Læknablaðið - 15.10.2011, Side 22

RANNSÓKN
Heimildir
1. Heilbrigðis- og tryggingamálaráðuneytið. Heilbrigðis-
áætlun til ársins 2010: Langtímamarkmið í heilbrigðis-
málum. Heilbrigðis- og tryggingamálaráðuneytið, Reykja-
vík 2001.
2. Vilhjálmsson R. íslenska heiibrigðiskerfið á krossgötum. í:
Jóhannesson G., ritstj. Rannsóknir í félagsvísindum VIII.
Félagsvísindastofnun, Reykjavík 2007:197-206.
3. Cockerham WC. Medical sociology, llth ed.: Prentice-
Hall, Upper Saddle River, NJ 2010.
4. Aday LA, Fleming GV, Andersen R. Access to medical
care in the US: Who has it, who doesn't? Pluribus Press,
Chicago, IL1984.
5. Vilhjálmsson R, Ólafsson Ó, Sigurðsson JÁ, Herbertsson
TÞ (2001). Aðgangur að heilbrigðisþjónustu á íslandi.
Landlæknisembættið, Reykjavík 2001. www.landlaeknir.
is/Uploads/FileGallery/Utgafa/utg_adgangur01.pdf -
mars 2011.
6. Adams PF, Benson V. Current estimates from the National
Health Interview Survey, 1991. National Center for Health
Statistics, Hyattsville, MD 1992.
7. Marcus AC, Siegel JM. Sex differences in the use of
physician services: A preliminary test of the fixed role
hypothesis. J Health Soc Behav 1982; 23:186-97.
8. Benzeval M, Judge K. Access to health care in England:
continuing inequalities in the distribution of GPs. J Public
Health Med 1996; 18:33-40.
9. Eyles J, Birch S, Newbold KB. Delivering the goods?
Access to family physician services in Canada: a
comparison of 1985 and 1991. J Health Soc Behav 1995; 36:
322-32.
10. Sharp K, Ross CE, Cockerham WC. Symptoms, beliefs, and
the use of physician services among the disadvantaged. J
Health Soc Behav 1983; 24: 255-63.
11. Evandrou M, Falkingham J, Le Grand J, Winter D. Equity
in health and social care. J Soc Policy 1992; 21:489-523.
12. Aday LA, Andersen RM. Equity of access to medical
care: a conceptual and empirical overview. í: President's
Commission for the Study of Ethical Problems in Medicine
and Biomedical and Behavioral Research: securing
access to health care. Vol. 3. Govemment Printing Office,
Washington, DC 1983:19-54.
13. Berk ML, Schur CL, Cantor JC. Ability to obtain health
care: recent estimates from the Robert Wood Johnson
Foundation National Access to Care survey. Health Aff
1995; 14:139-46.
14. Gerdtham UG, Sundberg G. Equity in the delivery of health
care in Sweden. Scand J Public Health 1998; 26: 259-64.
15. van Doorslaer E, Koolman X, Puffer F. Equity in the use of
physician visits in OECD countries: has equal treatment
for equal need been achieved? í: Measuring up: improving
health systems performance in OECD countries. OECD,
Paris, France 2002: 225-48.
16. Dunlop S, Coyte PC, Mclssac W. Socioeconomic status
and the utilisation of physicians' services: results from the
Canadian National Population Health Survey. Soc Sci Med
2000; 51; 123-33.
17. Schofield D. Ancillary and specialist health services: the
relationship between income, user rates and equity of
access. Aust J Soc Issues 1999; 1: 79-96.
18. Strauss AL, Corbin J, Fagerhaugh S, et al. Chronic illness
and the quality of life. Mosby, St. Louis, MO 1984.
19. Vilhjálmsson R. Failure to seek needed medical care:
results from a national health survey of Icelanders. Soc Sci
Med 2005; 61:1320-30.
20. Vilhjálmsson R, Jörundsdóttir E, Sigurðardóttir H,
Jóhannsdóttir ÞB. Þættir tengdir aðgengi að
læknisþjónustu á íslandi. í: Sveinsdóttir H, Nyysti
A, ritstj. Framtíðarsýn innan heilsugæsluhjúkrunar.
Rannsóknastofnun í hjúkrunarfræði og Háskólaútgáfan,
Reykjavík 2001: 70-94.
21. Nemet GF, Bailey AJ. Distance and health care utilization
among the rural elderly. Soc Sci Med 2000; 50:1197-208.
22. Vilhjálmsson R. Landskönnunin Heilbrigði og aðstæður
íslendinga - Aðferð og framkvæmd. Hjúkrunarfræðideild
Háskóla íslands, Reykjavík 2007.
23. Vilhjálmsson R. Bein útgjöld íslenskra heimila vegna
heilbrigðismála. Læknablaðið 2009; 95:661-8.
24. Vilhjálmsson R, Kristjánsdóttir G, Sveinbjamardóttir E.
Factors associated with suicide ideation in adults. Soc
Psychiatry Psychiatr Epidemiol 1998; 33:97-103.
25. Dillman DA. The design and administration of mail
surveys. Annu Rev Sociol 1991; 17: 225-49.
26. Dutton DB. Social class, health and illness. í: Aiken LH,
Mechanic D, ritstj. Applications of social science to clinical
medicine and health policy. Rutgers University Press,
New Brunswick, NJ 1986.
27. Baruch Y, Holtom BC. Survey response rate levels and
trends in organizational research. J Hum Relations 2008;
61:1139-60.
ENGLISH SUMMARY
Postponement and cancellation of physician visits among lcelanders: Extent and explanations
Vilhjálmsson R
Objective: Equal access to health care is a central goal in socialized health systems like the one in lceland. Previous research in lceland indicates
considerable individual and group differences in access to health care. The study maps the distribution of postponement and cancellation of physician
care among lcelandic adults and considers a number of potential explanations.
Material and methods: The data come from a national postal health survey of lcelandic adults, age 18-75, who were randomly drawn from the National
Register. 1532 individuals responded to the survey yielding a 60% response rate.
Results: 22% of the respondents had postponed or cancelled a physician visit they thought they needed in the past 6 months. The study found
considerable variations in postponement rates. Postponement was positively related to younger age, full employment, financial difficulties, high out-of-
pocket health care costs, inflexible daily schedules (fixed roles), dissatisfaction with last physician visit, and the number of chronic medical conditions
experienced.
Conclusions: Postponement or cancellation of medical care is fairly common among lcelandic adults, although considerable individual and group
differences in postponement are observed. The results raise concerns, as equal access to care is a central goal of the lcelandic heaith care system. It is
incumbent upon health authorities to pursue effective ways to equalize access to medical care and prevent postponement and cancellation of needed
services.
Key words: cancellation of medical care, access to health care, health services utilization, group differences.
Correspondence: Rúnar Vilhjálmsson, runarv@hi.is
534 LÆKNAblaðið 2011/97