A clearinghouse is needed to compile data from all of the nation's tumor registries. (National Cancer Institute, Public Health Service)

  1. In the interim, zip code information from birth certificates and census data on income should be linked to assess the importance of income as an access barrier. (Researchers)

  2. Research is needed to determine why improvements in the rates of cancer screening among blacks are not reflected in improvements in early diagnosis, mortality rates, and survival compared with rates for whites. (Researchers)

Objective 4: Reducing the Effects of Chronic Diseases and Prolonging Life

Indicator: Continuing Care for Chronic Diseases
  1. A longitudinal survey of individuals with chronic diseases should be conducted. (National Center for Health Statistics)

  2. In the interim the National Health Interview Survey should incorporate questions about access either in its disease-specific supplements or in the core portion of the survey. (National Center for Health Statistics, Public Health Service)

Indicator: High-Cost Discretionary Care
  1. The reasons some groups fail to use discretionary medical procedures need further attention. Resource barriers, patient and physician attitudes, and over- and underutilization of services need to be taken into account, along with financial barriers, if this indicator is to be correctly interpreted. (Health Care Financing Administration, Researchers)

  2. Additional referral-sensitive procedures should be explored to determine whether they might be added to the basic list. (Researchers)

Indicator: Avoidable Hospitalization for Chronic Diseases
  1. All states should require hospitals to maintain discharge data bases.

  2. States should explore the feasibility of incorporating income data and information to help determine severity of illness on the hospital discharge record. (Researchers)

  3. Studies are needed on the dynamics of patient care-seeking behavior. These studies should focus on ambulatory-care-sensitive conditions and physician admitting practices. The results of such research would be useful for interpreting differences in admission rates among groups and the relative contributions of various access barriers to delayed or poor-quality care. (Researchers)

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