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  • Access to Healthcare Services

    Immediate and longer-term needs.

    Access to quality healthcare is one of several factors that can influence health status. When people have easy access to care, they can see a healthcare provider in a reasonable amount of time and pay for care. People who have access to healthcare are more likely to receive preventative services (e.g., immunizations, colonoscopies, mental health support) compared to people who don’t have access to healthcare. 

    Often, people look for healthcare services through their primary care provider first. That’s why it’s important to understand some of the immediate and longer-term barriers and needs that face the primary healthcare system in Pierce County. You can read more in our full report.

    Immediate needs for 2022.

    Syndromic surveillance for Pierce County suggests depression, anxiety and pregnancy-related visits had the highest average primary care visit-based rates from 2020–June 2022.

    During the first half of 2022 (January–June), the average primary care visit-based rates for these conditions were: 

    • Depression—692.7 per 10,000 primary care visits, 111.1 per 10,000 primary care visits lower than the state average.
    • Anxiety—643.4 per 10,000 primary care visits, 90.5 per 10,000 primary visits lower than the state average.
    • Pregnancy-related visits—499.8 per 10,000 primary care visits, 272.0 per 10,000 primary care visits higher than the state average.

    Anecdotal evidence from healthcare partners aligns with these findings and emphasizes large numbers of mental/behavioral health patients stress all levels of healthcare, including primary care. Lack of available resources and appropriately trained professionals contribute to this stress. Hospital partners emphasize people under 18 often face these constraints.

    Hospitals report difficulty meeting the needs of those who require outpatient dialysis services statewide. The Northwest HealthCare Response Network reports Pierce County hospitals are feeling particularly strained because of dialysis patients—with many facilities operating at a crisis level of care (shortened/canceled sessions, changing dialysis type).

    Longer-term needs (clear away the barriers to healthcare).

    High numbers of mental/behavioral health patients and inadequate staffing exemplify short-term problems that can lead to difficulties in accessing care. Health care coverage, the ratio of primary care and mental health providers per population, and those who did not seek care because of cost—require more intervention or longer-term solutions.

    Healthcare coverage in Pierce County, 2016–2020:

    • 94.1% had some form of health insurance (prepaid plans, Medicare/Medicaid).
    • The percentage of people who were uninsured increased until age 34, reaching its peak among those aged 26-34 years (11.1% didn’t have health insurance), before decreasing.
    • People 75 years or older were most likely to have insurance (99.8%).
    • Men were less likely to have healthcare insurance compared to women (Men: 6.7%, Women: 5.1%).
    • Hispanic people were less likely to have healthcare insurance compared to white people (Hispanic: 13.0%, White non-Hispanic: 4.5%).
    • People without a high school education were less likely to have healthcare insurance compared to people with a college degree (Without a high school education: 18.8%, Bachelor’s degree or higher: 3.3%). 

    Ratio of primary care and mental health providers.

    For all people in Pierce County to have access to care, we must have enough primary and mental health care professionals. In 2019, Pierce County had:

    • 1,335 residents per every physician. This is a better ratio compared to 2017 (1,379 residents/1 physician) and 2018 (1,363 residents/1 physician).
      • This is worse than the state average of 1,176 residents/physician.
    • 190 residents per every mental health provider. This is a better ratio then the state (230 residents/mental health provider). 

    Adults who didn’t go to the doctor because of cost, 2016–2020.

    In Pierce County, the percentage of people 18 years and over who had an unmet healthcare need because of cost similar to the state (Pierce: 11.6%, State: 11.4%). 

    • Higher among women:
      • Women: 13.3%.
      • Men: 10.0%.
    • Higher among Hispanic people:
      • Hispanic: 19.5%.
      • White: 10.3%.
      • Asian: 6.6%.
    • Lower with increased income:
      • Under $20,000/year: 24.6%.o $75,000/year or more: 6.1%.

    Source information.

    The Behavioral Risk Factor Surveillance System (BRFSS) is the largest ongoing telephone health survey in the world. The survey collects information on a wide variety of health conditions, health-related behaviors, and risk and protective factors about individual adult health. It allows the Center for Disease Control and Prevention (CDC), state health departments, and other health agencies to monitor preventable risk factors for chronic diseases and other leading causes of death. The CDC reports the survey results annually.

    The Rapid Healthcare Response Network (RHINO) carries out syndromic surveillance in Washington. It is near real-time, population-based surveillance system accessed through the Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE). It is a visit-based system (as opposed to patient-based) that is continuously receiving new information. Visits are not deduplicated by a specific individual. All presented rates are per 10,000 primary care visits. 

    The American Medical Association maintains a list of all physicians in the United States, accessed through the Area Health Resource File.