6 Access to Primary Care
Mac Martin
The Organization for Economic Co-operation and Development (OECD) defines primary health care as “the first level of contact for the population with the healthcare system.” Its goal is to address community health by providing “preventative, curative and rehabilitative services” (OECD, n.d.). In the United States, this care typically takes the form of a physician who serves as the guardian of a patient’s health. Primary care physicians are meant to serve as the point of first contact for patients in the healthcare setting. This allows for adverse health outcomes to be either prevented or managed by the primary care physician as they facilitate their patient’s transfer to more specialized practitioners and orchestrate their patient’s wholistic treatment. There exists a robust body of literature demonstrating the connection between positive health outcomes and primary care access. One study proposed that the correlation stemmed from six mechanisms of primary care
“(1) greater access to needed services, (2) better quality of care, (3) a greater focus on prevention, (4) early management of health problems, (5) the cumulative effect of the main primary care delivery characteristics, and (6) the role of primary care in reducing unnecessary and potentially harmful specialist care” (Starfield et al., 2005).
In light of this, determining the extent of primary care use among Americans is of vital importance. One study found that roughly 75% of Americans reported having a primary care doctor in 2015 which was a decline of 2% from 2002 (Levine et al., 2019). While seemingly insignificant, this two percent reduction is indicative of millions who do not receive vital primary care on a yearly basis. Additionally, a separate review of data produced by the Centers for Disease Control and Prevention found that 25% of American men reported having no primary care doctor in 2020 (KFF, 2021). Due to the services that primary care physicians provide and the high percentage of individuals with no primary care physicians, it is essential that the barriers to accessing primary care and the determinants informing these barriers be identified and addressed.
In 2018, an international study examined the factors associated with barriers to access to primary care in 11 countries including the United States (Corscadden et al., 2018). The study found that 38% of Americans had experienced several barriers to care before they had connected with a primary care practice. Of particular note were the vulnerable groups that predicted increased difficulty to access to primary care. Individuals with below average income were found to have experienced multiple barriers to reaching a primary care provider in every country studied. A majority of the countries including the United States displayed being born outside of the country as being indicative of encountering barriers to receiving primary care after having established contact with a primary care provi