The severe underrepresentation of racial and ethnic minorities in the health professions affects access to care for minority populations, the quality of care they receive, and the level of confidence that minority patients have in the health care system. The disruption of traditional community-based care and the displacement of providers who are familiar with the language, culture, and values of ethnic communities create barriers to effective care (Leigh et al., 1999). Budget of the United States Government. 2000. AAMC (Association of American Medical Colleges). Comparison of uninsured and privately insured hospital patients: condition on admission, resource use, and outcome. A defining characteristic of the modern health care delivery system is the ubiquitous use of medical technology. Support the use of interpretation services where community need exists. In some instances, physicians and laboratories may be unaware of the requirement to report the occurrence of a notifiable disease or may underestimate the importance of such a requirement. Available online at Do you enjoy reading reports from the Academies online for free? As described in Crossing the Quality Chasm (IOM, 2001b) and other literature, this health care system is faced with serious quality and cost challenges. Barriers to care among racial/ethnic groups under managed care. Improving chronic illness care: translating evidence into action. Coffey RM, Mark T, King E, Harwood H, McKusick D, Genuardi J, Dilonardo J, Chalk M. 2001. Given the growing number of uninsured people, the adverse effects of Medicaid managed care on safety-net provider revenues, and the absence of concerted public policies directed at increasing the rate of insurance coverage, the committee believes that a new targeted federal initiative should be established to help support core safety-net providers that care for a disproportionate number of uninsured and other vulnerable people. Insurance status is a powerful determinant of access to care: people without insurance generally have reduced access. Mays GP, Miller CA, Halverson PK. Journal of the American Medical Association 265(3):374–379. The Surgeon General’s report on mental illness (DHHS, 1999) estimates that more than one in five adults are affected by mental disorders in any given year (see Box 5–6) and 5.4 percent of all adults have a serious mental illness. The importance of quality healthcare processes and delivery cannot be overstated – the results are, quite literally, life or death. A robust communication network is essential and critical for achieving these objectives. Additionally, public funding supports directly, 40 million aged and disabled individualsa, $247 billion (federal, $147 billion; state, $100 billion)b, 1.5 million American Indians and Alaska Nativese, 8.4 million active-duty members of the militaryf, 9 million federal employees, dependents, and retireesg. The organization and delivery of safety-net services vary widely from state to state and community to community (Baxter and Mechanic, 1997). Health Affairs 19:65–75. Health insurance and access to care for symptomatic conditions. The type of health plan is the most important predictor of coverage (RWJF, 2001). The total social costs of alcohol abuse alone were estimated at $177.3 billion in 1997 (Coffey et al., 2001). Children’s Health under Medicaid: A National Review of Early Periodic Screening, Diagnosis and Treatment. Health Services Research 34(6):1331–1350. Predicting the next configuration of insurance and plan delivery systems is dangerous in a system undergoing such rapid transition. Insurance plans and providers scramble to adapt and survive in a rapidly evolving and highly competitive market; and the variations among health insurance plans—whether public or private—in eligibility, benefits, cost sharing, plan restrictions, reimbursement policies, and other attributes create confusion, inequity, and excessive administrative burdens for both providers of care and consumers. Distributed, Improving the Quality of Addiction Treatment, The Institute of Medicine’s Committee on the Quality of Health Care in America challenged the US health care system to improve. Martinez RM, Closter E. 1998. Cost-sharing requirements for these services may also be higher than those for other commonly covered services. 1998. We are all consumers of health care… Managed care in three states: experiences of low-income African Americans and Hispanics. The committee also urges greater efforts on the part of the health care. First, managed care plans reimburse safety-net providers less generously than fee-for-service Medicaid providers do (under Medicaid, federally qualified health centers benefited from a federal requirement for full-cost reimbursement), and they impose administrative and service restrictions that result in reduced overall rates of compensation (IOM, 2000a). aBurn care beds and other special care beds intended for care that is less intensive than that provided in an ICU and more intensive than that provided in an acute care area. health system based on primary health care, as set out in the 2008 World Health Report (1). There were 138 members under 17 years of age and 114 members over 17 years of age. performed for self-limiting illnesses like diarrhea, there may be delays in recognizing a disease outbreak. Journal of the American Medical Association 286(11):1325–1330. The uninsured were less likely to receive health care services, even for serious conditions. Uninsured and unstably insured: the importance of continuous insurance coverage. Additionally, the media may be a powerful tool for familiarizing the public with health and health care issues and a conduit for raising important questions, stimulating public interest, or even influencing the public’s health behaviors. 1993. Journal of Health Administration Education 17(4):271–295. Untreated ear infections, for example, can have permanent consequences of hearing loss or deafness. Washington, DC: Veterans Health Administration. Barnett K, Torres G. 2001. The committee encourages the health care system and policy makers in the public and private sectors to give careful consideration to the interventions that are identified in Unequal Treatment (IOM, 2002b) and aimed at eliminating racial and ethnic disparities in health care (see Box 5–8).

importance of health care delivery system

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