Barriers to accessing primary health care: comparing Australian experiences internationally

Abstract

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.

Factors Associated With Access, Utilization, and Level of Satisfaction With Primary Health Care Services in Hafar Al-batain City of Saudi Arabia

“…It was not found significant to the satisfaction of PHC receivers or even perceived as a barrier. This finding contrasted a previous study, which reported that affordability of health care services was perceived as a substantial barrier (Corscadden et al, 2017) . In fact, this barrier was more common in Australia than 7 of 10 countries.…”

“…In the quantitative approach, a descriptive, cross-sectional survey was used to identify the factors that influenced the perceptions of the respondents concerning the access and utilization of PHC services. The design was descriptive, as it aimed to determine the participants' characteristics and perceptions through survey (Corscadden et al, 2017). Furthermore, data were collected at a specific point in time concerning participants' opinions or perceptions toward available PHC services.…”

Spatial Analysis of the Neighborhood Risk Factors for Respiratory Health in the Australian Capital Territory (ACT): Implications for Emergency Planning

“…For example, research focused on access to primary care will use multifaceted frameworks such as that proposed by Levesque, Harris, and Russell [34], which includes both characteristics of services: approachability, acceptability, availability and accommodation, affordability, and appropriateness as well as corresponding abilities of people: ability to perceive, ability to seek, ability to reach, ability to pay and ability to engage. A recent study in Australia has shown that despite a universal health care scheme which provides free or low-cost health care access for all Australians, a significant proportion of the population still faced financial and availability barriers to accessing health care, with 27% of Australian adults reporting difficulties with after-hours access and 16% foregoing healthcare due to cost [35]. There is, however, also evidence that distance to services itself can be associated with poorer health outcomes.…”

Characteristics of patients who access zero, one or multiple General Practices and reasons for their choices: a study in regional Australia.

“…A systematic assessment of barriers to primary care, reported that availability, after hours services and affordability were particularly important barriers in the Australian context (2). In Australia, people are free to choose their GP and/or practice on each occasion (4).…”