Encyclopedia of Gerontology and Population Aging

Living Edition
| Editors: Danan Gu, Matthew E. Dupre

Access to Care

  • Susanny J. BeltranEmail author
Living reference work entry
DOI: http://doi.org/10.1007/978-3-319-69892-2_1096-1



The Institute of Medicine defines access to healthcare as “timely use of personal health services to achieve the best health outcomes” (1993, p. 33). Guided by this definition, Healthy People 2020, the Centers for Disease Control and Prevention’s 10-year national objectives for improving the health of Americans, has proposed three components that make up access to care. These components are insurance coverage, usual source of services, and workforce availability (Office of Disease Prevention and Health Promotion [ODPHP] 2016365体育网站). In short, in order to have adequate access to care, an individual must be able to gain entry into the system by having health insurance, to obtain regular preventative and curative care in a timely and consistent manner, and to appropriate such services locally from qualified providers. The term “care” is broad-ranging; it includes health promotion, disease...

This is a preview of subscription content, log in to check access.


  1. Agency for Healthcare Research and Quality [AHRQ] (2018) Chartbook on access to health care. Accessed 12 May 2019.
  2. Beltran SJ (2018) Hispanic hospice patients’ experiences of end-stage restlessness. J Soc Work End Life Palliat Care 14(1):93–109
  3. Bentler SE, Morgan RO, Virnig BA, Wolinsky FD (2014) Evaluation of a patient-reported continuity of care model for older adults. Qual Life Res 23(1): 185–193
  4. Berchick ER, Hood E, Barnett JC (2018) Health insurance coverage in the United States: 2017. Current Population Reports. US Government Printing Office, Washington, DC, pp 60–264
  5. Bitton A, Martin C, Landon BE (2010) A nationwide survey of patient centered medical home demonstration projects. J Gen Intern Med 25(6):584–592
  6. Bliss DZ, Gurvich O, Savik K, Eberly LE, Harms S, Mueller C, Wiltzen K (2017) Racial and ethnic disparities in the healing of pressure ulcers present at nursing home admission. Arch Gerontol Geriatr 72:187–194
  7. Busby-Whitehead J, Flaherty E, Potter J (2016) The geriatrics workforce enhancement program: a major eldercare initiative. Generations 40(1):122–124
  8. Buttorff C, Ruder T, Bauman M (2017) Multiple chronic conditions in the United States. RAND, Santa Monica
  9. Carrillo JE, Carrillo VA, Perez HR, Salas-Lopez D, Natale-Pereira A, Byron AT (2011) Defining and targeting health care access barriers. J Health Care Poor Underserved 22(2):562–575
  10. Carrion IV, Bullock K (2012) A case study of Hispanics and hospice care. Int J Humanit Soc Sci 2(4):9–16
  11. Choi NG, Hegel MT, Marti CN, Marinucci ML, Sirrianni L, Bruce ML (2014) Telehealth problem-solving therapy for depressed low-income homebound older adults. Am J Geriatr Psychiatry 22(3):263–271
  12. Cooper LA, Roter DL, Johnson RL, Ford DE, Steinwachs DM, Powe NR (2003) Patient-centered communication, ratings of care, and concordance of patient and physician race. Ann Intern Med 139(11):907–915
  13. Cutler D (2010) Analysis & commentary: how health care reform must bend the cost curve. Health Aff 29(6): 1131–1135
  14. Douthit N, Kiv S, Dwolatzky T, Biswas S (2015) Exposing some important barriers to health care access in the rural USA. Public Health 129(6):611–620
  15. Federal Interagency Forum on Aging Related Statistics [ARC] (2016) Older Americans 2016: key indicators of well-being. Government Printing Office, Washington, DC
  16. Flaherty E, Busby-Whitehead J, Potter J, Lundebjerg N, Trucil DE (2019) The geriatric workforce enhancement program: review of the coordinating center and examples of GWEP in practice. Am J Geriatr Psychiatry 27(7):675–686
  17. Foglia MB, Fredriksen-Goldsen KI (2014) Health disparities among LGBT older adults and the role of nonconscious bias. Hastings Cent Rep 44(s4):S40–S44
  18. Fortuna KL, Lohman MC, Gill LE, Bruce ML, Bartels SJ (2017) Adapting a psychosocial intervention for smartphone delivery to middle-aged and older adults with serious mental illness. Am J Geriatr Psychiatry 25(8):819–828
  19. Fortuna KL, DiMilia PR, Lohman MC, Bruce ML, Zubritsky CD, Halaby MR et al (2018) Feasibility, acceptability, and preliminary effectiveness of a peer-delivered and technology supported self-management intervention for older adults with serious mental illness. Psychiatry Q 89(2):293–305
  20. Fredriksen-Goldsen KI, Kim HJ, Barkan SE, Muraco A, Hoy-Ellis CP (2013) Health disparities among lesbian, gay, and bisexual older adults: results from a population-based study. Am J Public Health 103(10): 1802–1809
