Access to What for Whom? How Care Delivery Innovations Impact Health Equity

Achieving health equity (where every person has the opportunity to attain their full health potential) requires the removal of obstacles to health, including barriers to high-quality medical care. Innovations in service delivery can inadvertently maintain, worsen, or introduce inequities. As such, i...

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Bibliographic Details
Published in:Journal of general internal medicine : JGIM 2023-04, Vol.38 (5), p.1282-1287
Main Authors: Szymczak, Julia E., Fiks, Alexander G., Craig, Sansanee, Mendez, Dara D., Ray, Kristin N.
Format: Article
Language:English
Subjects:
Health care
Health Equity
Health Policy
Health services
Health Services Accessibility
Humans
Innovations
Internal Medicine
Medical innovations
Medicine
Medicine & Public Health
Patient Acceptance of Health Care
Perspective
Synthesis
Telemedicine
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Summary:Achieving health equity (where every person has the opportunity to attain their full health potential) requires the removal of obstacles to health, including barriers to high-quality medical care. Innovations in service delivery can inadvertently maintain, worsen, or introduce inequities. As such, implementation of innovations must be accompanied by a dual commitment to evaluate impact on marginalized groups and to restructure systems that obstruct people from health and healthcare. Understanding the impact innovations have on access to high-quality care is central to this effort. In this Perspective, we join conceptual models of healthcare access and quality with health equity frameworks to conceptualize healthcare receipt as a series of interactions between people and systems unfolding over time. This synthesized model is applied to illustrate the effects of telemedicine on patient, population, and system outcomes. Telemedicine may improve or worsen health equity by altering access to care and by altering quality of care once it is accessed. Teasing out these varied effects is complex and requires considering multilevel influences on the outcome of a care-seeking episode. This synthesized model can be used to inform research, practice, and policy surrounding the equity implications of care delivery innovations more broadly.
ISSN:0884-8734
1525-1497
DOI:10.1007/s11606-022-07987-3