Access to Health Care

Paper Summary:

The measurement of access to health care in America is far from uniform. Even a cursory review of the literature reveals diverse methods, instruments and procedures for assessing access, each applied to diverse populations (e.g., poor, special needs, middle class, insured, uninsured, etc.) for diverse services (oncology, preventative care, prenatal care, etc.). This paper examines access to health care as related to the measurement of access and to the range of programs that have been developed to improve access. The writer's personal reaction to each issue is included in the report. The paper also includes articles referred to in the text.

From the Paper:

"Access has also been measured in terms of whether a person has medical insurance or a regular source of care, or whether people use emergency rooms as their usual site of medical care (Wood, Hayward, Corey, Freeman & Shapiro, 1990). Additional access measures include whether insurance covers recommended care (Hubbell, Waitzkin & Rodriquez, 1990), the number of structural barriers confronting an individual or group seeking health care (Dutton, 1986), and the degree of expertise of a target group's service providers (McCoy, Aversa & McCoy, 1999). My personal reaction to this issue is to doubt the accuracy of access data. This is because each of these different measures must necessarily vary in the extent to which they have adequately operationalized the access construct."

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