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

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Access to timely care varies across the state

This indicator tracks the percentage of patients receiving care in a timely manner, for both primary and specialty care.

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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.

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Coordinating care improves health outcomes while controlling costs

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.

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The nation spends billions annually on preventable hospitalizations

This indicator provides the rates of preventable hospitalizations (per 100,000 population) for selected conditions. It is based upon a composite indicator for twelve ambulatory care-sensitive conditions. Examples include diabetes complications, adult asthma, hypertension, heart failure, dehydration, urinary tract infection, and bacterial pneumonia. Hospitalizations due to these conditions are potentially preventable through access to high-quality outpatient care.

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California’s overall 30-day readmission rate has declined from 14% in 2011 to 13.6% in 2014.

The rate of unplanned hospital readmissions is an important measure of clinical quality. High rates may indicate concerns with low quality and are associated with high costs.

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California spends $3.1 billion each year on hospital-acquired infections

This indicator includes incidence of measurable hospital-acquired conditions (per 1,000 discharges). This data is comprised of a composite patient safety indicator, which includes an average of the observed-to-expected ratios of several other selected indicators of quality. The available data is limited and there remains opportunity for further development to establish a more definitive measure. At present, this indicator serves as a useful starting point for examining hospital quality. 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.

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