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Access to healthcare and population health 

Access to healthcare and population health
Chapter:
Access to healthcare and population health
Author(s):

Martin Gulliford

DOI:
10.1093/med/9780199661756.003.0015
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date: 23 September 2019

This chapter evaluates the relationship between access to health services and population health. Traditional thinking has been sceptical of the value of health services at improving health. This stems from recognition of the importance of wider determinants of health, the limited effectiveness of healthcare interventions, widespread problems of quality and safety, and wasteful use of resources in health services. A number of efficiency-oriented strategies have been developed to increase the health gains from healthcare including needs assessment, health technology assessment, cost-effectiveness analysis, implementation research to promote the uptake of research findings, and strategies to improve the organization and delivery of healthcare. Investment in health interventions is justified by the economic benefits associated with improved population health. The distribution of health services in middle- and low-income countries generally shows substantial pro-rich inequity and the financial costs of accessing healthcare may further impoverish poor households. Universal coverage, emphasising affordable primary care, has been promoted in some countries contributing to more favourable health outcomes. In the context of resource constraints and increasing costs of healthcare, public health specialists should advocate principles of efficiency and equity and contribute to realizing these.

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