Leveraging household survey data to measure barriers to health services access in the Americas

Ernesto Báscolo · Natalia Houghton · Amalia del Riego

35 citations0/0 files storedRevista Panamericana de Salud Pública

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Healthcare Systems and Reforms Healthcare Systems and Practices Public Health and Social Inequalities

Abstract

OBJECTIVE: To identify advantages and challenges of using household survey data to measure access barriers to health services in the Americas and to report findings from most recent surveys. METHODS: Descriptive cross-sectional study using data retrieved from publicly available nationally representative household surveys carried out in 27 countries of the Americas. Values for indicators of access barriers for forgone care were generated using available datasets and reports from the countries. Results were disaggregated by wealth quintiles according to income or asset-based wealth levels. RESULTS: Most surveys were similar in general approach and in the categories of their content. However, country-specific questionnaires varied by country, which hindered cross-country comparisons. On average, about one-third of people experienced multiple barriers to forgone appropriate care. There was great variability between countries in the experience of these barriers, although disparities were relatively consistent across countries. People in the poorest wealth quintile were more likely to experience barriers related to acceptability issues, financial and geographic access, and availability of resources. CONCLUSIONS: The analysis indicates major inequalities by wealth status and uneven progress in multiple access barriers that hinder progress towards the goals of equity as part of the Sustainable Development Goals and universal health in the Americas. Access barriers were multiple, which highlights the need for integrated and multisectoral approaches to tackle them. Given the variability between instruments across countries, future efforts are needed to standardize questionnaires and improve data quality and availability for regional monitoring of access barriers.

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References

2010How Health Insurance Design Affects Access To Care And Costs, By Income, In Eleven Countries 2011Defining and Targeting Health Care Access Barriers 2009Measuring Disparities in Health Status and in Access and Use of Health Care in OECD Countries 2009Bureaucratic Itineraries in Colombia. A theoretical and methodological tool to assess managed-care health care systems 2014Barriers in access to healthcare in countries with different health systems. A cross-sectional study in municipalities of central Colombia and north-eastern Brazil 2014Monitoring Intervention Coverage in the Context of Universal Health Coverage 2010Barriers of access to care in a managed competition model: lessons from Colombia 2017Surveillance for Health Care Access and Health Services Use, Adults Aged 18–64 Years — Behavioral Risk Factor Surveillance System, United States, 2014

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