HLTH2000 6 - Access To Healthcare

Access to Health Care

  • Levels of Care:

    • Primary Care: Frontline health care; gatekeepers.

    • Secondary Care: Hospital-based care (private or public).

    • Tertiary Care: Specialist care.

  • Dimensions of Access:

    • Perceived Access: Awareness of availability.

    • Realised Access: Physical access to services.

    • 5 A’s of Access:

    1. Availability

    2. Affordability

    3. Accessibility

    4. Accommodation

    5. Acceptability

  • Equity in Health Care:

    • Interplay between social context and health service features.

    • Inverse Care Law: Better care availability inversely related to community needs.

  • Horizontal vs. Vertical Equity:

    • Horizontal Equity: Equal treatment for equals.

    • Vertical Equity: Unequal treatment for unequals with greater needs.

  • Cultural Safety:

    • Awareness of biases affecting clinical interactions and care.

  • Cultural Appropriateness:

    • Delivery of services consistent with clients' cultural identities.

Quality Health Care

  • Components of Quality Care:

    • Evidence-based best practice

    • Health outcomes based

    • Cost efficiency

    • Patient satisfaction

  • Donabedian’s Definition of Quality:

    • Three components:

    1. Technical quality

    2. Interpersonal quality

    3. Amenities

  • Six Domains of Health Care Quality (IOM):

    • Safe

    • Effective

    • Patient-centred

    • Timely

    • Efficient

    • Equitable

  • Challenges in Providing Quality Care:

    • Competing priorities

    • Scarce resources

    • Limited workforce

  • Measuring Quality:

    • Difficult, depends on definitions chosen.

    • Consider comparisons and trends over time.

  • Key Questions for Quality Interventions:

    • Leadership, resources, accountability, pilot projects, communication.