Utilization Of Care: Needs Vs. Enabling Factors

Considering the complex nature of the access to health care and its relativity to the specific context, it is obvious that challenges in obtaining necessary healthcare services in a due time can occur at every step and refer to any dimension of access. However, investigation of the topic allows eliciting the major problems that are common across countries and populations. A targeted research of the published literature demonstrates that disparities in access to care account for the key obstacle towards due access to appropriate care to all. There is a number of ways to consider disparities; the first approach distinguishes between inequality and inequity in access to health care. While inequity is often caused by obstacles on the individual
Utilization of care: needs vs. enabling factors by Andersen
This section deliberately touches on Andersen’s models describing the utilization of care from the perspectives that are believed to be relevant to the study topic. In the course of the continuous adaptation and revision of the model initially developed in late 1960s (Andersen 1968) to describe the patterns of health care use by families, their access to care and necessary policy changes, the latest version of it was presented in 1995 (Andersen 1995). With time, Andersen reports of the shift in his focus from the family as the analysis unit to the individual, which he believed was easier to investigate. However, this narrowed focus allowed him to expand his framework beyond initial utilization of services; Andersen complemented the model by the concept of health outcomes which are believed to influence an individual’s needs in the future and health related beliefs (Fig 1).
Figure 1. Conceptual framework of factors associated with health service
The re-elaborated notion of habitus by Bourdieu describes the values, lifestyle and practices of a social group which have emerged in the result of a long-term everyday practice. Building on history and memory, the habitus can be conceptualized as the mentality of a social group with a set of acquired and accepted norms, beliefs and practices. The important note about habitus is that with time the original reason to develop a certain belief or practice vanishes from the collective memory of a society, while the belief or practice remains embedded in the social structure. It is often opposed to the concept of rationality and is based on the individual’s interest to act in the best way as seen by the society he belongs