Mexican-American adults and children are more likely to have untreated decayed teeth than any other population group. because the healthcare delivery system in the United States though referred to as a system as a result of its features, components, and services, cannot really be called a system per se. By almost any metric, uninsured adults suffer worse health status and live shorter lives than insured adults (IOM, 2002a). Yet the nation's substantial health-related spending has not produced superlative health outcomes for its people. health management associates accountable care institute 180 north lasalle, suite 2305, chicago, illinois 60601 telephone: 312.641.5007 fax: 312.641.6678 www.healthmanagement.com pat terrell, executive director terry conway, md, director of clinical practice doug elwell, director of finance art jones, md, director of finance greg vachon, md, director of clinical practice Total of medical and surgical beds, ICU beds, and special care beds. HMO. Barriers to and Facilitators of Digital Health Among Culturally and Linguistically Diverse Populations: Qualitative Systematic Review Barriers to and Facilitators of Digital Health Among Culturally and Linguistically Diverse Populations: Qualitative Systematic Review Additionally, those with no insurance all year paid nearly 60 percent of costs out-of-pocket, whereas those with some private insurance paid 40 percent of costs out-of-pocket in 1996 (Zuvekas, 2001). As a result, this research aimed to determine health professionals' and . For diseases under national surveillance, from 6 to 90 percent of cases are reported, depending on the disease (Teutsch and Churchill, 1994; Thacker and Stroup, 1994). Bindman and colleagues (1995) similarly concluded that at the community level, there is a strong positive association between health care access and preventable hospitalization rates, suggesting that these rates can serve as an indication of access to care. It would be a costly mistake to create additional emergency and inpatient capacity before decompressing demand by improving access to primary care services. Second, the shift of Medicaid services to a managed care environment led some public health departments to scale down or dismantle their infrastructure for the delivery of direct medical care. Consumers will be expected to shop for their own care with a medical spending account coupled with catastrophic benefits for very large expenses. Such arrangements have made possible some level of integration of health care and public health services, enhanced information exchange and continuity of care, and allowed public health departments to be reimbursed for the provision of some of the services that are covered by the benefits packages of managed care plans (Martinez and Closter, 1998).