Health Care Access

Contents:

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.

Research conducted by: RAND Health; RAND National Security Research Division; Global Health; Center for Military Health Policy Research

All Items (230)

JOURNAL ARTICLE

Providing Managed Care Options for a Large Population: Evaluating the CHAMPUS Reform Initiative — Jan 1, 2000

Managed care plans for large government-sponsored insurance programs can reduce utilization and maintain patient access and satisfaction. Careful structuring of such plans is needed, however, if they are to reduce costs.

JOURNAL ARTICLE

Health Behaviors, Health Status, and Access to and Use of Health Care: A Population-Based Study of Lesbian, Bisexual, and Heterosexual Women — Jan 1, 2000

Lesbians and bisexual women were more likely than heterosexual women to have poor health behaviors and worse access to health care. These findings support the hypothesis that sexual orientation has an independent effect on health behaviors and receipt of care, and indicate the need for the increased systematic study of the relationship between sexual orientation and various aspects of health and health care.

JOURNAL ARTICLE

Managed Care and Unmet Need for Mental Health and Substance Abuse Care in 1998 — Jan 1, 2000

This report demonstrates the importance of defining access to care more broadly.

JOURNAL ARTICLE

Use of Dental Care By HIV-infected Medical Patients — Jan 1, 2000

The authors conclude that, in spite of the high rate of oral disease in persons with HIV, many do not use dental care regularly, and that use varies by patient characteristics and availability of a regular source of dental care.

JOURNAL ARTICLE

Access of Vulnerable Groups to Antiretroviral Therapy Among Persons in Care for HIV Disease in the United States — Jan 1, 2000

Those HIV-positive persons with the greatest need (defined by a low CD4 count) are most likely to have early access to HAART, which suggests equitable access. However, some predisposing and enabling variables continue to be important as well, suggesting inequitable access, especially for African Americans and lower-income groups.

JOURNAL ARTICLE

Access to Medical Care Reported By Asians and Pacific Islanders in a West Coast Physician Group Association — Jan 1, 2000

Future studies need to clarify why Asians were more vulnerable to the access problems examined than other ethnic groups that might experience similar barriers.

JOURNAL ARTICLE

Strengthening the US Health Care Safety Net — Jan 1, 2000

Continued increases in the numbers of uninsured US citizens, increasing premiums for those who are insured, and the debate over prescription drug coverage all have served to thrust the issue of access to health care on the national radar screen once again.

JOURNAL ARTICLE

Community Effects on Access to Behavioral Health Care — Jan 1, 2000

To explore the effects of community-level factors on access to any behavioral health care and specialty behavioral health care.

JOURNAL ARTICLE

An English and Spanish Pediatric Asthma Symptom Scale — Jan 1, 2000

Pediatric asthma survey measures have not been adequately tested in non-English-speaking populations.

JOURNAL ARTICLE

Utilization of Mental Health and Substance Abuse Services Among Homeless Adults in Los Angeles — Jan 1, 1999

More attention must be directed at how to better deliver appropriate mental health and substance abuse services to homeless adults.

JOURNAL ARTICLE

The Impact of Competing Subsistence Needs and Barriers on Access to Medical Care for Persons with Human Immunodeficiency Virus Receiving Care in the United States — Jan 1, 1999

To examine whether competing subsistence needs and other barriers are associated with poorer access to medical care among persons infected with human immunodeficiency virus (HIV), using self-reported data. For persons infected with HIV to benefit more fully from recent advances in medical therapy, policy makers may need to address nonmedical needs such as food, clothing, and housing as well as transportation, home care, and employment…

JOURNAL ARTICLE

Physician Perceptions of Barriers to Care for Inner-City Latino Children with Asthma — Jan 1, 1999

This article describes physician perspectives on barriers to quality primary care experienced by inner-city children with asthma and presents policy recommendations to reduce these barriers.

JOURNAL ARTICLE

Costs and Use of Mental Health Services Before and After Managed Care — Jan 1, 1998

This paper tracks access, utilization, and costs of mental health care for a private employer over nine years during which mental health benefits were carved out of the medical plan and managed care was introduced.

JOURNAL ARTICLE

The Prospective Effect of Access to Medical Care on Health-Related Quality-of-Life Outcomes in Patients with Symptomatic HIV Disease — Jan 1, 1998

This study examined the prospective effect of reported access to medical care on health-related quality-of-life outcomes in patients with symptomatic human immunodeficiency virus (HIV) disease.

JOURNAL ARTICLE

Does Dissatisfaction with Access to Specialists Affect the Desire to Leave a Managed Care Plan? — Jan 1, 1998

Frequent changes in health plan enrollment may lead to discontinuity of care and compromise quality.

JOURNAL ARTICLE

Differences Between Child and Parent Reports of Symptoms Among Latino Children with Asthma — Jan 1, 1998

The objectives of this study were to determine, in a population of predominantly Latino children with asthma 6 to 18 years old

JOURNAL ARTICLE

Effect of California's Proposition 187 on the Use of Primary Care Clinics — Jan 1, 1997

California's ballot proposition 187, passed by the voters in November 1994, threatened to discontinue undocumented immigrants' eligibility for most health services while mandating that health care professionals report suspected undocumented patients to authorities.

JOURNAL ARTICLE

Medicaid Enrollment and Health Services Access By Latino Children in Inner-City Los Angeles — Jan 1, 1997

Using data on insurance, access, and utilization from a household survey of 817 families with young Latino children, the authors found that while most (84%) young Latino children in inner-city Los Angeles were eligible for Medicaid, a substantial proportion (39%) have episodic or no coverage. Insurance status and provider type were more consistently associated with access than were residency and language preference.

JOURNAL ARTICLE

Health Care Reform for Children and Families: Refinancing and Restructuring the U.S. Child Health System — Jan 1, 1996

This chapter examines the key issues underlying the discrepancies between the needs of children and families and the current and evolving structure of health services in the U.S. The authors look at the characteristics of the U.S. health care system that influence children's access to care and describe ways that emerging models of care can be modified to provide more efficient and effective health services for children.

JOURNAL ARTICLE

Regionalization of Cardiac Surgery in the United States and Canada: Geographic Access, Choice, and Outcomes — Jan 1, 1995

Regionalization of facilities performing cardiac surgery is one of the most contentious regulatory policies currently restricting the supply of specialized health services and technology. This article compares the regionalization policies of the United States (New York and California) and Canada (Ontario, Manitoba, and British Columbia) in terms of geographic access to coronary artery bypass surgery (CABS) and surgical outcomes.

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Celine Miani

Associate Analyst

Celine Miani

Celine Miani is an associate analyst working within the Health and Healthcare team at RAND Europe. Her background is in public policy and health economics. She joined RAND from the University of Cambridge Judge Business School, where she was a member of the CLAHRC (Collaboration for Leadership…

Beverly A. Weidmer

Survey Director

Beverly Weidmer Ocampo is a survey director in the Survey Research Group at RAND and is the deputy survey director for the Healthy Passages Study. She has over 15 years experience in both quantitative and qualitative survey research methodology, has worked on numerous studies focusing on racial…

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