Why Is Access to Care Important to Health?
Together, health insurance, local care options, and a usual source of care help to ensure access to health care. Having access to care allows individuals to enter the health care system, find care easily and locally, pay for care, and get their health needs met.
In 2014, 32 million Americans younger than age 65 were uninsured, nearly a 9 million decrease since 2013 [1]. The Affordable Care Act (ACA) is projected to extend coverage to some but not all of these people. The uninsured are much less likely to have primary care providers than the insured; they also receive less preventive care, dental care, chronic disease management, and behavioral health counseling. Those without insurance are often diagnosed at later, less treatable disease stages than those with insurance and, overall, have worse health outcomes, lower quality of life, and higher mortality rates [2].
Neighborhoods with low health insurance rates often have fewer providers, hospital beds and emergency resources than areas with higher rates. Even the insured have more difficulty getting care in these areas [3].
Nationally, many areas also lack sufficient providers to meet patient needs; as of June 2014, there were about 6,100 primary care, 4,000 mental health, and 4,900 dental federally designated “Health Professional Shortage Areas” in the US [4]. Having a usual primary care provider is associated with a higher likelihood of appropriate care, and a usual source of care is associated with better health outcomes. In 2010, 86% of Americans had a usual source of care, but those with low incomes were less likely to than those with higher incomes, and the uninsured were twice as likely as the insured to lack a usual care source [2].
Cost can be a barrier to care even for those who have insurance. In 2009, 17% of people younger than 65 had premium and out of pocket costs totaling more than 10% of family income. Those with private, non-group insurance were three times as likely as those with employer-sponsored insurance to face such costs [2].
Adopting and implementing strategies that reduce barriers to care and better match providers to community needs can increase access to care, improving health and well-being.
