Access to health care refers to the ease with which an individual can obtain needed medical services. RAND research has examined the social, cultural, economic, and geographic factors that influence health care access worldwide; the effects of changes in access; and the relationship between access and health for specific U.S. populations—including racial and ethnic minorities, people with limited English proficiency, the uninsured, the elderly, children, and veterans.
JOURNAL ARTICLE
If the Affordable Care Act is to successfully expand health care coverage and access for those who most need it, states must implement strategies to ensure that those eligible for coverage are appropriately and efficiently enrolled.
PROJECT
Policymakers are facing new challenges as they implement the Patient Protection and Affordable Care Act (ACA). RAND COMPARE is a modeling tool that simulates the impact of implementation decisions on insurance coverage, premiums, and health care spending.
JOURNAL ARTICLE
Given the current realities of African health systems, governments will need to rely more heavily on the private health sector. This report assesses and compares the ways in which African governments are engaging with their private health sectors.
REPORT
This report presents findings from a study of health innovations transferred from South to North. This briefing examines technologies developed for developing country settings, which may have an application in the UK National Health Service.
JOURNAL ARTICLE
This study found that the number of emergency departments operating in the US from 1990 to 2009 declined by 27%. EDs with safety-net status, for-profit ownership, and low profit margin were at higher risk of closure.
JOURNAL ARTICLE
California's prisons, which are operating under receivership for medical care, need help in improving the quality of health care they provide.
JOURNAL ARTICLE
More educated, affluent patients were no more likely to be offered a choice than other population groups, but there does appear to be a social gradient in who chose to travel beyond the local area for treatment. If these results were replicated across England, there is at least the potential risk that when local hospitals are failing, patient choice could result in inequitable access to high quality care, rather than enhancing equity as…
JOURNAL ARTICLE
A faith-based health research network could create a framework for evaluating such efforts.
JOURNAL ARTICLE
This research brief summaries results of a longitudinal study of military families, which found that spouses and children faced major challenges when one parent was deployed overseas.
JOURNAL ARTICLE
This article describes findings from a group of experts assembled to help improve the science of patient safety..
JOURNAL ARTICLE
Mexican American injection drug users reported fewer sex-related risks than Whites and African Americans. Mexican Americans were more likely to participate in drug treatment during a 6 month period, but less likely to receive any health care.
JOURNAL ARTICLE
The quickest way to assess the strength of a community's hospital systems is to spend a few hours in the emergency department.
JOURNAL ARTICLE
Children admitted to the hospital seem more likely to have a prolonged stay in the emergency department if they are Hispanic, come to the ED in the winter, and arrive early in the morning.
RESEARCH BRIEF
Researchers analyzed data on child and maternal health care use from 34 sub-Saharan African countries to examine the association between the degree of private sector participation in the health care system and outcomes related to access and equity.
RESEARCH BRIEF
Less than half of acute care visits in the United States involve a patient's personal physician. Emergency physicians, who comprise only 4 percent of doctors, handle 28 percent of all acute care encounters and nearly all after-hours and weekend care.
REPORT
The Affordable Care Act builds on the employer-based health insurance system by developing exchanges through which small employers can offer coverage and by penalizing large employers that do not offer coverage. The exchanges could alleviate some of the difficulties faced by small firms that want to offer insurance.
JOURNAL ARTICLE
The nature of employer-sponsored coverage may change substantially after implementation of the Patient Protection and Affordable Care Act, with an increase in the number of workers offered coverage through the health insurance exchanges.
JOURNAL ARTICLE
Only 42 percent of the 354 million annual visits in the U.S. for acute care—treatment for newly arising health problems—are made to patients' personal physicians. The rest are made to emergency departments (28 percent), specialists (20 percent), or outpatient departments (7 percent).
REPORT
Retail clinics have established a niche in the U.S. health care system based on their convenience and customer service. Levels of patient satisfaction and of the quality and appropriateness of care appear comparable to those of other providers. However, we know little about the effects of clinic use on preventive services, care coordination, and care continuity.
JOURNAL ARTICLE
Adolescents and parents reported that the most effective way to encourage preventive care utilization among teens was to directly address provider-level barriers related to the timeliness, privacy, confidentiality, comprehensiveness, and continuity of their preventive care.
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