Factors Influence on Community Health Care Access

Factors Influence on Community Health Care Access

Introduction

Health care is provided outside of hospitals with a wide range of programs and community services in private homes, retirement communities, care facilities or accommodation in long-term care and community clinics. The main aim of this report is to discuss three factors (economic, social , demographic, lifestyle, public choice, nutrition) influenced on the health care settings. This study addresses important economic issues that impact on health. Along with the economic analysis report also discuss few other determinants that influence on the health care access to a community.

Health Care and Economic Variables

Health care expenditures may be an indicator of community health. Although, several studies indicate that the level of expenditures has minimal impact on overall health. These studies compare health in one region with the health in another region. In separate studies, few researchers found that the quality of care in higher-spending regions was no better, access to care was no better, and there was no difference in patient satisfaction. Rather, regional differences are largely explained by practice variation across regions (Lundy & Janes 2009).

Salas (2002) found no difference in mortality rates following acute myocardial infarction, stroke, or gastrointestinal bleeding events in Miami and Minneapolis despite twice the level of Medicare expenditure per capita in Miami and nearly four times the number of Intensive Care Unit (ICU) days. Fuchs (1998) coined the term flat-of-the-curve medicine to describe this situation where costs can rise without a corresponding increase in health benefit.

National health expenditure (NHE) data are available from Centers for Medicare & Medicaid Services (CMS) and account for both expenditures by state of residence and state of provider. All spending data are expressed in dollars. Total health expenditures reached $2.6 trillion, which translates to $8,402 per person or 17.9 percent of the nation's Gross Domestic Product, the same share as in 2009 (www.cms.go). Other CMS data include the percentage of state populations on Medicare and Medicaid, the percentage of public and private expenditures (including out-of-pocket expenses), and the percentage of Medicare and Medicaid expenditures.

The U.S. Census Bureau provides data on the percentage of the state population that has private insurance and the percentage that is uninsured. Access to care can be a determinant of health. One measure of access is the number of physicians per capita. Presumably, more physicians per capita will lead to a higher availability to health care (Salas 2002). It may also lead to a higher level of visits per capita due to competition among physicians for the patient population. The number of physician visits is not part of the data set. Higher availability or higher usage both might be expected to increase health outcomes.

Other supply-side factors, such as the number of hospital beds per capita, provide additional indicators of access and usage. Hospital Referral Region (HRR) evidence suggests that greater supply of services (e.g., physicians, particularly specialists, and beds) leads directly to higher medical care use. Per capita income (represented by GDP ...