Health Reports & Data

Access to Health Services

Goal

Improve access to comprehensive, quality health care services.

Overview

Access to comprehensive, quality health care services is important for the achievement of health equity and for increasing the quality of a healthy life for everyone. This topic area focuses on four components of access to care: coverage, services, timeliness, and workforce.

Why is Access to Health Services Important?

Access to health services means the timely use of personal health services to achieve the best health outcomes.1 It requires 3 distinct steps:

  1. Gaining entry into the health care system.
  2. Accessing a health care location where needed services are provided.
  3. Finding a health care provider with whom the patient can communicate and trust.2

Access to health care impacts:

  • Overall physical, social, and mental health status
  • Prevention of disease and disability
  • Detection and treatment of health conditions
  • Quality of life
  • Preventable death
  • Life expectancy

Disparities in access to health services affect individuals and society. Limited access to health care impacts people’s ability to reach their full potential, negatively affecting their quality of life. Barriers to services include:

  • Lack of availability
  • High cost
  • Lack of insurance coverage

These barriers to accessing health services lead to:

  • Unmet health needs
  • Delays in receiving appropriate care
  • Inability to get preventive services
  • Hospitalizations that could have been prevented3

Additional Resources

HP2020’s National Objectives for Access to Health Care
HHDW Reports on Access to Health Care

References

  1. Institute of Medicine, Committee on Monitoring Access to Personal Health Care Services. Access to health care in America. Millman M, editor. Washington: National Academies Press; 1993.
  2. Bierman A, Magari ES, Jette AM, et al. Assessing access as a first step toward improving the quality of care for very old adults. J Ambul Care Manage. 1998 Jul;121(3):17-26.
  3. Agency for Healthcare Research and Quality (AHRQ). National healthcare disparities report 2008. Chapter 3, Access to healthcare. Washington: AHRQ; 2008. Available from: http://www.ahrq.gov/qual/nhdr08/Chap3.htm
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OBJECTIVES AND SUB-OBJECTIVES

AHS-1
Increase the proportion of persons with health insurance
State Indicator Definition:
Percentage of persons under 65 years of age who report coverage by any type of public or private health insurance. The national indicator is defined in exactly the same way.

State Baseline:
98.4% (2010)

Most Recent State Value:
96.9% (2012)

HP2020 Target:
National: 100%

National Data Source:
National Health Interview Survey

State Data Source:
Hawaii Health Survey

Data Reports:
HHDW Report
HHM Report
DHHS Health Indicators Warehouse

State Indicator Definition:
Percentage of persons 18 years and older who report they have at least one person they consider to be their personal doctor or health care provider; the indicator is based upon a single question. The national indicator is defined differently as it includes all persons and only classifies a doctor’s office or health center as a primary care provider if the respondent goes to the provider for sickness and health advice, new health problems, preventive care, and referrals; the indicator is derived from responses to four questions.

State Baseline:
82.7% (2011)

Most Recent State Value:
84.7% (2015)

HP2020 Target:
National: 83.9%

National Data Source:
Medical Expenditure Panel Survey

State Data Source:
Hawaii Behavioral Risk Factor Surveillance System

Data Reports:
HHDW Report
HHM Report
DHHS Health Indicator Warehouse

AHS-4
(Developmental) Increase the number of practicing primary care providers
State Indicator Definition:
Number of practicing primary care medical doctors per 100,000 population. The national indicator is developmental; the definition and target have yet to be established.

State Baseline:
81.7 practicing primary care medical doctors per 100,000 population (2010)

Most Recent State Value:
79.7 practicing primary care medical doctors per 100,000 population (2012)

HP2020 Target:
National: TBD

National Data Source:
TBD

State Data Source:
Area Health Resources Files

Data Reports:
HHM Report

State Indicator Definition:
Number of practicing primary care doctors of osteopathy per 100,000 population. The national indicator is developmental; the definition and target have yet to be established

State Baseline:
4.5 practicing primary care doctors of osteopathy per 100,000 population (2010)

Most Recent State Value:
4.2 practicing primary care doctors of osteopathy per 100,000 population (2012)

HP2020 Target:
National: TBD

National Data Source:
TBD

State Data Source:
Area Health Resources Files

Data Reports:
HHM Report

State Indicator Definition:
Number of practicing physician assistants per 100,000 population. The national indicator is developmental; the definition and target have yet to be established.

State Baseline:
11.9 practicing physician assistants per 100,000 population (2010)

Most Recent State Value:
18.8 practicing physician assistants per 100,000 population (2013)

HP2020 Target:
National: TBD

National Data Source:
TBD

State Data Source:
Area Health Resources Files

Data Reports:
HHM Report

State Indicator Definition:
Number of practicing nurse practitioners per 100,000 population. The national indicator is developmental. The definition and target have yet to be established.

State Baseline:
23.2 practicing nurse practitioners per 100,000 population (2010)

Most Recent State Value:
30.4 practicing nurse practitioners per 100,000 population (2013)

HP2020 Target:
National: TBD

National Data Source:
TBD

State Data Source:
Area Health Resources Files

Data Reports:
HHM Report

AHS-5
Increase the proportion of persons who have a specific source of ongoing care
State Indicator Definition:
Percentage of persons 17 years and younger who report they have a usual place of care they go to when they are sick and that this place is categorized as a doctor’s office, hospital outpatient department, clinic or health center, or some other place. Responses indicating that the child does not have a usual source of care or that the place of care is a hospital emergency room, is located outside the U.S., or the child does not go to one place most often, are defined as not having a usual source of care. The national indicator is defined differently as the percentage of persons 17 years and younger who report that they go to a clinic or health center, a doctor’s office or HMO, a hospital outpatient department, or some other place when they are sick or need advice about their health. Persons who report that they typically go to a hospital emergency room, or do not go to any one place most often are classified as not having a specific source of primary care.

State Baseline:
94.8% (2007)

Most Recent State Value:
85.7% (2011-2012)

HP2020 Target:
National: 100%

National Data Source:
National Health Interview Survey

State Data Source:
National Survey of Children’s Health, via Data Resource Center for Child & Adolescent Health

Data Reports:
DHHS Health Indicators Warehouse

State Indicator Definition:
Percentage of adults aged 18 to 64 years with at least one person they think of as their personal doctor or health care provider. The national indicator is defined differently as the percentage of adults who report that they go to a clinic or health center, a doctor’s office or HMO, a hospital outpatient department, or some other place when they are sick or need advice about their health. Persons who report that they typically go to a hospital emergency room, or do not go to any one place most often are classified as not having a specific source of primary care.

State Baseline:
88.6% (2011)

Most Recent State Value:
90.2% (2014)

HP2020 Target:
National: 89.4%

National Data Source:
National Health Interview Survey

State Data Source:
Hawaii Behavioral Risk Factor Surveillance System

Data Reports:
HHDW Report
HHM Report
DHHS Health Indicators Warehouse

State Indicator Definition:
Percentage of adults aged 65 years and older with at least one person they think of as their personal doctor or health care provider. The national indicator is defined differently as the percentage of adults who report that they go to a clinic or health center, a doctor’s office or HMO, a hospital outpatient department, or some other place when they are sick or need advice about their health. Persons who report that they typically go to a hospital emergency room, or do not go to any one place most often are classified as not having a specific source of primary care.

State Baseline:
95.7% (2011)

Most Recent State Value:
96.9% (2013)

HP2020 Target:
National: 100%

National Data Source:
National Health Interview Survey

State Data Source:
Hawaii Behavioral Risk Factor Surveillance System

Data Reports:
HHDW Report
DHHS Health Indicators Warehouse