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To Your Health: NLM update Transcript

Four health care challenges: 10/10/2017

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Greetings from the National Library of Medicine and MedlinePlus.gov

Regards to all our listeners!

I'm Rob Logan, Ph.D., senior staff, U.S. National Library of Medicine (NLM).

Here is what's new this week in To Your Health, a consumer health oriented podcast from NLM, that helps you use MedlinePlus to follow up on weekly topics.

The U.S. health care delivery system needs to address four challenges in order to be one of the best in the world, suggests a succinct perspective recently published in the New England Journal of Medicine.

The perspective's authors immediately contextualize their topic by noting (and we quote): 'reports from the Commonwealth Fund have consistently rated the performance of the U.S. health care system last among high-income countries; despite the fact that we spend far more on health care than these other countries' (end of quote). The New York-based Commonwealth Fund is an independent foundation that seeks to improve health care delivery; the perspective's authors work at the Fund.

The perspective's authors suggest the first challenge the U.S. health care system needs to address is to improve access to health care. The perspective's authors write (and we quote): 'affordable and comprehensive insurance coverage is fundamental. If people are uninsured, some delay seeking care, some of those end up with serious problems, and some of them die' (end of quote).

Second, the perspective's authors suggest the U.S.' investment in primary healthcare needs to improve. The authors explain the percentage of physicians dedicated to primary rather than secondary care is lower in the U.S. than other high-income nations.

Third, the perspective's authors suggest the U.S. health care system's administrative efficiency needs a transformation. Comparatively, the authors write: (and we quote): 'both patients and professionals in the United States are baffled by the complexity of obtaining care and paying for it' (end of quote).

The authors continue (and we quote): 'Coping with the byzantine layers of administration results in high levels of burnout for doctors and other professionals, which can reduce the quality of care' (end of quote).

Fourth, the perspective's authors add the U.S. needs to address the pervasiveness of disparities within the current health care system. The authors write (and we quote): "People with low incomes, low educational attainment, and other social and economic challenges face greater health risks and worse health in all countries, but especially in the United States, which has a less robust social safety net than other high-income countries' (end of quote).

The perspective's authors explain expanded social services, such as stable housing, more educational opportunities, better nutrition, and transportation would boost the U.S.' safety net, which would reduce patient demand for costly emergency and long-term care services.

The perspective's authors suggest the U.S. could achieve the best-performing health care system in the word by simultaneously addressing all of the four most pressing challenges. The perspective's authors conclude (and we quote): 'Instead of reversing course, addressing the four challenges through new legislation and new commitments by regulators, payers, and providers could improve the health of the American population and move the United States from last place to first among high-income countries' (end of quote).

It strikes us while the authors may be writing about the health care delivery system's challenges from a conceptually high altitude, the issues they raise provide a clear sense of direction to assist those on the ground.

Notably within the area of health disparities, MedlinePlus.gov provides helpful, accessible information. For example, the U.S. Centers for Disease Control and Prevention provides an overview of health disparities within the 'start here' section of MedlinePlus.gov's health disparities health topic page.

The Rural Health Information Hub provides information about health disparities in rural America within the 'specifics'

section of MedlinePlus.gov's health disparities health topic page.

MedlinePlus.gov's health disparities health topic page additionally provides links to the latest pertinent journal research articles, which are available in the 'journal articles' section. Clinical trials that may be occurring in your area can be found in the 'clinical trials' section. You can sign up to receive updates about health disparities as they become available on MedlinePlus.gov.

To find MedlinePlus.gov's health disparities health topic page, please type 'health disparities' in the search box on MedlinePlus.gov's home page, then, click on 'health disparities (National Library of Medicine).

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A disclaimer — the information presented in this program should not replace the medical advice of your physician. You should not use this information to diagnose or treat any disease without first consulting with your physician or other health care provider.

It was nice to be with you. Please join us here next week and here's to your health!