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Provider-Perceived Barriers
(from least to greatest)
5. Physical Access
– Equipment Access
– Building Access
– Restroom Access
4. Appointments
3. Communication
– Talking about Needs
– Understanding Provider
2. Insurance Coverage
1. Transportation
As
s is
He ted
alt Li
h v in
Ce g
nt
er
De s
De tox
nt
Ho ist
sp s
i ta
I/P
ls
H
Be VM
M hav A
H/ io
SA ra
Pr
l
c
im lin
ar
i
y c
ca
re
M Reh
et
ha ab
do
ne
100%
80%
60%
40%
20%
0%
Physical Access Barriers
Some saw equipment
as more of a barrier
Equipment
Restrooms
Building
Physical Access Barriers
st
e
ea d L
lth ivi
C ng
en
te
r
D s
et
D ox
en
H tist
os s
pi
t
I/P H als
Be VM
M hav A
H
/S iora
Pr A c l
im lin
ar ic
y
ca
r
R e
M eh
et
ha ab
do
ne
H
Detox
Hospital
HVMA
MH/SA
si
–
–
–
–
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
As
• Building and Restrooms
are very similar
• For the most part,
equipment access is a
greater barrier
• Exceptions:
Equipment
Restrooms
Building
As
sis
He ted
alt Liv
h
Ce ing
nt
er
s
De
De tox
nt
Ho ists
sp
ita
ls
I/P
HV
Be M
A
M havi
H/
or
S
a
Pr A c l
im
l
ar inic
y
ca
re
Re
M
et hab
ha
do
ne
Communication Barriers
100%
80%
60%
40%
20%
0%
Treated the same by providers
Communication
Understanding
Communication Barriers
Communication & Understanding
As
sis
He ted
alt Liv
h C ing
en
ter
s
De
De tox
n
Ho tists
sp
ita
l
I/P
HV s
Be
M
ha A
MH vio
ra
/S
Pr A c l
im
l
ar inic
yc
ar
Re e
Me
h
tha ab
do
ne
100%
80%
60%
40%
20%
0%
Communication
Understanding
• Both communication
and understanding
were treated the same
by all providers
• Highest barriers for:
– Detox
– I/P Behavioral
– Rehabilitation
• Lowest barriers for:
– PC
As
sis
te
He d L
alt ivg
h
Cn
t rs
De
De tox
nt
Ho ists
sp
ita
l
I/P
HV s
Be M
A
h
a
M
H/ vior
SA al
Pr
im clin
ar
i
y c
ca
re
R
M eh
et
ab
ha
do
ne
Insurance Coverage
100%
20%
Bad: most non-medical services
80%
60%
40%
Good: all medical facilities
0%
Insurance Coverage
is
t
He ed
al Liv
th g
C
nt
rs
D
e
D to x
en
Ho tists
sp
i ta
ls
I/P
HV
Be M
h
A
M av
H/ io
S ra
Pr A c l
im lin
ar ic
y
ca
r
R e
M eh
et
ha ab
do
ne
As
s
• Coverage is a low
barrier for all basic
traditional health
services
• Lowest for Detox c/c
to methadone
• I/P Behavioral easier
to cover than MH/SA
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Coverage
Transporation vs. Appointment
As
sis
He ted
alt Liv
h C in
en g
ter
De s
De tox
n
Ho tists
sp
ita
I/P
HV ls
Be
M
MH havi A
/S or
Pr A c al
im
ar linic
yc
ar
e
R
Me eh
tha ab
do
ne
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Appointments
Transportation
• Transportation is by
far perceived highest
by all providers
• C/c: appointments
easy to get, but
transportation difficult
• Coincide, except:
– Hospitals/Methadone
– Rehabilitation
Major Barriers by Provider
100%
80%
60%
40%
20%
C
ov
er
ag
Eq
e
ui
C
om pm
en
m
t
un
ic
at
io
R
n
es
t ro
Ap
om
po
s
in
tm
U
en
nd
ts
er
st
an
di
ng
Bu
Tr
ild
an
in
g
sp
or
ta
tio
n
0%
Dentists
MH/SA clinic
Health Centers/HVMA
Hospitals
Primary care
Major Barriers by Provider
Major Barriers by Provider
uip
me
Co
nt
mm
un
ica
tio
n
Re
str
oo
ms
Ap
po
int
me
nt
Un
s
de
rs
ta
nd
ing
Bu
ild
ing
Tr
an
sp
or
ta
tio
n
Eq
ve
ra
ge
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Co
• Follow Similar Pattern
within each barrier
• PC is lowest overall
• Dentist is highest,
followed by HC &
HVMA
Dentists
MH/SA clinic
Health Centers/HVMA
Hospitals
Primary care
Notable Differences:
1. Coverage
•
•
PC & Hospital are lower than others
Dentist, MH, & HC are higher
2. Understanding
•
PC is lower than all others
3. Building Access
•
Dentists are distinctly higher than others
Provider-Perceived
Access Barriers
Hypothesis 3:
There are differences between
providers and consumers in their
perceptions of access barriers
100%
Overall Barriers:
Consumer vs. Provider
80%
•Providers higher than consumers
60%
• Similar pattern!
