Working definition: ACCESS—accessibility to the health care system requires that the patient overcome certain barriers. Geographic distance to health care facility, transportation, language and cultural differences, physician attitudes, behavioral factors, and lack of sufficient income are all potential obstacles to care.

Objectives:

• The County’s centralized health care system should be continued with the County in the provider role.
• San Mateo County General Hospital should remain open as an acute care general hospital with its outpatient clinics, which provide both primary and secondary care. If financially feasible, satellite primary health care services should be provided throughout the county. If satellite primary health care services are not provided, transportation to the centralized facility at San Mateo County General Hospital is essential.
• The county should provide equitable health care services throughout the county.
• The components of a health care delivery system should include:
• Comprehensive medical care, including mental health care
• Quality care
• Continuity of services
• Availability (Working definition: existence of services for use by those who need them.)
• Transportation
• Eligibility services
• Translation services
• Social services
• Information and referral servic
• Among the non-medical components, special emphasis should be placed on transportation and availability. Decisions should be based on more than monetary factors.
• Planning for coordination and implementation of health care services is needed.
• There is a need for uniform cost accounting. Standardized data collecting, reporting and retrieval are also necessary for decision making.
• Continue ambulance and emergency vehicle dispatch and response, and a central emergency communication system. Quality standards of training should be enforced for those who staff vehicles responding to emergency calls. Paramedic service is desirable.
• There is a need to create public awareness and knowledge of available health care services.