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Access to Health Care in America (1993)

Chapter: Index

« Previous: Appendix D: Ambulatory-Care Sensitive Conditions and Referral-Sensitive Surgeries
Suggested Citation:"Index." Institute of Medicine. 1993. Access to Health Care in America. Washington, DC: The National Academies Press. doi: 10.17226/2009.
×

Index

A

Access, definition of, 4-5, 32-34

Acute conditions

avoidable hospitalization for, 14, 121-124, 144

of homeless, 210

of migrant workers, 204-206

physician contacts for, 14, 112-115, 144

Admissions, see Hospitalization

Aerosolized pentamidine, 164

African Americans, see Black

population

Aged persons, see Older population

AIDS, see HIV infection

Ambulatory care

for acute conditions, 112-115

and avoidable hospitalization, 12-14, 102-105, 121-124, 143, 219-221

for HIV patients, 155-156, 159-161

Assistance programs, 42

for migrant and homeless populations, 200-201

for vaccination, 73

see also Integration of services;

Medicaid;

Medicare;

WIC

Asthma, 106

AZT, 164-165

B

Barriers to access, 20, 31-32, 39, 44

for HIV patients, 150-169

for migrants and homeless, 207-208, 211-212

see also Cultural factors;

Financial factors;

Structural Factors

Battered women, 133-134

Behavioral Risk Factor Surveillance System (BRFSS), 79, 86

Birth certificates, 25, 51, 54-55, 62

and infant mortality, 56, 59-60, 140

Births and birth outcomes, 5

see also Birth certificates;

Birthweight;

Congenital syphilis;

Infant mortality;

Prenatal care

Birthweight, 3, 5, 61-66, 141

among homeless, 210

Black population, 3, 17, 41, 105, 139

Suggested Citation:"Index." Institute of Medicine. 1993. Access to Health Care in America. Washington, DC: The National Academies Press. doi: 10.17226/2009.
×

birthweight, 62-65, 141

cancer and cancer screening, 80-81, 87-89, 91, 143

congenital syphilis, 67-69, 141

dental care, 118, 119

excess deaths, 106-109

infant mortality, 58-60, 61, 140

physician contacts, 113-114

prenatal care, 5, 52-54

referral-sensitive procedures, 99, 101-102

Breast cancer, 86-89, 142-143

screening, 8-11, 79-84

Bureau of Health Care Delivery and Assistance, 214

Bureau of Maternal and Child Health, 56

C

Cancer

breast, 8-11, 79-84, 86-89, 142-143

cervical, 8-9, 11, 79-80, 84-87, 89-90, 142-143

lung, 99

registries, 27, 87, 91, 142-143

screening, 8-11, 79-86

Case management, 40, 101

Cervical cancer, 86-87, 89-90, 142-143

screening, 8-9, 11, 79-80, 84-86

Children

abuse of, 133

chronic diseases, 95

dental condition, 118

homeless and migrant, 204-205, 212

physician contacts, 115

well-child care, 56, 74

see also Infant mortality;

Vaccination

Chronic diseases, 11-14, 112, 143-144

among homeless, 210

among migrant workers, 206

avoidable hospitalization, 102-106, 143

continuing care, 91-98

discretionary care, 98-102, 143

excess deaths, 106-112, 144

Claims data, 28

Cocaine, and congenital syphilis, 6, 69, 141

Compliance with treatment, 38

Congenital syphilis, 5-6, 66-69, 141

Cultural factors, 42-43

and birthweight, 65-66, 141

Current Population Survey, 41

D

Data bases, 22, 23-25, 28, 29, 102

on birthweight, 65, 141

see also Discharge records;

Disease reporting and registries;

Surveys;

