Academic journal article International Journal of Child Health and Human Development

Tiers of Access: Conceptualizations of Access to Health Care Services among Families of Children with Special Health Care Needs

Academic journal article International Journal of Child Health and Human Development

Tiers of Access: Conceptualizations of Access to Health Care Services among Families of Children with Special Health Care Needs

Article excerpt

Navigating the United States health-care system poses challenges for many families, but particularly for caregivers of children with special health-care needs (CSHCN), who struggle to gain access to quality health-care services. Access is typically defined as the actual utilization of health-care services and all that facilitates or hinders their use. This paper presents an alternative definition of access reflecting the social contexts of health-care service use.

Methods: From May-2009 to February-2010, 30 qualitative, open-ended interviews (60-90 minutes) were conducted in Illinois with caregivers of CSHCN. Respondents were recruited using purposive quota sampling techniques from a group of 102 respondents who had participated in a related telephone survey. Audio transcriptions and field notes were entered into Nvivo software and analyzed with a thematic coding scheme.

Results: 13 respondents described access for their child as obtaining a timely appointment with any available health-care provider. These were more likely to be living at or below median income (n=12), minorities (n=8), and to have smaller, sparser social networks (n=9). …

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