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Access granted! barriers endure: determinants of difficulties accessing specialist care when required in Ontario, Canada

BACKGROUND: In the Canadian context, health care services are governed by the Canada Health Act, which ensures that primary care doctors, specialists, hospitals and dental surgeries are covered through provincial health insurance plans. This ensures access to medically necessary health care services...

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Detalles Bibliográficos
Autores principales: Harrington, Daniel W, Wilson, Kathi, Rosenberg, Mark, Bell, Scott
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3637586/
https://www.ncbi.nlm.nih.gov/pubmed/23607393
http://dx.doi.org/10.1186/1472-6963-13-146
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author Harrington, Daniel W
Wilson, Kathi
Rosenberg, Mark
Bell, Scott
author_facet Harrington, Daniel W
Wilson, Kathi
Rosenberg, Mark
Bell, Scott
author_sort Harrington, Daniel W
collection PubMed
description BACKGROUND: In the Canadian context, health care services are governed by the Canada Health Act, which ensures that primary care doctors, specialists, hospitals and dental surgeries are covered through provincial health insurance plans. This ensures access to medically necessary health care services for all Canadians regardless of ability to pay. Despite this important piece of legislation, research has shown persistent inequalities in access between and within socio-demographic groups, and geographic areas. To date, most research has focused on access to primary care, with much less attention paid to specialist care as an important component of the health care continuum. Thus, the objectives of this research are to address this gap in knowledge by examining the factors associated with difficulty accessing specialist services, and the reasons why particular subpopulation groups report experiencing difficulties. METHODS: This research uses multivariate logistic regression to analyze data from the Canadian Community Health Surveys’ optional content from the province of Ontario (n=21,526) related to accessing specialist health care services. The multivariate logistic regression model identifies several subpopulation groups that are more likely to report difficulty accessing specialist care when required. Cross-tabulations are subsequently used to establish the main reasons why difficulties are faced. RESULTS: Over 26% of respondents required a specialist visit in the 12 months preceding administration of the survey. Of these, 22% reported difficulty accessing specialist care. Those with difficulties were more likely to be immigrants, post-secondary educated, and have one or more chronic conditions. People living in urban health regions were also more likely to report difficulties accessing care. Primarily wait times were cited as reasons for these difficulties, followed by a perceived lack of availability. CONCLUSIONS: There are difficulties faced by the general population as a whole (e.g., wait times) as well as particular difficulties experienced more frequently by certain groups (e.g., transportation, language, and cost barriers for newcomers). These issues are important, as they may discourage individuals from using necessary health care services, and may contribute to feelings of dissatisfaction with the health care system.
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spelling pubmed-36375862013-04-28 Access granted! barriers endure: determinants of difficulties accessing specialist care when required in Ontario, Canada Harrington, Daniel W Wilson, Kathi Rosenberg, Mark Bell, Scott BMC Health Serv Res Research Article BACKGROUND: In the Canadian context, health care services are governed by the Canada Health Act, which ensures that primary care doctors, specialists, hospitals and dental surgeries are covered through provincial health insurance plans. This ensures access to medically necessary health care services for all Canadians regardless of ability to pay. Despite this important piece of legislation, research has shown persistent inequalities in access between and within socio-demographic groups, and geographic areas. To date, most research has focused on access to primary care, with much less attention paid to specialist care as an important component of the health care continuum. Thus, the objectives of this research are to address this gap in knowledge by examining the factors associated with difficulty accessing specialist services, and the reasons why particular subpopulation groups report experiencing difficulties. METHODS: This research uses multivariate logistic regression to analyze data from the Canadian Community Health Surveys’ optional content from the province of Ontario (n=21,526) related to accessing specialist health care services. The multivariate logistic regression model identifies several subpopulation groups that are more likely to report difficulty accessing specialist care when required. Cross-tabulations are subsequently used to establish the main reasons why difficulties are faced. RESULTS: Over 26% of respondents required a specialist visit in the 12 months preceding administration of the survey. Of these, 22% reported difficulty accessing specialist care. Those with difficulties were more likely to be immigrants, post-secondary educated, and have one or more chronic conditions. People living in urban health regions were also more likely to report difficulties accessing care. Primarily wait times were cited as reasons for these difficulties, followed by a perceived lack of availability. CONCLUSIONS: There are difficulties faced by the general population as a whole (e.g., wait times) as well as particular difficulties experienced more frequently by certain groups (e.g., transportation, language, and cost barriers for newcomers). These issues are important, as they may discourage individuals from using necessary health care services, and may contribute to feelings of dissatisfaction with the health care system. BioMed Central 2013-04-22 /pmc/articles/PMC3637586/ /pubmed/23607393 http://dx.doi.org/10.1186/1472-6963-13-146 Text en Copyright © 2013 Harrington et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Harrington, Daniel W
Wilson, Kathi
Rosenberg, Mark
Bell, Scott
Access granted! barriers endure: determinants of difficulties accessing specialist care when required in Ontario, Canada
title Access granted! barriers endure: determinants of difficulties accessing specialist care when required in Ontario, Canada
title_full Access granted! barriers endure: determinants of difficulties accessing specialist care when required in Ontario, Canada
title_fullStr Access granted! barriers endure: determinants of difficulties accessing specialist care when required in Ontario, Canada
title_full_unstemmed Access granted! barriers endure: determinants of difficulties accessing specialist care when required in Ontario, Canada
title_short Access granted! barriers endure: determinants of difficulties accessing specialist care when required in Ontario, Canada
title_sort access granted! barriers endure: determinants of difficulties accessing specialist care when required in ontario, canada
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3637586/
https://www.ncbi.nlm.nih.gov/pubmed/23607393
http://dx.doi.org/10.1186/1472-6963-13-146
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