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Show HEALTH CARE COSTS, ACCESS, AND QUALITY Major concerns in health care are cost, access, and quality. Costs can affect quality because if costs are too high, access is likely to be restricted and quality of care may be compromised. Four major factors generally account for annual increases in costs: population growth, general inflation, inflation specific to the health care industry, and changes in the nature and intensity of health care.1 The data presented in this section show total expenditures and also provide details which focus upon the intensity of health care. Quality of health care has traditionally been measured by considering the number and training of health care providers, the availability and quality of facilities and equipment, and the completeness of peer review. Currently, there is increased emphasis on outcome, in some sense better reflecting the patient's perspective. Outcome measures may be of medical outcomes (did the patient recover, die, etc.) and/or of patient satisfaction (did results meet expectations, was the patient treated with respect, etc.). Although this section does not include measures of quality, state-wide measures are being developed and may be available for the next edition of Utah's Health: An Annual Review. Accessible health care has been defined as care that is available, acceptable, and affordable.2 This section provides three measures of access. The first is the proportion of the population which is uninsured. Insured status is considered an important component of access because those who do not have insurance tend to postpone health care. The second access measure is use of emergency rooms. When care is absolutely necessary, persons without insurance or regular primary care often go to an emergency room. This manner of obtaining health care reduces the effectiveness of preventive measures and increases costs. A state having relatively few emergency room visits is not only reducing costs but probably providing better care. In 1990 Utah ranked 36th in the nation in emergency visits per 1,000 population, with a rate of 335 visits per 1,000 population.3 The third measure of access is concerned with geographic distribution of facilities. It is measured by the proportion of the population which is within 40 minutes of a health care delivery center. Sources for this section are found on pp. 91-92 of the Review. * Shortell, Stephen M. & Reinhardt, Uwe E. (Editors) Improving Health Policy and Management. Health Administration Press, 1992. p. 233 2Shortell, Stephen M. & Reinhardt, Uwe E. (Editors) Improving Health Policy and Management. Health Administration Press, 1992. p. 111 ^States in Profile: The State Policy Reference Book. U.S. Data on Demand, Inc. and State Policy Research, Inc. First Edition. Utah's Health: An Annual Review 1994 63 |
