Our next installment of the 2018 Live Healthy State Health Assessment summaries covers access to healthcare.  Because the document is 346 pages, we will summarize each section.  Check out our previous posts:  overview of the report, South Carolina demographics, leading causes of death and hospitalization, and cross-cutting.  Data is analyzed from 2010-2016.

Access to health care refers to the ability of residents in a community to find a consistent medical provider for their primary and specialty care needs and ability to receive that care without encountering significant barriers.  Special populations who may face unique barriers include those who are experiencing homelessness or mental illness, lacking adequate health insurance, or non-English speakers such as some immigrants and refugees.

Primary Care Physicians

Primary care physicians specialize in family medicine, internal medicine, obstetrics/gynecology, and pediatrics.  They provide preventative care, identify and treat common conditions, and make referrals to specialists as needed.  Typically people with familiar primary care physicians have better chronic disease management, lower overall health care costs, and a higher level of satisfaction with their care.

According to America’s Health Rankings, in 2017, South Carolina ranked 36^th in the nation for the number of primary care physicians per 10,000 residents.  The counties with the highest rates of primary care physicians in 2015 were Charleston, Greenwood, and Greenville.

Physician Assistants

Physician assistants are certified medical professionals who can give medical and surgical care in teams with physicians.  They can practice under the direction of a physician to diagnose, treat, and prescribe medicine.  The ratio of physician assistants increased from 1.5 physician assistants per 10,000 residents in 2009 to 2.5 physician assistants per 10,000 residents in 2015.

Nurse Practitioners

Nurse practitioners have clinical knowledge and skills to provide direct patient care.  They have the authority to prescribe medications and can also be utilized in rural communities, which often lack primary care providers.  South Carolina saw a 50% increase in the ratio of nurse practitioners from 2009 to 2015.

Health Insurance Coverage Among Adults

The Kaiser Family Foundation estimated 550,000 South Carolinians were without health insurance in 2016.  Although the number of insured adults in South Carolina increased from 2008 to 2015, the rate was below the United States, as well as the Healthy People 2020 target.  In 2015, 85.7% of South Carolina women were insured compared to 81.6% of men.

Delayed Medical Care

Worse health outcomes and higher medical expenditures are often results of delayed medical care.  Late diagnosis and advanced disease may require more extensive services.  Being insured and having access to affordable medical care could increase utilization of preventive health care services.

In South Carolina in 2016, 21.2% of Hispanic/Latinos delayed healthcare due to cost, compared to 18.8% of non-Hispanic Blacks and 13.7% of non-Hispanic Whites.  More women delayed medical care due to cost than men.

For more information about avoidable hospitalizations and emergency department visits, the leading causes of hospitalizations among children, and oral health, read the full chapter about Access to Health Care.