title: Defining and targeting health care access barriers.
abstract: The impact of social and economic determinants of health status and the existence of racial and ethnic health care access disparities have been well-documented. This paper describes a model, the Health Care Access Barriers Model (HCAB), which provides a taxonomy and practical framework for the classification, analysis and reporting of those modifiable health care access barriers that are associated with health care disparities. The model describes three categories of modifiable health care access barriers: financial, structural, and cognitive. The three types of barriers are reciprocally reinforcing and affect health care access individually or in concert. These barriers are associated with screening, late presentation to care, and lack of treatment, which in turn result in poor health outcomes and health disparities. By targeting those barriers that are measurable and modifiable the model facilitates root-cause analysis and intervention design.
authors.affiliation: Weill Medical College of Cornell University, New York City, NY 10032, USA. ecarrill@nyp.org
authors.forename: J Emilio
authors.initials: JE
authors.lastname: Carrillo
authors.forename: Victor A
authors.initials: VA
authors.lastname: Carrillo
authors.forename: Hector R
authors.initials: HR
authors.lastname: Perez
authors.forename: Debbie
authors.initials: D
authors.lastname: Salas-Lopez
authors.forename: Ana
authors.initials: A
authors.lastname: Natale-Pereira
authors.forename: Alex T
authors.initials: AT
authors.lastname: Byron
mesh_terms: D003153:Community Health Services / Q000458:organization & administration*; D055317:Evidence-Based Practice; D006297:Health Services Accessibility / Q000458:organization & administration*; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000208:ethnology*; D006801:Humans; D008403:Mass Screening; D017146:Models, Organizational; D010342:Patient Acceptance of Health Care / Q000208:ethnology; D012959:Socioeconomic Factors