Information Needs Associated with the Changing Organization and Delivery of Health Care: Summary of Perceptions, Activities, Key Gaps, and Priorities. 3. Population-Based Information on Access and Distribution


The shifts in the system are generating needs for population-based information about access and distribution. A key concern of a number of groups and individuals we interviewed involves whether one could be confident that existing information would show whether individuals are being squeezed out of the health system. Historically, hospital data on bad debt have been one marker of this event, but what if providers see fewer of such people in a competitive market? Similarly, insurance coverage has often been used as a proxy for potential access, but can we assume people get the care they need once they are insured and affiliated with a provider? What are the effects of differential cost sharing at point of service? How can one assess whether needed care is obtained when it is not clear what care people need? For example, with the growth of consolidation and competition, how can we assess the value of a nonprofit institution or determine the relationship between managed care and the public health infrastructure and how this affects community health? All of these are issues poorly captured in existing data.

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