Health Care Utilization
October 28, 2013
Urmi Bhaumik, Facilitator
Health Care Utilization
Health care utilization has caused for debate for almost a century in the United States (US). U.S. citizens have faced the challenge of not being able to properly access affordable and convenient health care providers and services. There are many factors that cause these problems. In this paper the case of John Q. will be examined reviewing mutable and immutable factors with health care utilization.
According to "Keeping America Healthy" (2013), “Medicaid provides coverage for individuals according to poverty guidelines who are unable to afford health care insurance because of limited income” (Eligibility). John Q. qualifies for Medicaid but lives in a rural community with no public transportation to travel to access his benefits due to provider office hours and the distance he must travel to the location. John does own have a car.
John is predisposed to heart disease through heredity and has been diagnosed with high blood pressure. According to "What Is High Blood Pressure?" 2011),” blood pressure is when blood is forced against the artery walls to disperse oxygen and nutrients carried in the blood to the body. Blood pressure is measured by two numbers; Systolic the top number or the higher of the two is measured when the heart beats pushing the blood against the walls of the arteries. Diastolic is the measure when the heart is at rest between beats. The normal measure for normal is 120/80. Persons with a measuring of 140/90 or higher is a person with High Blood Pressure or HBP” (What happens in the body when blood pressure is high?). HBP can lead to Hypertensive heart disease ("Hypertensive Heart Disease", 2013). Regular doctor visits and prescribed medications to control blood pressure can offset the onset of Hypertensive Heart disease in patients with high blood pressure. Regular physician visits are required to keep check on John’s condition ("What Is High Blood Pressure? “ 2011).
The problems with health care utilization for John is that he lives in a rural community with limited providers, the distance of travel to reach locations, time needed to schedule appointments, and office hours of the available physician locations will not provide him with reasonable access. Many Medicaid participants are faced with this same set of problems and have to adjust their lives to gain access to healthcare. Medicaid programs have benefits available to help participants conquer many obstacles. Patients need to inquire and learn what benefits are available to help. Utilizing social programs available in the community, and accessing information on Medicaid websites help to inform members of what is available for help. Medicaid programs have established grants for rural health clinics; John needs to find out if a clinic exits in his area. These clinics provide information about benefits and do health screenings. The clinic can be a place where John can go to get blood pressure checks to make sure he is in target range regularly without having to travel to a physician’s location for blood pressure checks. Rural health clinics provide education to patients and can issue devices such as blood pressure monitoring equipment and train patients to utilize self-check methods between physician visits. Government medical programs do provide for education and training to use medical devices like blood pressure monitors used at home for patient self-monitoring. Missing time from work can be a problem. Most employers have paid time off that employees can access and schedule for personal situations. John can have his physician provide documentation of his appointments to submit to his employer and arrangements can be made for an adjustment in hours or to come into work on additional days if possible. Other options to John may be to use vacation time or sick time to cover missed time at work when he...
References: CMS.gov: Centers for Medicare and Medicaid Services. (2013). Retrieved from http://www.cms.gov/Center/Provider-Type/Rural-Health-Clinics-Center.html
Hypertensive Heart Disease. (2013). Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/000163.htm
Medicaid.gov; Keeping America healthy. (2013). Retrieved from http://www.medicaid.gov/AffordableCareAct/Provisions/Eligibility.html
Medicaid.gov; Keeping America Healthy. (2013). Retrieved from http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Benefits/Medicaid-Benefits.html
What is High Blood Pressure? (2011). Retrieved from http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/AboutHighBloodPressure/What-is-High-Blood-Pressure_UCM_301759_Article.jsp
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