Access to health care : from territorial perceptions to the initiatives of stakeholders : concepts, measures and surveys for a geographical analysis of the organization and the development of a sustainable supply of care
Access to health care is a concern for governments, patients and physicians. This study identifies the role and aspirations of health stakeholders and, based on the construction of social science concepts, it compares the previous conceptual frameworks analyzing and measuring access to health care. Access to health care is a multidimensional concept; however it was mainly analyzed through financial difficulties or geographical distance in France. Two surveys were conducted to collect the perceptions of one thousand patients and five hundred liberal doctors to determine the origin and frequency of problems of access to health care. The results show that the main barriers are the waiting time in the office of general practitioner and the waiting period to get an appointment with specialists. These previous factors lead also to health carerenunciation. Concerning the physicians, the survey identifies their perceptions of patient’s difficulties, their working conditions and their preferred solutions against the waiting period before patients care receiving. It appears that young doctors are particularly interested in group medical practices. Thus, the two main emerging organizations offering health care i.e., multidisciplinary health house and telemedicine are analyzed and discussed as a result of feedbacks and semi-structured interviews. At the initiative of local actors, cooperation between health professionals promotes the quality and sustainability of health care services in the territories.