40%
20%
TOTAL Providers
Bu
ild
ing
Tr
an
sp
or
tat
ion
Co
ve
ra
ge
Eq
uip
me
nt
Ta
lki
ng
Re
str
oo
ms
Ap
po
int
me
nts
Un
de
rst
an
din
g
0%
TOTAL Consumers
Overall Barriers
Consumer
Provider
Coverage Transportation
Talking About Needs
Appointments
Equipment
Understanding
Restrooms
Building
Provider: Appointments vs. Transportation
100%
80%
60%
40%
20%
0%
t
u
O
p
e
i
t
a
M
t
n
Big Gap!
e
l
a
dic
x
s
s
P
c
C
l
i
t
A
o
r
T
a
t
s
H
S
t
i
t
/
e
i
t
a
C
i
M
p
n
H
D
h
s
e
M
c
o
M
D
y
t
H
s
n
P
e
i
t
a
I/P
tp
u
O
Appointments
Transportation
Consumer: Appointments vs. Transportation
Transportation
De
utp
to
ati
x
en
tM
H/
SA
O
CH
C
Much Closer!
Ho
sp
ita
l
In
De
pa
nti
tie
st
nt
Ps
yc
hia
tri
c
M
M
TP
O
utp
ati
en
t
M
ed
ica
l
60%
50%
40%
30%
20%
10%
0%
Appointment
Consumer: Appointments vs. Talking
60%
50%
40%
30%
20%
10%
0%
Appointment
Ou
De
tpa
tox
tie
nt
M
H/
SA
M
M
TP
In
De
pa
nti
tie
st
nt
Ps
yc
hia
tri
c
Ho
sp
ita
l
C
CH
Ou
tpa
tie
nt
M
ed
ica
l
Overlaps with Talking
Talking
Top Barriers:
Outpatient MH/SA
Consumer Self-Report
1. Transportation
2. Coverage
2. Talking/Understanding
Provider-Perceived
1. Transportation
2. Coverage
3. Talking/Understanding
REMARKABLY SIMILAR!
Top Barriers:
Freestanding Detox
Consumer Self-Report
1. Coverage
2. Transportation
3. Appointments
3. Talking
Provider-Perceived
1. Talking/Understanding
2. Transportation
3. Appointments
•Logistics are bigger barriers for consumers than is Talking about
their needs.
Top Barriers:
Inpatient Psychiatric
Consumer Self-Report
1. Transportation
2. Talking
3. Appointments
3. Coverage
4. Understanding
Provider-Perceived
1. Transportation
2. Talking/Understanding
3. Appointments
3. Coverage
Very similar; consumers see Talking about needs as more of
a barrier than Understanding provider.
Top Barriers:
Dentists
Consumer Self-Report
1. Coverage!
2. Appointments
3. Transportation
3. Talking/Understanding
Provider-Perceived
1. Coverage
1. Transportation
2. Talking/Understanding
3. Equipment
Top Barriers
Outpatient Medical
Consumer Self-Report
1. Talking
1. Transportation
2. Appointments
2. Understanding
Provider-Perceived
1. Transportation!
2. Coverage
3. Talking
Consumers see Talking about needs as biggest barrier
verses Transportation by providers; hospitals are similar.
Top Barriers
Hospitals
Consumer Self-Report
1. Talking/Understanding
2. Transportation
3. Equipment
4. Coverage
Provider-Perceived
1. Transportation!
2. Talking/Understanding
3. Coverage
4. Equipment
Top Barriers:
CHC
Consumer
1. Transportation
2. Appointments
2. Talking/Understanding
2. Coverage
Provider
1. Transportation
2. Coverage
3. Talking/Understanding
4. Appointments
4. Equipment
Summary of Findings:
Preliminary Results
• Barriers higher for providers vs. consumers
• Similar pattern overall
• Foremost barrier
– Provider = Transportation
– Consumer not as clear
• Differences in perceptions
– Importance of Appointments
– Talking vs. Understanding