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Healthcare Access Improvement Process

Identification of the Problem

  • Number of patients continues to grow;
  • Number of medical specialists is in decline;
  • Bad healthcare infrastructure;
  • Narrow medical networks in all healthcare spheres;
  • Long waiting times;
  • Lack of insurance coverage.

What Can Be Improved

  • Higher medical training of nurse practitioners, physician assistants, and pharmacists;
  • New coordinated care models (“patient-centered medical homes”) (Modern Medicine Network, 2014, para. 13);
  • Dissemination of “shared medical appointments” (Modern Medicine Network, 2014, para. 20);
  • Dissemination of telehealth initiative;
  • Possibility to make an appointment in after-hours;
  • Popularization and financial facilitation of primary care training;
  • Reduction of paperwork tasks.

What Processes Does This Affect

  • Federal legislation;
  • State economic process;
  • Social service;
  • Healthcare organization;
  • Scientific research;
  • Infrastructure development.

What Is the Current Situation

  • As of 2014, 26,000 new doctors a year (Modern Medicine Network, 2014, para. 2);
  • As of 2014, 9 million of persons with newly gained health insurance (Modern Medicine Network, 2014, para. 5);
  • As of 2015, the percentage of the uninsured is 9.1% (U.S. Department of Health and Human Services, 2015, p. 2);
  • As of 2015, 10.5% of persons under age 65, 12.8% of persons aged 18–64, and 4.5% of children under age 18 are uninsured (U.S. Department of Health and Human Services, 2015, p. 6);
  • As of 2015, 4.5% of persons failed to obtain needed medical care due to high cost (Centers for Disease Control and Prevention, 2016, para. 1);
  • As of 2015, 87.8% of persons have a usual place to go for medical care (Centers for Disease Control and Prevention, 2016, para. 1).

Ethical Principles

  • Gender, age, race, level of income and education influence the insurance coverage;
  • The uninsured receive poor-quality healthcare;
  • The problem of fair healthcare resources allocation among the insured;
  • Existing principles of distributive justice complicate the problem of allocation;
  • Discord in the national community with regards to fair healthcare access principles;
  • People do not have the opportunity to influence the allocation decisions that affect them (Trotochaud, 2006).

Communication Process

  • Occurs in healthcare continuum (Augmentative Communication News, 2009);
  • Arsenal of communication tools (synchronous and asynchronous) to expand access to healthcare;
  • Influences consumer satisfaction;
  • If effective, reduces waiting time;
  • Clinicians take communication training courses;
  • The shared medical appointment allows for time-saving.

Strategies That Contribute to Resolution of the Problem

  • Increase or decrease of the healthcare services use;
  • Evaluation of policies that affect healthcare services use;
  • Adoption of new healthcare access principles;
  • Reduction of social characteristics influence;
  • Minimization of the costs of healthcare services use;
  • Implementation of new communicative tools.

Stakeholders Involved in the Process

  • Federal government;
  • Healthcare organizations and services;
  • Social services;
  • Influential individuals;
  • State doctors and vendors;
  • Healthcare service consumers.

Challenges and Opportunities That Arise in the Process of Resolution

  • Discord in governmental and private healthcare services;
  • Greater costs for insurance coverage provision;
  • Social attitude to healthcare minorities;
  • Discord in the scientific community with regards to healthcare access principles;
  • Development of healthcare infrastructure;
  • New working places for primary care specialists;
  • Strengthening of healthcare networks.

Evaluation Plan That Can Be Tracked Over Time

  • Purpose: assessment of the fair distribution of healthcare services
  • Questions:
    • How many people receive healthcare?
    • What kind of healthcare do the uninsured people receive?
    • What ethical principles affect the distribution of healthcare? Are they fair?
    • What communicative tools does the healthcare industry use?
    • How many newly trained medical professionals are there?
    • How many retired medical professionals are there?
    • Did the healthcare infrastructure improve?
  • Statistical reports will count as a key criterion in the evaluation

Indicators That Can Be Tracked Over Time

  • Number of the insured;
  • Number of the uninsured;
  • Number of medical specialists in all healthcare spheres;
  • The efficiency of newly introduced communicative tools;
  • The efficiency of newly introduced meth.


Augmentative Communication News. (2009). Communication access across the healthcare continuum. Web.

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Centers for Disease Control and Prevention. (2016). Access to Health Care. Web.

Modern Medicine Network. (2014). 7 ways to improve access. Web.

Trotochaud, K. (2006). Ethical issues and access to healthcare. Journal of Infusion Nursing, 29(3), 165-171.

U.S. Department of Health and Human Services. (2015). Early release of selected estimates based on data from the 2015 National Health Interview Survey. Web.

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