Older adults use far more health care services than younger groups. While the health status of older adults varies considerably, most of them have at least one chronic condition that requires care. The committee was responsible for identifying factors that influence a person's use of health services, including poverty and the level of urbanization. These factors will be addressed in this chapter.
The committee organized the beginning of the chapter around the individual and social determinants of health care utilization, including factors affecting the need for care, the propensity to use services, and barriers to the use of services. This is followed by a brief summary of disparities in health care use that have affected different population groups differently. Finally, it concludes with an analysis of what is known about the relationship between disability status and the use of health care services. The need for and access to medical care are discussed below.
These sections are followed by an analysis of the differences in use according to the characteristics selected. Finally, the use of health services by people with disabilities is analyzed. The following analyzes the way in which need affects the differential use of health care by specific interest populations with reference to poverty and its correlations and the geographical area of residence, race and ethnicity, sex, age, spoken language and disability status. Ideally, need should be the main determinant of the use of health services, but it is clear that there are other factors that influence.
One of those factors is the ability to access care, including whether it is available, timely, convenient, and affordable (Figueroa et al. Many Americans who belong to racial and ethnic minorities face language barriers and have little or no command of speaking, reading, or understanding English. In a healthcare environment, those barriers can present serious challenges for both patients and providers. A systematic review of studies on language barriers in health care for Latino populations showed that access to care, quality of care, and health status are affected as a result of language barriers.
If a patient does not speak the language of their healthcare provider, multiple adverse effects can occur in the patient's healthcare. For example, a patient's inability to understand a provider's diagnosis or treatment plan can result in low patient satisfaction, poor compliance, and underutilization of services (Timmins, 200). It has been demonstrated that the degree of urbanization is associated with the utilization of health services in several ways, including the correlation of residents' sociodemographic characteristics with needs, risk factors and access to care. Communities that differ in terms of urbanization differ in their demographic, environmental, economic and social characteristics, and these characteristics are correlated with the magnitude and types of health problems to which communities are confronting each other.
For example, more urban counties tend to have more health care providers per capita, and residents of more rural counties tend to live farther away from health care resources. In addition to our survey of U.S. consumers, we conducted an actuarial analysis of medical claims data to identify health conditions that are unique or more prevalent in men or women. The analysis concluded that women need an average of 9.9% more health care services than men, even if materny-related health care expenses are excluded3. This difference could be due to various biological differences or to the prevalence of the disease.
Women, for example, are more likely than men to be affected by autoimmune disorders4 and Alzheimer's disease5. Some health conditions, such as heart disease, affect men and women differently. 6.The lack of health insurance coverage can negatively affect health. 9,10 Adults without health insurance are less likely to receive preventive services for chronic diseases such as diabetes, cancer and cardiovascular diseases, 10,11 Likewise, children without health insurance coverage are less likely to receive appropriate treatment for diseases such as asthma or critical preventive services such as dental care, immunizations and child follow-up visits that track the milestones of the development, 10. Under the ACA, most health plans must cover at least one annual checkup or follow-up visit for women, which may include diet and physical activity evaluations, pre-conception care, and cancer screening. Similarly, nearly two-thirds of users of the telehealth company MDLive's platform are women; more than half of MDLive's annual wellness exams are for women; and 70% of women's wellness exams are performed among women ages 25 to 45, suggesting that virtual care plays a valuable role in the overall health needs of that demographic. The independent source for health policy research, surveys and news, KFF is a nonprofit organization based in San Francisco, California.
Residents of central counties of large metropolitan areas and non-metropolitan counties have equally high percentages of residents who lack health insurance. In a survey of American consumers conducted by the Deloitte Center for Health Solutions, women are 35% more likely than men to say they have skipped or delayed medical care for a period of 12 months. Compared to peers who don't provide care, caregivers are more likely to report health problems, have one or more chronic health conditions, and have depression, anxiety, or other mental health conditions. This can lead to an increase in both the severity of health problems and the costs associated with treatment.
However, it is relatively independent of the percentage of revenue that goes to the costs of targeted programming, so the percentage of revenue that goes to the costs of cost-oriented programming to the costs of expenditure-oriented programming is, in and of itself, a poor measure of the unaffordability of health care. In addition, health plans could help employers select plans that fit both their financial goals and their equity objectives, while negotiating more affordable rates with network providers for the health care services they use with often women. Women aged 25 to 44 are the most frequent users of telehealth, while women aged 45 to 64 use the treatment of chronic diseases the most. Nearly a quarter (24%) of women with health insurance (through individual or business plans or Medicaid) reported that their plan didn't cover a medical bill for services they considered covered, or that they paid less for that service than they expected.
JENNIFER RADIN, of Deloitte Consulting LLP, is the director and chief innovation officer of Deloitte's healthcare office. Much of women's health care is limited to what are known as bikini medications (for example, breast cancer, reproductive health, and contraception treatments and needs).). Health coverage plays an important role in allowing people to access health care and protecting families from high medical costs.
