The 130th Annual Meeting of APHA

Abstract #41956

Firoozeh Molaparast Vali, PhD, Research Department, New Jersey Hospital Association, 760 Alexander Road, Princeton, NJ 08543, 609-275-4146, fvali@njha.com

Lack of “medical home” and regular access to primary care is an important issue for the poor and uninsured populations, leading to more severe episodes of unattended conditions and more expensive treatments, including hospital admissions for illnesses that are manageable on an outpatient basis. As part of a prior study on geographic analysis of hospitalizations for ambulatory care sensitive conditions (ACS), areas in New Jersey with highest admission rates and barriers to access primary care were identified. To further investigate contributing local and systemic factors, a qualitative study was designed and 21 focus groups were conducted (with consumers and community leaders, public health officials and physicians) in 11 areas spanning 26 zipcodes. The purpose was to identify specific access barriers and solicit suggestions for possible remedies. To be recruited, providers had to practice in the specific zip code and consumer residents had to be 18-64, low-income, uninsured or underinsured, with direct or indirect experience with hospital ER. Identified barriers were classified under seven categories: hassles with healthcare delivery system especially for poor and Medicaid recipients, lack of education on importance of prevention, inconvenience with physicians’ hours and locations, language, transportation, childcare and negative attitudes of healthcare providers. Recommendations addressed system-related, consumer-related and provider-related barriers. The findings helps providers and policy makers develop an understanding of healthcare issues of poor and uninsured populations to establish regional and local health priorities for planning and resource allocation. This two-year study, funded by a grant from the Robert Wood Johnson Foundation, completed in 2000.

Learning Objectives:

• Develop an understanding of specific barriers that have contributed to the problem of healthcare access in poor disadvantaged areas of New Jersey.
• Learn the underlying themes that were highlighted in discussions of focus groups and reveal the reasons why indigent populations are not properly accessing primary care in their areas.
• Assess identified barriers by type (systemic, consumer-related or provider-related)and identify strategies to address them.
• Discuss feasibility of plans recommended to remove barriers to primary care access.

Keywords: Access to Health Care, Barriers to Care

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.