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Healthcare Utilisation—Why the Problem of Equalising Access Has Become Even Harder

journal contribution
posted on 2023-09-01, 14:12 authored by Sally Fowler-DavisSally Fowler-Davis

People use healthcare services to diagnose, cure, or ameliorate disease or injury, to improve or maintain function, or to obtain information about their health status and prognosis [1]. Disparities in access to healthcare have been widely recognised to be associated with social and economic deprivation [2–4] but are often attributed to information deficits about communities needs at the neighbourhood or population level [5]. In conceptualising access and utilisation, this Special Issue is focused on ageing and the utilisation of the healthcare system based on user entitlement in different healthcare systems, focusing in on the differential access to healthcare. Multimorbidity, social and economic determinants and user expectations are the main considerations for the services. Targeting poorer, older, and more marginalised communities to improve accessibility to the services is now recognised as an important challenge to improve health outcomes internationally. Levesque et al., in 2019 [3], generated five dimensions of accessibility: (1) approachability; (2) acceptability; (3) availability and accommodation; (4) affordability; and (5) appropriateness of services. In addition, they developed a corresponding set of dimensions that identify the relative capabilities of populations to interact with services: (1) ability to perceive; (2) ability to seek; (3) ability to reach; (4) ability to pay; and (5) ability to engage. The connection that they made between provision and engagement usefully highlights the reciprocal nature of the access dilemma and provides a tool for considering the failures to effectively equalise access to all populations.



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