Socio-economic and locational determinants of accessibility and utilization of primary health-care
Abstract
Differences in levels of utilization vary and are a function of socio-economic and geographical factors. This paper presents the results of a questionnaire study involving twelve GP practices in Northamptonshire, UK, of factors which affect access and utilization in asthmatics and diabetics; these groups were selected to control for differences in utilization behaviour, as a result of different aetiologies. The questionnaire sought data on: residential location of patients, utilization characteristics of primary health-care, personal circumstances and mobility and hindrances to access and utilization. Key themes were identified relating to age, gender, social class, employment, ethnicity and proximity to the GP surgery. The young, elderly and females report higher rates of utilization, as do nonmanual workers and those who are unemployed. However, accessibility and utilization vary greatly in response to mobility and locational characteristics; these variations tend to be masked by data on overall rates of usage. Optimal scaling techniques were used to investigate the interactions between the factors affecting accessibility and utilization, and to characterize patients in terms of their levels of utilization. Results confirmed that current service provision afforded a differential level of service to patients, which does not directly reflect their level of need.
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A key practical resource that impacts on the ability to seek care for the socio-economically disadvantaged is transport.
“A key practical resource that impacts on the ability to seek care for the socio-economically disadvantaged, for example, is transport [44,47,48].”
From Conducting a critical interpretive synthesis of the literature on access to healthcare by vulnerable groups (2006) · cites this paper as [47]
Other practical resources that may impact on the ability of disadvantaged groups to negotiate health services include more rigid patterns of working life.
“Other practical resources that may impact on the ability of disadvantaged groups to negotiate health services include more rigid patterns of working life [47].”
From Conducting a critical interpretive synthesis of the literature on access to healthcare by vulnerable groups (2006) · cites this paper as [47]
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- Authors
- Field, K. S., & Briggs, D. J.
- Affiliations
- University of Northampton (GB)
- Imperial College London (GB)
- Venue
- Health & Social Care in the Community
- Publisher
- Hindawi Limited
- Published
- 2001-09
- Volume
- 9
- Issue
- 5
- Pages
- 294-308
- ISSN
- 0966-0410 (ISSN-L)
- OpenAlex
- W2114370972
- Cited by
- 223
- References
- 46
- Citations by year
- 2026: 25 · 2025: 6 · 2024: 8 · 2023: 8 · 2022: 6 · 2021: 4 · 2020: 9 · 2019: 7 · 2018: 9 · 2017: 7 · 2016: 7 · 2015: 3 · 2014: 14 · 2013: 11 · 2012: 12
- FWCI
- 4.63
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Health & Social Care in the Community (publishedVersion)
- PubMed (publishedVersion)
- Research Repository (Kingston University London) (submittedVersion)
- Topics
- Social Sciences › Health › Public Health and Social Inequalities
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Social Sciences › Health › Health disparities and outcomes
- Keywords
- primary care utilization, health care access, socio-economic determinants, place of residence, mobility barriers, asthma, diabetes mellitus, social class, employment status, ethnicity, gender differences, age differences, Northamptonshire
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Asthma, Catchment Area, Health, Community Health Services, Diabetes Mellitus, England, Evaluation Studies as Topic, Female, Geography, Health Services Accessibility, Health Status, Humans, Male, Middle Aged, Primary Health Care, Socioeconomic Factors, Transportation, Chi-Square Distribution, Health Care Surveys
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