Inequalities in health care need and demand across the District – The D.C. Policy Center – DC Initiative on Racial Equity
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This article is the second in a series on COVID and the District’s health care workforce, which will discuss the ecosystem of care providers relevant to COVID and primary care outcomes, evaluate patient’s access to clinicians, and measure health care capacity. Read the first article in the series here.

The public health emergency caused by COVID-19 has increased scrutiny on the District of Columbia’s health care system. Does D.C. have adequate health care workforce capacity to handle the health care need and health care demand of its residents during this pandemic? If not, what supply gaps exist, and what impact do those gaps have on residents? To examine these questions, we turn to data from the D.C. Department of Health (DOH) and other clinical boards in the Washington metropolitan area.

In order to understand the District’s COVID-19 response, health needs of the population, and whether the existing network of health care professionals is sufficient to support the needs of the population, we must first determine how many primary care visits the population needs, and what barriers exist to getting care.

To understand the healthcare need of District residents, we asked: What drives differences in the health care needs of different groups of Washingtonians? How can our knowledge of primary care need and demand inform our understanding of the inequitable COVID-related outcomes seen in the District?

The health care needs of District residents are largely dependent on age, sex, and underlying health conditions. For example, a child is likely to see a primary care provider for school-mandated checkups, common colds, and sports injuries, while an older person is more likely to seek prescription refills and bloodwork for chronic conditions. Women are more likely to need more primary care visits than men between the onset of puberty and menopause. Age, sex, and health status (as impacted by pre-existing conditions and genetic and environmental factors) are the primary determinants of a person’s health care need. Thus, health care need is the number of annual primary care visits an individual is predicted to have based on their age, sex, and health status.

However, for various reasons, not everyone who needs health care seeks it. Health care demand is the number of annual primary care visits an individual is predicted to have, accounting for barriers such as cost, cul


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