Barriers to Care

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Barriers to Care

Many individuals and families encounter barriers to receiving needed healthcare.  A barrier is anything that limits or prevents a patient from receiving healthcare.  Barriers are often times thought of as a financial or insurance issue but there are several other barriers as well.  Transportation to and from appointments is a common barrier.  The lack of available services is also a barrier that many patients encounter.

In 1981, Penchansky and Thomas described a framework for barriers to care consisting of five categories: 

  • Affordability – the relationship of prices of services to patients’ income, ability to pay, and existing health insurance. 
  • Accommodation – the relationship between the manner in which the supply resources are organized to accept patients as well as the patients’ perceptions of the appropriateness of these systems (e.g., appointment systems and hours of operation). 
  • Availability – the relationship of the volume of existing services and resources to patients’ volume and types of needs (e.g., the adequacy of the supply of clinicians, clinical facilities, and specialized programs). 
  • Accessibility – the relationship between the location of services and the location of patients (e.g., transportation resources and travel time). 
  • Acceptability – the relationship between patients’ attitudes about personal and practice characteristics of clinicians and facilities to actual characteristics of existing clinicians and facilities (e.g., clinician gender or ethnicity, clinic neighborhood or type), as well as clinician attitudes about acceptable personal characteristics of patients. 
    (From: Kullgren, McLaughlin, Mitra, and Armstrong, 2012) 

For more information on Barriers to Care and overcoming them visit:

Healthy People 2020 Access to Health Services

Promoting Health Equity: Culturally Competent Health Care

Health Literacy

Patient Centered Medical Home