title: Barriers to accessing primary health care: comparing Australian experiences internationally.
abstract: Most highly developed economies have embarked on a process of primary health care (PHC) transformation. To provide evidence on how nations vary in terms of accessing PHC, the aim of this study is to describe the extent to which barriers to access were experienced by adults in Australia compared with other countries. Communities participating in an international research project on PHC access interventions were engaged to prioritise questions from the 2013 Commonwealth Fund International Health Policy Survey within a framework that conceptualises access across dimensions of approachability, acceptability, availability, affordability and appropriateness. Logistic regression models, with barriers to access as outcomes, found measures of availability to be a problematic dimension in Australia; 27% of adults experienced difficulties with out-of-hours access, which was higher than 5 of 10 comparator countries. Although less prevalent, affordability was also perceived as a substantial barrier; 16% of Australians said they had forgone health care due to cost in the previous year. After adjusting for age and health status, this barrier was more common in Australia than 7 of 10 countries. Findings of this integrated assessment of barriers to access offer insights for policymakers and researchers on Australia's international performance in this crucial PHC domain.
authors.affiliation: Bureau of Health Information, Level 11, 67 Albert Avenue, Chatswood, NSW 2067, Australia.
authors.forename: Lisa
authors.initials: L
authors.lastname: Corscadden
authors.affiliation: Bureau of Health Information, Level 11, 67 Albert Avenue, Chatswood, NSW 2067, Australia.
authors.forename: Jean-Frederic
authors.initials: JF
authors.lastname: Levesque
authors.affiliation: Australian Institute for Primary Care & Ageing, LaTrobe University, Melbourne, Vic. 3068, Australia.
authors.forename: Virginia
authors.initials: V
authors.lastname: Lewis
authors.affiliation: Community Health Sciences Department, Université de Sherbrooke, Longueuil, QC, J4K 0A8, Canada.
authors.forename: Mylaine
authors.initials: M
authors.lastname: Breton
authors.affiliation: Bureau of Health Information, Level 11, 67 Albert Avenue, Chatswood, NSW 2067, Australia.
authors.forename: Kim
authors.initials: K
authors.lastname: Sutherland
authors.affiliation: IQ healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center PO Box 9101, NL-6500 HB Nijmegen, Netherlands.
authors.forename: Jan-Willem
authors.initials: JW
authors.lastname: Weenink
authors.affiliation: Faculty of Medicine, McGill University, Montreal, QC, H3A 0G4, Canada.
authors.forename: Jeannie
authors.initials: J
authors.lastname: Haggerty
authors.affiliation: Southern Academic Primary Care Research Unit, School of Primary Health Care, Monash University, Clayton, Vic. 3800, Australia.
authors.forename: Grant
authors.initials: G
authors.lastname: Russell
mesh_terms: D001315:Australia; D000069576:Health Equity; D006291:Health Policy; D006297:Health Services Accessibility; D006801:Humans; D011320:Primary Health Care