IMPROVING ACCESS TO HEALTHCARE

IMPROVING ACCESS TO HEALTHCARE THROUGH THE USE OF

NURSE PRACTITIONER MIDWIVES: A RESEARCH PROPOSAL

Dynamic change characterizes the American health care environment in the 1990s (Hammonds, 1994, pp. 48-57). A major problem associated with the dynamic character of this health care environment is the increase in the number of people whose access to health care services is beling limited. Limitations in access are related to the increasing costs of health care services, changing societal values in the United States that tend to reject the concept of universal access, advances in treatment therapies and technological innovation that freighten some people away from seeking care, changing demographics that create ever larger population groups with limited English language proficiency and limited education, and many other factors (Nichols and Stevens, 1992, pp. 86-95). Cost is a major factor involved in changes in the accessibility of health care delivery and support services. It is, therefore, imperative for health care delivery and support organizations to develop procedures that will lead to more effective and more efficient operations. Proposed national health care reform, increased consumer demands for quality health care, and public outcries for the control of health care costs are issues that must be addressed by all health care institutions in both the public and private sectors; however, such concerns should not be permitted to disassociate large segment

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ance in the delivery of health care services to indigent persons because their health care needs tend to be complex as a consequence of delaying health care consultation. The public health community views nurse practitioner-managed clinics as a means of promoting improved levels of general health in the country (Richmond and Wise, 1986, pp. 219-223). Cited as evidence of the contention that the use of nurse practitioners leads to improvements in the level of health care, as an example, are infant mortality statistics that declined to a level of 10.5 per 100,000 (near to the national norm) as the role of nurse practitioner managed clinics increases (Trnobranski, 1994, pp. 134-139; Warner, 1991, pp. 242-247). It is feasible to site nurse practitioner-managed clinics are frequently sited where indigent persons are found and where more traditional health care delivery venues are either not available or are in short supply. Nurse practitioner managed clinics are also able to delivery health care services at costs that are well below those associated with most of the more traditional health care service providers (Sharp, 1992, pp. 30-32). Thus, there are indications that both the quality of and the access to health care services

Category: Medical - I