University of Phoenix
Health Care Utilitzation/ Option B
There are many factors that affect John’s health care utilization; one example is the disparity in incomes for rural residents that cause financial constraints. According to the National Rural Health Association, the average per capita income is $7,417 lower than in urban areas and the rural residents are more likely to live below the poverty level (2013). John Q. has a full-time job but his income is still not enough to allow him to shop around for a better health care coverage that meet his needs. John’s employers are less likely to provide health care coverage which is why he is relying on Medicaid. According to the Centers for Medicare and Medicaid Services (CMS), Medicaid is a “government insurance programs for a person or persons of all ages whose income and resources are insufficient to pay for health care” (CMS, 2010). At least John is still fortunate enough to have Medicaid due to other rural lower income people do not have coverage at all. On the contrary, the area he now lives in has limited number of health care physicians that accept Medicaid. Also, the appointments have to be made two weeks ahead due to the high volume of patients already registered. The few physicians that accept Medicaid are overwhelmed with a tremendous amount of patients making it less possible for the physicians to spend more time with each patient. The quality of care is not as efficient as it should have been because the patient would feel rushed. Additionally, the physician's hours and days of operation are limited and may not be appropriate for John to attend because of his work schedule. Even if John is allowed to go to his appointment during work hours or has time on the weekends, he does not have his own transportation to get to the physician’s office. John relies on his friend to get work and at times, his friend will not be available. In rural areas the residents often have to travel long distances to get help from the health care delivery system. More often the health care facilities in these rural areas tend to be small and provide limited services. Based on Bonnen, many rural areas do not have sufficient patient volume to support full-service hospitals. In John’s case, it is a 40-minute drive to the primary physician and if he needs other types of services he might have to travel to another facility. Often, because of geographic barriers such as distance, dangerous or unpredictable weather conditions, lack of public transportation, and challenging terrains are factors that can limit or even prohibit John Q. from accessing health care services. His existing high blood pressure is another factor, he needs to be seen by the physician as soon as possible especially if his blood pressure does not come down to where it should be.. The risk of hypertension is two times greater in people whose parent or parents have a history of hypertensive. Finally, the difficulties of finding health care facilities may damage John’s physical and emotional stress level and reducing the probability of seeking care or follow-up care. There are many that do not except new patients or are full and he may not be able to be seen as soon as he needs to be seen. His stress level would go up because of this and it would affect his health in many ways.
Now that the factors affecting John’s health care utilization were presented, these factors can be categorized as either mutable or immutable. Immutable factors are the ones that cannot be changed while mutable factors can be changeable (Austin & Wetle, 2012). The mutable factors will be explained further by how they can be changed. John Q’s immutable factors such as his age, race or ethnicity, and cultural beliefs are not disclosed. However, his personal and community factors are revealed and they are mutable factors. For instance, his type of work can be changed which can