RESEARCH INSIGHT | Access to Health Care: Perceptions Outweigh Objective Measures
The Research
Access to health services affects the well-being of millions of consumers, and objective or situational access factors, such as distance from facility, often dominate the conversation. However, the reality is that subjective perceptions play just as great a role in consumers’ overall health and well-being. For example, when a consumer approaches a health care encounter, her health service experience may be constrained because she only qualifies for a single insurance option that does not cover an important therapy she needs. Similarly, only one health care provider might serve her community with office hours that conflict with her work schedule, or expensive hospital bills from past visits might discourage her from visiting a local hospital again. Focusing on personally experienced service availability and access ease, the authors find that these factors jointly determine consumers’ access perceptions and offer insight into the relationships between access, perceived health vulnerability, and overall health. They discover a “muting” effect of health system distrust on the relationship between perceived access and perceived vulnerability and an “amplifying” effect of health motivation on the relationship between perceived vulnerability and overall health.
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What You Need to Know
- When designing services, hospitals and medical providers should consider their target population’s needs regarding convenience of travel, service hours, wait times, variety of services offered, and other factors likely to affect the affordability, acceptability, and availability of care. Offering office hours that allow patients with jobs to schedule appointments outside of their working hours or setting up more mobile clinics to reach communities that lack public transportation has the potential to improve consumers’ perceived health services access and their perceived overall health. Telemedicine is also a potential solution.
- Access improvements should also include trust-building measures directed toward individuals cynical about their past health service experiences.
- High health motivation amplifies the negative effects of perceived vulnerability on an individual’s overall health. Improving a person’s health motivation, one conceivable path to overcoming the negative effects of limited health access, may actually contribute to worse health outcomes for the person if his or her perceived vulnerability is not first addressed.
Abstract
Access to health services affects the well-being of millions of consumers. Although the topic of health-related access is regularly featured in popular and academic conversations, these conversations primarily concentrate on objective or situational access factors. This research focuses instead on consumers’ subjective perception of access to better appreciate how personally experienced service availability and ease of access jointly determine consumers’ access perceptions. The authors find that perceived access to health services (PAHS) offers insight into the relationships between access, perceived health vulnerability, and overall health. Through scale development and a series of three theory-testing studies, this work demonstrates the close link between PAHS and perceived vulnerability (Study 1), connects this relationship to overall health (Studies 1–3), and establishes behavioral changes associated with access-vulnerability concerns (Study 2). Moreover, Study 3 finds evidence for a “muting” effect of health system distrust on the relationship between PAHS and perceived vulnerability as well as an “amplifying” effect of health motivation on the relationship between perceived vulnerability and overall health. Together, these studies illustrate PAHS’s relevance for explaining consumer vulnerability and overall health.
Emily C. Tanner, Richard J. Vann, Elvira Kizilova (2020), “Consumer-Level Perceived Access to Health Services and Its Effects on Vulnerability and Health Outcomes,” Journal of Public Policy & Marketing, 39 (2), 240–55,