The Continuum of Care Process and Major Institutions

The Continuum of Care Process and Major Institutions 
First Question
Outline
Healthcare access in my setting is inequitable owing to several structural barriers at the patient and organizational levels. The outline below depicts the challenges and barriers to equitable healthcare access in my setting.
* Transportation barriers to healthcare access
Many patients are unable to continue receiving medical care in my setting owing to transportation-related disadvantages such as lack of a vehicle, high transportation costs, long-distance travel, and insufficient infrastructure. Patients from rural communities seeking care in my urban setting are often unable to take advantage of public transportation improvements in my area like bike lanes, improved bus access, or ridesharing. Elderly and mobility-impaired patients are the most affected and getting to and from physician appointments is not only stressful, but also time-consuming and laborious. Because of these difficulties, a significant number of patients fail or neglect to make crucial appointments.
* Lack of affordable medical care
Low-income individuals and the underinsured fail to obtain necessary medical care in my setting because of cost. Many of these patients have to choose between paying for medical care and settling their bills like food, rent, or mortgage: a large number choose to forego needed medical care in order to pay for these utilities. Even those who come for a medical visit end up skipping a test, prescription fill, or treatment because of cost.
* Limited patient information about care sites
The challenges to healthcare access in my setting are also tied to limited education about care sites. A significant number of patients do not have sufficient information to determine the appropriate facility for their needs. For instance, the emergency department in my setting has a large number of low-acuity cases and fewer high-acuity cases. There is no patient-centered mechanism in place to ensure that patients know the correct uses of different care sites.
* Clinician shortages
Clinician shortages, particularly nurse shortages, is another challenge contributing to inequitable health access in my setting. The patient-to-clinician ratio in my setting is high and long wait times are a common phenomenon. This problem has been worsened by a growing aging population and increasing care needs.
Table
A table that reflects the continuum of care access for a patient population in my healthcare setting is shown below.
Patient journey

Activities

Preadmission

This is the first step in the continuum of care where administrative functions are performed before actual care can be delivered. Preadmission activities include data collection through patient assessment. The ...