerable, more than 7 million
working-age adults with chronic conditions remain uninsured, and almost two-thirds
of them have low incomes. Uninsured working-age adults with chronic conditions
are more likely to report poorer health and more functional limitations than
the privately insured with chronic conditions and are substantially more likely
to have unmet or delayed health care needs. Yet, an HSC analysis of proposals
to expand insurance coverage—from tax credits to SCHIP expansions—found most
would provide only limited relief to the chronically ill.
Related Publications by HSC Staff on Access to Care
Tracking Report No. 2, June 2002
The Insurance Gap and Minority Health, 1997-2001
by J. Lee Hargraves
Issue Brief No. 51, April 2002
Prescription Drug Access: Not Just a Medicare Problem
by Peter J. Cunningham
Tracking Report No. 1, March 2002
Treading Water: Americans' Access to Needed Medical Care, 1997-2001
by Bradley C. Strunk and Peter J.
Cunningham
Issue Brief No. 50, February 2002
Options for Expanding Health Insurance for People with Chronic Conditions
by Ha T. Tu and Marie C. Reed
Issue Brief No. 49, February 2002
Triple Jeopardy: Low Income, Chronically Ill and Uninsured in America
by Marie C. Reed and Ha T. Tu
Health Services Research, Vol. 36, No.5, October 2001
Racial and Ethnic Differences in Access to Medical Care in Managed Care Plans
by J. Lee Hargraves, Peter J.
Cunningham and Robert G. Hughes
Medscape, Web exclusive, Aug. 9, 2001
Minority Physicians' Experiences Obtaining Referrals to Specialists and Hospital
Admissions
by J. Lee Hargraves, Jeffrey
Stoddard and Sally Trude