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
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
Many Californians with fair or poor health do not receive timely care1
Timely care results in better treatment adherence, lowers the cost of care, and improves health outcomes. Importantly, timely care allows for early detection and intervention to prevent or treat serious health conditions.2 California has established appointment wait time standards for health plans. The standards require plans to offer an appointment to address urgent health concerns within 2-4 days and non-urgent health concerns within 10-15 days.3 There are shorter wait time requirements for primary care appointments than for specialist appointments.
This indicator tracks the percentage of patients who report receiving outpatient care in a timely manner, for both primary and specialty care. It is a subjective measure of patients’ experience in receiving care that was perceived to be timely, and does not indicate whether they received care within the wait time standards. Data for this indicator comes from the Patient Assessment Survey (PAS), which was sunset in 2024. We hope to identify a comparable data source to continue monitoring this priority area of attention.
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.
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Coordinating care improves health outcomes while controlling costs1
Coordinated care is an important component of quality, patient-centered care. Care coordination happens when providers listen to patients, take the prior and current care patients receive from other practitioners into account, and administer individualized care from an informed perspective. Coordination of care reduces the risk of medication errors or adverse events.2 Moving the system toward integrated and coordinated care allows patients to receive care in the most appropriate setting, reduces duplication, and enhances quality.3
This indicator tracks the percentage of adult patients whose doctors’ office helps coordinate outpatient care with other providers and services.
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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