Health Care Access: A Consumer Perspective

Abstract

This article describes the use of action research as an information base for policy formulation by a collaborative partnership in Spokane, Washington. Health and social service providers recognized access to care by uninsured persons as a major community issue. Little was known from the consumers' perspective about factors limiting access. No benchmarks existed against which to measure progress. Investigators collected mailed surveys from 475 residents of six Spokane neighborhoods and 97 persons participated in 12 focus group sessions. Income, education, and ethnicity were primary factors affecting perceptions of degree to which medical, dental, and mental health needs were being met. Many residents were unable to obtain needed health care; low-cost dental and mental health services were named as their highest priorities. Quality of care, relationships with providers, immediacy of access, and cost were important concerns. Major barriers were cost, length of time before one could get an appointment, lack of comfort with providers, and having to miss work for appointments. Consumer input is critical in understanding local issues in health care. Action research that combines qualitative and quantitative data enhanced practice/policy decisions through assuring ownership of the research and immediate use of findings by involved agencies.

African American Consumers' Perceptions of Racial Disparities in Mental Health Services

“…Today's consumers are increasingly well informed about health care and often eager to be collaboratively involved with providers in treatment decision-making (Lammers & Happell, 2003). The consumer perspective is now actively solicited and reflected in federally funded research efforts, agency boards, community needs assessments, and policy development (Higgs, Bayne, & Murphy, 2001;Billings & Cowley, 1995).…”

Urban American Indian family caregivers' perceptions of barriers to management of childhood asthma

“…Minority and low-to middle-income consumer participants in focus groups in the Higgs et al (2001) study identified health care access and availability, providers' lack of understanding of low-income families' needs, and lack of information about community resources as major barriers. Johnson (2001) also used focus groups to identify perceived barriers to health care for a vulnerable population of women and children in a medically underserved area.…”

“…Other studies, not specific to asthma, have identified barriers to health care from the perspective of consumers (Higgs, Bayne, & Murphy, 2001;Johnson, 2001). Minority and low-to middle-income consumer participants in focus groups in the Higgs et al (2001) study identified health care access and availability, providers' lack of understanding of low-income families' needs, and lack of information about community resources as major barriers.…”

The Influence of a Change in Medicare Reimbursement on the Effectiveness of Stage III or Greater Decubitus Ulcer Home Health Nursing Care

“…The Aday et al (1998) framework can be expanded to incorporate five domains of interrelatedness that include health policy, population characteristics, health delivery system characteristics, customer satisfaction, and utilization of services (Higgs, Bayne, & Murphy, 2001). Both Aday et al (1998) and Marconi and Rudzinski (1995) go further to indicate that health services research is strengthened by the study of patient outcomes.…”