1. Improving Health Care for the Future Uninsured in Los Angeles County: A Community-Partnered Dialogue.
- Author
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Iyer, Sharat P, Jones, Andrea, Talamantes, Efrain, Barnert, Elizabeth S, Kanzaria, Hemal K, Detz, Alissa, Daskivich, Timothy J, Jones, Loretta, Ryan, Gery W, and Mahajan, Anish P
- Subjects
Health Services and Systems ,Public Health ,Health Sciences ,Health Services ,Clinical Research ,8.1 Organisation and delivery of services ,Health and social care services research ,Generic health relevance ,Good Health and Well Being ,Community Health Services ,Health Services Accessibility ,Humans ,Los Angeles ,Medically Uninsured ,Patient Protection and Affordable Care Act ,Public-Private Sector Partnerships ,Public Health and Health Services ,Epidemiology ,Public health - Abstract
ObjectiveTo understand the health care access issues faced by Los Angeles (LA) County's uninsured and residually uninsured after implementation of the Affordable Care Act (ACA) and to identify potential solutions using a community-partnered dialogue.DesignQualitative study using a community-partnered participatory research framework.SettingCommunity forum breakout discussion.DiscussantsRepresentatives from LA County health care agencies, community health care provider organizations, local community advocacy and service organizations including uninsured individuals, and the county school district.Main outcome measuresKey structural and overarching value themes identified through community-partnered pile sort, c-coefficients measuring overlap between themes.ResultsFive overarching value themes were identified - knowledge, trust, quality, partnership, and solutions. Lack of knowledge and misinformation were identified as barriers to successful enrollment of the eligible uninsured and providing health care to undocumented individuals. Discussants noted dissatisfaction with the quality of traditional sources of health care and a broken cycle of trust and disengagement. They also described inherent trust by the uninsured in "outsider" community-based providers not related to quality.ConclusionsImproving health care for the residually uninsured after ACA implementation will require addressing dissatisfaction in safety-net providers, disseminating knowledge and providing health care through trusted nontraditional sources, and using effective and trusted partnerships between community and health care agencies with mutual respect. Community-academic partnerships can be a trusted conduit to discuss issues related to the health care of vulnerable populations.
- Published
- 2015