Access to health care in America

Starting p. 1) -- General Conclusions on the State of Access (starting p. 3) -- Defining Access (starting p. 4) -- The Committee's Indicators and Progress Toward Access Objectives (starting p. 5) -- Objective 1: Promoting Successful Birth Outcomes (starting p. 5) -- Objective 2: Reducing the Incidence of Vaccine-Preventable Childhood Diseases (starting p. 7) -- Objective 3: Early Detection and Diagnosis of Treatable Diseases (starting p. 8) -- Objective 4: Reducing the Effects of Chronic Disease and Prolonging Life (starting p. 11) -- Objective 5: Reducing Morbidity and Pain Through Timely and Appropriate Treatment (starting p. 14) -- Recommendations (starting p. 16) -- 1 Introduction (starting p. 19) -- Background (starting p. 20) -- Developing a Set of Indicators (starting p. 21) -- Relationship of Access Monitoring to Other Relevant Activities (starting p. 22) -- Major Data Sources: Their Uses and Limitations (starting p. 23) -- Strengths and Weaknesses (starting p. 25) -- Crosscutting Issues (starting p. 28) -- 2 A Model for Monitoring Access (starting p. 31) -- Defining Access (starting p. 32) -- Measuring Access (starting p. 34) -- Indicators (starting p. 34) -- Utilization and Its Relationship to Health Care (starting p. 37) -- Barriers to Access (starting p. 39) -- 3 Using Indicators to Monitor National Objectives for Health Care (starting p. 46) -- Objective 1: Promoting Successful Birth Outcomes (starting p. 49) -- Utilization Indicator: Adequacy of Prenatal Care (starting p. 49) -- Outcome Indicator: Infant Mortality (starting p. 56) -- Outcome Indicator: Low Birthweight (starting p. 61) -- Outcome Indicator: Congenital Syphilis (starting p. 66) -- Objective 2: Reducing the Incidence of Vaccine-Preventable Childhood Diseases (starting p. 69) -- Utilization Indicator: Preschool Immunization (starting p. 69) -- Outcome Indicator: Incidence of Vaccine-Preventable Childhood Diseases (starting p. 75) -- Objective 3: Early Detection and Diagnosis of Treatable Diseases (starting p. 79) -- Utilization Indicators: Breast and Cervical Cancer Screening Procedures (starting p. 79) -- Outcome Indicator: Incidence of Late-Stage Breast and Cervical Cancers (starting p. 86) -- Objective 4: Reducing the Effects of Chronic Diseases and Prolonging Life (starting p. 91) -- Utilization Indicator: Continuing Care for Chronic Diseases (starting p. 91) -- Utilization Indicator: Use of High-Cost Discretionary Care (starting p. 98) -- Outcome Indicator: Avoidable Hospitalization for Chronic Diseases (starting p. 102) -- Outcome Indicator: Access-Related Excess Mortality (starting p. 106) -- Objective 5: Reducing Morbidity and Pain Through Timely and Appropriate Treatment (starting p. 112) -- Utilization Indicator: Percentage of Healthy Individuals Who Do Not Contact a Physician During an Acute Episode of Illness (starting p. 112) -- Utilization Indicator: Dental Services (starting p. 115) -- Outcome Indicator: Avoidable Hospitalization for Acute Conditions (starting p. 121) -- 4 Future Indicators (starting p. 130) -- Access to Health Care for People with Disabilities (starting p. 132) -- Family Violence (starting p. 133) -- Emergency Services (starting p. 134) -- Post-Acute-Care Services for the Elderly (starting p. 134) -- Prescription Drugs (starting p. 135) -- 5 Recommendations (starting p. 137) -- Crosscutting Recommendations (starting p. 137) -- Future Steps (starting p. 140) -- Objective 1: Promoting Successful Births (starting p. 140) -- Objective 2: Reducing the Incidence of Vaccine-Preventable Childhood Diseases (starting p. 141) -- Objective 3: Early Detection and Diagnosis of Treatable Diseases (starting p. 142) -- Objective 4: Reducing the Effects of Chronic Diseases and Prolonging Life (starting p. 143) -- Objective 5: Reducing Morbidity and Pain Through Timely and Appropriate Treatment (starting p. 144) -- App. A: Developing Indicators of Access to Care: The Case for HIV Disease (starting p. 147) / Vincent Mor -- App. B: Developing Indicators of Access to Care: Waiting Lists for Drug Abuse Treatment (starting p. 181) / Don C. Des Jarlais, Samuuel R. Friedman -- App. C: Developing Indicators of Access to Care: The Case for Migrants and the Homeless (starting p. 199) / Joanne E. Lukomnik -- App. D: "Ambulatory-Care-Sensitive" Conditions and "Referral-Sensitive" Surgeries (starting p. 219) -- Index (starting p. 223).