SD5 - Developing Primary Care Services in Virginia
Executive Summary: In accordance with the directives of SJR 179, local health directors, along with representatives of the private medical care community, businesses, schools, hospitals, consumers, non-profit service organizations, and many others, compiled data to identify what people in their locality did not have access to primary care health care services, and what barriers prevented that access. While the findings were not surprising, their work allowed all participants to see together what problems they were facing and the impact of these problems on the general well-being of the community at large. Findings In general, the needs assessments together found that Virginia does not lack for primary care providers in terms of sheer numbers. Those providers are spread throughout the state, but are more concentrated in urban areas near hospitals and sparse in rural areas and even within certain urban and suburban communities. Together, these assessments found that the state needs between 253 and 361 primary care physicians located in identified underserved communities. In addition to a provider manpower shortage, other barriers to care were identified: • Poor access for persons not covered by insurance, public or private. • Lack of transportation to medical providers. • Insufficient perinatal and pediatric services. • Limited services for chronically ill and elderly, particularly those of low income and the uninsured. • Lack of health promotion and disease prevention activities. • Poor health care provider perception of Medicaid services. • High teen pregnancy rates. • Inappropriate use of hospital emergency rooms for regular primary care. Some differences across the state are clearly evident, such as the percentage of providers accepting Medicaid payment. A far higher percentage of primary care physicians in the southwest region of the state accept some level of Medicaid reimbursement for care than in the northern region. Other needs reported by community advisory groups may not directly reflect needs as illustrated by other means. For example, only one district in the eastern region identified teen pregnancy as a problem even though other districts also have high teen pregnancy rates. Other variations in local need are more apparent in reviewing each district's analysis of its needs assessment. Summaries of those findings as reported by each health district are found on pages 10 - 27 of the full report. This year's work clearly documents what local communities across the Commonwealth have identified as critical health care needs in their own communities. In 1992, the Advisory Committee will develop cooperative plans for addressing the most critical needs. Many plans will be similar, but each unique to meet that locality's needs, environment, and resources. A final report of these activities will be reported to the Governor and the 1993 session of the General Assembly. |
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