Expanding the definition of access: It isn't just about health insurance

被引:28
|
作者
Hall, Allyson G. [1 ,3 ]
Lemak, Christy Harris [1 ]
Steingraber, Heather [1 ]
Schaffer, Stephen [2 ]
机构
[1] Univ Florida, Coll Publ Hlth & Hlth Profess, Gainesville, FL 32611 USA
[2] Univ Florida, Coll Liberal Arts & Sci, Gainesville, FL 32611 USA
[3] Univ Florida, Florida Ctr Medicaid & Uninsured, Gainesville, FL 32610 USA
关键词
access to care; health insurance; primary care providers; appointment availability;
D O I
10.1353/hpu.0.0011
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Measurement of access to health care services is often limited to such variables as having health insurance or a usual source of care. We argue for an expanded definition of access measuring whether providers accept a particular form of insurance (overall accessibility), ease of contacting providers for appointments (contact accessibility), length of time it takes to get an appointment (appointment accessibility), and proximity of providers to patients (geographic accessibility). Interviewers posing as Medicaid beneficiaries telephoned providers in Florida's Medicaid primary care case management program, to determine whether the provider was accepting new patients, had weekend or evening hours, and how long it would take to get an appointment. Approximately 87% were accepting new patients, but only 68% were accepting new Medicaid patients. The survey also showed that beneficiaries may encounter difficulty in reaching physicians and making appointments: 22% of all calls were not answered on the first attempt and over two-thirds of providers had no weekend or evening hours.
引用
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页码:625 / 638
页数:14
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