Trends in Unmet Need for Physician and Preventive Services in the United States, 1998-2017

Hawks, Laura; Himmelstein, David U.; Woolhandler, Steffie; Bor, David H.; Gaffney, Adam; McCormick, Danny

doi:10.1001/jamainternmed.2019.6538

Cited by 34 publications

(36 citation statements)

References 34 publications

(49 reference statements)

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“…[6][7][8] Indeed, American researchers Himmelstein and Woolhandler, long-term critics of the U.S. system, argue that the U.S. private insurance multi-payer system is inefficient and over-burdened with administrative costs and that, despite Obamacare, there continues to be considerable unmet need. [9][10][11][12][13] So, relatively, how effective is the American health care system?…”

mentioning

confidence: 99%

Mortality in the USA, the UK and Other Western Countries, 1989–2015: What Is Wrong With the US?

et al. 2020

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This population-based study compares U.S. effectiveness with 20 Other Western Countries (OWC) in reducing mortality 1989–1991 and 2013–2015 and, responding to criticisms of Britain’s National Health Service, directly compares U.S. with U.K. child (0–4), adult (55–74), and 24 global mortality categories. World Health Organization Age-Standardized Death Rates (ASDR) data are used to compare American and OWC mortality over the period, juxtaposed against national average percentages of Gross Domestic Product (GDP) Expenditure on Health (%GDPEH) drawn from World Bank data. America’s average %GDPEH was highest at 13.53% and Britain’s the lowest at 7.68%. Every OWC had significantly greater ASDR reductions than America. Current U.S. child and adult mortality rates are 46% and 19% higher than Britain’s. Of 24 global diagnostic mortalities, America had 16 higher rates than Britain, notably for Circulatory Disease (24%), Endocrine Disorders (70%), External Deaths (53%), Genitourinary (44%), Infectious Disease (65%), and Perinatal Deaths (34%). Conversely, U.S. rates were lower than Britain’s for Neoplasms (11%), Respiratory (12%), and Digestive Disorder Deaths (11%). However, had America matched the United Kingdom’s ASDR, there would have been 488,453 fewer U.S. deaths. In view of American %GDPHE and their mortality rates, which were significantly higher than those of the OWC, these results suggests that the U.S. health care system is the least efficient in the Western world.

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confidence: 99%

Mortality in the USA, the UK and Other Western Countries, 1989–2015: What Is Wrong With the US?

et al. 2020

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“…These outcomes have been analyzed with socioeconomic status, health care coverage, and travel distance to health care facilities, in addition to access to primary care clinicians. 13 , 27 , 28 , 29 , 30 , 31 , 32 …”

Section: Discussionmentioning

confidence: 99%

“… 12 Historically, people living in rural areas of the US have experienced limited access to primary care clinicians compared with those living in urban areas. 13 , 14 More than one-third of rural US residents live in federally designated health professional shortage areas 15 , 16 and approximately 82% of rural counties are classified as medically underserved regions. 17 The shortage of primary care physicians in rural areas is associated with longer travel distance to accessing services, which may mitigate the prevention and management of the prevalent chronic diseases.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Changes in Rural and Urban Primary Care Workforce in the United States From 2009 to 2017

et al. 2020

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Key Points Question What are the changes in the rural-urban distribution of the primary care workforce in the US from 2009 to 2017? Findings In this cross-sectional study of 3143 US counties (1167 urban and 1976 rural) using county-level data, the density of primary care clinicians increased significantly in both rural and urban counties from 2009 to 2017. The increase in primary care clinician density was more pronounced in urban counties compared with rural counties. Meaning In this study, the density of primary care clinicians increased overall, yet rural-urban disparities in the primary care workforce are increasing in the US.

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“…Such a study will fill a growing gap in care of this population—a population that is increasing and that experiences low HRQoL. 4 , 36 , 37 Although to the authors’ knowledge there is little research exploring the development, implementation, and efficacy of HRQoL interventions tailored for uninsured and underinsured individuals, the evidence examining the efficacy of tailored health promotion interventions for specific populations (e.g., racial/ethnic minorities) is promising. 27 - 29 …”

Section: Discussionmentioning

confidence: 99%

An Exploratory Study to Understand Factors Associated with Health-related Quality of Life Among Uninsured/Underinsured Patients as Identified by Clinic Providers and Staff

Wippold

Nmezi

Williams

et al. 2020

J Prim Care Community Health

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Since the release of Healthy People 2020, there has been extensive research understanding factors associated with health-related quality of life (HRQoL) among specific populations. Despite this growing body of research, little has been conducted to understand the factors associated with HRQoL among uninsured/underinsured Americans. The purposes of the present study were to assess clinic staff to determine: (1) whether there is a need to examine HRQoL among uninsured/underinsured individuals, (2) whether there is a need for tailored HRQoL-promoting interventions among uninsured/underinsured individuals, and (3) the factors associated with HRQoL among uninsured/underinsured individuals. A survey was sent to an association of 41 clinics that provides free medical services to uninsured/underinsured individuals. The majority of participants indicated that uninsured/underinsured individuals experience unique factors associated with HRQoL and that there was a need to implement tailored HRQoL-improving interventions among uninsured/underinsured individuals. The results also present the personal/contextual factors associated with HRQoL of uninsured/underinsured individuals.

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Trends in Unmet Need for Physician and Preventive Services in the United States, 1998-2017

Cited by 34 publications

References 34 publications

Mortality in the USA, the UK and Other Western Countries, 1989–2015: What Is Wrong With the US?

Mortality in the USA, the UK and Other Western Countries, 1989–2015: What Is Wrong With the US?

Assessment of Changes in Rural and Urban Primary Care Workforce in the United States From 2009 to 2017

An Exploratory Study to Understand Factors Associated with Health-related Quality of Life Among Uninsured/Underinsured Patients as Identified by Clinic Providers and Staff

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