Vital statistics

Death certificates, 25

HIV data, 174-175

and infant mortality, 56, 59-61

Deaths

among homeless, 210-211

excess, 106-112, 144

Dental services, 14-15, 115-120, 144

for HIV patients, 164

Department of Health and Human Services, 139

Diabetes, 91-92, 96-97, 106, 205

Disabled population, 132-133

Discharge records, 27, 102, 103, 106, 143

for HIV patients, 171-172, 174

for migrant and homeless population, 215

Discretionary care, 98-102, 143

Disease reporting and registries, 28

cancer, 27, 87, 91, 142-143

congenital syphilis, 66-67

HIV, 171, 174

vaccine-preventable disease, 75-76, 78, 142

Domestic violence, 133-134

Drug abuse, 131

among HIV patients, 160

and congenital syphilis, 6, 69, 141

and hospitalization, 105-106

treatment waiting lists, 181-197

Drugs, prescription, 135-136

for HIV treatment, 172-173

Suggested Citation:"Index." Institute of Medicine. 1993. Access to Health Care in America. Washington, DC: The National Academies Press. doi: 10.17226/2009.
×

E

Early detection, see Screening and testing

Early Periodic Screening, Diagnosis, and Treatment program, 74

"Ecological fallacy," 27

Elderly, see Older population

Emergency care, 121-122, 123, 134

for battered women, 133

as primary provider, 40

Employer-provided insurance, 41, 151

End-stage renal disease, 99

Equity of access, issues, 3, 4, 17-18, 31-33

Ethnic groups, see Black population;

Cultural factors;

Hispanic population;

Racial and ethnic groups

F

Family planning services, 50

Family violence, 133-134

Federal Interagency Committee on Migrants, 214-215

Federal monitoring role, 16, 29, 138-139

prenatal care, 56, 140

Financial factors, 40-42

dental care, 15, 116, 119

for disabled, 132

HIV treatment, 150-159

Pap tests, 85

prenatal care, 56, 140

vaccination, 73-74

see also Insurance and insurance coverage;

Poverty and low-income;

Uninsured and underinsured population

Frequency of services use, 36

G

Geographic factors and analyses, 3, 14, 27, 40

chronic diseases, 93, 95

for HIV patients, 162, 174

hospitalization, 103-104

prenatal care, 56

vaccination, 71

H

Health Care for the Homeless programs, 209-210, 211, 213-214, 215

Health Objectives for the Year 2000, 23

birthweight, 63-64

cancer and cancer screening, 83, 85

congenital syphilis, 69

domestic violence, 133

infant mortality, 60

preventable disease, 78

vaccination, 73

Healthy People 2000, 23, 133

"Herd immunity," 76

Hip replacements, 98

Hispanic population, 41

birthweight, 62-63, 65

cancer and cancer screening, 80-82, 84-85

dental condition, 118

infant mortality, 60, 61, 141

measles, 78

physician contacts, 113-115

HIV infection, 147-175

among migrant workers, 206

Home health services, 134-135

for HIV patients, 157, 169, 173-175

Homeless population, 199-202, 209-216

Hospices, HIV patient care, 157-158

Hospitalization, 3, 14

avoidable, 12-14, 102-106, 121-124, 143, 144

for dental conditions, 199-120

of HIV patients, 153, 155, 158-159, 168-169, 171, 173-175

Human immunodeficiency virus, see HIV infection

I

Immunization, see Vaccination

Income levels, see Financial factors;

Poverty and low-income

Suggested Citation:"Index." Institute of Medicine. 1993. Access to Health Care in America. Washington, DC: The National Academies Press. doi: 10.17226/2009.
×

Indicators of access, 1-2, 4-5, 34-36, 46-49, 130-131

development of, 20, 21-22

see also Outcome indicators;

Utilization indicators

Infant mortality, 3, 5, 56-61, 140-141

among migrant and homeless populations, 204, 210, 216

Insurance and insurance coverage, 3, 14, 17, 19-20, 26, 27, 28, 41

and birthweight, 65

chronic diseases, 93-95, 97

dental services, 15, 116, 118-120

disabled persons, 132

HIV patients, 150-154

prescription drugs, 135

referral-sensitive procedures, 101

vaccination, 73-74

see also Medicaid;

