Access to Health Services

Question 1

What does a health system look like?

Answer 1

All organisations, people and actions whose primary
purpose is to promote, restore or maintain health.

Question 2

List two boundaries of the health system.

Answer 2

• Services and activities to enable their delivery (finance & resource generation)
• Stewardship, including activities seeking to influence the positive health impact of other sectors

Question 3

Why is health important?

Answer 3

• Central to human happiness & well-being
• It is a human right
• Economic prosperity: healthy people live longer, are more productive, save more

Question 4

What does equity in health mean?

Answer 4

People’s needs guide the distribution of opportunities for wellbeing.

Question 5

Describe the Inverse Care Law.

Answer 5

Availability of good medical care tends to vary inversely with the need of the population served.

Question 6

List the 3 Anderson’s Determinants of Service Use.

Answer 6

• Predisposing Factors
• Enabling Factors
• Need Factors

Question 7

What are the predisposing factors of service use?

Answer 7

The socio-cultural characteristics of individuals that exist prior to their illness.

Question 8

Which socio-cultural characteristics are included in the predisposing factors?

Answer 8

• Social Structure: Education, occupation, ethnicity, social networks, social interactions, and culture
  – Health Beliefs: Attitudes, values, and knowledge that people have concerning and towards the health care system
  – Demographic: Age and Gender

Question 9

What are the enabling factors of service use?

Answer 9

The logistical aspects of obtaining care.

Question 10

Which logistical aspects of obtaining care are applied to the enabling factors?

Answer 10

• Personal/Family: The means and know how to access health services, income, health insurance, a regular source of care, travel, extent and quality of social relationships
  – Community: Available health personnel and facilities, and waiting time
  – Possible additions: Genetic factors and psychological characteristics

Question 11

What are the need factors of service use?

Answer 11

The most immediate cause of health service use, from functional and health problems that generate the need for health care services.

Question 12

Which immediate causes of health service use are included in the need factors?

Answer 12

• Perceived: “How people view their own general health and functional state, as well as how they experience
  symptoms of illness, pain, and worries about their health and whether or not they judge their problems to be of sufficient importance and magnitude to seek professional help.”
  – Evaluated: “Represents professional judgment about people’s health status and their need for medical care.”

Question 13

List inequalities in health care that need to be monitored.

Answer 13

• Resources, e.g. budgets & doctors
• Access/use, e.g. waiting times, opening hours, prescriptions dispensed, operations performed
• Quality, e.g. patient satisfaction, outcomes (e.g. mortality rates)

Question 14

List a few examples of barriers to healthcare access which are imposed by services.

Answer 14

• Poor provision of information
• Waiting times for appointments
• GP registration difficulties
• Lack of specialised staff
• Physical environment

Question 15

List a few examples of barriers to healthcare access which are linked to the patient.

Answer 15

• Language barrier
• Travel and parking costs
• Denial or unawareness of pregnancy
• Chaotic lifestyle
• Perceived benefits of antenatal care
• Concerns over confidentiality