Accessibility

Give defs of access - don’t need to remember all of these - just know there any many ways of defining terminology of access - as such a broad term- comes down to what is their research interests (HS side or patients)

Don-proof of access is use of services

Freeborn - availibility of services when need arises

Anderson-end result of a process flowing from predisposing characteristics and enabling resources (potential access) through needs (perceived and evaluated to ultimate HO (health status and satisfaction)

Gulliford - four dimensions - availability, utilisation, relevanc

Describe predisposing factors, need, enabling factors

e, equity

Predisposing factors (beliefs, ethnicity, sex, age) - affects ability to seek help/decisions

Enabling factors (purchasing power)

Need - perceived and evaluated (doctors evaluates and says whether you need treatment)

HS

Diff studies will focus on diff aspects

Describe potential vs realised access

Potential access refers to the knowledge and availability of services.

- For example, some people do not have knowledge of certain services like ACC.

Realised access refers to the actual usage of these services.

- For example, making an ACC claim.

Describe the main def of access

Access is viewed as a set of specific areas (dimensions of access) of FIT between the patient and heath care system

Describe availability/existence of services barrier

The relationship between the volume and type of exisiting services (and resources) to the client’s volume and type of needs

(How confident to get care when you and fam need, how satisfied to have 1 good dr for fam, ability to get care in emergency, how satisfied with knowledge of where to get heath care)

-how much confidence do you have in being able to get good medical care for you and your fam when you need it

How satisfied are you with your ability to find one good doctor to treat the whole family?

-How satisfied are you with your knowledge of where to get health care?

-How satisfied are you with your ability to get medical care in an emergency?

Describe accomodation/organisational barriers

The relationship between the manner in which supply resources are organised and the expectation of clients.

(Waiting times for appointment in room and before, convenience of hours, how easy is it to get in contact)

o How satisfied are you with how long you have to wait to get an appointment?

o How satisfied are you with how convenient physicians’ office hours are?

o How satisfied are you with how long you have to wait in the waiting room?

o How satisfied are you with how easy it is to get in touch with your physician(s)?

Describe acceptability/psychosocial barriers

The relationship between clients’ and providers’ attitudes to what constitutes appropriate care.

(Discrimination, cultural beliefs, appearance of drs office, neighbours in, other patients)

o How satisfied are you with the appearance of the doctor’s offices?

o How satisfied are you with the neighbourhoods their offices are in? (E.g toys in dental offices)

o How satisfied are you with the other patients you usually see at the doctors’ offices?

Describe accessibility

The relationship between the location of supply and the location of clients, taking account of client transportation resources and travel time, distance and cost.

(Closeness to home, difficulty in travel)

o How satisfied are you with how convenient your physician's offices are to your home?

o How difficult is it for you to get your physician's office?

Describe affordability

The cost of provider services in relation to the client’s ability and willingness to pay for these services.

o How satisfied are you with your health insurance?

o How satisfied are you with the doctors’ prices?

o How satisfied are you with how soon you need to pay the bill?

Describe the titanic analogy

Lifeboats/treatment available - but not enough for everyone (Availability)

More men died then women → social norms/belief at time - women prioritised (acceptability)

Accessibility - distance to get into the lifeboat - Jack and rose had to cross many classes, gates - how quickly could they get there as third-class passengers

Affordability - more people getting saved in first class compared to second then third

Accomodations look out how me can adapt/manage to increase efficiency - how were lifeboats lowered

Describe the ACC study 2004-2005 (Qualitative study)

Barriers for asians access to ACC

Availability:

-Types of health services available

-Not all services are recognised and subsided by ACC

-Lack of knowledge of the services and eligibility of ACC (potential and realized access)

Accessibility:

-Transportation for the elderly

Affordability:

-direct and indirect cost, GP surcharge, value of cost

Accomodation:

-opening hours of services, costs more for after hours (links to affordability), INTERPRETATION SERVICES

Acceptability:

-use of interpreter, health beliefs (what is a serious injury), cultural appropriate services fx guidelines