Barriers to accessing primary health care: comparing Australian experiences internationally
Lisa Corscadden A H , Jean-Frederic Levesque A B , Virginia Lewis C , Mylaine Breton D , Kim Sutherland A , Jan-Willem Weenink E , Jeannie Haggerty F and Grant Russell GA Bureau of Health Information, Level 11, 67 Albert Avenue, Chatswood, NSW 2067, Australia.
B Centre for Primary Health Care and Equity, University of New South Wales, Sydney NSW 2052, Australia.
C Australian Institute for Primary Care & Ageing, LaTrobe University, Melbourne, Vic. 3068, Australia.
D Community Health Sciences Department, Université de Sherbrooke, Longueuil, QC, J4K 0A8, Canada.
E IQ healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center PO Box 9101, NL-6500 HB Nijmegen, Netherlands.
F Faculty of Medicine, McGill University, Montreal, QC, H3A 0G4, Canada.
G Southern Academic Primary Care Research Unit, School of Primary Health Care, Monash University, Clayton, Vic. 3800, Australia.
H Corresponding author. Email: lisa.corscadden@health.nsw.gov.au
Australian Journal of Primary Health 23(3) 223-228 https://doi.org/10.1071/PY16093
Submitted: 2 August 2016 Accepted: 7 October 2016 Published: 8 December 2016
Journal Compilation © La Trobe University 2017 Open Access CC BY-NC-ND
Abstract
Most highly developed economies have embarked on a process of primary health care (PHC) transformation. To provide evidence on how nations vary in terms of accessing PHC, the aim of this study is to describe the extent to which barriers to access were experienced by adults in Australia compared with other countries. Communities participating in an international research project on PHC access interventions were engaged to prioritise questions from the 2013 Commonwealth Fund International Health Policy Survey within a framework that conceptualises access across dimensions of approachability, acceptability, availability, affordability and appropriateness. Logistic regression models, with barriers to access as outcomes, found measures of availability to be a problematic dimension in Australia; 27% of adults experienced difficulties with out-of-hours access, which was higher than 5 of 10 comparator countries. Although less prevalent, affordability was also perceived as a substantial barrier; 16% of Australians said they had forgone health care due to cost in the previous year. After adjusting for age and health status, this barrier was more common in Australia than 7 of 10 countries. Findings of this integrated assessment of barriers to access offer insights for policymakers and researchers on Australia’s international performance in this crucial PHC domain.
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