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What is access of care?
Access of care within healthcare is associated with the availability of medical services, providers and institutions. Therefore, it determines whether patients and communities can use healthcare services when necessary. Access of care is often determined by such factors as “availability, price, and quality of resources, goods and services in healthcare industry” (Levesque, Harris, & Russell, 2013, p. 2).
When it is easy to get to the nearest medical institution and ask healthcare professionals for help, then the access of care does exist. Meanwhile, people who do not have hospitals or other medical establishments in the area, or doctors do not respond to their queries, then the access of care is poor. Sometimes, access of care is associated with insurance as a means to provide full or partial healthcare coverage.
How does service availability affect access of care?
Service availability and access of care are two interrelated notions complementing each other, but they are not equal. People seek care either as a preventive measure or a treatment during illness. Living near healthcare facility increases the probability of seeking care. However, greater availability of referral health services in the area does not influence much a decision to seek care, while a great availability of staff and equipment positively affects it (Anselmi, Lagarde, & Hanson, 2015).
When people who need care realize that they could receive appropriate treatment, this is indicative of service availability. On the contrary, when a patient gets at the medical facility easily, but there is no necessary equipment or lack of the qualified staff, service availability is undermined, which negatively influences the access of care credibility.
How do affordability, physical accessibility (delivery), and acceptability (quality) of services affect access of care?
Service availability is extremely important in healthcare, but such characteristics as accessibility, affordability and acceptance are also crucial in delivery of medical care. Services are useful only when they are physically accessible to the clients. Even though the doctors and nurses are highly qualified, the patient cannot be satisfied once they are not accessible in critical situations. Affordability is another service characteristic feature which greatly influences decision-making in patients. In case one has no insurance program, the costs for medicine or healthcare services might be too high (Mosadeghrad, 2013).
Furthermore, healthcare services must be also acceptable and meet the client expectations and preferences. For instance, when a patient feels more comfortable with a woman doctor, it is necessary to assure that female medical workers will be at the place.
What are some barriers to access of care?
Many countries have been struggling to develop sophisticated healthcare infrastructures for decades. Still, there are some factors that form barriers in the access of care. Those factors are generally consistent across different countries – “below-average income, immigrant status, and chronic conditions, particularly mental health conditions” (Corscadden et al., 2018, p.5). People with low income or those unemployed are often deprived of the healthcare coverage or insurance, which decreases the access of care levels.
Furthermore, people with immigrant status obviously do not have any social benefits that guarantee access to healthcare services and affordable medical treatment. Another barrier to access of care is chronic conditions, especially those concerning mental health, which usually require specialized medical institutions.
How is equity of access measured?
Apparently, some barriers in access of care tend to deprive patients of adequate delivery of healthcare services. Equity of access is measured by “taking social and health determinants, needs of patients and populations as well as resources available into account” (Richard et al., 2016, p. 17). When patients in rural areas do not have the basic equipment or highly qualified staff to guarantee appropriate healthcare services, then inequity is present at the place. If some communities particularly suffer from cardiovascular diseases, then insufficient number of professionals and medicine would also evidence insufficient equity.
References
Anselmi, L., Lagarde, M., & Hanson, K. (2015). Health service availability and health seeking behaviour in resource poor settings: Evidence from Mozambique. Health Economics Review, 5(26), 1-13.
Corscadden, L., Levesque, J.F., Lewis, V., Strumpf, E., Breton, M., & Russell, G. (2018). Factors associated with multiple barriers to access in primary care: An international analysis. International Journal for Equity in Health, 17(28), 1-10.
Levesque, J.-F., Harris, M.F., & Russell, G. (2013). Patient-centred access to health care: Conceptualising access at the interface of health systems and populations. International Journal for Equity in Health, 12(18), 1-9.
Mosadeghrad, A.M. (2013). Healthcare service quality: Towards a broad definition. International Journal of Health Care Quality Assurance, 26(3), 203-219.
Richard, L., Furler, J., Densley, K., Haggerty, J. Russell, G., Levesque, J.-F., & Gunn, J. (2016). Equity of access to primary healthcare for vulnerable populations: The IMPACT international online survey of innovations. International Journal for Equity in Health, 15(64), 1-20.
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