A Review of Models Used for Investigating Barriers to Healthcare Access in Australia

Abstract

Understanding barriers to healthcare access is a multifaceted challenge, which is often highly diverse depending on location and the prevalent surroundings. The barriers can range from transport accessibility to socio-economic conditions, ethnicity and various patient characteristics. Australia has one of the best healthcare systems in the world; however, there are several concerns surrounding its accessibility, primarily due to the vast geographical area it encompasses. This review study is an attempt to understand the various modeling approaches used by researchers to analyze diverse barriers related to specific disease types and the various areal distributions in the country. In terms of barriers, the most affected people are those living in rural and remote parts, and the situation is even worse for indigenous people. These models have mostly focused on the use of statistical models and spatial modeling. The review reveals that most of the focus has been on cancer-related studies and understanding accessibility among the rural and urban population. Future work should focus on further categorizing the population based on indigeneity, migration status and the use of advanced computational models. This article should not be considered an exhaustive review of every aspect as each section deserves a separate review of its own. However, it highlights all the key points, covered under several facets which can be used by researchers and policymakers to understand the current limitations and the steps that need to be taken to improve health accessibility.

Keywords: access barrier; health outcome; model; review.

Figure 1

Analysis of the literature database from 1999–November 2019. The left Y axis represents the number of articles per year and the right Y axis depicts the cumulative number of articles for the entire period.

Figure 2

Number of studies conducted across various states of Australia.

Figure 3

Australian Statistical Geography Standard: Structure (Source: ABS).

Figure 4

Remoteness map of Australia, 2016 (Source: ABS).

Figure 5

Percentage of studies conducted for various disease types (others include diabetes, disability, frailty, hepatitis C and strokes, each contributing equally).

Figure 6

Flowchart of the present study and future directions.