Last modified: August 2, 2019
Richard Honaker M.D.View Full Profile
Health care for women may be at risk in the current social/political climate. However, telehealth may be the perfect solution to bridge this health and wellness gap.
Health care access and precautionary care differences between low-income women with and without health insurance show the importance of Medicaid in states that are yet to expand their health care coverage.
Access to health care is lesser for women with no insurance
Without any health care coverage, there will be lesser access to basic care for women with low income. Low-income women actually report that they go without any care at all because of the costs involved.
Low-income women with insurance, on the other hand, report less often that they have a personal health care provider or even have had a regular check-up in the last two years. These health care access differences put women’s health at risk.
Thankfully, states have an immediate tool ready to address the problems in access to regular health care services for women with low income and no insurance. States can actually integrate millions of low-income women into the health care system by expanding coverage through Medicaid.
Uninsured, low-income women have worse access to basic health care . . .
|In the last 12 months, have needed to see a doctor but could not because of cost*||57.7%||22.5%|
|Have a personal doctor or health care provider||51.9%||87.6%|
|Had a “regular checkup” in the last two years||62.4%||87.9%|
*For the first question only: A higher percentage means that fewer women are able to access basic health care.
For women with no insurance, use of precautionary services is limited
Precautionary services permit people to detect problems earlier, so treatment can begin in a timely manner and more serious illnesses can be avoided down the line.
This will ultimately enable for healthier and longer lives. Without health insurance coverage though, low-income women have trouble accessing important precautionary services and even report lower use of mammograms, colon cancer screening, cervical cancer screening, HIV testing, and even flu vaccines.
States can help minimize the differences in women’s use of precautionary services by expanding the coverage through Medicaid, which will minimize at risk situations and ultimately improve their overall health.
Uninsured, low-income women have lower use of precautionary care . . .
|Had a mammogram in the past two years (aged 40+)||45.5%||72.2%|
|Had a sigmoidoscopy or colonoscopy (aged 50+)||37.1%||62.4%|
|Had a Pap test in the past three years (18+)||65.35%||80.8%|
|Ever tested for HIV||44.5%||46.4%|
|In the last 12 months, have had either a seasonal flu shot or a seasonal flu vaccine that was sprayed through the nose||21.5%||38.3%|
Generally, the difference between uninsured low-income women and insured low-income women on critical access and precautionary measures shows that going without health insurance put women’s health at risk.
The population is actually in desperate need for affordable health coverage so they can have access to the care that they need to become and stay healthy.
How Telehealth is Bridging the Gap for Women
The advantages of telehealth stretch far beyond enhancing access to health care.
Telehealth makes the health care system more productive, enriches quality of care, helps minimize costs by aiding chronic disease management, addresses staffing shortages by giving access to a team of health care professionals, lessens travel times for patients and providers, and diminishes the length and number of hospital stays.
It has also shown improvement in patient satisfaction by giving access to health professionals and services that would otherwise need traveling long distances or adding more expenses.
As an example, telehealth is usually employed to expand access to wound care, radiology, obstetric and gynecological care, and primary care. It can also aid in care delivery for patients who need interpreters or have disabilities that could affect their mobility, which could put them at risk because of difficult travel situations.
The use of telehealth technology like patient portals and transmission of still images is already common. But it is expected to become even more advanced as the standard practice of medicine in the near future will receive federal incentives for embracing health information technology, which in turn will accelerate the implementation.
New payment models will also be needed to become more effective, as well as operative provision and coordination of care.
Road Trips are not Fun if you’re going to your Doctor’s Office
The country is facing a health care workforce crisis that has extended providers to their limits and even access to care for millions of Americans has become jeopardized.
One out of five Americans have less or no access at all to a primary care doctor and access to specialty care are even more limited.
Low-income Americans and those who are living in the rural and medically underserved areas have more economic and geographic barriers to even care, even if they are the most disadvantaged ones by the strained health care system of the country, even if they put themselves at risk of getting worse health conditions..
Without telehealth, millions of Americans will have to travel long distances just to see a doctor.
Here are some of the reasons:
- The US has 191 doctors for every 100,000 people. In rural areas, that ratio is 73 percent lower.
- Almost 20 percent of the population – a total of 62 million people – lives in rural areas and only around 10 percent of doctors practice in rural areas, which put many of the residents’ health at risk of worsening.
- Sixty million Americans don’t have adequate access to primary care because of a shortage of primary care doctors in their communities. This shortage is only going to get worse according to the Association of American Medical Colleges. They project a shortage of 124,000 doctors by 2020, and 37 percent of the gap is primary care providers.
- Increased use of telehealth allows providers to reach more patients. For example, in both rural and urban areas, telehealth can be employed to triage patient care, reserving limited appointment times for those who require to be seen in person, and giving more routine elements of care via telehealth. The Medical Association of Georgia has recommended the use of telehealth to increase access to specialty care by enabling trauma specialists to consult with doctors in smaller emergency rooms until a patient can be moved to a major trauma center. This will also minimize the chances of uninvolved people to be at risk of getting exposed to communicable diseases.
- For women in rural areas, there are insurmountable challenges that they need to face to be able to have access to health care, which makes them always at risk of worse health conditions.
- For women in rural areas, significant health disparities are being experienced compared to their urban counterparts, and disparities being experienced by rural minority women are even greater.
- For women in rural areas, there are higher rates of obesity, suicide, cervical cancer, and limitations caused by chronic health conditions compared to women living in urban areas. For women who live in rural areas, they are also less likely to get recommended precautionary health services, which will make them at risk of contracting diseases instead of being able to prevent them from developing.
- Plenty of rural areas have a specific shortage of obstetric and gynecologic care providers. Almost 6 million women live in counties without a single obstetrician-gynecologist.
- Around 97 percent of non-metropolitan counties don’t have an abortion provider. Nonhospital abortion providers give an appraisal of about 10 percent of their patients travel 50 to 100 miles, and 8 percent travel more than 100 miles. This puts women’s health at risk of death in case the facility wouldn’t know what to do with unexpected profuse bleeding.
- Access to obstetric and gynecological care has been restricted by closures of hospital-based obstetric services. This usually happens because of the lack of sufficient incentives for health care providers to practice in rural areas. The American Congress of Obstetricians and Gynecologists suggests that there should be encouragements for health care providers to use effective telehealth technologies to expand and improve services for women in the rural areas.
Telehealth Can Actually Increase Safety for Patients
Having the consultation with your doctor via video conferencing may not be the traditional visit, but recent studies and practices have demonstrated that care delivered via telehealth is not only safe and efficient, but it can actually enhance care safety and effectivity.
There was this study of heart failure patients by the University of Missouri that found telehealth allowed for earlier detection of important warning signs in patients, which also resulted to having timely interventions from the providers. Telehealth patients also experienced less hospital readmissions.
Another study also found that there are no significant differences between the quality of care indicators like patient’s self-management, use of medication, or patient satisfaction between patients with chronic illnesses who receive care through in-person visits and telehealth consultations.
By having more access to health care through more frequent and patient-focused communication with qualified providers, telehealth results in having improved quality, safety, and efficiency of the country’s health care system.
Submitted by Dr. Richard Honaker: http://www.independentmedicalexaminer.com/IME-Directory/Virginia/Dr-Richard-A-Honaker-MD.asp
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