The Relationship of Access Barriers to Indicators

As is evident from the foregoing discussion, there are no clear demarcation lines among the types of barriers to access. They are highly interrelated—part of the complex processes involved in seeking health care and achieving good outcomes from that care. Nevertheless, they allow us to begin thinking about how measures of access (utilization and outcome) vary according to measures of equity (financing, structural, and personal/cultural factors). The number of uninsured, poor, and ethnic and racial minorities is growing. How well has the health care system adjusted to these changing realities?

In the next chapter the committee proposes a set of outcome and utilization indicators. The extent and direction of change in these indicators should reflect the efforts of policymakers to reduce barriers to care.

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