Barriers to healthcare access in a non-elderly urban poor American population
Barriers to healthcare access in a non-elderly urban poor American population
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DOI：
10.1046/j.1365-2524.2001.00318.x
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发表时间：
2001-11-01
影响因子：
2.4
通讯作者：
Mann, B
中科院分区：
文献类型：
--
作者：
Ahmed, SM;Lemkau, JP;Mann, B
了解医疗保健的感知障碍对于改善所有美国人的医疗保健服务至关重要。为了确定在代顿，俄亥俄州的城市贫困人口的医疗保健的感知障碍，面对面的门到门的个人调查确定通过有针对性的，分层的，区域概率抽样。413名非老年贫困成年人（包括19%没有电话的人）的样本报告了各种医疗保健障碍的个人相关性。最常被认可的障碍是缺乏关于免费或低价保健、预期费用的信息，以及难以获得儿童保育。74%的答复者报告说存在一个以上的障碍。没有电话和没有健康保险的个人报告说，他们在获得保健方面遇到更多障碍。除了交通问题之外，工作和非工作穷人报告的障碍相似，非工作受访者更经常报告。这项研究提供了重要的数据，说明在医疗服务不足的社区中，穷人认为获得保健的障碍是什么，并强调了将没有电话的人纳入研究设计的重要性。没有电话的受访者更有可能报告多重障碍，特别是缺乏有关免费或打折医疗、儿童保育和交通的信息。这些调查结果表明，要获得关于穷人的准确数据，必须进行挨家挨户的调查，而不是电话调查。
An understanding of perceived barriers to health-care is critical to improving healthcare access for all Americans. To determine perceived barriers to health-care in an urban poor population in Dayton, Ohio, a face-to-face door-to-door survey of individuals identified through targeted, stratified, area probability sampling was done. A sample of 413 non-elderly poor adults, including 19% without telephones, reported personal relevance of various barriers to healthcare access. Most frequently endorsed barriers were lack of information about free or reduced-cost health-care, anticipated cost, and difficulty accessing child-care. Seventy-four per cent of respondents reported more than one barrier. Individuals without telephones and those without health insurance reported more barriers to health-care. Reported barriers were similar for working and non-working poor, except for transportation problems, more frequently reported by nonworking respondents. This study provides important data on what poor people in a medically underserved community perceive to be barriers to accessing health-care and underscores the importance of including people without telephones in the study design. Respondents who did not have telephones were more likely to report multiple barriers, particularly problems with lack of information about free or discounted medical care, child-care, and transportation. These findings suggest the importance of door-to-door surveys rather than telephone surveys for getting accurate data on the poor.