Paper
Friday, July 23, 2004
10:00 AM - 10:30 AM
Friday, July 23, 2004
3:00 PM - 3:30 PM
Appropriate Access to Emergency Health Care Services: Can It Be Measured?
Marilyn J. Hodgins, RN, PhD, Marilyn Merritt-Gray, RN, MN, and Judith A. Wuest, RN, PhD. Faculty of Nursing, University of New Brunswick, Fredericton, NB, Canada
| Learning Objective #1: n/a |
| Learning Objective #2: n/a |
Problem: Traditionally, the well-being of a community was measured in part by the availability of emergency health care services. Canadians living in rural communities have had to re-evaluate this practice however, in light of recent health care reforms that have resulted in the closure of some emergency departments and a reduction of services in others. Such actions have prompted considerable controversy because of the lack of a clear definition of what constitutes appropriate access to emergency health care services. Theoretical Underpinnings: According to Andersen’s (1995) model of health care utilization, health policies founded on a principle of equitable access should maximize the role played by illness (need) while minimizing the role of contextual or individual-specific factors. However others argue that smaller health care facilities can no longer provide true acute care services due to their increasing complexity, diversity, and cost. Study: During the pilot phase of this descriptive-correlational study, a questionnaire, operationalizing the facets of Andersen’s model in relation to the use of emergency health care services, was constructed and tested. The sample consisted of adults who accessed an emergency department due to an unanticipated, non-life or limb threatening, health problem. Structured interviews were conducted at two time periods. First, participants answered questions while they waited for emergency treatment. A follow-up interview was then conducted within two weeks. Conclusions: An underlying premise of this study was that the nature and quality of the services received influenced people’s perceptions of their health status and self-care abilities as well as satisfaction with the health care system. Results from the first 250 participants provide insight as to how Canadians currently define appropriate access. Implications: Nurses who live and work in rural communities need to be proactive in articulating the health care needs of their community and identifying alternative approaches to care delivery.
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