  21. Gellis ZD, Kenaley B, McGinty J, Bardelli E, Davitt J, Ten Have T (2012) Outcomes of a telehealth intervention for homebound older adults with heart or chronic respiratory failure: a randomized controlled trial. Gerontologist 52(4):541–552
  22. Hakeem FF, Bernabé E, Sabbah W (2019) Association between oral health and frailty: a systematic review of longitudinal studies. Gerodontology 1–11.  
  23. Huang DL, Park M (2015) Socioeconomic and racial/ethnic oral health disparities among US older adults: oral health quality of life and dentition. J Public Health Dent 75(2):85–92
  24. Institute of Medicine (1993) A model for monitoring access. In: Millman M (ed) Access to health care in America, 4th edn. National Academy Press, Washington, DC
  25. Interprofessional Education Collaborative (IPEC) (2016) Core competencies for interprofessional collaborative practice: 2016 update. Interprofessional Education Collaborative, Washington, DC
  26. Kietzman K (2012) Using a “person-centered” approach to improve care coordination: opportunities emerging from the affordable care act. J Geriatr Care Manag J 22(2):13–19
  27. King WD, Wong MD, Shapiro MF, Landon BE, Cunningham WE (2004) Does racial concordance between HIV-positive patients and their physicians affect the time to receipt of protease inhibitors? J Gen Intern Med 19(11):1146–1153
  28. Krahn DD, Bartels SJ, Coakley E, Oslin DW, Chen H, McIntyre J, Levkoff SE (2006) PRISM-E: comparison of integrated care and enhanced specialty referral models in depression outcomes. Psychiatr Serv 57(7):946–953
  29. Levy H, Janke A (2016) Health literacy and access to care. J Health Commun 21(sup1):43–50
  30. Li Y, Harrington C, Temkin-Greener H, You K, Cai X, Cen X, Mukamel DB (2015) Deficiencies in care at nursing homes and racial/ethnic disparities across homes fell, 2006–11. Health Aff 34(7):1139–1146
  31. Meghani SH, Brooks JM, Gipson-Jones T, Waite R, Whitfield-Harris L, Deatrick JA (2009) Patient–provider race-concordance: does it matter in improving minority patients’ health outcomes? Ethn Health 14(1):107–130
  32. Miller S, Wherry LR (2017) Health and access to care during the first 2 years of the ACA Medicaid expansions. NEJM 376(10):947–956
  33. Miller BF, Ross KM, Davis MM, Melek SP, Kathol R, Gordon P (2017) Payment reform in the patient-centered medical home: enabling and sustaining integrated behavioral health care. Am Psychol 72(1):55
  34. National Council on Aging (2012) Older Americans behavioral health issue brief: series overview. Accessed 12 May 2019.
  35. O’Keefe EB, Meltzer JP, Bethea TN (2015) Health disparities and cancer: racial disparities in cancer mortality in the United States, 2000–2010. Front Public Health 3:51
  36. Office of Disease Prevention and Health Promotion (2016) Access to health services. Accessed 12 May 2019.
  37. Osborn R, Squires D, Doty MM, Sarnak DO, Schneider EC (2016) In new survey of eleven countries, US adults still struggle with access to and affordability of health care. Health Aff 35(12):2327–2336
  38. Ottmann G, Allen J, Feldman P (2013) A systematic narrative review of consumer-directed care for older people: implications for model development. Health Soc Care Community 21(6):563–581
  39. Powers BW, Rinefort S, Jain SH (2016) Nonemergency medical transportation: delivering care in the era of Lyft and Uber. JAMA 316(9):921–922
  40. Sawyer B, Sroczynski N (2017) How do health expenditures vary across the population? Kaiser Family Foundation. Retrieved from
  41. Sommers BD, Gunja MZ, Finegold K, Musco T (2015) Changes in self-reported insurance coverage, access to care, and health under the Affordable Care Act. JAMA 314(4):366–374
  42. Uberoi N, Finegold K, Gee E (2016) Health insurance coverage and the Affordable Care Act, 2010–2016. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Washington, DC
  43. Verhagen I, Steunenberg B, de Wit NJ, Ros WJ (2014) Community health worker interventions to improve access to health care services for older adults from ethnic minorities: a systematic review. BMC Health Serv Res 14(1):497
  44. Yamada T, Chen CC, Murata C, Hirai H, Ojima T, Kondo K (2015) Access disparity and health inequality of the elderly: unmet needs and delayed healthcare. Int J Environ Res Public Health 12(2):1745–1772
  45. Beltran SJ, Miller VJ (in press) Breaking out of the silo: A systematic review of university-level gerontological curricula in social work and nursing programs. J Soc Work Educ.  

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.School of Social WorkUniversity of Central FloridaOrlandoUSA

Section editors and affiliations

  • Karen L. Fortuna
    • 1
  • Nazmi Sari
    • 2
  1. 1.Geisel School of MedicineDartmouth CollegeHanoverUSA
  2. 2.Department of EconomicsUniversity of SaskatchewanSaskatoonCanada