Medicare;

Uninsured and underinsured population

Integration of services, 18, 122

for battered women, 133-134

for disabled, 132-133

International Classification of Diseases, 61, 103

K

Kessner index, 52, 53

L

Language barriers, 42, 200

Late-stage cancer, 10-11, 86-91, 142-143

Local-level monitoring, 16-17, 137-138

tumor registries, 27

Longitudinal surveys, on chronic diseases, 96-97, 143

Long-term care, 134-135

Low birthweight, 3, 5, 61-66, 141

among homeless, 210

Low-income, see Poverty and low-income

Lung cancer, 99

M

Mammography, 9-10, 81-84

Measles, 76-78

Medicaid, 40

and chronic diseases, 94-96

dental coverage, 120

HIV patient coverage, 153-158

migrant and homeless coverage, 207-208, 215

vaccination coverage, 74

Medi-Cal, dental coverage, 120

Medicare, 42

and chronic diseases, 93-96

end-stage renal disease program, 99

and referral-sensitive procedures, 102

Migrant farmworkers, 199-209, 212-216

Minority groups, see Black population;

Cultural factors;

Hispanic population;

Racial and ethnic groups

Models and modeling, 36, 110-112

N

National Center for Health Statistics (NCHS), 55, 65

National Fetal and Infant Mortality Review Program, 56

National Health and Nutrition Examination Survey, 96

National Health Interview Survey (NHIS), 25-26, 41

cancer screening data, 79-80, 86

chronic disease data, 92-93, 98, 143, 144

dental care data, 116, 120, 144

disability care data, 133

physician contact data, 115

vaccination data, 142

National Maternal and Infant Health Survey (NMIHS), 55, 62, 140, 141

National Medical Expenditure Survey (NMES), 26, 41

National Mortality Followback Survey, 111

Suggested Citation:"Index." Institute of Medicine. 1993. Access to Health Care in America. Washington, DC: The National Academies Press. doi: 10.17226/2009.
×

Neonatal intensive care units (NICUs), 57

New York

drug treatment programs, 183, 188-189

HIV patient services, 157, 160

Statewide Planning and Research Cooperative System (SPARCS), 172

Notifiable diseases, see Disease reporting and registries

Nurses, HIV patient contacts, 168

Nursing homes, HIV patient care, 156-157, 169

Nutrition services, and prenatal care, 50-51

O

Older population, 42

cancer screening, 9, 80-82, 84, 85

dental care, 118

postacute services, 134-135

Outcome indicators, 33-34, 37-38, 131

avoidable hospitalizations, 12-14, 102-106, 121-124, 144

breast cancer, 86-89, 142-143

cervical cancer, 86-87, 89-90, 142-143

chronic diseases, 102-112, 143-144

congenital syphilis, 5-6, 66-69, 141

for HIV patients, 170-175 passim

infant mortality, 56-61, 140-141

low birthweight, 61-66, 141

vaccine-preventable diseases, 75-78, 142

Outpatient care, see Ambulatory care;

Physicians

P

Pap tests, 9, 84-86, 89

Payment sources, on vital statistics records, 60, 62

see also Insurance and insurance coverage;

Medicaid;

Medicare

Perinatal care, 56

Physicians, 112-115, 144

disease reporting, 28, 78

HIV patient contacts, 156, 161-162, 163-164, 167

and hospital admissions, 104, 124

migrant worker contacts, 208

and Pap tests, 85-86

Planned pregnancies, 50

Pneumocystis carinii pneumonia, 174

Population groups, see Black population;

Cultural factors;

Disabled population;

Hispanic population;

Homeless population;

Migrant farmworkers;

Older population;

Poverty and low-income;

