Professor and class,

For this week I have chosen to discuss access to Health Services as one of the five determinants. This topic stands out greatly to me especially with the recent fields of nursing I have been in. My last job was in telephonic case management for Humana and my current job is telephonic triage for Cigna. Both of which Health services play a huge role. I often hear members say they have gone to the ER 4 times in one week for something minor that they maybe could have gone to their PCP for. Better yet maybe another member might need to go the ER for chest pain, but they are refusing due to the high cost that they will have to pay. These situations create barriers for people’s healthcare needs. Other barriers may include lack of coverage or available services, lack of culturally competent care and again high cost issues. All of which lead to unmet health needs, delayed care, inability in preventative services, financial burdens, and preventable and repeat hospitalizations (Healthy People 2020).

According to Healthy People 2020, access to health services is so important and necessary for people to be able to achieve the best possible outcomes but it also requires 3 distinct steps : Gaining entry into the health care system, Accessing a location where needed health care services are provided, and Finding a health care provider whom the patient trusts and can communicate with.

It is essential for people to have an established relationship with a PCP (primary care provider) as this is a good first line of defense for them and can be the one who is ordering preventatives and annual exams. A big role I provide currently is educating people on establishing and maintaining with a PCP so that they have someone who they can call and that can follow any changes with their healthcare needs or possible abnormalities that may occur. Additionally, I also educate regarding cost and timeliness according to their medical needs. For instance, depending on their coverage if they have a telehealth benefit and this is something minor that telehealth can treat that may save them money and it is very efficient as they will speak directly with a doctor that can call in a script if needed to their local pharmacy. Next would be convenience care as it is generally quick and cost efficient but again treat minor things then up to Urgent Care until finally ER. People get very confused and very frustrated with their healthcare plans from my experience. Either they just don’t understand their coverage, or they are frustrated with the cost. Education is extremely important. I would have to choose Health teaching from the wheel of intervention categories. Health teaching according to Nies & McEwen 2019, communicates facts, ideas, and skills that change knowledge, attitudes, values, beliefs, behaviors, and practices of individuals, families, systems, and /or communities. Afterall, knowledge is power. We need to simplify plans educate more and break down the barriers to help give people back some of their health care power again. This is one step that I can think that will help I am sure there are several others as well.

References

Nies, M. A., & McEwen, M. (2019). Community/Public Health Nursing: Promoting the Health of Populations (7th ed.). St. Louis, MO: Saunders/Elsevier.

U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. (2018). Healthy People 2020: About Determinants of Health. Retrieved from https://www.healthypeople.gov/2020/about/foundatio… (Links to an external site.)

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