Download Health Care Access, Care Coordination, Utilization

Research Priority: Health Care Access, Care Coordination, Utilization
Health care access, care coordination, and utilization is a priority area across the lifespan, and in clinical and
community settings. There is a great need for more effective interventions and improved outcomes.
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Access to health services is a key component in efforts to achieve health equity and health quality for all
people; this goal in Healthy People 2020 focuses on coverage, services, timeliness, and workforce
needs. Emerging issues in healthcare access include: appropriate, safe, and effective care, prevention
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programs, health disparities, long-term and palliative care, and measuring progress.
“Care coordination is identified by the Institute of Medicine as a key strategy that has the potential to
improve the effectiveness, safety, and efficiency of the American health care system. Well-designed,
targeted care coordination that is delivered to the right people can improve outcomes for everyone:
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patients, providers, and payers.”
Research on care coordination is needed to identify specific patient education and psychosocial needs
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and examine outcomes related to medical utilization, medication errors, and self-management.
Utilization databases and quality indicators have been developed to help researchers and healthcare
providers address “a broad range of health policy issues, including cost and quality of health services,
medical practice patterns, access to health care programs, and outcomes of treatments at the national,
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State, and local market levels.”
Health disparities and inequities are evident “across a wide range of diseases, behavioral risk factors,
environmental exposures, social determinants, and health-care access by sex, race and ethnicity,
income, education, disability status and other social characteristics.” The CDC Health Disparities and
Inequalities Report - United States, 2013 outlines the urgent need for better measures and evidencebased programs and interventions that address the activity limitations, work-related injuries and illness,
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and health-related quality of life issues.
Challenges related to recruitment and retention of participants in clinical trials remain a significant
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barrier to the development of promising new interventions that may improve health outcomes.
Urgent Need
Health care access, care coordination, and utilization have been identified as
 a critical issue for improving health and healthcare for many conditions and populations
 an area in which evidence-based measures and interventions are needed
 an area that is perfectly suited for more involvement by the unique skills of occupational therapy
The OT Lens
Occupational therapy knowledge of the complex person factors and environmental factors that serve as
supports and barriers to engagement in health care may support development of effective interventions to meet
the needs of different populations and address health inequities. The focus of occupational therapy on clientcentered, person-centered, and relationship-based care may introduce new avenues for improving access, care
coordination, and utilization.
In the area of health care access, care coordination, and utilization, current knowledge, research training,
measures and interventions are inadequate for addressing the needs of clinical and community populations.
AOTF is committed to the development of a scientific network and body of evidence-based knowledge to
achieve effective and efficient advances in the area of health care access, care coordination, and utilization to
improve health outcomes.
Opportunity to Affect Progress
There are a few occupational therapy scientists who are building knowledge related to health care access, care
coordination, and utilization. However, there is not a coordinated network for occupational therapy research in
this area, nor sufficient resources to train more occupational therapy researchers and practitioners. We believe
a significant investment is needed in order to address clinical and community populations across the lifespan in
order to have better outcomes for all people and improve quality of life.
1. Office of Disease Prevention and Health Promotion. (July, 2016). Access to Health Care. Retrieved from
https://www.healthypeople.gov/2020/topics-objectives/topic/Access-to-Health-Services
2. Agency for Healthcare Research and Quality. (May, 2015). Care Coordination. Rockville, MD. Retrieved
from http://www.ahrq.gov/professionals/prevention-chronic-care/improve/coordination/index.html
3. Agency for Healthcare Research and Quality. (April, 2015). Care Management: Implications for Medical
Practice, Health Policy, and Health Services Research. Rockville, MD. Retrieved from
http://www.ahrq.gov/professionals/prevention-chroniccare/improve/coordination/caremanagement/index.html
4. Agency for Healthcare Research and Quality (March, 2016). HCUP Overview. Healthcare Cost and
Utilization Project (HCUP). Rockville, MD. Retrieved from www.hcup-us.ahrq.gov/overview.jsp
5. Centers for Disease Control and Prevention. (2013). CDC Health Disparities & Inequalities Report (CHDIR).
Retrieved from https://www.cdc.gov/minorityhealth/chdireport.html
6. Gul, R. B., & Ali, P. A. (2010). Clinical trials: the challenge of recruitment and retention of participants.
Journal of clinical nursing, 19(1‐2), 227-233.
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