Access To Care: A Literature Review

The literature support for this project consists of analysis of several studies that examine the impact on access to care for those who live with a minimum of one health condition, and have limited income. Further, the studies examine these impacts on both those less than 65 years-old, and those 65 years-old and greater. Last, the impact of access to transportation is examined with regard to its impact on access to care (access). These issues are contrasted with how telemedicine can improve access for this patient population. A summary of these articles is located in Appendix C.
Analysis of literature to support this project range from randomized controlled trials, to surveys, and focus groups. All the study analyses ranked from Level II

Studies also showed that individuals that live in rural settings, and have disabilities have access issues. These factors result in lower use of health care services and poorer health for these individuals. In contrast, other studies show that implementation of a telemedicine program provide patients opportunity for access to care and improve their experience of care. Studies of telemedicine show reduced cost of care that result in time savings for both the patient and health care providers.
Literature included here includes evidence from 1993 through 2013. Several studies indicate the need for continued research to show the impact of telemedicine on access to care. Access to care is not a new issue that has a negative impact on society. As shown in evidence reaching back to 1993 the issue has been around for some time. Evidence is now beginning to show that there are alternatives like telemedicine that can help reduce the impact of access to care through bringing services to some patients who otherwise could not travel to where care is

A Randomized Control Trial evaluated elderly patients who experience heart failure and chronic obstructive pulmonary disease (Gellis et al., 2012). This trial showed how patients tracked by telemedicine had less use of acute care services such as the Emergency Department than the control group over a 12-month period. Lastly, a study was conducted in a senior living community for seniors who did have primary care, but experienced medical needs that required care before their next available appointment (Shah et al., 2010). Successful implementation of telemedicine meant that these patients avoided unnecessary ambulance trips to the Emergency Department, or Urgent Care. The researchers concluded that telemedicine was well received by both the patient, and care