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Authors
Rúnar VilhjálmssonIssue Date
2011-10
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[Postponement and cancellation of physician visits among Icelanders: extent and explanations].Citation
Læknablaðið 2011, 97 (10):529-34Abstract
Equal access to health care is a central goal in socialized health systems like the one in Iceland. Previous research in Iceland indicates considerable individual and group differences in access to health care. The study maps the distribution of postponement and cancellation of physician care among Icelandic adults and considers a number of potential explanations.The data come from a national postal health survey of Icelandic adults, age 18-75, who were randomly drawn from the National Register. 1532 individuals responded to the survey yielding a 60% response rate.
22% of the respondents had postponed or cancelled a physician visit they thought they needed in the past 6 months. The study found considerable variations in postponement rates. Postponement was positively related to younger age, full employment, financial difficulties, high out-of-pocket health care costs, inflexible daily schedules (fixed roles), dissatisfaction with last physician visit, and the number of chronic medical conditions experienced.
Postponement or cancellation of medical care is fairly common among Icelandic adults, although considerable individual and group differences in postponement are observed. The results raise concerns, as equal access to care is a central goal of the Icelandic health care system. It is incumbent upon health authorities to pursue effective ways to equalize access to medical care and prevent postponement and cancellation of needed services.
Tilgangur: Jafnt aðgengi að heilbrigðisþjónustu er meginmarkmið í félagslegum heilbrigðiskerfum eins og því íslenska. Fyrri innlendar rannsóknir benda til þess að talsverður munur sé á aðgengi einstaklinga og hópa að heilbrigðisþjónustunni. Markmið rannsóknarinnar var að kortleggja frestun læknisþjónustu í ólíkum samfélagshópum fullorðinna Íslendinga og meta vægi einstakra áhrifaþátta. Efniviður og aðferðir: Rannsóknin byggði á landskönnuninni Heilbrigði og aðstæður Íslendinga I. Spurningalistar voru póstsendir til þjóðskrárúrtaks Íslendinga á aldrinum 18-75 ára. 1532 manns svöruðu könnuninni og heimtur voru 60%. Niðurstöður: Alls höfðu 22% fullorðinna Íslendinga frestað eða fellt niður læknisþjónustu á sex mánaða tímabili. Frestunarhlutföll voru misjöfn eftir hópum. Þeir sem voru ungir að árum í fullri vinnu, áttu við fjárhagserfiðleika að etja, höfðu há heimilisútgjöld vegna heilbrigðisþjónustu, áttu erfitt með að komast frá daglegum verkefnum, voru óánægðir með síðustu læknisheimsókn, eða glímdu við langvinna sjúkdóma og kvilla, frestuðu oftar en aðrir ferð til læknis. Ályktun: Nokkuð algengt er að Íslendingar fresti eða felli niður læknisþjónustu sem þeir telja þörf fyrir. Jafnframt er verulegur munur á tíðni frestunar milli fólks og hópa. Niðurstöðurnar eru umhugsunarefni í ljósi þess meginmarkmiðs heilbrigðiskerfisins að allir landsmenn hafi jafnan aðgang að heilbrigðisþjónustu. Mikilvægt er að heilbrigðisyfirvöld leiti leiða til að jafna aðgengi einstaklinga og hópa að læknisþjónustu og vinni gegn frestun eða niðurfellingu hennar.
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