Efficient, Safe, and Patient-Centered Care
Being the healthiest state in the nation will require the health care system to be better aligned toward population health goals and outcomes. The system should be patient-centered and look beyond illness to health. To advance this goal, health care systems and plans across the state are already innovating ways to redesign the health delivery system.
Goal Highlights
Quality Care
An effective and efficient outpatient system includes high levels of patient safety and quality of care standards.
Health Systems Promoting Prevention
Improving prevention and management of chronic diseases through a more efficient and effective health delivery system allows Californians to obtain better value for each health care dollar spent.
Hospital System Improvements
Approximately 33 percent of all health care spending in 2009 in California went to hospital care. With sustained and system-wide quality improvement efforts in hospitals, safety and quality of care for patients can be enhanced and costs avoided.
Patient-Centered Care
Enhancing patient-centered care includes increasing integrated and coordinated care, offering care in the most appropriate setting, including a range of supports outside the clinical setting, as well as providing access to culturally and linguistically appropriate services.
Health Systems Transformation
It will take changing practices, incentives, and cultures to drive the integration and re-orientation of the health and health care systems to reach the goal of optimal health.
Innovations in Redesigning the Health System
Check out creative ways that innovators in many organizations and communities are working to improve outcomes in Redesigning the Health System.
Redesigning The Health System Indicators
In the next decade, California will need an additional 4,100 primary care providers to meet projected demand.1
Although insurance provides access to care, it does not ensure that everyone receives appropriate or high-quality care at the right time.2 An estimated 7 million Californians live in provider shortage areas, with shortfalls in access to primary, dental or mental healthcare providers.3 The shortage of health professionals impacts access to care, causing a significant delay in obtaining timely health services and resulting in barriers which negatively affect health outcomes. Access to comprehensive and quality healthcare services is important for physical, social, mental health, and overall quality of life.4 Access to care also promotes preventative measures, managing disease, and reducing unnecessary disability and premature death.4
This indicator tracks access to primary care providers based on the ratio of health professionals to population size. A primary care shortage area is defined as having a population greater than 2,000 per provider.
Learn More » about Increasing Access to Primary Care Providers
Access to timely care varies across the state1
This indicator tracks the percentage of patients receiving care in a timely manner, for both primary and specialty care.
Californians need access to health care that reflects their diverse cultures and languages
For California’s diverse populations, ensuring that providers can engage with their patients in a culturally and linguistically competent way is essential to meaningful access.1 Culturally and Linguistically Appropriate Services (CLAS) are health care services that are provided to patients in a language that they understand, and with sensitivity to patients' unique cultural and individual needs.2. Use of CLAS in healthcare settings is associated with care that is more efficient and less costly.3,4
There is currently no indicator to directly measure levels of access to CLAS. This has been identified as an opportunity for further data development to monitor this priority area of attention. In the meantime, the ability of patients to understand what their health care provider says is a way to measure one downstream dimension of CLAS: access to linguistically appropriate services. This indicator tracks the percent of adults who had difficulty understanding their medical provider among those who both speak a language other than English in the home and report not speaking English well.
Learn More » about Increasing Access to Culturally and Linguistically Appropriate Services
Coordinating care improves health outcomes while controlling costs1
This indicator tracks the percent of patients whose doctors' office helps coordinate care with other providers and services. Moving the system toward integrated and coordinated care allows patients to receive care in the most appropriate setting, reduces duplication, and enhances quality.2
Learn More » about Increasing Coordinated Outpatient Care – Adults
The nation spends billions annually on preventable hospitalizations1
Hospitalization is costly, stressful for patients, and carries a risk of adverse health outcomes.1,2 Preventable hospitalizations are hospitalizations for conditions that can be safely managed in an outpatient setting through access to high-quality preventative care, such as diabetes and hypertension.1
This indicator tracks the rate of preventable hospitalizations (per 100,000 population) using a composite measure based on ten ambulatory care-sensitive conditions.
Hospital readmissions cost the nation billions each year.1
Hospital readmissions refer to a hospital stay that occurs shortly after a patient has been discharged from the hospital. Hospital readmissions that occur within a short amount of time following a hospital discharge are a measure of clinical quality.1 High rates may indicate low quality care either during the hospital stay or after discharge, and are associated with high costs.2
This indicator tracks unplanned hospital readmissions within the first 30 days after hospital discharge.
California spends billions each year on hospital-acquired infections1
Hospital acquired conditions are complications such as injuries or infections that can occur in the course of receiving healthcare services.2 Measuring the incidence of hospital acquired conditions is one way to assess healthcare safety. With sustained and system-wide quality improvement efforts in hospitals, safety and quality of care for patients can be enhanced and billions of dollars saved.
This indicator tracks the incidence of measurable hospital-acquired conditions (per 1,000 discharges). It is a composite patient safety indicator that is an average of the observed-to-expected ratios of several other selected indicators of quality. The available data is not a definitive measure of hospital quality and there may be opportunities for further development to establish a more definitive measure.
Learn More » about Hospital Safety and Quality of Care (Acquired Conditions)
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