1 . Theme / Strategic Objective 1 : Increasing Access to Care
National Strategy for Quality Improvement in Health Care ( National Quality Strategy , or NQS ) 12 sees access as the first step in obtaining high-quality care : To receive quality care , people must first be able to gain entry into the health care system .
The NQS uses the framework of the National Healthcare Quality and Disparities Report ( QDR ) to track Achieving Healthy People / Healthy Communities . Measures of access to care tracked in the QDR include having health insurance , having a usual source of care , encountering difficulties when seeking care , and receiving care as soon as wanted . Historically , Americans have experienced variable access to care based on race , ethnicity , socioeconomic status , age , sex , disability status , sexual orientation , gender identity , and residential location .
For community members , the word “ access ” also refers to multiple aspects of receiving care . For the purposes of this report , access has been broken down into several “ action areas ”:
• Capacity , availability , and care coordination services
• Awareness of services and community education
• Transportation and other logistics
• Motivation and process of care
• Improve system efficiency
• Insurance and financial concerns
Throughout the conversations both in one-on-one interviews and focus groups , all of the above facets of access are areas of concern , and each are broken down below .
a )
Action Area : Capacity and Availability
The research suggests that more providers at all levels of care are needed , including outpatient behavioral health counselors , psychiatrists , psychologists , case managers , social workers , therapists , and others .
Capacity issues 13 are particularly acute in parts of Polk County away from Lakeland . One particular subspecialty specifically mentioned included child and adolescent psychiatrists , psychologists , and therapists , which dovetails with the reported importance of addressing behavioral health issues as early as possible to reduce the incidences of behavioral health and substance misuse in adulthood .
To a person , participants indicated that the lack of behavioral health providers ( e . g ., counselors , case managers , peer specialists , and others ) is widespread throughout the county . The lack of providers has a domino effect such that inadequate numbers of providers leads to long wait times for initial visits , long wait times for follow-up visits and medication management services , and a more highly acute patient population – often requiring more services .
In addition , respondents also frequently indicated that the distribution of available providers heavily favors the larger cities in the county , including Lakeland and Winter Haven , and to a lesser extent Bartow . Residents of the outlying rural areas – such as in the northeast along the “ Ridge ” and the southern area – have a more difficult time accessing geographically convenient providers .
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Note : Available system “ capacity ” include the number of providers ( e . g ., doctors , counselors , and other direct care providers ) but more specifically , those currently in practice and accepting patients . Capacity is also refined by the availability of convenient hours of operation and available appointment times . Not that both issues are also addressed as part of this study with an Access Audit . The results are included later in the report .
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