Disparities in Perceptions of Healthcare Access in a Community Sample

Abstract

Disparities in health status persist for many sociodemographic groups in the United States. An understanding of barriers to healthcare access and utilization can assist community-based initiatives in developing strategies to improve the health of minority and low-income populations. Using self-reported information from 3014 community residents, a factor analysis was conducted that defined barriers to healthcare by 4 dimensions: (1) time and competing priorities, (2) convenience and availability, (3) healthcare utilization, and (4) healthcare affordability. Differential effects of demographics were observed on all factors. Racial disparities were found where African Americans experienced more problems based on the convenience and availability of services (P < .02) than did whites, after controlling for income, education, age, and marital status. In addition, gender differences showed that women experienced greater difficulty with time and competing priorities than men (P < .001); however, women experienced fewer problems related to utilization (P < .001). Of the covariates, income was significant (P < .01) on 3 of the 4 indicators. This study points to the need to develop interventions that address the unique challenges faced by different population groups to ensure timely healthcare. In addition, the reduction of economic disparities should be considered as an important strategy to improve public health.

Clinical prioritizations and contextual constraints in nursing homes - a qualitative study

“…The nurses, in particular, reflected on this and assumed that it had to do with the patient being a resident in a nursing home, a status associated with age and comorbidity. This status may result in the patient’s not was being offered the same treatment as other hospitalized patients, and the conclusion appears to be in line with findings in international studies which suggest that age might unduly influence access to care and quality of care (6–9). In Norway, the ‘Patients’ Rights Act’ (23) states that each person in need of health care services is entitled to have access and treatment regardless of age or location.…”

“…The act mentions several patient rights: the right to necessary health care, the right to an evaluation and a re‐evaluation, the right to choose which hospital to go to and the right to an individual care plan, which coordinates the patient’s treatment from different professional groups and at different levels in the health care system. If physicians in hospitals are reluctant to admit residents, or physicians in the nursing homes are reluctant to refer patients to the hospital, the residents’ rights to specialist health care are not guaranteed (6–9).…”

“…A number of factors impact on setting priorities, including the expertise of the health care professional, the resident’s condition, availability of resources, ward organization, philosophy and model of care, the nurse–resident relationship, and the cognitive strategy used by to set priorities (5). International studies suggest that age might unduly influence access to care and quality of care (6–9), but there is limited research addressing the manner in which clinical priorities are decided on in geriatric care. Consequently, the aim of this study was to describe how physicians and nurses experienced the challenges, prioritizing dilemma and factors affecting prioritization decisions within the nursing home setting.…”

Studying Healthcare Affordability during an Economic Recession: The Case of Greece

“…If we accept that access may be defined as freedom from barriers to healthcare [133], then understanding the full range of barriers for vulnerable populations such as the poor is important to optimizing healthcare and health outcomes [134].…”

Self-care Behaviors for Orofacial Pain Among Different Racial/Ethnic Groups: Influences of Acculturation and Socioeconomic Status

“…Our findings are consistent with previously reported data that minority groups may be using more self-care for pain. (28) Individuals reporting White race/ ethnicity on average have better access to health care; consequently, as a group they have other options in care-seeking so there may be less need for them to use self-care for pain (29).…”