Access to Rehabilitation

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Introduction

Access to health care means having timely use of personal health services to achieve the best possible health outcomes and comprises of four components;

Coverage

Facilitates entry into the health care system. Uninsured people are less likely to receive medical care and more likely to have poor health status (Healthy People 2020).

Services

Having a usual source of care and / or usual health care provider. People with a usual source of care have better health outcomes, fewer disparities, and lower costs (Healthy People 2020). While people with a usual place of care and a usual provider are more likely to receive preventive services and recommended screenings than people with no usual source of care (Blewett, et al., 2008).

Timeliness

Ability to provide health care when the need is recognised. Timeliness in health care is system’s capacity to provide care quickly after a need is recognized. (Healthy People 2020). Timely delivery of appropriate care can help reduce mortality and morbidity for chronic conditions, such as kidney disease (Smart & Titus, 2011).

Workforce

Health Service with capable, qualified, culturally competent providers. Ensuring well-coordinated, high-quality health care requires the establishment of a supportive health system infrastructure (IOM, 2010). Key elements include: Well-distributed capable and qualified workforce. Organizational capacity to support culturally competent services and ongoing improvement efforts. Health care safety net for hospital admissions of vulnerable populations.

Barriers

There are wide range of barriers that can prevent individuals from receiving high quality health care.  These include:

Governmental

Laws or policies that do not consider rehabilitation needs of the population e.g. rehabilitation services and assistive products not covered under a nation’s Health Care Plan

Institutional

Policies or standards that systematically disadvantage those in need of rehabilitation services e.g.  at a health care facility people may need to stand in a long line before receiving services, which can be a barrier for individuals who have balance problems or a hospital administrator who does not allocate needed resources for rehabilitation services. )

Service Delivery

Negative attitudes, presumptions, prejudices, or misconceptions e.g. low prioritisation of coordination of care by rehabilitation professionals leading to a lack of appropriate referrals for needed continuum of care.  

Environmental

Barriers in the built or natural environment e.g. no ramp to enter the health facility or no public transportation that accommodates wheelchairs

Informational

Not offering the same health information to all people e.g. lack of data and research on which treatment interventions for specific impairments are most effective.

Facilitators

• reforming policies, laws, and delivery systems, including development or revision of national rehabilitation plans;
• developing funding mechanisms to address barriers related to financing of rehabilitation;
• increasing human resources for rehabilitation, including training and retention of rehabilitation personnel;
• expanding and decentralising service delivery;
• increasing the use and affordability of technology and assistive devices;
• expanding research programmes, including improving information and access to good practice guidelines.

Right To Health

The right to health contains four elements:

Availability: Functioning public health and health care facilities, goods and services, as well as programmes in sufficient quantity.

Accessibility: Health facilities, goods and services accessible to everyone, within the jurisdiction of the State party. Accessibility has four overlapping dimensions: non-discrimination; physical accessibility; economical accessibility (affordability); and information accessibility.

Acceptability: All health facilities, goods and services must be respectful of medical ethics and culturally appropriate as well as sensitive to gender and life-cycle requirements.

Quality: Health facilities, goods and services must be scientifically and medically appropriate and of good quality.