Understanding health care utilization and the underlying processes, as well as attitudes from the point of view of patients and providers, is important in today’s complex health care environment. One of the principal objectives in the management of health care utilization is the reduction of practice variation through defined parameters that seek to ensure a cost-effective use of health care resources. However, factors related to individual determinants of utilization of health care services as well as the enabling factors must be taken into consideration in the discussion of health care utilization. Looking at the case of San Antonio, Texas, there are several factors related to socio-economic characteristics that include race/ethnicity, income, age, and education attainment that affect health care utilization in the city.
San Antonio City is located in Bexar County, Texas and is ranked 7th most populous city in the U.S. According to the 2010 census, the city had a population of over 1.3 million which was estimated to have grown to 1.4 million by 2016 with about 50.8% of the population being male and 49. 2 female (San Antonio Economic Development Forum). About 74% of the total population is White, 7% is African American, 2% is Asian, 3% is mixed race, 1.3% American Indian, and about 12.7% is made up of other races. 34.21% of the total population speaks either English or Spanish, about 62% speak English only, and about 4% speak other languages and English. The median age is 38.3 with many young men making up a larger percentage of the city’s population. However, the population of older adults in the city as reflected in the larger Bexar County is increasing. Economic prosperity varies across the city and income disparities with approximately 5.9% of the population being unemployed. Statistics indicate that the average household income in the city stood at $15,150 compared to national median household income of $55,889 with the majority of the population in the low-income bracket being largely the minority group (Simms, McDaniel, Monson and Fortuny 1). In addition, the average number of individuals with insurance coverage in the city is below the national average (SAEDF).
San Antonio’s demographics reflect both an increase in population and older population. In addition, it reflects a significant population without health care coverage and without the financial ability to access quality health care due to cost-related factors. For health care utilization and costs, the trend in the population growth and elderly population increase, as well as limited access to quality care, equates to increased rates of diseases and prevalence of multiple conditions. In addition, owing to the lower health status of poorer individuals considering the environment they live in, the general assumption is that the individuals will likely require more health care resources which they lack adequate access to. Access to health care, in general, is primarily a problem of the poor and minorities population, particularly the African Americans and Asians as depicted in the statistics indicating that the groups form the majority in the low-income bracket. Therefore, there is inequality in the utilization of health care in relation to socioeconomic characteristics such as income.
Education is also an important aspect with regard to how people may utilize health care services. A study carried out in San Antonio investigating access to education by minorities reveals that only about 13% of the Latinos and 18% of African Americans aged over 25 years hold college degrees and also a majority of the minority population still have the lowest educational attainment compared to the Whites (Nuñez and Murakami-Ramalho). From the study findings, it is likely that knowledge among the black and minority ethnic groups on how best to make use of health care services available locally may be restricted. This further adversely affects health care utilization in the city.
Reflecting on industry-wide problems that confront the health care field in San Antonio and the US in general, hospitals and health care organizations have been experiencing acute workforce shortages among nurses and the allied health professions (American Hospital Association 7). With the growing population, this means that health demand is greater than health care supply and thus compounded further by an increase in health care costs which limits further access to health care for the racial/ethnic minorities in the low-income bracket. There is a need to improve health care utilization in San Antonio.
Considering that a significant portion of the city’s growing population is uninsured and the minority groups socio-economic characteristics, there is a need for Medicaid expansion, developing public education programs, and increasing the health care sector workforce. Texas State’s Medicaid is largely limited due to federal eligibility rules and administrative processes partly reflecting the status of the State as one that is politically conservative and this has meant that low-income families face barriers to obtaining coverage (Foster 4). There is a need to expand Medicaid expansion to increase health care utilization for the low-income and ethnic/racial minority groups in San Antonio. The expansion will provide subsidized health coverage, expand access, increase administrative and clinical efficiency in health care centers, and encourage the low-income population to seek health care services because it relieves them the cost burden.
Public education activity increases the provision of information relating to care options available, improves data collection activities, and enables the collection of feedback in relation to other factors that limit access to care. Public education activities may improve the confidence of patients and encourage their involvement in health care services. Increasing the number of health care workforce is a challenging option but one that is inevitably important in improving health care utilization in the city. Increasing the care workforce means that more people will be attended to and services may be distributed to reach the areas that the low-income population of the city lives.
Works Cited
American Hospital Association. Workforce 2015: Strategy Trumps Shortage. American Hospital Association, 2010.
Foster, Leslie. “Health Care Coverage and Access for Children in Low-Income Families: Stakeholder Perspectives from Texas.” Mathematica Policy Research - Research Brief 3, 2016.
Nuñez, Anne-Marie, and Elizabeth Murakami-Ramalho. "The demographic dividend: Why the success of Latino faculty and students is critical." Academe, vol. 98, no. 1, 2012, pp. 32-37, https://www.aaup.org/article/demographic-dividend#.WI-sio42vIV. Accessed 30 January 2017.
San Antonio Economic Development Forum (SAEDF). “Data: Discover why San Antonio is the premier city for business relocation and expansion.” San Antonio Economic Development Forum, http://www.sanantonioedf.com/why-san-antonio/data/. Accessed 30 January 2017.
Simms, Margaret C., Marla McDaniel, William Monson, and Karina Fortuny. Education and Employment of Disconnected Low-Income Men. Washington, DC: Urban Institute, 2013.
