Primary Care

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Access Indicators: Primary Care

Primary care helps prevent illness and death, reduces health disparities among populations, and lowers spending. It is the most important gateway to the health care system. More below…

The Agency for Healthcare Research and Quality defines primary care as “the provision of integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community.” It is during primary care visits that patients receive immunizations and booster shots and are screened for chronic and/or potentially life-threatening diseases, including pre-diabetic conditions, hypertension and cancers.

Data show that insured people receive more preventative care than the uninsured. It should therefore not be surprising that the uninsured suffer more diseases, and cost the system more money. Susan G. Komen for the Cure estimates that treatment and care for the early stages of breast cancer cost an average of $22,000 while stages 3 and 4, when the cancer has spread to other parts of the body, cost more than $120,000. For some cancers, screening is an essential tool for early intervention, where the chances of positive outcomes are greatest.

A study by Stanford University concluded that the decline of colorectal cancer could be explained by an increase in colonoscopies (Sharaf & Ladabaum, 2013). Lower screening rates could lead to a large number of preventable cancer deaths because diagnosis and treatment are delayed. Evidence can be seen in the trend of deaths from colorectal cancer, which illustrates the link between access to preventive care and health. For all ethnicities, colorectal mortality rates have declined during the past two decades. Compliance with recommended colonoscopy scheduling is uneven across ethnic groups, with Whites having the highest compliance rates, followed by Blacks, Hispanics and Asians. The rate has dropped most sharply for Whites and Blacks. While colorectal cancer mortality is actually lowest for Asians and Hispanics, their mortality rate has decreased more slowly over time.


Source cited

Sharaf, R.N., & Ladabaum U., “Comparative effectiveness and cost-effectiveness of screening colonoscopy vs. sigmoidoscopy and alternative strategies,” The American Journal of Gastroenterology, 108 (1), 120-32. doi: 10.1038/ajg.2012.380, 2013.

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