Racial and ethnic groups

Poverty and low-income, 3, 40-41

cancer and cancer screening, 83, 85, 87, 88-89

dental care, 116

emergency care, 134

hospitalization, 14, 104-106, 122-124

physician contacts, 115

prenatal care, 51, 140

referral-sensitive procedures, 11-12, 99-101

vaccination, 73-74

Preconception medical care, 50

Prenatal care, 2, 5, 18, 25, 49-56, 140

among homeless, 212

and congenital syphilis, 69

and low birthweight, 61

Preschool immunization, 69-75, 141-142

Prescription drugs, 135-136

President's Commission for the Study of Ethical Problems in Medicine and Biomedicine and Behavioral Science Research, 32-33

Providers of care, 36

for HIV patients, 155-164, 166-169

for migrants and homeless, 208, 211-212

Pap tests, 85

see also Physicians

Public Health Service, 141

Suggested Citation:"Index." Institute of Medicine. 1993. Access to Health Care in America. Washington, DC: The National Academies Press. doi: 10.17226/2009.
×

Expert Panel on the Content of Prenatal Care, 49-50

Q

Quality of care, issues, 37-38

R

Racial and ethnic groups, 3, 11, 17, 28-29, 41, 139

birthweight, 62-65, 141

cancer and cancer screening, 9, 11, 80-82, 84-85, 87-89

childhood diseases, 78

chronic diseases, 96, 144

congenital syphilis, 67-69

dental care, 15

infant mortality, 3, 69-61, 140

prenatal care, 5, 52-54, 55

vaccination, 71, 72

see also Black population;

Cultural factors;

Hispanic population

Referral-sensitive procedures, 11-12, 98-102, 143, 221

Regular sources of care, 114-115

for HIV patients, 159-162

Reports and reporting, see Disease reporting and registries;

School-based reporting systems;

Self-reported health status;

Surveys

Research needs, 17, 29

birth outcomes, 54-56, 60-61, 65-66, 69, 140-141

cancer and cancer screening, 86, 91, 142-143

chronic diseases, 96-98, 100-101, 102, 104, 106, 110-112, 143-144

dental care, 120, 144

drug abuse treatment, 195-196

HIV treatment, 169-175

hospitalization, 104, 106, 123-124, 143, 144

migrant and homeless population, 209, 212-216

minority groups, 17, 29, 139

vaccination, 74-75, 78, 141-142

Risk factors, data collection and analysis, 57, 79, 86, 107-112

see also Drug abuse

Robert Wood Johnson Foundation, AIDS Health Services Programs, 149 -150

Routine care, 114-115

S

School-based reporting systems, for vaccination, 74-75, 141-142

Screening and testing, 8-11

cancer, 8-11, 79-86

for HIV, 170-171

Self-reported health status, 11, 25, 92-93

Sentinel diseases, 37

Social indicators, 34, 36

Social services, see Integration of services

Special Supplemental Food Program for Women, Infants, and Children , 50-51

State-level monitoring, 16-17, 137-138

hospital discharge data, 106, 143

migrant and homeless populations, 216

prenatal care, 56, 140

tumor registries, 27, 87, 142-143

Statistical programs, see Data bases;

Research needs;

Surveys

Structural factors, 39-40

in HIV treatment, 159-164

in migrant and homeless care, 215

Substance abuse, see Drug abuse

Surgical procedures, discretionary, 98-102, 143

Surveillance, Epidemiology, and End Results (SEER) program, 87, 91 , 142-143

Surveillance programs, see Disease reporting and registries

Surveys, 25-26

cancer screening, 79-80, 86

chronic diseases, 96-98, 144

drug abuse treatment, 196

Suggested Citation:"Index." Institute of Medicine. 1993. Access to Health Care in America. Washington, DC: The National Academies Press. doi: 10.17226/2009.
×

excess mortality studies, 111-112

migrant and homeless populations, 199, 200, 212, 213-214, 215-216

oversampling of minorities, 17, 29, 139

vaccination, 70, 74, 142

see also National Health Interview Survey;

