Dawkins, B orcid.org/0000-0002-7038-1975, Renwick, C, Ensor, T orcid.org/0000-0003-0279-9576 et al. (3 more authors) (2021) What factors affect patients’ ability to access healthcare? An overview of systematic reviews. Tropical Medicine and International Health. ISSN 1360-2276
Abstract
OBJECTIVES
This overview aims to synthesise global evidence on factors affecting healthcare access, and variations across low- and middle-income countries (LMICs) vs. high-income countries (HICs); to develop understanding of where barriers to healthcare access lie, and in what context, to inform tailored policies aimed at improving access to healthcare for all who need it.
METHODS
An overview of systematic reviews guided by a published protocol was conducted. Medline, Embase, Global Health and Cochrane Systematic Reviews databases were searched for published articles. Additional searches were conducted on the Gates Foundation, WHO and World Bank websites. Study characteristics and findings (barriers and facilitators to healthcare access) were documented and summarised. The methodological quality of included studies was assessed using an adapted version of the AMSTAR 2 tool.
RESULTS
Fifty-eight articles were included, 23 presenting findings from LMICs and 35 presenting findings from HICs. While many barriers to healthcare access occur in HICs as well as LMICs, the way they are experienced is quite different. In HICs, there is a much greater emphasis on patient experience; as compared to the physical absence of care in LMICs.
CONCLUSIONS
As countries move towards universal healthcare access, evaluation methods that account for health system and wider cultural factors that impact capacity to provide care, healthcare finance systems and the socio-cultural environment of the setting are required. Consequently, methods employed in HICs may not be appropriate in LMICs due to the stark differences in these areas.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2021 John Wiley & Sons Ltd. This is the peer reviewed version of the following article: Dawkins, B., Renwick, C., Ensor, T., Shinkins, B., Jayne, D. and Meads, D. (2021), What factors affect patients’ ability to access healthcare? An overview of systematic reviews. Trop Med Int Health, which has been published in final form at https://doi.org/10.1111/tmi.13651. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. |
Keywords: | healthcare access; healthcare equity; international health; overview of systematic reviews; systematic review; three delays framework |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Academic Unit of Health Economics (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Nuffield Centre for International Health and Development (Leeds) |
Funding Information: | Funder Grant number NIHR National Inst Health Research 16/137/44 |
Depositing User: | Symplectic Publications |
Date Deposited: | 02 Jul 2021 12:30 |
Last Modified: | 04 Jul 2022 00:13 |
Status: | Published online |
Publisher: | Wiley |
Identification Number: | 10.1111/tmi.13651 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:175773 |