WK5- 2/7/17

WK5- 2/7/17

by Katherine Dang -

Apologies for the delay in posting, but here is my response to the questions:

1)        Structural issues within health care delivery are implicated in health care disparities.  Please brainstorm 4 structural issues that might contribute to these disparities. Which of these are relevant to your particular area of research, and how?

According to the CDC, costs for parents of kids with autism include health care, education, ASD-related therapy, family-coordinated services, and caregiver time, which can accumulate up to $17,000 or $21,000 more per year than those parents with kids whom do not have autism. With the rising prevalence of autism cases in the United States, 4 structural issues that arise include:

1.     States being less inclined to require insurers to provide coverage for health care, education or family-coordinated services due to fear of the rising premiums. Therefore, much of the financial burden falls upon parents and the schools to provide most of the care for these children.

2.     Difficulty in access to competent clinical service providers may lead to improper diagnoses of children with autism or autism spectrums. The expenses to see a highly-experienced clinician, child psychologist, pediatricians, or psychiatrist can be a major obstacle for many families, especially those with a low income.

3.     The lack of coordinated communication between the many different educational, medical and therapeutic providers can lead to confusion and consequentially, inadequate treatment for these individuals with autism.

4.     Lastly, providing adequate translators for those who do not speak English. Language barriers have always been one of the major concerns for families who have recently immigrated here to the United States. These families especially will have limited knowledge on the different care providers necessary for their child’s growth and development and will have difficulty coordinating themselves all the proper care.

 

 

2)        How do individual physicians contribute to health care disparities?  Thinking about an area of health care of particular interest to you, what research do you think could be done to either understand the effect of individual physicians on health disparities, or to decrease this effect?

 

I feel that the lack of communication between the health care providers and the families of the individuals with autism will be the main debilitating factor. Research thus needs to be done on coordinated care between the educators, health care providers and therapists to allow for optimal care for these individuals with autism.

 

Re: WK5- 2/7/17

by Christine Dehlendorf -

I like your point about the fact that complex health conditions that require more coordination and an interdisciplinary approach are likely to have larger health disparities. And while I definitely agree with you about the issue of financial coverage, as we discussed in class this is usually considered distinct from the issue of health care disparities.

 

With respect to influences on the individual physician level, I think communication is key, but the question for this class is how that might be related to disparities specifically. Are patients of color/low SES patients likely to experience poor quality communication? If so, why? And does this matter only because it is connected to a health outcome, or is it, as Berwick argues in the Triple Aim, also because patient experience is an end in and of itself that we should consider. Therefore, disparities in communication are a health care disparity by definition, regardless if they are linked to worse clinical outcomes, because they reflect disparities in the quality of care.