Core dimensions of healthcare access
In the health services literature, access to healthcare has five core dimensions, outlined below. 6
In this brief, we explore how instances of delayed and forgone care over the course of the pandemic are related to the availability and affordability dimensions of healthcare access, such as not being able to find an available physician or not being able to afford necessary services. Our next brief explores the remaining dimensions of access. Understanding and addressing such barriers can help improve health outcomes by eliminating reasons that patients might delay or forgo care, especially among high-need New Yorkers. Changes in healthcare needs among high-need New Yorkers During the pandemic, high-need New Yorkers needed physical healthcare. More than half of economical- ly disadvantaged high-need New Yorkers needed care (56% in 2021 and 52% in 2022). More advantaged high-need New Yorkers reported roughly similar levels of physical healthcare needs: 50% in 2021 and 59% in 2022 (Figure 1). The need for mental healthcare among high-need New Yorkers, however, varied substantially by one’s eco- nomic position. In both years explored, about half of economically disadvantaged New Yorkers reported needing mental healthcare, compared to only about one-third of their more-advantaged counterparts (Fig- ure 1). AVAILABILITY : the supply of appropriate care options versus patients’ needs AFFORDABILITY: the cost of services versus patients’ ability to pay or insurance coverage ACCESSIBILITY: the geographic location of healthcare services versus patients’ location and ability to reach them (e.g., transportation) ACCOMMODATION: the organization of services versus patients’ circumstances (e.g., after-hours and weekend appointments) ACCEPTABILITY: the cultural competence in service delivery versus patients’ preferences and beliefs (e.g., feeling welcome or respected by your provider)
6 Penchansky and Thomas, “The concept of access: definition and relationship to consumer satisfaction.”
PATTERNS OF DELAYED HEALTHCARE AMONG NEW YORKERS WITH HIGH HEALTHCARE NEED 5
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