National Maternal and Infant Health Survey;

National Medical Expenditure Survey

Syphilis, see Congenital syphilis

T

Testing, see Screening and testing

Timeliness of treatment, 4, 14-15, 112-115, 144

for drug abuse, 181-197

for migrant workers, 208-209

Transplants, 99

Tumor registries, 27, 87, 91, 142-143

U

Uninsured and underinsured population, 3, 14, 28, 41-42

chronic diseases, 93-96

dental care, 116, 118-119

physician contacts, 113-115

referral-sensitive procedures, 99

Unwanted pregnancies, 50

Utilization indicators, 34, 36-37, 131

cancer screening, 8-11, 79-86

chronic diseases, 91-102, 143

dental services, 115-120, 144

frequency, 36

for HIV patients, 170-175 passim

for migrant and homeless populations, 212-216

physician contacts, 112-115, 144

prenatal care, 49-56, 140

vaccination, 69-75, 141-142

V

Vaccination, 7-8, 69-75, 141-142

preventable diseases, 75-78, 142

Violence, domestic, 133-134

Vital statistics, 25

on migrant and homeless populations, 204, 210-211, 214-215

see also Birth certificates;

Death certificates

W

Waiting lists and times

for drug abuse treatment, 191-197

for HIV patients, 162-163

Well-child care, 56, 74

WIC, 50-51

Women, see Battered women;

Breast cancer;

Cervical cancer;

Prenatal care

World Health Organization, Health for All Project, 23

Y

Year 2000 Health Objectives for the Nation, see Health Objectives for the Year 2000

Z

Zidovudine, 164-165

Zip codes, use in analysis, 3, 14, 27, 103-104

Suggested Citation:"Index." Institute of Medicine. 1993. Access to Health Care in America. Washington, DC: The National Academies Press. doi: 10.17226/2009.
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Suggested Citation:"Index." Institute of Medicine. 1993. Access to Health Care in America. Washington, DC: The National Academies Press. doi: 10.17226/2009.
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Suggested Citation:"Index." Institute of Medicine. 1993. Access to Health Care in America. Washington, DC: The National Academies Press. doi: 10.17226/2009.
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Suggested Citation:"Index." Institute of Medicine. 1993. Access to Health Care in America. Washington, DC: The National Academies Press. doi: 10.17226/2009.
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Suggested Citation:"Index." Institute of Medicine. 1993. Access to Health Care in America. Washington, DC: The National Academies Press. doi: 10.17226/2009.
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Suggested Citation:"Index." Institute of Medicine. 1993. Access to Health Care in America. Washington, DC: The National Academies Press. doi: 10.17226/2009.
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Suggested Citation:"Index." Institute of Medicine. 1993. Access to Health Care in America. Washington, DC: The National Academies Press. doi: 10.17226/2009.
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Suggested Citation:"Index." Institute of Medicine. 1993. Access to Health Care in America. Washington, DC: The National Academies Press. doi: 10.17226/2009.
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Suggested Citation:"Index." Institute of Medicine. 1993. Access to Health Care in America. Washington, DC: The National Academies Press. doi: 10.17226/2009.
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Access to Health Care in America Get This Book
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Americans are accustomed to anecdotal evidence of the health care crisis. Yet, personal or local stories do not provide a comprehensive nationwide picture of our access to health care. Now, this book offers the long-awaited health equivalent of national economic indicators.

This useful volume defines a set of national objectives and identifies indicators—measures of utilization and outcome—that can "sense" when and where problems occur in accessing specific health care services. Using the indicators, the committee presents significant conclusions about the situation today, examining the relationships between access to care and factors such as income, race, ethnic origin, and location.

The committee offers recommendations to federal, state, and local agencies for improving data collection and monitoring.

This highly readable and well-organized volume will be essential for policymakers, public health officials, insurance companies, hospitals, physicians and nurses, and interested individuals.

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